北京第二外国语学院学报, 2018, 40(4): 24-40 doi: 10.12002/j.bisu.168

语言学研究

国内外多动症阅读发展探究

李苗1,2,3, 赵微1, 王庭照1, 赵娅琪4, 李雷雷5

Review of Reading Development in Children with ADHD

LI Miao1,2,3, ZHAO Wei1, WANG Tingzhao1, ZHAO Yaqi4, LI Leilei5

1. Shaanxi Normal University, Xi’an 710062, China

2. Harvard University, Cambridge 02138, USA

3. University of Houston, Houston 77204, USA

4. Shandong Hearing and Language Rehabilitation Center, Ji’nan 250100, China

5. Handan Special Education Center, Handan 056001, China

收稿日期: 2017-05-9   网络出版日期: 2018-08-15

基金资助: 本文系2015 年教育部人文社科青年多动症儿童早期读写能力发展研究的阶段性研究成果(15YJC880036)

Received: 2017-05-9   Online: 2018-08-15

作者简介 About authors

李苗,陕西师范大学教育学院,710062,美国哈佛大学教育学院博士后研究员,美国休斯顿大学助理教授、博士生导师,研究方向:儿童语言发展、双语教育、特殊教育电子邮箱:mli@snnu.edu.cn 。

赵微,陕西师范大学教育学院教授、博士生导师,710062,研究方向:特殊教育王庭照,陕西师范大学教育学院教授、博士生导师,710062,研究方向:特殊教育 。

赵娅琪,山东省听力语言康复中心,250100,研究方向:特殊教育 。

李雷雷,邯郸市特殊教育中心,056001,研究方向:特殊教育 。

摘要

阅读是个体习得语言过程中必须掌握的一个重要技能,同时又被不同的因素所影响。近年来多动症(ADHD)儿童得到人们越来越多的关注,该类儿童的症状主要有:注意力不集中、多动以及冲动。由于其自身的缺陷,ADHD儿童的语言习得和阅读发展会受到影响。国外相关研究表明:ADHD与阅读障碍(RD)存在很高的并发率,其阅读发展存在语音加工、注意力以及工作记忆等认知缺陷。国内对ADHD儿童的阅读发展研究不多,已有对RD儿童的阅读发展研究表明语素意识缺陷是汉语阅读障碍的核心缺陷。鉴于RD和ADHD有着很高的并发率,笔者预测,语素缺陷很可能是汉语为母语的ADHD儿童阅读发展的重要影响因素。本文从认知角度对国内外ADHD儿童的阅读发展进行综述并提出其研究发展方向,希望为未来研究提供理论依据。

关键词: 多动症儿童 ; 阅读障碍 ; 语言发展

Abstract

Reading is a crucial skill required by individuals in the course of language acquisition. It is affected by various cognitive factors. In recent years, children with attention deficit/hyperactive disorder (ADHD) have received more and more attention. The symptoms of ADHD children include: inattention, hyperaction, and impulse. Among them, inattention is the main characteristic of children with ADHD. Because of their unique deficit, ADHD children will also develop problems in their language acquisition and reading development. Research outside of China has shown a high comorbidity rate between ADHD and Reading Disabilities (RD). RD refers to a condition in which a student displays difficulty in reading in spite of normal IQ. It is the most common disability in regular school settings. In western countries, research has demonstrated that deficits in phonological processing, attention, and working memory may cause reading problems in children with ADHD. However, there is limited research on reading development of ADHD children within China. The existing studies in Chinese RD have reported that morphological awareness is a core deficit for Chinese children with RD. Due to the high comorbidity rate between RD and ADHD, we hypothesize that morphological awareness may be a powerful predictor of reading difficulties in addition to inattention of children with ADHD in China. This paper first reviews studies about cognitive predictors of reading development of ADHD children published outside of China, and then reviews reading research on children with ADHD or RD in China, and finally suggests directions for future research, in the hope of laying some theoretical foundations for future studies.

Keywords: ADHD ; RD ; language development

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引用本文

李苗, 赵微, 王庭照, 赵娅琪, 李雷雷. 国内外多动症阅读发展探究. 北京第二外国语学院学报, 2018, 40(4): 24-40. DOI:10.12002/j.bisu.168

LI Miao, ZHAO Wei, WANG Tingzhao, ZHAO Yaqi, LI Leilei. Review of Reading Development in Children with ADHD. JOURNAL OF BEIJING INTERNATIONAL STUDIES UNIVERSITY, 2018, 40(4): 24-40. DOI:10.12002/j.bisu.168

引言

阅读能力作为一种基本技能,影响着学生的学业和未来的发展,乃至国家社会经济的进步。阅读是基础教育课程中重要的学习环节,然而在普通学校环境下,一些儿童具有注意缺陷多动障碍(Attention Deficit / Hyperactive Disorder,ADHD),这是一种发生于儿童期的神经发展性障碍,该类儿童患者的症状主要有:注意力不集中、多动以及冲动,其中注意力不集中是其核心缺陷(APA,2013),国内称之为多动症。在西方国家中,ADHD在学龄儿童中的发病率约为3%~5%,男女比例约为3:1。ADHD在我国学龄儿童中的整体发病率为5.7%,男女总发病率比率接近2.3:1(童连、史慧静、臧嘉捷,2013)。学龄期的ADHD儿童在学业、同伴关系等方面出现不良状况,这些儿童长期发展会对以后的学习和行为造成不良影响。

随着患者年龄的增长,ADHD症状会相对得到缓解,也有可能持续伴随患者到其成年。ADHD儿童的症状非常复杂,往往伴随着其他障碍,如阅读障碍、品行障碍、焦虑等。阅读障碍(Reading Disability,RD)是“智力正常并接受正常的学校教育,但是在阅读准确性和阅读理解的标准化测验中的成绩显著落后于其年龄和年级所应该达到水平的一种学习障碍现象”(APA,2013)。研究表明,在所有伴随障碍中,阅读障碍(RD)与ADHD之间的并发率最高。Willcutt & Pennington(2000)发现,超过80%的ADHD儿童满足对RD儿童的诊断标准。同样,在RD儿童中,ADHD儿童所占的比例也很高,约为18~42%(Gayán et al.,2005;Wisniewska,Baranowska & Wendorff,2007)。既然RD和ADHD有着很高的并发率,在这两类病症儿童患者的阅读发展中应该也存在着一些共同的影响因素。

