Neuropsychological Testing for Children with ADHD：A Background Review and Four Case Analyses

注意力缺失暨過動症兒童之神經心理功能測試：背景文獻回顧與個案分析

林姿儀(Tzu-Yi Lin) ； 林克忠(Keh-Chung Lin)

《職能治療學會雜誌》 21卷 (2003/01) Pp. 68-80

https://doi.org/10.6594/JTOTA.2003.21.06

摘要

注意力缺失暨過動症個案常因分心、過動、衝動等症狀，影響日常生活功能或學習表現，為職能治療常需介入的診斷族群。為了獲致對注意力缺失暨過動症更全面性的了解，以利後續治療計劃之擬定與執行，本研究回顧有關此症的新近文獻，並援引刪除測驗及線段兩等分測驗，測試注意力缺失暨過動症兒童之神經心理功能，進行個案分析。四位注意力缺失暨過動症兒童與一位無發展異常之控制組兒童均個別受測，除了測驗本身所呈現之神經行為表現（例如目標物圈選數、完成測驗所費時間、視覺空間注意力偏側指數），受試者的受測行為亦在本研究之分析範圍內。結果顯示注意力缺失暨過動症兒童在執行測驗時有諸多困難，包括在目標物圈選上容易闕漏，受測時衝動控制不佳、煩躁、坐立不安，此外亦顯現視覺空間注意力的偏側現象。既有文獻顯示注意力缺失暨過動症個案的神經心理功能可能與右腦功能缺失有關，本研究之受試表現並未完全支持此理論，顯示注意力缺失暨過動症可能為一異質性高的族群。未來研究應進一步分析此症個案神經行為缺失的類別，以釐清可能的肇因，並據以設計個別化介入方案，建立本土實證資料庫。

關鍵字

注意力缺失暨過動症 ； 神經心理功能測試 ； 刪除測驗 ； 線段兩等分測驗 ； 個案分析

並列摘要

Attention-deficit hyperactivity disorder (ADHD) is a developmental disorder with core symptoms including inattentiveness, impulsivity, and hyperactivity. These symptoms often cause disruptive performance at home and school. Neuropsychological assessments can be used for examining neurobehavioral functions of children with ADHD in order to formulate appropriate rehabilitation and management interventions. This paper reviewed current literature pertinent to ADHD and then presented neuropsychological test profiles of four children with the disorder. These children were recruited from Taipei Municipal Women and Children’s Hospital Department of Child Psychiatry. Each child received the randomized letter and shape cancellation tests and the line bisection test individually. Measures of performance on the cancellation task included on-task behaviors, number of target omissions and commissions, and time spent for task completion. Deviation from the true midpoint was measured for the line bisection test. Results showed that children with ADHD exhibited significant deficits on the tests relative to the control child with typical development. The children with ADHD showed deficits such as fidgeting, impulsivity, reduced ability to identify target stimuli, and attentional bias. The findings were, however, not fully congruent with the right hemisphere dysfunction theory of ADHD, which implies the heterogeneity of this diagnostic group. Intervention for attentional deficits in ADHD should thus be individually tailored keeping in mind the possibility of differential neurobehavioral dysfunctions among the afflicted children that may differ in neuropathological mechanism and comorbidity pattern.

並列關鍵字

attention-deficit hyperactivity disorder ； ADHD ； neuropsychological assessment ； the cancellation test ； the line bisection test ； case analysis