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特定 CPT 指标在区分曾被诊断为注意缺陷/多动障碍的学龄儿童和普通教育教室里无注意缺陷/多动障碍的学龄儿童的有效性:病例对照研究。

Validity of specific CPT indices in differentiating school-aged children previously diagnosed with attention deficit/hyperactivity disorder from school-aged children with non-attention deficit/hyperactivity disorder in general education classrooms: a case control study.

机构信息

School of Medicine, Chung Shan Medical University, No. 110, Section 1, Jianguo North Road, Taichung, Taiwan.

Department of Paediatrics, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo North Road, Taichung, Taiwan.

出版信息

BMC Pediatr. 2024 Oct 26;24(1):680. doi: 10.1186/s12887-024-05142-x.

Abstract

BACKGROUND

Continuous performance tests (CPTs) are a popular tool for evaluating the symptoms of attention-deficit/hyperactivity disorder (ADHD). Performance measurements are typically linked to the biological features and cognitive functions of individuals. To determine the validity of specific CPT indices in differentiating between school-aged children with ADHD from with non-ADHD, each student's sex, chronological age, and cognitive abilities should be considered.

METHODS

In this prospective case-control study, a total of 30 non-ADHD students and 26 with ADHD who were aged 6 to 12 years were from general education classrooms. All students completed the Continuous Performance Tests (CPTs) and the Peabody Picture Vocabulary Test-revised (Mandarin-Chinese version). Demographic data were collected from the students' parents.

RESULTS

Detectability, Omissions, Commissions, and Hit Reaction Time Standard Deviation (HRT SD) yielded higher T-scores in children with ADHD than those without. Compared with non-ADHD students, those with ADHD had higher classification scores for Detectability, Omissions, Perseverations, and HRT SD. For each CPT index, after individual factors were controlled for, logistic regression revealed that only students with positive scores for Detectability, Omission, and HRT SD (adjusted odds ratios = 4.627, 9.977, and 3.908, Ps < 0.05) were likely to receive a diagnosis of ADHD. Furthermore, after individual characteristics were controlled for, Logistic regression also revealed that the cumulative positive scores of the Detectability, Omission, or and HRT SD remained associated with an increased risk of ADHD (adjusted odds ratio = 3.116, P < 0.01).

CONCLUSIONS

Compared with school-aged children with non-ADHD in general education classrooms, those with ADHD exhibited significantly lower performance in inattention-related CPT indices. To reach an accurate diagnosis through CPTs, clinicians should pay attention to Detectability, Omission, and HRT SD. Compared with other CPT indices, Detectability, Omission, and HRT SD may function as more suitable indicators for distinguishing between school-aged children with and non-ADHD in general education classrooms. These indicators are robust and unobscured by individual characteristics.

摘要

背景

连续性能测试(CPTs)是评估注意力缺陷/多动障碍(ADHD)症状的常用工具。性能测量通常与个体的生物特征和认知功能相关联。为了确定特定 CPT 指数在区分学龄儿童 ADHD 与非 ADHD 方面的有效性,应考虑每个学生的性别、实际年龄和认知能力。

方法

在这项前瞻性病例对照研究中,共有 30 名非 ADHD 学生和 26 名 ADHD 学生,年龄在 6 至 12 岁之间,均来自普通教育教室。所有学生都完成了连续性能测试(CPTs)和皮博迪图片词汇测试修订版(普通话-中文版本)。从学生家长那里收集人口统计学数据。

结果

与无 ADHD 的学生相比,ADHD 儿童的检测、遗漏、错误和反应时标准偏差(HRT SD)的 T 分数更高。与非 ADHD 学生相比,ADHD 学生在检测、遗漏、坚持和 HRT SD 方面的分类得分更高。对于每个 CPT 指数,在控制个体因素后,逻辑回归显示,只有检测、遗漏和 HRT SD 得分阳性的学生更有可能被诊断为 ADHD(调整后的优势比分别为 4.627、9.977 和 3.908,P<0.05)。此外,在控制个体特征后,逻辑回归还显示,检测、遗漏或 HRT SD 的累积阳性得分与 ADHD 风险增加相关(调整后的优势比为 3.116,P<0.01)。

结论

与普通教育教室中的非 ADHD 学龄儿童相比,ADHD 儿童在注意力相关的 CPT 指数上表现出明显较低的表现。为了通过 CPTs 进行准确诊断,临床医生应注意检测、遗漏和 HRT SD。与其他 CPT 指数相比,检测、遗漏和 HRT SD 可能是区分普通教育教室中 ADHD 与非 ADHD 儿童的更合适指标。这些指标稳健且不受个体特征的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b1d9/11515130/dc76eef3d5df/12887_2024_5142_Fig1_HTML.jpg

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