由于其自身的缺陷,ADHD儿童在学校学习过程中会面临一系列问题,从而导致其学业成绩的落后。本文主要针对ADHD儿童的阅读发展以及影响阅读的认知机制进行综述。鉴于阅读障碍和ADHD存在着非常高的并发率,我们有理由相信影响阅读障碍儿童的某些认知缺陷极有可能也是影响ADHD儿童阅读发展的缺陷。虽然国内外对于阅读障碍的研究已经比较完善,但是对ADHD儿童的阅读研究还不多。因此,本文在综述影响ADHD儿童阅读的认知机制的同时,还会探讨可能同时影响ADHD和阅读障碍的相关因素。在以下内容中,本文先讨论影响国内外ADHD儿童阅读发展的一般认知因素,然后再探讨由于语言特异性所导致的影响国内外ADHD儿童阅读发展的特定认知因素。国外学者对以字母文字为主的ADHD儿童阅读发展的认知机制研究主要集中于语音意识、快速命名、注意力、工作记忆和英语阅读理解之间的关系。而汉语是非字母文字,存在其特异性,所以影响我国ADHD儿童阅读发展的核心缺陷也许和影响西方国家儿童阅读发展的缺陷有所不同。接下来本文将详细介绍影响国内外ADHD儿童阅读发展的一般和特殊认知因素。

一、影响多动症儿童阅读发展的一般认知因素

ADHD儿童的主要表现为注意力不集中、冲动及过度活动。认知缺陷被广泛认为是影响ADHD儿童的核心缺陷。国内外对于影响ADHD儿童阅读发展的一般认知因素的研究主要集中在注意力和工作记忆上。这里的一般认知因素主要指不受不同语言正字法影响的认知因素。也就是说,不论ADHD儿童说何种语言,这些认知因素都会影响其阅读发展。

1. 注意力与阅读理解的关系研究

注意力是对事物的指向性和集中性,注意力又分为选择性注意力、定向注意力、执行注意力和持续性注意力。注意力缺陷是ADHD的主要临床症状,表现为患者注意力不集中、不能按时完成作业、上课不注意听讲。注意力缺陷会影响视觉、听觉信号的准确输入和信息的处理速度,导致阅读能力下降。Reynolds & Besner(2006)认为,在阅读流畅性方面,注意力的作用是非常重要的,所以注意力是影响阅读的一个非常重要的因素。虽然学者对注意力在阅读方面的重要性达成了一致,但是只有一部分专家对注意力与ADHD阅读理解之间的关系进行了研究。Lam & Beale(1991)通过对7~10岁的ADHD儿童进行持续性测验和延迟任务来考查其持续性注意力和阅读理解之间的关系。研究结果发现,和对照组相比,ADHD儿童在阅读理解的测试中表现较差,成绩较低。Ghelani et al.(2004)在其研究中也得出一致结论,认为注意力缺陷可能是ADHD儿童的核心缺陷,因为他们的持续性注意力比较差,很难将注意力集中在所读的单词上,这样单词的流畅性以及正确率都会有所下降,从而影响阅读理解成绩。但是,还有研究认为注意力缺陷导致个体在单词水平上比较差,使得其单词解码技能比较差,进而导致其在阅读理解上的困难(Perfetti,1985)。注意力缺陷和ADHD儿童阅读理解有一定的联系,但是ADHD儿童较差的阅读理解是由注意力缺陷导致的还是由其他的阅读相关技能导致的,还有待进一步探讨。

国内也有大量文献显示注意力缺陷是ADHD儿童的核心缺陷(刘豫鑫、王玉凤,2002a;王淑玉等,2005;刘海润等,2016)。刘豫鑫和王玉凤(2002a)通过比较60例ADHD门诊患儿以及按年龄、性别、母亲教育水平匹配的60名正常儿童,对他们进行认知功能评定,结果显示ADHD儿童的注意力显著低于正常儿童。刘海润等(2016)也对60余名ADHD儿童以及与其数量、年龄、性别相匹配的正常对照组儿童进行了Das-Naglieri认知评估,研究结果表明,ADHD儿童的接受性注意力与正常组儿童相比存在显著差距。但还没有相关实证研究证明ADHD儿童注意力与阅读之间的关系,所以希望未来研究者们可以探究ADHD儿童的阅读水平低下是否主要由于注意力缺陷导致。

2. 工作记忆与阅读理解的关系研究

工作记忆是个体在执行认知任务中,对信息暂时保持与操作的能力(Baddeley,1992)。它主要包括三个不同方面:语音环路、视空模板、中央执行系统。它可以帮助我们集中注意、抵制注意分散以及指导我们在比较复杂的活动中作出决定,如心算、阅读理解以及推理(Daneman & Carpenter,1980;Swanson,1999;Gathercole & Pickering,2000;Baddeley,2003)。McInnes et al.(2003)发现ADHD儿童在对听觉信息的细节进行理解时表现正常,但是在比较高级的理解水平(推论和理解监控)上表现较差。对细节任务的简单回忆考查的是语音短时记忆,高级的听觉理解任务考查的是工作记忆能力,ADHD儿童在涉及工作记忆相关的加工时存在一定的缺陷。Gooch,Snowling & Hulme(2011)在其研究中采用重复假词、数字回想等任务来探讨RD、ADHD、ADHD+RD、正常组四组儿童的工作记忆能力。研究结果发现,ADHD组儿童的工作记忆能力落后于正常组儿童,RD儿童和ADHD+RD儿童的工作记忆差异不显著。随后Hutchinson et al.(2012)在其研究中通过倒背数字、听觉回忆等任务来考察四组儿童的工作记忆能力,研究表明,RD和ADHD+RD儿童的工作记忆能力最差,其次是ADHD儿童。工作记忆能力低下导致其语音短期存储能力和言语复述能力在不同程度上受损或发展滞后,这与Gooch,Snowling & Hulme(2011)的研究结果一致。上述研究可以说明,在ADHD儿童阅读发展过程中工作记忆是影响其发展的一个重要变量,但是否是关键变量还有待研究。

国内对ADHD儿童工作记忆的研究结果表明,与正常儿童相比,ADHD儿童的工作记忆存在明显缺陷(刘豫鑫、王玉凤,2002a;李建英等,2005;赵鑫、付丽、周仁来,2011)。张微、宋红艳(2010)通过对ADHD儿童与正常儿童进行识字和记忆广度测验来考查ADHD儿童的解码能力和工作记忆能力,结果发现,ADHD儿童在倒背数字任务中成绩显著落后于正常组儿童,这说明ADHD儿童存在工作记忆能力缺陷。郭耀光等(2012)采用背数测验变式、方块图敲击试验变式等探讨了ADHD儿童的工作记忆存储能力的特征,发现ADHD儿童的工作记忆能力远低于正常儿童。随后的研究也证实了此结论:杨斌让等(2012)的横断面研究中同样采用韦氏儿童智力测验中的背数测验任务对ADHD儿童和正常儿童的工作记忆能力进行了探讨,研究显示ADHD儿童的倒背数字成绩均显著落后对照组。周勤学和张群会(2013)以40名9~12岁的ADHD儿童为被试,其研究结果表明ADHD儿童的倒背数字成绩也落后于正常儿童。ADHD儿童的工作记忆缺陷很可能是脑机制和神经网络异常造成的(卢又燃等,2006;王璐等,2008)。还有研究表明,ADHD+RD共患儿童的工作记忆比单纯的ADHD儿童的工作记忆受损的程度更重(刘豫鑫、王玉凤,2002b;帅澜、王玉凤,2007)。

