第21屆 神經心理測量學齡前專注力缺陷衝動過動症之臨床應用與相關性之初探 Clinical Practice and Correlation of Neuropsychological Measurements in Preschool ADHD-a preliminary study

神經心理測量學齡前專注力缺陷衝動過動症之臨床應用與相關性之初探

Clinical Practice and Correlation of Neuropsychological Measurements in Preschool ADHD-a preliminary study

林建諭、趙慧璇、陳韻如、陳怡君*

Chien-Yu Lin , Hui-Xuan Zhao , Yun-Ju Chen , I-Chun Chen*

東元綜合醫院復健科早期療育聯合評估中心

Department of Physical Medicine and Rehabilitation, Ton-Yen General Hospital

Background and Purpose: Fully characterizing children at risk for attention deficit hyperactivity disorder (ADHD) at preschool age and providing early intervention are imperative. The diagnosis of preschool ADHD is challenging for the less consistency and reliability from multi-informant clinical evaluation. Neuropsychological measurements with continuous performance test (CPT) can be used to directly investigate and quantify an individual’s performance in tasks demanding attention to facilitate diagnosis and possess the advantages of low cost, speed, and convenience. This study investigated the clinical practice and the correlation of two CPTs with a counter balance design for preschool children suspect with ADHD. Methods: Thirty-six preschool children (aged 5 to 7 years) participated in this study, which involved comprehensive developmental evaluations. Among them, 20 were diagnosed with ADHD (16 boys, mean ± standard deviation [SD] age: 67.10 ± 4.54 months) and 16 children exhibited typical development (12 boys, mean ± SD age: 65.88 ± 4.77 months). Two standard CPTs including Gordon diagnostic system (GDS) and kiddie CPT (K-CPT) were used to evaluate the attention performance. Results: Significant differences between groups were observed in GDS error numbers, inhibitory control, detectability, omissions, commission, hit reaction time (HRT) standard deviation (SD), and HRT inter-stimulus-interval change. GDS error numbers correlate positively with K-CPT scores including detectability, commission, and HRT SD; negative correlation between GDS error numbers and HRT was observed. Sustain attention dimension grading correlate positively with K-CPT scores including detectability, omission, HRT SD, and variability; inhibitory control dimension grading correlate positively with K-CPT scores including detectability, omission, commission, and HRT SD. However, negative correlation between inhibitory control dimension grading and HRT was observed. Conclusions: Neuropsychological measurements provide valuable supplement for clinical diagnosis and information to plan early intervention program for preschooler with ADHD tendency. 

Keywords: ADHD, K-CPT, GDS, early intervention