Objective:To explore the effects of sandplay therapy in mother-child attachment of children with attention deficit hyperactivity disorders and ADHD symptom. Method:All the children from two primary schools in the Shanghai Putuo district were surveyed,and a total of 103 children with ADHD were identified. U-sing randomized controlled study,32 children with ADHD whose parents were willing to participate in the sand-play therapy were selected and divided into intervention group (16 cases)and non-interventional group (16 ca-ses),and 16 matched normal children were randomized for normal control group. The children and children's mother of intervention group received sandplay therapy once two week in 24 weeks,and the non-interventional group did not receive intervention. The efficacy was assessed with Kerns Security Scale and SNAP-Ⅳ scale. Results:Before sandplay intervention the KSS scores of mother-child in intervention group(2. 63 ± 0. 31)were lower than those in normal control group(3. 04 ± 0. 22)(P<0. 001). After 24 weeks of sandplay intervention the KSS scores of mother-child in intervention group(2. 86 ± 0. 26)were higher than those before sandplay inter-vention (2. 63 ± 0. 31),but were lower than those in normal control group(3. 06 ± 0. 20)(P<0. 01),and the group main effect of intervention group and non-interventional group was statistically significant(P<0. 05). After sandplay intervention the SNAP-Ⅳ scores of attention deficit(1. 56 ± 0. 41),hyperactivity(0. 57 ± 0. 37)and the total scores(1. 07 ± 0. 35)were lower than those before sandplay intervention(2. 27 ± 0. 41),(1. 42 ± 0. 66), (1. 85 ± 0. 46),and the group main effects and interaction effects of intervention group and non-interventional group were all statistically significant(P<0. 05,P<0. 01). Conclusion:Sandplay therapy may be effective and safe in the treatment of poor mother-child attachment of children with ADHD and ADHD core symptom.%目的:探讨沙盘治疗对学龄期注意缺陷多动障碍(ADHD)患儿母子依恋关系及ADHD症状的疗效.方法:从上海市普陀区2所小学整群抽样后确诊103例ADHD患儿,其中32例家长愿意参加沙盘治疗的ADHD患儿作为研究对象.采用随机对照研究方法,将32例患儿随机分为干预组(16例)和非干预组(16例);与干预组儿童一般情况相匹配的正常儿童16名作为正常对照组.对干预组患儿及其母亲进行为期24周的沙盘治疗,非干预组不给予干预.采用依恋安全性量表(KSS)、SNAP-IV量表进行疗效评定.结果:沙盘治疗前干预组KSS分(2.63±0.31)低于正常对照组(3.04±0.22),差异有统计学意义(P<0.001),24周沙盘治疗后干预组KSS分(2.86±0.26)比治疗前增高,干预组与非干预组组间主效应有统计学意义(P<0.05),但仍低于正常对照组(3.06±0.20)(P<0.05);治疗后SNAP-IV干预组儿童的注意缺陷分(1.45±0.25)、多动冲动分(0.57±0.37)及总分(1.01±0.28)均比治疗前[(2.27±0.41),(1.42±0.66),(1.85±0.46)]降低,干预组与非干预组的组间主效应(均P<0.05)时间效应及交互效应(均P<0.01)差异有统计学意义.结论:沙盘治疗能够安全、有效的改善ADHD儿童不良母子依恋关系及ADHD核心症状.
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