首页> 中文期刊> 《中华实用儿科临床杂志》 >Asperger综合征和注意缺陷多动障碍儿童的韦氏智商比较

Asperger综合征和注意缺陷多动障碍儿童的韦氏智商比较

摘要

Objective To compare the intelligence quotient (IQ) between children with Asperger syndrome (AS) and children with attention deficit hyperactivity disorder (ADHD) in order to provide reliable evidence for differential diagnosis.Methods The intelligence of 141 children with AS,154 children with ADHD and 102 normal control (NC) children aged 6-13 years old examined by the China-Wechsler Intelligence Scale for Children was analyzed,and the diagnoses of AS and ADHD was made according to the Fourth edition of the Diagnostic and Statistical Manual of Mental Disorder.Results The proportions of children at low level of IQ (borderline and mental retardation range) in children with AS and with ADHD group were both significantly higher than those of NC group.The proportions of children at top level of IQ (superior and very superior range) in ADHD group were significantly lower than those of AS and NC groups.In the AS group,higher proportions of verbal IQ (VIQ) at top level and performance IQ (PIQ) at low level were found.The average VIQ,PIQ and full IQ (FIQ) of the AS,ADHD and NC groups were (102.55 ± 17.27,91.31 ± 16.01,97.10 ± 15.88),(95.39 ±13.49,94.16 ± 12.92,94.40 ± 12.78) and (104.06 ± 13.66,103.05 ±11.80,103.91 ± 12.92),respectively.The VIQ,PIQ and FIQ in ADHD group were lower than those in NC group significantly(P < 0.01);compared with NC group,the PIQ and FIQ in AS group were significantly lower (P < 0.01),while the VIQ was not significantly different(P >0.05).The AS and ADHD group scored both lower than the NC groupin the subtests of " comprehension"," coding"," picture completion" and " picture arrangement" (P < 0.01).The difference values between VIQ and PIQ in the AS,ADHD and TD group were(11.23 ± 17.29),(1.23 ± 13.10) and (1.00 ± 10.91),respectively,among which only the value in AS group was statistically significant (P < 0.01) but not in ADHD and NC group(P >0.05).The proportion of children having a VIQ-PIQ difference value more than 15 in AS group was 54.60% (77/141 cases),which was significantly higher than that in ADHD [22.07% (34/154 cases)] and NC groups [13.72% (14/102 cases)] (P < 0.01),while the latter 2 value had no statistical difference (P > 0.05).The differences among scores on the three Kaufman factors were significant in AS group (P < 0.01) but not in ADHD and NC groups(P > 0.05).Conclusions Compared with ADHD and normal control children,there are some unique intelligence profiles in children with AS,which show VIQ and PIQ separation,imbalance intelligence structure as well as strengths and weaknesses coexisting.Furthermore,children with ADHD and AS children share common features in some subtests scores.%目的 比较Asperger综合征(AS)和注意缺陷多动障碍(ADHD)儿童的智商,为鉴别诊断提供可能的依据.方法 根据美国《精神障碍诊断与统计手册》第4版确诊AS患儿141例和ADHD患儿154例(6~13岁),采用韦氏儿童智力量表中文版对2组患儿及102例健康对照(NC)组同龄儿进行智力测试并比较结果.结果 AS组和ADHD组患儿智商处于低分值端(边缘和缺损)比例均显著高于NC组.ADHD组智商处于高分值端(高常和超常)比例明显低于AS组和NC组.AS组内有更高比例儿童其言语智商(VIQ)落在高分值端,相反有更高比例儿童其操作智商(PIQ)落在低分值端.AS组、ADHD组和NC组其VIQ、PIQ和总智商(FIQ)分别为(102.55 ±17.27,91.31 ±16.01,97.10 ±15.88)、(95.39±13.49,94.16±12.92,94.40±12.78)和(104.06±13.66,103.05±11.80,103.91 ±12.92);ADHD组VIQ、PIQ和FIQ均低于NC组(P均<0.01);AS组PIQ和FIQ均低于NC组(P<0.01),但AS组和NC组VIQ比较差异无统计学意义(P>0.05).AS组和ADHD组在“领悟”、“编码”、“填图”和“图片排列”等分测验得分均低于NC组(P均<0.01).AS组VIQ比PIQ高(11.23±17.29),差异有统计学意义(P<0.01);ADHD组和NC组VIQ和PIQ差值分别是(1.23±13.10)和(1.00±10.91),ADHD组和NC组VIQ和PIQ比较差异均无统计学意义(P均>0.05).AS组VIQ和PIQ差值有显著性(≥15)的比例[54.60%(77/141例)]明显高于ADHD组[22.07%(34/154例)]和NC组[13.72%(14/102例)],差异有统计学意义(P<0.01);ADHD组和NC组比较则无统计学差异(P>0.05).ADHD组和NC组在Kaufman 3个因子得分间的差异均无统计学意义(P均>0.05),AS组3个因子得分间差异则有统计学意义(P<0.01).结论 相对于ADHD和健康儿童,AS儿童存在一些独特的智力特征:显著的VIQ和PIQ分离及智力结构不平衡,呈现显著的优劣势共存.另外ADHD和AS儿童在某些分测验得分方面存在一些共性.

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