注意缺陷多动障碍学龄前儿童应用整合心理行为干预研究

摘要

目的 探讨整合心理行为干预模式对注意缺陷多动障碍学龄前儿童多动行为的改善.方法 选择本院儿科和临床心理科就诊的58例学龄前儿童,按就诊顺序分成注意缺陷多动障碍干预组和对照组,干预组给予安思定治疗仪+沙盘治疗+生物反馈+感觉统合训练,对照组按常规处理.结果 干预组治疗后在多动/冲动、多动指数两项因子分有显著下降(P＜0.05),品行障碍、学习问题、心身问题、焦虑4项因子分下降(P＜0.05);治疗2个月后,干预组α波、θ波、θ/β比值均较干预前下降(P＜0.05),β波、SMR节律较干预前显著提高(P＜0.05);治疗6个月后干预组本体觉、前庭觉2项因子分较治疗前显著提高(P＜0.05),触觉防御、学习能力两项因子分较治疗前提高(P＜0.05).结论 通过整合心理行为干预能强化注意缺陷多动障碍学龄前儿童感觉、认知、行为间的整合能力,提升儿童从信息获取、加工到输出的连续性和协调性,提高神经系统的稳定性,增强身体协调能力,提高行为自我控制能力,改善注意缺陷多动儿童的多动行为.%Objective To explore the effect of integrated psycho-behavioral intervention for improvement of preschool children with attention deficit hyperactivity disorder.Methods A total of 58 preschool children in the Departments of Pediatrics and Clinical Psychology in our hospital were selected and divided into intervention group and observation group according to the order of visits.The intervention group was given Alpha-Stim SCS,sandplay therapy,biofeedback and sensory integration training,the observation group was treated by routine treatment.Results After treatment,the intervention group had a significant decrease in hyperactivity/impulsivity and hyperkinetic index (P ＜ 0.01),and scores of conduct disorders,learning problems,psychosomatic problems,and anxiety decreased significantly (P ＜ 0.05).After two months of treatment,the ratios of α-wave,θ-wave,and ratio of θ wave to β wave in the intervention group were significandy lower than the intervention before (P ＜0.01),and the β-wave and SMR rhythm were significantly higher than those the intervention before (P ＜0.01).After 6 months of treatment,scores of proprioception and vestibular sensation in the intervention group were significantly higher than treatment before (P ＜ 0.01),and scoresof the tactile defense and learning ability were significantly higher than treatment before (P ＜ 0.05).Conclusion Integrating psychological behavioral intervention can strengthen the integration of sensory,cognitive,and behavioral skills among preschool children with attention deficit hyperactivity disorder.It can not only improve the continuity and coordination of children from information acquisition,processing,and output,but also improve the stability of the nervous system,enhance physical coordination,improve self-control of behavior,and significantly improve the hyperactivity behavior of attention deficit hyperactivity children.