注意力变量测试在诊断儿童注意缺陷多动障碍中的应用

刘倩筠（广州市妇婴医院儿科，广东 广州510180）

摘要：

【目的】探讨注意力变量测试（Test of Variables of Attention,TOVA）在儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)辅助诊断及鉴别诊断中的意义。

【方法】根据DSM-Ⅳ诊断标准，将儿童心理门诊以“注意力不集中、多动”为主诉就诊，且瑞文渐进模型测验智商（intelli gence quotient,IQ）≥85分的56例儿童分为ADHD组(34例)和非ADHD组（22例）；分别予注意力变量测试，分析 各组测试结果及各参数的辅助诊断意义。

【结果】34例ADHD患儿TOVA异常占85.29%；22例非ADHD儿童TOVA异常占27.27%，其中提示ADHD可 能的占13.64%,均为行为问题儿童。各参数中，ADHD组遗漏（omission errors，OE）、反应时间（response time，RT）、反应时间变量（response time variability，RV）得分及ADHD评分均显著低于非ADHD组（P＜0.01）。ADHD组第二部分反应时间（re sponse time in half 2，RT2）比第一部分反应时间（response time in half 1，RT1）得分显著提高（P＜0.05）。

【结论】注意力变量测试（TOVA）是客观、标准、高精确度的持续性操作测试，在ADHD诊断中有较理想的辅助诊断意义，值得推 广应用。

关键词：注意力变量测试； 持续性操作测试； 注意缺陷多动障碍

Application of Test of Variables of Attention in the diagnosis of attention deficit hyperactivity disorder in children. LIU Qian-jun. (Department of Pediatrics, Guangzhou Maternal and Children Health Care Hospital, Guangzhou,Guangdong  510180, China)

Abstract:

【Objective】To evaluate The Value of the test of Variables of Attention (TOVA) in the diagnosis of attention deficit hyperactivity disorder (ADHD).

【Methods】A total of 56 children were diagnosed with DSM-Ⅳ. These children’s Raven Progressive Matrices (RPM) intelligence quotient (IQ) scores were no less than 85. They were divided into two groups. “ADHD Group” which had 34 children. and “nonADHD group”  which included 22 children. Two groups of children were tested using the visual software of TOVA. And the results were carefully examined. 

【Results】Significant difference in each variables of TOVA was found among the two groups. In the ADHD group, 85.29% of children were out of normal limits. As a comparison, the percentage was 27.27% for the 22 nonADHD children. And these 27.27% of children were exclusively from the behavioral disorder children. Additionally, the investigation indicated significant difference in a number of standard scores including: omission errors (OE), response time (RT), response time variability (RV), and ADHD score. The scores in ADHD group were significantly lower than that in nonADHD group (P ＜0.01). Finally, the investigation also indicated that the ADHD group’s score in response time in half 2（RT2） was significantly higher than that in response time in half 1（RT1）(P＜0.05).

【Conclusions】This preliminary study indicates that the TOVA is an objective, standardized and highly accurate continuous performance task. It makes useful contribution to the diagnosis of children with ADHD and should be widely used in research and clinical practice.

Key words:test of variables of attention； continuous performance task； attention deficit hyperactivity disorder