以上研究表明,ADHD儿童的工作记忆存在缺陷,ADHD+RD儿童存在更严重的工作记忆损伤,并在一定程度上影响其阅读理解成绩。但是学者们对影响其阅读理解成绩的因素还没有得出一致结论。相关研究表明,35%~50%的ADHD儿童存在语言方面的缺陷,而且阅读理解涉及更高级的言语认知技能,因此还需研究对其产生影响的阅读认知机制。

二、国内外多动症儿童的语音加工与阅读关系研究

由于语言的特异性,影响不同文字体系下的ADHD儿童阅读发展的认知因素包含一般性,同时也存在其特殊性。即使字母文字和拼音文字在构成上存在显著差别,已有研究表明语音加工是对ADHD儿童的阅读发展产生重要作用的认知因素。

1. 多动症儿童语音意识与阅读关系的研究

语音加工技能主要由语音意识、快速命名和语音记忆构成,而语音意识在语音加工中具有重要作用,它不仅能够显著预测字母文字的阅读能力,对汉语阅读能力中的字词识别、阅读理解、阅读流畅性等阅读技能也有重要的预测作用(Hu & Catts,1998;钟毅平,2002;陶沙,2004;李虹等,2011;Kibby,Lee & Dyer,2014)。西方研究者对处于不同发展期ADHD儿童的语音意识进行了探讨,发现ADHD个体的语音意识和阅读理解成绩能力落后于正常人,但整体差异不显著;而ADHD+RD个体的语音意识和阅读能力显著落后于正常人(Gooch,Snowling & Hulme,2011)。有的研究则发现ADHD儿童在个别语音意识任务上有显著差异(Gonçalves-Guedim & Crenitte,2015),而年龄和共患障碍症状是影响ADHD个体语音意识的重要变量(Alves et al.,2014)。

de Jong et al.(2012)从语言双通道理论的角度对ADHD儿童、阅读障碍儿童的共病现象进行了探讨,该研究将儿童分为ADHD组、RD组、ADHD+RD组、正常组,采用真假语音决策任务考察了其亚词典通道的加工能力,发现与正常组儿童相比,ADHD儿童的语音决策成绩并没有显著差异,而RD组与正常组之间的语音决策成绩差异显著。但是,Gooch,Snowling & Hulme(2011)采用音位删除任务考察了ADHD儿童、正常儿童、RD儿童、RD+ADHD儿童的语音意识能力,发现ADHD儿童的语音意识成绩落后于正常组,但两组儿童成绩差异并不明显;RD+ADHD儿童在语音意识任务上的表现与RD组儿童相似。同样地, Gonçalves-Guedim &Crenitte(2015)考察了9~12岁ADHD儿童和普通儿童的语音加工能力,也发现ADHD组儿童的语音意识落后于普通儿童,其中音位意识测验中的表现差异尤其突出。Alves et al.(2014)的研究中考察了7~16岁ADHD儿童和青少年的语音加工能力,采用音节删除、音位分割及音位删除任务考察了ADHD患者的语音意识,研究发现,低年龄段的ADHD患者的语音意识成绩低于高年龄段ADHD患者,ADHD+RD组的语音意识成绩显著低于ADHD组。该研究表明,年龄和共患病症状是影响ADHD患者语音意识的两个重要变量。

从西方学者对ADHD患者语音意识的研究来看,ADHD儿童的语音意识与同龄人的差异是否显著还没有统一定论,其语音意识与阅读的关系尚在进一步探讨中。国内对多动症儿童语音意识与阅读的关系的研究不多,其中Chan et al.(2008)发现,ADHD儿童及ADHD+RD儿童的语音意识成绩对其阅读流畅性成绩具有一定的贡献作用。但是由于该研究未设置对照组,未能深入探讨ADHD儿童及并发症儿童与正常儿童语音意识的发展差异以及ADHD儿童语音意识成分中是否存在缺陷,因而存在一定的局限性。由此可见,国内学界要加大对ADHD儿童语音意识的研究以了解其发展特点,采取有效措施对可能存在的缺陷进行积极干预。

2. 多动症儿童快速命名与阅读关系的研究

快速命名被普遍认为是预测阅读能力的一项重要认知指标,要求被试在最短时间内快速准确地对字母、数字、颜色或物体命名。国内外已有大量研究表明,RD儿童的快速命名速度和错误率显著低于正常儿童(Tannock,Martinussen & Frijters,2000;王恩聪等,2014)。对于ADHD儿童,国外有研究者认为,在语音加工技能的快速命名能力方面,ADHD儿童和RD儿童落后于正常儿童,RD儿童落后于ADHD儿童;与ADHD儿童、RD儿童相比,ADHD+RD儿童整体快速命名能力受损程度更加显著(Rucklidge & Tannock,2002;Bental & Tirosh,2007)。也有研究者认为ADHD+RD儿童与其他两组儿童相比无显著差异(Willcutt et al.,2005;de Jong et al.,2012)。研究者还考察了ADHD儿童在不同快速命名任务上的反应时间,认为ADHD儿童的数字和物体快速命名速度均明显慢于正常儿童(Tannock,Martinussen & Frijters,2000;Ghelani et al.,2004;Shanahan et al.,2006;Alves et al.,2016)。Semrud-Clikeman et al.(2000)的研究结果表明,ADHD儿童的物体快速命名速度显著慢于正常儿童,但数字快速命名速度则与正常儿童无明显差异。还有研究者发现,ADHD儿童的颜色命名(Ghelani et al.,2004)和字母命名(Gonçalves-Guedim & Crenitte,2015)速度显著落后于正常儿童。Gonçalves-Guedim & Crenitte(2015)的研究发现,除了数字快速命名反应时间显著落后于对照组外,ADHD儿童的字母快速命名也显著落后,但在物体快速命名和颜色快速命名用时反应上与对照组之间不存在显著差别。Li et al.(2009)则考察了8~14岁ADHD儿童的快速命名速度与阅读技能之间的关系。研究发现ADHD儿童与对照组儿童的快速命名能力无显著差异,颜色和字母快速命名是解释ADHD儿童阅读流畅性成绩变异的重要变量,数字和字母则能显著预测阅读理解成绩。

