Research On Diagnisis And Evaluation Of Preschool Children With Attention Deficit/Hyperactivity Disoreders And Opponsitional Defiant Disorders

Objective:To investigate executive function(BRIEF-P scores)difference among preschoolers with attention-deficit/hyperactivity disorder(ADHD),comorbidity with oppositional defiant disorder(ADHD+ODD),which were diagnosed according to DSM-5 and Diagnostic Infant and Preschool Assessment,and normal control children(NC).To research the correlation between EF with ADHD and ODD symptom.Method:Parents of normal(4y0m～5y 11m,N=105)and parents of ADHD(4y0m～5y11m,N=234),including pure ADHD(N=191)and with ODD(N=43)children,completed the BRIEF-P and SNAP-Ⅳ which evaluating children’s EF,ADHD symptom and ODD symptom.MANOVA and partial correlation were aimed at the relationship between EF with ADHD and ODD symptoms.Results:The comorbidity rate of ADHD with ODD is 18.4%,there is no difference between boys who diagnosed as ADHD with ODD and girls who got the same diagnosis(χ2=0.03,P>0.05).After controlling gender and IQ,it was showed that BRIEF-P scores of ADHD+ODD were higher than ADHD children conducted by MANOVA analysis,and higher than scores in NC(P<0.01).There was a decreasing trend that scores in ADHD with ODD group,ADHD,and NC(P<0.05),which was conducted by Post Hoc analysis.We can see the similar trend on the scores of SNAP-Ⅳ evaluated symptoms of ADHD and ODD among three groups(P<0.05),using MANOVA analysis to control gender and IQ.Besides,after controlling gender,IQ and ADHD symptom scores,BRIEF-P of ADHD+ODD was higher than ADHD children on inhibit,shift,emotional control and plan/organize;there was no difference between working memory and metacognition among the three groups.There was low to mediate correlation between ODD symptom and EF on inhibit,shift,emotional control and plan/organize(r=0.11～0.49,P<0.05)using partial correlation analysis;no significant correlation between ODD and EF on working memory.The correlation varied from low to high between ADHD symptoms and EF after controlling gender,IQ and ODD scores(r=0.16～0.70,P<0.01).Conclusion:Compared with normal children,both ADHD only and ADHD with ODD have executive dysfunction.Attention deficit,hyperactivity/impulsivity and ODD symptoms among preschoolers have apparent correlation with executive dysfunction.Object i ve:Discuss the correlation between executive function and ADHD symptoms on preschool children,and to establish the ADHD diagnostic prediction model based on clinical data.Methods:Parents of kindergarten students(4y0m～5y11m,n=105),non-reference clinical patients who were diagnosed with Attention-Deficit Hyperactivity Disorders(4y0m～5y11m,n=263)by psychiatrist based on DSM-5 completed the SNAP-Ⅳ,strength and difficulty questionnaire(SDQ),and Behavior Rating Scale of Executive Function-Preschool Version(BRIEF-P)parent form to evaluate children’s symptoms and executive function through different perspectives.Significant factors which contribute to relationship were chosen by correlation analysis,whole prediction was made by Logistic regression.To improve the prediction of ADHD,subsections prediction was made using decision tree analysis and logistic regression conditionally to classify ADHD types.Results:(1)Factors which were relative to ADHD mainly including inhibition,working memory,inhibitory self-control,emergent metacognition and total EF,hyperactivity,inattention and hyperactive/impulsivity;(2)Logistic regression predicted 88.8%of ADHD,decision tree analysis got the prediction node of ADHD were containing inattention,inhibition and inhibitory self-control;(3)Logistic regression and decision tree analysis were conducted on ADHD subtype diagnostic prediction and related significant factors.Conclusion Inattention symptom,inhibition and inhibitory self-control factors of executive function can predict the ADHD diagnosis.Conclusion:The ADHD symptoms and executive function can predict the diagnosis of ADHD in preschool children.Moreover,it predicts the diagnosis of ADHD subtype and comorbidity with ODD,providing the references of clinic application.Objective:The main aim of the present study was to explore the diference between ADHD preschool children in clinical evaluation(mainly mismatch negativity)and normal control children,as well as the correlation between ADHD symptoms and IQ with MMN.Methods:Parents of kindergarten students and non-reference clinical patients who were diagnosed with Attention-Deficit Hyperactivity Disorders by psychiatrist based on DSM-5 completed the SNAP-Ⅳ,parent form.Cognionics were used to record the brain wave with oddball stimulus,observing the characters of amplitudes and potentials on MMN and P3a.Using Neuroscan analyse the data of EEG.Results:(1)ADHD children(n=25)and normal preschool(n=22)were recruited,there was a significant difference on gender between two groups,χ2=10.32,p=0.001。There were significant differences on age(t=-3.92,p=0.000)and IQ(t=-2.77,p=0.008).(2)ADHD children and normal had significant differences on DMMN-Cz(t=-2.15,p=0.037)and P3a-Cz(t=2.88,p=0.006).(3)There were significant correlations between DMMN-Cz and gender(r=0.34,p=0.02),as well as P3a-Cz and gender(r=0.32,p=0.04).Besides,the significant relationship can be seen between P3aFz and IQ,r=0.33,p=0.04.(4)The associations between P3a-Cz and hyperactivity(r=-0.34,p=0.03),ODD(r=-0.34,p=0.03)and CD(r=-0.36,p=0.02)respectively were significantly negative.Conclusion:ADHD preschool children had lower DMMN-Cz and P3a-Cz amplitude comparing to normal children,and no differences can be seen on Fz.There were significant correlations between P3a-Cz amplitude and total IQ,as well as hyperactivity symptom and oppositional defiant symptom.