注意力不足型ADHD成人之學習策略

A Case Study of Learning Strategies of ADHD Primary Inattentive Type-A College Student

李宏鎰(Horng-Yih Lee)

《中華心理衛生學刊》 20卷4期 (2007/12) Pp. 317-341

https://doi.org/10.30074/FJMH.200712_20(4).0001

摘要

研究目的：ADHD成人之研究日益受到重視，然而ADHD成人的就醫情況並不普遍。因此，進行大量樣本的研究並不容易。再者，ADHD患者接受高等教育者本來就很少，因此想探討他們求學之路上的學習困擾情況就更加困難。研究方法：本研究訪談一位正就讀大專院校的注意力不足型的ADHD成人，瞭解其ADHD症狀(尤其是注意力不足)隨著年齡的增長，如何影響課業學習，並探討其曾嘗試用哪些有效策略應付這些困擾行為以利課業學習。研究結果：個案之持續性及選擇性注意力不足現象隨著年齡的增加，並沒有多大的改變。此外，與執行功能相關的工作記憶及組織事物能力受損亦困擾著個案。研究結論：ADHD成人自行衍生出一些良好的因應策略。如：同時克服選擇性與持續性注意力不足的好策略是創造一個可免於干擾又不會無趣的環境，如參與讀書會與同學討論功課；而克服組織事物能力不足的好策略是將所學內容用生活事件連結組織起來。

關鍵字

注意力不足型 ； ADHD成人 ； 執行功能 ； 學習策略 ； 質性研究

並列摘要

Purpose: Attention Deficit Hyperactivity Disorder (ADHD) affects 4%-5% of children (APA, 2000; Barkley, 1998). Of those children diagnosed with ADHD, 30%-70% will continue to be affected by the disorder into adulthood (e.g. Barkley et al., 1990). No prevalence or base rate has been established for adults with ADHD; however, studies have estimated that between 0.30% and 3.5% of the adult population have ADHD (Barkley, 1998). Therefore, the study of adults with ADHD is emphasized gradually. On the other hand, the core symptoms of ADHD - hyperactivity, inattention, and impulsivity - change as the child grows older. Research suggests that hyperactivity declines with age, attentional problems remain fairly constant, and executive function problems increase in adulthood. Adults with ADHD often face their biggest challenges in higher education and later in the work world. Adults need to plan and execute their own internal structure, which is especially difficult for those with ADHD. Poor time management, chronic lateness, and difficulties completing paperwork and meeting deadlines are exceedingly common workrelated problems of adults with ADHD. However, in fact, to conduct a great sample study of adults with ADHD is not easy, because there are only a few of adults with ADHD seek medical advice. Thus this paper is a case study - a college student with ADHD. In addition, many young adults with ADHD and related comorbid disorders are not able to attend college. In Taiwan, the special education and disability law have not enabled many qualified students with ADHD to graduate from college preparatory high school programs and enter institutions of higher education. Thus, it is quite important to teach students with ADHD effective learning strategies which can cope with those symptoms of the disorder. This paper tries to find out some helpful learning strategies allow students with ADHD to succeed in their schoolwork.
Methods: Adults have had a lifetime of coping with their symptoms and it’s important to look at how they're coping. This study interviews a college student with ADHD inattentive type, to explore whether or not the symptoms of the disorder changed with maturation and development, how the symptoms affect her learning, and which strategies that she developed are useful for learning. Qualitative research methods are employed in order to further understand these issues.
Results: The results show that the deficits of sustained and selective attention of the case vary slightly with maturation. For example, in early adulthood the case had only difficulty finishing homework what she not likes. In contrast, she had difficulty finishing all the homework in childhood. The deficits of working memory and organization which related to executive functions are observed on the case (ADHD-inattentive type), too. For example, in early adulthood the case has more trouble maintaining routine and organization, because subjects she learned will increase every grade level. Thus, as respected as it should be, this paper suggests that attentional problems of students with ADHD-inattentive type remain fairly constant, and executive function problems seem increase in adulthood. These results may reflect the fact that young person with ADHD who is making the transition from the structured environments of primary school and home to an unstructured life at college. In addition, it is surprising that the case could develop spontaneously some good strategies which cope with the deficit of attention - both sustained and selective attention. For example, in order to focus attention the case creates interesting space, free from interruption, for learning. Additionally, to maintain attention for a long time she discusses homework with classmates, not to study it singly. Finally, to cope with disorganization, the case relates class material to everyday events that allow them to deal with some of their symptoms better.
Conclusions: This paper has several suggestions as following: A. ADHD can develop spontaneously some good strategies that allow them to deal with some of their symptoms better. Therefore, it is necessary for parents and teachers to let students with ADHD know about themselves, and help them learn to help themselves. B. To create situations that allows students with ADHD to cope with their inattention symptoms. For example, if they have a lot of problems with distraction and they may discusses schoolwork with peers that allows them to be unintentionally remanded, that will be much more in line with their symptoms than if they sit at a desk alone all day. C. Choice-type questions will be one of proper exams for students with ADHD, because they have trouble organizing what they think in mind, so that oppositely essay exams are not suitable for them.

並列關鍵字

ADHD-inattentive type ； Adults with ADHD ； Executive function ； Learning strategy ； Qualitative study

參考文獻

王乙婷、何美慧(2003)。自我教導策略增進ADHD兒童持續注意力之效果。特殊教育學報。18，21-54。

王乙婷、何美慧(2003)。自我教導策略增進ADHD兒童持續注意力之效果。特殊教育學報。18，21-54。

林寶貴、錡寶香(2000)。國小學童書寫語言測驗指導手冊。台北:師大特教系。

鄭昭明、陳學志(1991)。漢字簡化對文字讀寫的影響。華文世界。62，86-104。

American Psychiatric Association(1994).Diagnostic and statistical manual of mental disorders.Washington, DC:American Psychiatric Association.