国内也有学者考察了汉语ADHD儿童在完成不同任务时的快速命名能力。王恩聪等人(2014)的研究发现,ADHD儿童的图片快速命名及数字快速命名的准确率与正常儿童没有差异,但图片和数字命名速度均显著慢于正常儿童,这表明ADHD儿童言语反应用时长于正常儿童。还有研究发现汉语ADHD儿童的数字快速命名显著快于ADHD+RD组儿童,RD组、ADHD+RD组的快速命名表现最差,在控制年龄、智力因素、语音意识和正字法知识后,快速命名对阅读成绩变化的贡献为17.5%,表明快速命名是预测ADHD+RD组儿童阅读能力的重要因素(Chan et al.,2008)。

综上所述,对使用字母文字的ADHD儿童在不同快速命名任务上反应时间研究结果差异较大,但是针对于汉语ADHD儿童快速命名能力的研究较少。因此仍需加大力度对此进行研究,对比字母文字ADHD儿童与非字母文字ADHD儿童的快速命名能力与其对照组的差异,并对快速命名与阅读能力之间的关系进行深度探讨。

3. 多动症儿童语音记忆与阅读关系的研究

语音记忆是语音加工技能的重要组成部分,主要是指对短时记忆中的相关语音信息进行存储的能力(陶沙,2004)。语音记忆不同于工作记忆,工作记忆是对信息存储的过程,同时还包括加工过程,而语音记忆主要是对语音信息的存储过程。西方学者采用不同的记忆广度测验、以听觉或视觉呈现的方式对ADHD儿童的语音记忆进行探讨,结果均表明ADHD儿童的语音记忆存在缺陷(Martinussen & Tannock,2006;Bolden et al.,2012;Kasper,Alderson & Hudec,2012)。有学者发现,ADHD儿童在音节记忆广度测验中只能回忆较短的音节,这表明其语音记忆能力可能受损。Tiffin-Richards et al.(2008)采用假词重复任务测验考察了ADHD儿童和RD儿童的语音短时记忆和中央执行加工,研究发现RD儿童的语音短时记忆成绩显著落后于正常组和ADHD组,而ADHD儿童的语音短时记忆成绩落后于正常组,但无显著差异。Bolden et al.(2012)采用回想单音节字词任务考察了ADHD男童与正常组男童的语音记忆能力,包括短期存储和言语复述机能。研究结果表明,在控制年龄、智力、阅读时间因素后,与正常组男童相比,ADHD组男童的语音短期存储能力和言语复述能力在不同程度上受损或发展滞后。de Lima Ferreira et al.(2015)采用重复和倒述长度不断递增的音同义不同、同义不同音的假词任务考察了7~10岁ADHD儿童的语音能力,研究发现ADHD组间性别无显著差异,ADHD儿童的两项任务表现与正常儿童相比成绩均落后,ADHD儿童重复和倒述字符较长的假词成绩显著差于普通儿童,这可能与其注意缺陷和执行功能受损有关。

国内对汉语ADHD儿童的语音记忆的研究很少。张微和宋红艳(2010)采用韦氏记忆测验考察了6~11岁ADHD儿童的语音记忆能力,研究发现,ADHD儿童与正常儿童无显著差异。综上研究来看,国外对使用字母文字的ADHD儿童语音记忆的研究表明,ADHD儿童的语音记忆可能受损,并对ADHD儿童阅读能力的发展造成了一定的影响。对ADHD患者的语音记忆与阅读理解进行的大量探讨表明,ADHD患者在阅读理解中建构知识的能力存在缺陷。国内只对ADHD儿童的语音记忆与字词解码之间的关系进行了探讨,还需要更多的研究来阐明ADHD儿童与正常儿童在语音记忆方面的差异以及语音记忆与阅读理解的关系。

三、国内外多动症儿童的语素与阅读关系的研究

与英语不同,汉语是一种表意文字。在汉语中,语素是构成汉语最基础的单位,是最小的音义结合体,在言语交流和阅读中主要负责传达语义方面的信息。Ehri(1979)认为,语素意识是元语言意识的一种,是个体对字词的音义信息进行匹配的意识,是儿童对字词的语素结构进行识别和操作的能力(Carlisle,1995)。在汉语阅读过程中,学习者对字词的识别主要从音义通达向形义通达转换,语素意识在这个过程中发挥着重要作用。相关研究表明,汉语语素意识对个体的阅读理解有着显著的预测作用,这种预测作用会随着学习者年龄的升高越来越显著。

已有大量研究证明,语音加工缺陷是导致英语RD和ADHD的核心缺陷。在汉语中,越来越多的研究表明语素可能是导致汉语RD的核心缺陷(Shu et al.,2006;Wu et al.,2009)。既然RD和ADHD有着很高的并发率,因而在这两类儿童的阅读发展中也必然存在着一些共同的影响因素,那么语素意识缺陷是否也会影响ADHD儿童的阅读?ADHD儿童在语言习得过程中是否存在语素意识缺陷?迄今为止,尚没有研究者针对汉语语素意识在ADHD儿童阅读中的影响作过系统性的研究。如果语素意识缺陷是汉语RD儿童的核心缺陷,那么它也很可能是主要影响汉语ADHD儿童语言阅读发展的特殊认知因素。所以笔者接下来回顾语素意识在汉语阅读发展和阅读障碍中的影响,希望未来的研究可以探索语素意识在ADHD儿童阅读中的作用。

在非字母文字体系中,汉字的特殊性使得其对语素意识的测量更加多样化。不同的学者对学龄儿童汉语语素意识的测量有不同的观点。Li et al.(2002)认为,语素意识主要分为三部分:形旁和声旁意识、词的内部结构意识以及对同音/同形语素进行区分的能力。张洁(2004)认为汉语语素意识主要包括两个方面:构词意识和释词意识。郝美玲、张伟(2006)认为汉语语素意识主要是针对个体对同音/同形语素的区分能力。赵微、陈泊蓉(2015)认为汉语语素意识主要包括三个方面:词素意识、同音语素/同形语素意识、解释语素意识。词素意识也就是对词的内部的语素结构的意识,例如,“教”和“室”能否组成一个有意义的词语。同音语素意识主要是对一音多字进行探讨,而同形语素意识主要是对一字多义进行探讨。解释语素意识是指个体对语素进行解码并对其进行操作的能力。

