| Objective: To investigate the prevalence and clinical characteristics of Attention deficit hyperactivity disorder(ADHD)symptom in preschool children with cerebral palsy(CP)aged 4 ～ 7 years.To explore the effects of sensory integration intervention on attention deficit symptoms,fine motor function and gross motor function of Cerebral Palsy children in this age group.Methods: 140 children aged 4 to 7 with cerebral palsy without severe cognitive impairment who diagnosed by the Third Affiliated Hospital of the Jiamusi University from December 2018 to October 2019.The parent version of the SNAP-IV rating scale(26 items)was used to assess the ADHD symptoms,and the gross motor function was graded by the cerebral palsy gross motor function rating system(GMFCS).Through systematic analysis and summary of the data,the prevalence and clinical characteristics of ADHD symptoms in preschool children with cerebral palsy(CP)aged 4 ～ 7 years were obtained.Twenty preschool CP children(GMFCS in Ⅰ or Ⅱ)with ADHD symptoms were divided into intervention group(n = 10)and control group(n = 10).The control group received routine rehabilitation training,including physical therapy training,occupational therapy training,language therapy training and massage treatment.In the intervention group,sensory integration training was added on the basis of routine rehabilitation training.The treatment was 30 minutes / time,1 time / day,5 days / week for 12 weeks.SNAP-IV scale,Peabody motor development scale fine motor scale(PDMS-FM)and cerebral palsy gross motor scale 88(GMFM-88)were used to assess D and E areas before treatment,8 weeks and 12 weeks.Results: Among 134 effective questionnaires,65 children with cerebral palsy had ADHD symptoms of different degrees,the clinical detection rate was 48.51%;there was no difference between boys and girls(66.15% vs 33.85%,P > 0.05);59 cases in marginal state(90.77%),6 cases in abnormal state(9.23%);52 cases in attention deficit symptom type(80.00%),13 cases in attention deficit mixed with hyperactivity impulse type(20.00%),and 0 case in hyperactivity impulse type(0.00%).The clinical detection rates of dyskinesia,ataxia,spastic diplegia,spastic hemiplegia,spastic quadriplegia and mixed type were 52.00%,61.54%,41.82%,42.86%,77.28% and 50%,respectively,the difference was not statistically significant(P > 0.05);the clinical detection rates of attention deficit hyperactivity disorder in children with cerebral palsy whose GMFCS were grade I,II,III and IV were 51.35%,67.86% respectively The difference was statistically significant(P<0.05).After 8 weeks of treatment,PDMS-FM,GMFM-88 D and E scores were significantly improved(P<0.05),but the parents’ Version(26 items)of SNAP-IV was not significantly improved(P>0.05)in control group.There were significant differences(P < 0.05)in the parent version of SNAP-IV Assessment Scale(26 items)and PDMS-FM,GMFM-88 D and E scores(P<0.01)in the intervention group;In the intervention group,there were significant differences(P<0.05)between the parents’ Version(26 items)of SNAP-IV assessment scale and PDMS-FM before treatment,and there were great significant differences(P<0.01)in GMFM-88 D and E scores before treatment;The scores of the parents’ Version(26 items)of SNAP-IV of the intervention group were significantly higher than those in the control group(P<0.05).There was no significant difference in the scores of PDMS-FM and GMFM-88 D and E regions between the Control Group and the intervention group(P>0.05).After 12 weeks of treatment,there were significant differences in the scores of the parents’ Version(26 items)of SNAP-IV assessment scale(P<0.05),and great significant differences in the scores of PDMS-FM,GMFM-88 D and E regions(P<0.01).There were significant differences between the intervention group and the control group in the attention deficit disorder subscale of the parents’ version of SNAP-IV assessment scale(26 items)(P<0.05),and there were significant differences between gm FM-88 D area(P<0.05)and E area(P<0.01).Conclusions: The detection rate of ADHD symptoms in children with cerebral palsy is higher than that in normal children of the same age,and the main type is attention deficit symptoms performance type.The detection rate has no significant correlation with gender and type.The higher GMFCS is the higher clinical detection rate of ADHD symptoms is.Sensory integration intervention and routine rehabilitation treatment can improve the attention deficit symptoms of children with cerebral palsy,but the effect of sensory integration training combined with routine rehabilitation training is more significant.The effect of sensory integration training combined with conventional rehabilitation training on the gross motor function of children with ADHD symptoms is better than that of routine rehabilitation training alone,and there is no difference in the improvement of fine motor function. |
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