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注意力缺失過動症孩童工作記憶訓練的成效
The Effects of Working Memory Training in Children with Attention-Deficit/Hyperactivity Disorder
摘要
先前研究指出注意力缺失過動症孩童(Attention Deficit/Hyperactivity Disorder, ADHD)有工作記憶的缺失，過去國外文獻大多透過電腦化軟體-Cogmed工作記憶訓練方式，提升孩童工作記憶任務的表現，目前很少以N-back任務，持續地記憶目前的刺激並與前N個刺激做配對反應，做為工作記憶訓練應用在ADHD孩童，因此，本研究採用N-back任務來訓練，並使用傳統神經心理測驗來檢測ADHD孩童訓練前後，在視覺空間和口語工作記憶上之訓練效益。本研究招募40位年齡介在8-10歲的ADHD孩童，隨機分配至實驗組20位（8.9±0.6歲）進行N-back任務訓練，與控制組20位（8.7±0.6歲）進行配對任務訓練，每次1小時，每周3次持續六周的訓練。訓練前後皆進行傳統神經心理測驗。兩組訓練後，由自動化工作記憶評量的結果顯示，實驗組在視覺空間方面任務上的表現比控制組佳。在魏氏兒童智力量表工作記憶測驗的結果顯示，雖然兩組在口語方面任務上的表現皆有進步，但是實驗組的進展幅度大於控制組。實驗組在視覺空間及口語類型的工作記憶任務可觀察到有顯著訓練效果。本研究的結果顯示ADHD孩童在經過N-back任務訓練後，視覺空間及口語工作記憶能力進步，透過N-back任務融入電腦化工作記憶訓練的模式，提供臨床個案的介入方式之發展與應用。
並列摘要
Previous research indicated that children with attention-deficit/hyperactivity disorder (ADHD) were characterized by deficits in working memory (WM). Computerized-Cogmed WM training programs in children with ADHD has been validated to enhance the performance of WM tasks. There are few studies using N-back task to study the effects of WM training in children with ADHD. Therefore, we used psychological assessments (PA) to investigate the effects of N-back WM training in children with ADHD. Forty children with ADHD in the age range of 8–10 years were recruited and randomly assigned to two groups: WM training with N-back task (n=20, 8.9±0.6 years) and active controls with matching task (n=20, 8.7±0.6 years). Both groups received the training program 3 times per week, 60 minutes per session, for 6 weeks. The PA were measured before and after the training. The results of the Automated Working Memory Assessment showed that the performance of visuospatial WM task in the experimental group was better than that of the control group after WM training. The results of the Wechsler Intelligence Scale for Children found the improved performance of verbal WM task in both groups. However, the experimental group made greater progress compared with the control group. Significant training effects on visuospatial and verbal tasks were found in the experimental group. Our findings suggest that N-back training may benefit WM in children with ADHD. We could provide the effective intervention in clinics by using the N-back training.