1. 汉语语素意识与阅读的关系研究

虽然对语素意识的研究开始于英语研究,但是随着学者对语素意识作用的关注,越来越多的学者开始对汉语中的语素意识及其与阅读的关系进行研究。Li et al.(2002)对640多名一年级和四年级的小学生进行的研究是探讨汉语语素意识和阅读关系的规模最大、最为系统的研究。他们对被试的语素意识、语音意识、句法意识、阅读量和词汇量进行了考查,结果发现语素意识在阅读发展中作用最关键,并且可以独立预测儿童阅读理解的成绩。在McBride-Chang et al.(2003)的研究中也验证了语素意识显著的预测作用。该研究通过同音语素辨别测验和语素类比测验来考查儿童的语素意识,同时还考查了儿童的语音意识和快速命名,测验结果表明小学二年级学生的语素意识成绩显著高于幼儿园学生的成绩,并且在汉字识别方面,语素意识的预测作用更显著。吴思娜、舒华和刘艳茹(2005)在其研究中通过语素生成、汉字命名和同音字识别等测验来考查五、六年级学生的汉语语素意识、语音意识、命名速度在阅读中的作用,结果发现:语素意识及命名速度在命名组词中的作用比较显著;在同音字识别测验中,语素意识、语音意识的作用比较显著;重要的是在命名组词、同音字识别两类测验中,语素意识是唯一对两者有显著预测作用的变量。虽然研究结果显示了汉语语素意识在阅读中具有显著的作用,但是该研究结果并没有考查语素意识在句子和篇章理解中的作用。Chen et al.(2009)为了探讨一、二年级学生的复合语素意识和汉字认读的关系,采用语素建构测验和语素类别测验对被试进行测验,结果显示,在汉语儿童成长过程中复合语素意识出现得比较早,而且随着年龄的增长也在不断地提高;同时,在控制了年龄、快速命名以及语音意识的影响后,语素意识对儿童的词汇和汉字阅读有显著预测作用。Liu & McBride-Chang(2010)在其研究中通过语素类比、同音语素辨别以及复合语素生成等测验来考查三年级儿童的汉语语素意识,研究结果发现,汉语语素意识对汉字认读以及词汇都有一定的预测作用,其中语素意识中的同音语素识别的贡献最大。陈泊蓉(2011)采用不同层面的语素意识测验,并通过与影响阅读理解成绩的语音和正字法意识的比较来探讨四至六年级儿童汉语语素意识和阅读理解之间的关系,回归分析结果发现,语素意识对阅读理解成绩有显著的预测作用,预测作用超过了语音意识和正字法意识对阅读理解成绩的预测作用,证明了汉语语素意识在阅读理解中的重要性。

2. 汉语语素意识对阅读障碍的影响研究

汉语语素意识对阅读有非常重要的作用,研究表明,汉语语素意识缺陷是RD儿童的核心缺陷,是影响其阅读发展的一个重要变量。吴思娜、舒华和王彧(2004)通过对RD组和正常组在语音意识、语素意识、语音/语义通达等测验中的表现进行对比,考查汉语阅读困难内部的异质性和导致汉语阅读困难的主要原因。研究结果发现,在语音意识、语素意识、词典通达等测验中,阅读正常组的成绩优于RD组。通过进一步分析发现,15名RD儿童都存在汉语语素意识缺陷。这项研究表明,在RD儿童中,语素意识缺陷发生的范围较大,程度也较深。吴思娜、舒华和王艳茹(2005)在其研究中对五年级和六年级的RD儿童进行语音意识、语素意识和命名速度测验,对其所存在的缺陷进行分析后发现,在这些RD儿童中,存在语素意识缺陷的学生比例为76%,而语音意识缺陷、命名速度缺陷的学生比例分别是43%和41%,这在一定程度上说明了语素意识在阅读理解中的重要作用。为了进一步探讨影响RD儿童的核心因素,Shu et al.(2006)在其研究中对五年级和六年级的RD儿童进行了语言学和非语言学的认知测验。研究结果发现,在所有的语言学认知测验中,RD组儿童和正常组儿童差异显著,而在非语言学的认知测验中差异不显著。通过进一步的分析后发现,语素意识对两组儿童阅读技能的预测作用是一致的。这就表明语素意识很有可能是导致汉语阅读困难的核心因素。隋雪、马立波和王彦(2009)在其研究中将二至五年级的学生作为被试,通过RD儿童和正常儿童在同音语素测验中的成绩对其语素意识进行考查,并记录两组儿童在语素意识测验中的正确率以及反应时间,测验结果发现,RD组的成绩与正常组的成绩存在显著差异。该研究表明RD儿童存在语素意识缺陷,并且汉语语素意识是导致其汉语阅读困难的主要原因。

综上所述,语素意识在汉语阅读发展过程中有着重要的作用,很可能是ADHD和RD的共享障碍,也极有可能是影响ADHD儿童阅读发展的关键变量。当然,这还需要大量的实证研究加以证明。

结语

国外大量研究表明,与RD儿童相比,ADHD儿童阅读能力落后与其语音加工技能、注意和工作记忆等相关阅读认知技能存在不同程度的缺陷有关,而国内对这些方面关注较少。国内已有许多研究证明语素意识是RD的核心缺陷,而语素意识在ADHD儿童的语言阅读发展中的作用还不明确。汉语语素意识在正常儿童阅读过程中发挥着重要的作用,尤其是在RD儿童的阅读理解中,语素意识也被证明是导致其阅读障碍的核心缺陷。而RD和ADHD存在比较高的并发率,语素意识缺陷是否也是ADHD儿童的缺陷尚无定论。因此,未来研究应该尝试探讨在以汉语为背景的语言发展体系中ADHD儿童的语素意识是否存在缺陷,并通过与语音加工、注意力和工作记忆与阅读关系的对比来寻找导致ADHD儿童阅读发展的核心缺陷。另外,现存文献大多数都是从RD和ADHD共患来研究ADHD的阅读发展问题,而针对ADHD特异的认知和语言相关的缺陷的研究不多,希望未来研究可以探索ADHD儿童阅读发展的特有缺陷。

The authors have declared that no competing interests exist.
作者已声明无竞争性利益关系。

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URL     PMID:14523382      [本文引用: 1]

The concept of working memory proposes that a dedicated system maintains and stores information in the short term, and that this system underlies human thought processes. Current views of working memory involve a central executive and two storage systems: the phonological loop and the visuospatial sketchpad. Although this basic model was first proposed 30 years ago, it has continued to develop and to stimulate research and debate. The model and the most recent results are reviewed in this article.

Bental B & Tirosh E ..

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[J]. Journal of Child Psychology and Psychiatry, 2007,48(5):455~ 463.

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Bolden J, Rapport M D, Raiker J S , Sarver D E&Kofler M J.

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[J]. Journal of Abnormal Child Psychology, 2012,40(6):999~ 1011.

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Carlisle J F.

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[C]// Feldman L. Morphological Aspects of Language Processing. Hillsdale,N. J.:Lawrence Erlbaum Associates, 1995: 189~ 209.

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Chan W S R, Hung S F L iu S N&Lee C K K.

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[J]. Reading and Writing, 2008,21(6):661~ 674.

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Chen Xi, Hao Meiling, Geva E ,Zhu Jin & Shu Hua .

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[J]. Reading & Writing, 2009,22(5):615~ 631.

[本文引用: 1]

Daneman M & Carpenter P A.

