| Attention deficit hyperactivity disorder (ADHD) ,also called multi-action symptom , is a children'common disease of phychological behavior , usually occurring in early age and having hereditary development characteristic .ADHD is divided into three subtypes : predominantly inattentive type (PI) ,predominantly hyperactive impulsive type (HI) and combined type (CTI) .The main features of three sub-types are : unconcentrated attention disagreeing with children's age , hyperactive and impulsive behaviors , multiple psychological behavior disorders , such as emotional disorder , behavioral disorder,et. All these features seriously affect children'study ability and study results , leading to great difficulty in study and getting more and more attention from the society . Neurophycological tests play an important role in the ADHD studies . The functional disorders described by the tests are the bases of ADHD symptoms and the theory of the tests connects ADHD's behavior and mechanism with the nervous system .The study about ADHD's three subtypes is now the hot point. The study about ADHD's three subtypes being carried out by the Neurophycology lacks specific characteristics and homogeneity and the result of the study can not be used to distinguish ADHD's each type .The aim of this study is to give ADHD children's three subtypes some tests in reaction time and intelligence , exploring their different neuropsychological characteristies and offering scientific base to the clinical diagnosis .Contents and Methods1 The obeject of studyFrom August, 2004 to March ,2005,in the psychological clinic of Shenyang children's Hospital ,according to ADHD diagnostic standard of DSM-IV ,177 children's cases were diagnosed , among which 128 cases were male , 49 cases were female , at the age from 7 to 12 . According to ADHD type-dividing standard of DSM-IV ,Among 177 diagnosed cases , 51 cases were predominantly inattentive type (PI) ,31 cases were predominantly hyperactive impulsive type (HI) and 95 cases were combined type (CT) . After clinical examination and other diseases being excluded,All children patients were given intelligent tests and reaction time tests .2 Main contents of study2.1 The sexual formation of ADHD children patients and three subtypes. Analyse the relationship between ADHD and sex and whether the distributions of sexual formation among three subtypes are agreed with each other .2.2 Three subtype intelligent formation of ADHDchildren patients and its proportionality.Analyse whether there is difference in three subtype intelligent formations of ADHD children patients and the proportionality of each patient's intelligent formation.2.3 The visual and audio reaction time of three subtype ADHD children patients. Analyse whether there is difference in the visual and audio reaction time of three subtype ADHD children patients .3 Methods of tests3.1 Intelligent measurementUse wei's children's intelligent measurement table (C-WISC) compiled by Gong Yaoxian to evaluate intelligence of children , to calculate verbal intelligence quotient (VIQ) , preformance intelligence quotient (PIQ ) and total intelligence quotient (FIQ) .3.2 Measurement of reaction timeUse computer's reaction time measuring software system . The items of reaction time measurement include : simple visual reaction time , complex visual reaction time and audio reactione time . Analytical targets are : average reaction time ,the fastest reaction time , the slowest reaction time and the reaction error rate , etc . The unit of reaction time is (ms) and the reaction error rate is calculated by percentage .4 Analytical method in statisticsThe methods include : normality test,equality of variance test,one-way analysis of variance,q test,chi-square test,paired t test.Result1 Sexual formation of ADHD children patients and three subtypes . For ADHD children, the male is obviously higher than the female (p<0.001).For each subtype ,the sexual formation of ADHD children is not significant (p>0.05).2 Three subtypes intelligent formation and its proportionality . Between different subtypes, the differences of ADHD children patient's total intelligent guotient (FIQ) , verbal intelligence quotient (VIQ) and performance intelligence quotient (PIQ ) are not significant (p>0.05) .The differences between VIQ and PIQ of PI and CT are significant(p<0.05,p<0.001).3 ADHD children patient's the visual and audio reaction time of three subtypes .The differences of the average ,the fastest and the slowest simple visual reaction time among three subtypes are significant (p<0.05 , p<0.01) ,of which the average and the fastest reaction time are significant between HI and CT ,the slowest reaction time is between HI and CT (p<0.05,p<0.01).The differences of the average,the fastest and the slowest complex visual reaction time among three subtypes are significant(p<0.05,p<0.01), of which the differerces between targets of HI and CT are significant(p<0.05 ) .The differences of the average audio reaction time among three subtypes are significant (p<0.05 ),of which the different between HI and CT are significant(p<0.05).the differences of the complex visual reaction error rate of among three subtypes are significant(p<0.01)and the differences between any two subtypes are significant(p<0.05)Discussion1 the sexual formation of ADHD children patients and three subtypes through comparison and analysis of the sexual