ADHD兒童執行功能量表之發展

The Development of Executive Functions Rating Scale for Children with ADHD

林欣樺(Hsin-Hua Lin)

指導教授 ： 李宏鎰

中山醫學大學/醫學科技學院/物理治療學系/碩士(2018年)

摘要

注意力不足過動症（Attention deficit hyperactivity disorder, ADHD）已於DSM-5被正式納入神經發展疾患之一，有許多學者以執行功能（Executive Function）角度進行相關研究，發現ADHD與其他疾患有不同的表現，然國內仍未有以此觀點為基礎之量表。本研究試以Naglieri與Goldstein（2014）提出的執行功能意涵，彙整過去文獻較常發現ADHD兒童執行功能缺損，試圖建構出專屬ADHD兒童的執行功能檢測項目並發展相關量表。本研究招募6至12歲孩童之主要照顧者參與研究（ADHD孩童家長51人，一般家長325人）。運用問卷調查法進行驗證性因素分析，編製成正式量表。正式問卷共16題，含工作記憶、計劃、抑制及情緒調節四向度，採李克特氏四點量表進行計分。量表經驗證後獲得良好的信效度證據，整體命中率為82%，準確率高。最後為方便臨床應用，本研究亦提供最佳決斷分數為26分以上，建議可以此檢測ADHD兒童的執行功能。雖量表僅納入四種執行功能缺損向度，無法完整描繪出ADHD執行功能缺損的樣貌，但尚可作為快速篩選ADHD患者執行功能的簡要工具，並可協助後續規畫及介入方案之依據。

關鍵字

注意力不足過動症 ； 決斷分數 ； 執行功能量表 ； 情緒調節

並列摘要

Attention deficit hyperactivity disorderhas been formally included in DSM-5 as one of the neurodevelopment disorders, and past studies have been related it from the perspective of Executive Function (EF). Researches have found that ADHD does have a different performance from other diseases. However, there is no rating scale based on this view in Taiwan. This study based on the EF theory of Naglieri and Goldstein (2014) then summarized the EF deficits in children with ADHD from previous study, and develops a new rating scale for children with ADHD. The sample includes the caregivers of 6 to 12 years old school-aged children to participate in the study (51caregivers of children with ADHD and 325 caregivers of normal children). 16 items are included in this scale and each is scored by four-point Likert type scale. Four domains included in this scale are working memory, planning, inhibition and emotion regulation. The scale tested by structural equation model reveals reliable and valid factor structures. As the results, this scale showed high accuracy for screening, and 82% of original grouped cases are correctly classified. Finally, to facilitate the practical usage, ROC curve and standard deviation were used to determine the best cutoff score (above 26 points). We would like to recommend that our newly-developed Executive Functions Rating Scale for Children with ADHD be a good tool for clinicians to use this scale to detect the EF of ADHD children. The limitation were we only includes four domains of impairment of EF, and cannot completely described the appearance of executive impairment of ADHD, but it can be used as a brief tool to quickly screen the EF of children with ADHD.

並列關鍵字

Attention deficit hyperactivity disorder (ADHD) ； cutoff score ； executive functions rating scale ； emotion regulation

參考文獻

Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological bulletin, 121(1), 65-94.

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