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[J]. Journal of Verbal Learning and Verbal Behavior, 1980,19(4):450~ 466.

URL     [本文引用: 1]

Individual differences in reading comprehension may reflect differences in working memory capacity, specifically in the trade-off between its processing and storage functions. A poor reader's processes may be inefficient, so that they lessen the amount of additional information that can be maintained in working memory. A test with heavy processing and storage demands was devised to measure this trade-off. Subjects read aloud a series of sentences and then recalled the final word of each sentence. The reading span, the number of final words recalled, varied from two to five for 20 college students. This span correlated with three reading comprehension measures, including verbal SAT and tests involving fact retrieval and pronominal reference. Similar correlations were obtained with a listening span task, showing that the correlation is not specific to reading. These results were contrasted with traditional digit span and word span measures which do not correlate with comprehension.

de Jong C G W, Licht R S ergeant J A&Oosterlaan J.

RD,ADHD,and their comorbidity from a dual route perspective

[J]. Child Neuropsychology, 2012,18(5):467~ 486.

URL     PMID:21999484      [本文引用: 2]

In order to achieve further insight into the comorbidity of reading disorder (RD) and attention deficit/hyperactivity disorder (ADHD), lexical processing and rapid naming were studied in RD and ADHD. The Dual Route Cascaded model postulates that lexical processing contains two parallel processes: lexical route processing and sublexical route processing. An orthographic decision task and a phonological decision task were used to measure lexical and sublexical route processing, respectively. In addition, a rapid naming task was used to compare 27 children with RD, 18 children with ADHD, 20 children with ADHD+RD, and 29 controls. RD and ADHD shared impairments in accuracy of orthographic and phonological decision making as well as in rapid naming, which suggest that RD and ADHD may be overlapping disorders that share deficits in both lexical route and sublexical route processing. RD was dissociated from ADHD by being slower in both orthographical and phonological decision making that indicates unique deficits in RD on lexical and sublexical speed.

de Lima Ferreira T, Brites C A zoni C A S&Ciasca S M.

Evaluation of working memory in children with attention deficit/hyperactivity disorder

[J]. Psychology, 2015,6(13):1581~ 1588.

[本文引用: 1]

Ehri L C. Linguistic insight: Threshold of reading acquisition[C]// Waller T G & Mackinnon G E. Reading Research:Advances in Theory and Practice. New York:Academic Press, 1979: 63~ 114.

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Gathercole S E & Pickering S J.

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[J]. British Journal of Educational Psychology, 2000,70(2):177~ 194.

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Gayán J, Willcutt E G, Fisher S E, Francks C, Cardon L R, Olson R K, Pennington B F, Smith S D Monaco A P&DeFries J C.

Bivariate linkage scan for reading disability and attention-deficit/hyperactivity disorder localizes pleiotropic loci

[J]. Journal of Child Psychology and Psychiatry and Allied Disciplines, 2005,46(10):1045~ 1056.

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Ghelani K, Sidhu R ,Jain U & Tannock R .

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[J]. Dyslexia, 2004,10(4):364~ 384.

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Gonçalves-Guedim T F & Crenitte P A P.

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[J]. Psychology, 2015,6(10):1331~ 1339.

[本文引用: 4]

Gooch D ,Snowling M & Hulme C .

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[J]. Journal of Child Psychology and Psychiatry, 2011,52(2):195~ 203.

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Hu C F & Catts H W.

The role of phonological processing in early reading ability:What we can learn from Chinese

[J]. Scientific Studies of Reading, 1998,2(1):55~ 79.

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Research has demonstrated that there is a strong relation between children's phonological processing skills and their ability to learn to read an alphabetic orthography. It is unclear whether this relation is specific to an alphabetic orthography or whether it extends as well to logographic orthographies such as Chinese. In this study, a group of Chinese 1st graders were administered three measures of phonological processing, including phonological memory, phonological awareness, and phonological retrieval. A visual memory task was also included. Two weeks later, the children were administered 2 reading tasks. One assessed their ability to read familiar and less familiar words printed in the Chinese alphabet. The other assessed their ability to read familiar and less familiar Chinese characters. Results showed that children's performance on the visual memory task was not related to their performance on either of the reading measures. In contrast, performance on the phonological measures was related to performance on both reading tasks. These results suggest that the relation between phonological processing skills and early reading ability is not specific to reading an alphabetic orthography. This relation extends to a logographic orthography as well.

Hutchinson E, Bavin E ,Efron D & Sciberras E.

A comparison of working memory profiles in school-aged children with specific language impairment,attention deficit/hyperactivity disorder,comorbid SLI and ADHD and their typically developing peers

[J]. Child Neuropsychology, 2012,18(2):190~ 207.

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Kasper L J Alderson R M&Hudec K L.

Moderators of working memory deficits in children with attention-deficit/hyperactivity disorder (ADHD):A meta-analytic review

[J]. Clinical Psychology Review, 2012,32(7):605~ 617.

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Kibby M Y Lee S E&Dyer S M.

Reading performance is predicted by more than phonological processing

[J]. Frontiers in Psychology, 2014,5(960):1~ 7.

URL     PMID:4168686      [本文引用: 1]

We compared three phonological processing components (phonological awareness, rapid automatized naming and phonological memory), verbal working memory, and attention control in terms of how well they predict the various aspects of reading: word recognition, pseudoword decoding, fluency and comprehension, in a mixed sample of 182 children ages 8-12 years. Participants displayed a wide range of reading ability and attention control. Multiple regression was used to determine how well the phonological processing components, verbal working memory, and attention control predict reading performance. All equations were highly significant. Phonological memory predicted word identification and decoding. In addition, phonological awareness and rapid automatized naming predicted every aspect of reading assessed, supporting the notion that phonological processing is a core contributor to reading ability. Nonetheless, phonological processing was not the only predictor of reading performance. Verbal working memory predicted fluency, decoding and comprehension, and attention control predicted fluency. Based upon our results, when using Baddeley model of working memory it appears that the phonological loop contributes to basic reading ability, whereas the central executive contributes to fluency and comprehension, along with decoding. Attention control was of interest as some children with ADHD have poor reading ability even if it is not sufficiently impaired to warrant diagnosis. Our finding that attention control predicts reading fluency is consistent with prior research which showed sustained attention plays a role in fluency. Taken together, our results suggest that reading is a highly complex skill that entails more than phonological processing to perform well.

Lam C M & Beale I L.

Relations among sustained attention,reading performance,and teachers’ ratings of behavior problems

[J]. Remedial and Special Education, 1991,12(2):40~ 47.

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Li J J, Cutting L E, Ryan M, Zilioli M Denckla M B&Mahone E M.

Response variability in rapid automatized naming predicts reading comprehension

[J]. Journal of Clinical and Experimental Neuropsychology, 2009,31(7):877~ 888.