formation of 117 cases of ADHD children and each sub-type, the stuy finds:the difference of the children's sexual formation is significant(p<0.001)and the male is obviously higher than the female. The proportion of the male the female is 128:49,the comparatine difference of sexes of each sub-type ADHD children is not significant(p>0.05).This finding tends to agree with the conclusion made by scholar Jim Xingming , by mean of diagnosing 118 eases as ADHD children patients,which means the sexual formation of ADHD children has significant difference and the male is obviously higher than the female .Some scholars think that its cause is related to our social and cultural background.2 three subtypes intelligent formation and its proportionality of ADHA children patients.Psychologists think that intelligence is the combination of various capabilities, of which the verbal and process capabilities are two main factors of intelligent formation, the former(verbal capability)reflects man's thinking capability and the latter reflects the process capability of non-verbal information, both of which can be used to judge man's high level spiritual activities of the brain function. The result of this study shows that the average value of total,verbal and performance intelligence quotients of each subtype ADHD children is between 90-102,belonging to the normal range,the differences of intelligence quotients among each subtypes are not significant(p>0.05),which is the same as the report in China,that is ,the intelligences of ADHD children are normal or close to normal level. In the Childhood, the intelligence develops as the nervous system does and the developments of VIQ and PIQ are relatively balanced. Most previous studies believe that for ADHD children patients, PIQ>VIQ, denoting there exists functional in the children's left brain relative to understanding languages. Through comparing and analyzing each subtype ADHD children patients'verbal and performance intelligence quotients, the result of the study shows that for the ADHD children patients of HI and CT, their differences(VIQ>PIQ)are significant, denoting HI and CT children patients'intelligent formations do not develop in balance due to the damage existing in the right brain(non-predominant right half part of the brain).The result is the same as the report presented by Chinese scholar zhang vanxia et al. Recently in ADHD neuropsychological study, the common recognition, whether in structure or in function, is that there is strange phenomenon in ADHD frontal lobe-base ganglion system, and basing on which leads to ADHD's defect in recognition. The front part of frontal lobe and the function in the contex motion area are very important to maintaining the attention, controlling the impulses and regulating the attacking and exercising activities. The damage in the non-predominant right half part is closely related to the presentation of clinical symptoms.3 The visual and audio reaction time of ADHD children patients'three subtypes.the responsine time of controlling the impulse.The visual reaction time mainly reflects the capability of controlling the impulse. The audio reaction time mainly reflects the capability of attention. The study finds that targets of different subtype ADHD children patients'reaction times of visual and audio senses are significant (p<0.05 or p<0.01),of which the reaction time of CT children patients's visual and audio senses is the slowest, and the reaction error rates are higher than those of other two types, denoting CT children patients have the most serious damage. Attentive steadiness and process accuracy are comparatively worse which corresponds to the reports in literature. The studies at home and abroad show that in the aspects of activity level, impulse, attention, learning and recognition, the combined type suffers the most serious damage. Through comparing HI with PI ,each reaction time target of HI visual sense is higher than PI, which agree with the characteristics of PI, easy to act, impulsive and quickly responsive, but with high error rate. It's reaction time targets and reaction error rate of audio sense are lower than those of PI, which also agree with the characteristics of HI . HI's characteristic is multi-action and impulsive and the attentive defect is relatively weaker .Conclusion(1) ADHD children have sexual difference , the male is higher than the female .There is no sexual difference in various subtypes.(2) In the intelligence tests of each subtypes ,the ADHD children's intelligence is normal , but having the characteristics of unbalanced intelligence(VIQ>PIQ), probably having damage in non-predominant right half part of the brain (right brain ).(3) The reaction time measurements of each subtype have their own characteristics,of which the damage is the most serious in each target measurement of visual sense and audio sense reaction time of CT . The study shows that reaction time measurement can reflect pathology characteristics of brain nerve of ADHD children, providing important and scientific reference for clinical diagnose.Above statements being combined , each subtype of ADHD ,in the neuropsychological measurement , has its own characteristic and therefore in practice individual interfering measures should be made up to reduce disease-developing rate and raise children's health level . |
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