Yoshikawa R
Mental Health and Welfare Center of Nagano Prefecture.
Seishin Shinkeigaku Zasshi. 1997;99(2):47-67.
Forty children with the following behavior characteristic were selected by observing the attachment behavior between them and their parents at the time of developmental exam in a 18 months' health checkup. The behavior in question is; 18 month old children scurry away from their parent without looking back on parent's calls and without confirming parent's positions. Then all the examined 978 children including the children who had shown the above scurrying away behavior were prospectively followed until before the entry to school. At age six, 6 children were diagnosed of Mental Retardation, 4 of Pervasive Developmental Disorder, and 28 of Attention-Deficit Hyperactivity Disorder (ADHD). Now these results (especially the relationships between this scurrying away behavior at 18 months and ADHD before the entry to school) were analyzed statistically and discussed, then the next conclusions were derived. 1. This scurrying away behavior, especially the behavior without confirming parent's positions, is significantly related to ADHD before the entry to school. 2. This scurrying away behavior is one of the characteristic behaviors at 18 months in ADHD and corresponds to hyperactivity at 18 months. 3. The conduct of throwing a toy block is one of the behaviors that indicates impulsivity at 18 months, when children are requested to hand over a toy block in the developmental exam. 4. Through behavioral observation, ADHDs before the entry to school are categorized to 3 subtypes by presence or absence of this scurrying away behavior at 18 months or by presence or absence of aggressivity before the entry to school. 5. Among the 3 subtypes, the type with this scurrying away behavior and aggressivity before the entry is most necessary to be treated continuously from early childhood. Because it has impulsivity and speech delay since 18 months and untreatable behavioral problems in day nurseries or kindergartens, and therefore it might have Conduct Disorder or Learning Disorder in the future.
在18个月健康检查的发育检查中，通过观察40名儿童与其父母之间的依恋行为，挑选出具有以下行为特征的儿童。相关行为如下：18个月大的儿童在父母呼唤时不回头看也不确认父母位置就匆匆跑开。然后，对包括表现出上述跑开行为的儿童在内的所有978名接受检查的儿童进行前瞻性跟踪，直至入学前。6岁时，6名儿童被诊断为智力迟钝，4名患有广泛性发育障碍，28名患有注意力缺陷多动障碍（ADHD）。现在对这些结果（尤其是18个月时这种跑开行为与入学前ADHD之间的关系）进行了统计分析和讨论，得出了以下结论。1. 这种跑开行为，尤其是不确认父母位置的行为，与入学前的ADHD显著相关。2. 这种跑开行为是ADHD儿童18个月时的特征行为之一，与18个月时的多动相对应。3. 在发育检查中，当要求儿童交出玩具积木时，扔玩具积木的行为是表明18个月时冲动性的行为之一。4. 通过行为观察，入学前的ADHD根据18个月时是否存在这种跑开行为或入学前是否存在攻击性分为3个亚型。5. 在这3个亚型中，18个月时有这种跑开行为且入学前有攻击性的类型最需要从幼儿期开始持续治疗。因为它从18个月起就有冲动性和语言迟缓，在日托所或幼儿园有无法治疗的行为问题，因此未来可能会出现品行障碍或学习障碍。