URL     PMID:19221923      [本文引用: 1]

A total of 37 children ages 8 to 14 years, screened for word-reading difficulties (23 with attention-deficit/hyperactivity disorder, ADHD; 14 controls) completed oral reading and rapid automatized naming (RAN) tests. RAN trials were segmented into pause and articulation time and intraindividual variability. There were no group differences on reading or RAN variables. Color- and letter-naming pause times and number-naming articulation time were significant predictors of reading fluency. In contrast, number and letter pause variability were predictors of comprehension. Results support analysis of subcomponents of RAN and add to literature emphasizing intraindividual variability as a marker for response preparation, which has relevance to reading comprehension.

Li Wenling, Anderson R C, Nagy W&Zhang Houcan.

Facets of metalinguistic awareness that contribute to Chinese literacy

[C]// Li Wenling,Gaffney J S & Packard J L. Chinese Children’s Reading Acquisition: Theoretical and Pedagogical Issues. New York:Springer Science & Business Media, 2002: 87~ 106.

[本文引用: 2]

Liu P D & McBride-Chang C.

What is morphological awareness? Tapping lexical compounding awareness in Chinese third graders

[J]. Journal of Educational Psychology, 2010,102(1):62~ 73.

URL     [本文引用: 1]

ABSTRACT One hundred twenty-one third-grade Chinese children were assessed with a new morphological awareness task involving open-ended lexical compounding, in addition to completing other measures. With children's age, nonverbal intelligence, phonological awareness, and previously established measures of morphological awareness statistically controlled, this compounding production task significantly explained unique variance in both Chinese character reading and vocabulary knowledge. Within this new task, subordinate and coordinative structures were significantly easier to compound than were subject–predicate and verb–object structures. Moreover, novel compounds that made use of verb morphemes were more difficult to manipulate than were those that did not contain verbs. This newly developed task of compounding production may be optimal for tapping older children's morphological awareness in the form of lexical compounding, in both Chinese and possibly other languages. In addition, these results demonstrate that linguistic manipulations within tasks of morphological awareness can influence their difficulty levels. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Martinussen R& Tannock R.

Working memory impairments in children with attention-deficit hyperactivity disorder with and without comorbid language learning disorders

[J]. Journal of Clinical and Experimental Neuropsychology, 2006,28(7):1073~ 1094.

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McBride-Chang C, Shu Hua, Zhou Aibao W at C P&Wagner R K.

Morphological awareness uniquely predicts young children’s Chinese character recognition

[J]. Journal of Educational Psychology, 2003,95(4):743~ 751.

URL     [本文引用: 1]

Two unique measures of morphological awareness, along with other reading-related tasks, were orally administered to 100 kindergarten and 100 2nd-grade Hong Kong Chinese children. These morphological awareness tasks were developed on the basis of 2 special properties of Chinese: (a) the relatively large number of homophones requires speakers to distinguish unique meanings in syllables with identical sounds, and (b) complex vocabulary words are often built from 2 or more previously learned morphemes. Both tasks of morphological awareness predicted unique variance in Chinese character recognition in these children, after controlling for age, phonological awareness, speeded naming, speed of processing, and vocabulary. Developmentally, both tasks of morphological awareness improved with age. Results demonstrate that morphological awareness is uniquely important for early Chinese character recognition.

McInnes A, Humphries T H ogg-Johnson S&Tannock R.

Listening comprehension and working memory are impaired in attention-deficit hyperactivity disorder irrespective of language impairment

[J]. Journal of Abnormal Child Psychology, 2003,31(4):427~ 443.

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Perfetti C A. Reading Ability[M]. Oxford: Oxford University Press, 1985.

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Reynolds M & Besner D.

Reading aloud is not automatic:Processing capacity is required to generate a phonological code from print

[J]. Journal of Experimental Psychology, 2006,32(6):1303~ 1323.

[本文引用: 1]

Rucklidge J J & Tannock R.

Neuropsychological profiles of adolescents with ADHD:Effects of reading difficulties and gender

[J]. Journal of Child Psychology and Psychiatry, 2002,43(8):988~ 1003.

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Semrud-Clikeman M, Guy K Griffin J D&Hynd G W.

Rapid naming deficits in children and adolescents with reading disabilities and attention deficit hyperactivity disorder

[J]. Brain and Language, 2000,74(1):70~ 83.

URL     [本文引用: 1]

Shanahan M A, Pennington B F, Yerys B E, Scott A, Boada R, Willcutt E G Olson R K&Defries J C.

Processing speed deficits in attention deficit/hyperactivity disorder and reading disability

[J]. Journal of Abnormal Child Psychology, 2006,34(5):585~ 602.

URL     PMID:16850284      [本文引用: 1]

Abstract The goal of the current study was to test whether deficits in processing speed (PS) may be a shared cognitive risk factor in reading disability (RD) and Attention Deficit/Hyperactivity Disorder (ADHD), which are known to be comorbid. Literature on ADHD and RD suggests that deficits on tasks with a speeded component are seen in both of these disorders individually. The current study examined a wide range of speeded tasks in RD, ADHD, comorbid RD+ADHD, and a control group to test whether RD and ADHD have similar profiles of PS deficits, and whether these deficits are shared by the two disorders. The results suggest that a general PS deficit exists in both clinical groups compared to controls, although children with RD demonstrate greater PS deficits than children with ADHD. Two tests (underadditivity and partial correlations) were conducted to test whether these PS deficits are shared. Since we found that PS deficits were underadditive in the comorbid group and that partialling PS reduced the correlation between RD and ADHD, it appears that PS is a shared cognitive risk factor that may help explain the comorbidity of these two disorders.

Shu Hua , McBride-Chang C,Wu S&Liu Hongyun.

Understanding Chinese developmental dyslexia:Morphological awareness as a core cognitive construct

[J]. Journal of Educational Psychology, 2006,98(1):122~ 133.

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Swanson H L .

Reading comprehension and working memory in learning-disabled readers:Is the phonological loop more important than the executive system?

[J]. Journal of Experimental Child Psychology, 1999,72(1):1~ 31.

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Tannock R , Martinussen R&Frijters J.

Naming speed performance and stimulant effects indicate effortful,semantic processing deficits in attention-deficit/hyperactivity disorder

[J]. Journal of Abnormal Child Psychology, 2000,28(3):237~ 252.

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Tiffin-Richards M C, Hasselhorn M, Woerner W R othenberger A&Banaschewski T.

Phonological short-term memory and central executive processing in attention-deficit/hyperactivity disorder with/without dyslexia—evidence of cognitive overlap

[J]. Journal of Neural Transmission, 2008,115(2):227~ 234.

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Willcutt E G & Pennington B F.

Comorbidity of reading disability and attention-deficit/hyperactivity disorder:Differences by gender and subtype

[J]. Journal of Learning Disabilities, 2000,33(2):179~ 191.

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Willcutt E G, Pennington B F, Olson R K , Chhabildas N&Hulslander J.

Neuropsychological analyses of comorbidity between reading disability and attention deficit hyperactivity disorder:In search of the common deficit

[J]. Developmental Neuropsychology, 2005,27(1):35~ 78.

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Wisniewska B , Baranowska W&Wendorff J.

The assessment of comorbid disorders in ADHD children and adolescents

[J]. Advances in Medical Sciences, 2007,52(S1):215~ 217.

URL     PMID:18229669      [本文引用: 1]

The aim of these examinations undertaken by their authors was to run analysis concerning types and frequency of comorbid disorders occurrence in Attention Deficit Hyperactivity Disorders (ADHD) children and teenagers. Research, carried out from May 2005 to January 2007, in the area of the L d province, used a questionnaire, worked out by the above authors, addressed to parents of ADHD children and teenagers (research made in schools and among patients contacting the Clinical Psychology Institute of CZMP), and the study of medical documentation. 28 persons, 5 girls and 23 boys made the research group 7 to 13 years old (with an average age of 10.2), who had previously been ADHD diagnosed. Out of disorders pointed out by parents, school problems of different degree of intensity appeared the most frequent ones, (39% of the examined) 18% with diagnosed dyslexia, head injuries (in 12 cases--26%), bed-wetting at 8 boys (17% of all registered diseases). Moreover tics disorder was diagnosed in 3 boys, epilepsy in 2 boys, habitual activity in one girl and one boy. Head injuries, bed-wetting and dyslexia have most often been comorbid disorders. Boys with ADHD more often than ADHD girls, suffer from comorbid disorders. Desirable in the scope of ADHD diagnosis, further research on co-accompanying illnesses and its improvement.

Wu X, Anderson R, Li W, Wu X , Li H & Zhang J. Morphological awareness and Chinese children’s literacy development:An intervention study[J]. Scientific Studies of Reading, 2009(13):26~ 52.

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陈泊蓉 .

小学中高年级儿童汉语语素意识的发展特点及其与阅读理解的关系

[D]. 西安:陕西师范大学, 2011.

[本文引用: 1]

郭耀光, 陈强, 周翔, 静进 .

注意缺陷多动障碍儿童的工作记忆存储特征

[J]. 中国心理卫生杂志, 2012,26(6):419~ 423.

[本文引用: 1]

郝美玲, 张伟 .

语素意识在留学生汉字学习中的作用

[J]. 汉语学习, 2006(1):60~ 65.

[本文引用: 1]

李虹, 饶夏溦, 董琼, 朱瑾, 伍新春 .

语音意识、语素意识和快速命名在儿童言语发展中的作用

[J]. 心理发展与教育, 2011,27(2):158~ 163.

URL     [本文引用: 1]

以130名幼儿园小、中、大班儿童为研究对象,通过分层回归,系统比较了语音意识、语素意识和快速命名三种认知技能在学前儿童口语词汇、汉字识别和阅读理解等言语能力发展中的作用和相对重要性,结果发现:(1)学前儿童的各项能力随着年龄的增加而显著提高;(2)除了年龄因素之外,语音意识和语素意识是解释口语词汇的重要变量;(3)在控制了年龄和口语词汇量之后,语音意识、语素意识和快速命名能力都分别对汉字识别成绩具有独立的预测作用;(4)在控制了年龄、口语词汇量、汉字识别和其他两种认知技能之后,只有语素意识仍然能够独立预测阅读理解成绩,表明语素意识对于汉语阅读能力的发展具有独特的作用。

李建英, 邹小兵, 静进, 唐春, 陈凯云 .

注意缺陷多动障碍儿童执行功能特征

[J]. 中国心理卫生杂志, 2005,19(3):162~ 165.

URL     [本文引用: 1]

目的:探讨注意缺陷多动障碍(ADHD)儿童执行功能的特征.方法:采用Stroop效应、视觉和听觉Go/No-Go反应、倒背数字、延缓期的空间位置记忆广度、伦敦塔任务和连线测验分别测试40例ADHD儿童和25例正常对照组儿童的反应抑制、语音工作记忆、视空间工作记忆、计划能力和定势转移能力.结果:1.ADHD儿童完成字义与字色相矛盾的字色命名时间较正常对照组儿童明显延长(P<0.05).2.ADHD儿童完成视觉和听觉的Go/No-Go反应所犯错误数均较正常对照组儿童明显增多(P<0.01).3.ADHD儿童倒背数字分数和延缓期的空间位置记忆广度均较正常对照组儿童明显低(P<0.01).4.ADHD儿童完成两步、四步和五步伦敦塔任务的时间均较正常对照组儿童明显延长、犯错误数明显增多(P<0.05);而完成四步、五步伦敦塔任务的最初计划时间则较正常对照组儿童明显缩短(P<0.01).5.ADHD儿童完成连线测验甲式的时间和犯错误数与正常对照组儿童无显著性差异(P>0.05),而完成乙式所需时间则较正常对照组儿童明显延长、犯错误数较正常对照组儿童明显增多(P<0.05).结论:ADHD儿童存在反应抑制、语音工作记忆、视空间工作记忆、计划能力和定势转移能力等多项执行功能的缺陷.

刘海润, 秦岭, 张鸿, 傅燕红, 李丹丹, 梁正友 .

Das-Naglieri认知评估系统对注意缺陷多动障碍儿童认知过程评估的对照研究

[J]. 中华实用儿科临床杂志, 2016,31(7):540~ 543.

URL     [本文引用: 1]

目的 了解Das-Naglieri认知评估系统(DN:CAS)对注意缺陷多动障碍(ADHD)儿童认知过程的评价情况.方法 采用DN:CAS对61例ADHD儿童以及与其年龄、性别相匹配的61例健康对照组儿童进行测验,比较2组测验量表分结果的差异.结果 ADHD组与健康对照组的DN:CAS4个分测验中的计划测验[(24.18±5.64)分比(30.07±5.28)分,t=-6.985,P<0.01]、同时性加工测验[(33.97 ±7.64)分比(36.90±7.20)分,t=-2.211,P<0.05]、注意测验[(26.52±6.80)分比(31.21±5.86)分,t=-4.909,P<0.01]以及总分[(117.85±21.45)分比(132.48±17.95)分,t=-5.286,P<0.01]的量表分差异均有统计学意义.其中计划测验中的数字匹配[(8.77±2.33)分比(10.87±2.31)分,t=-5.220,P<0.01]、计划编码[(7.87±2.37)分比(9.44±2.61)分,t=-4.006,P<0.01]、计划连接[(7.54±2.29)分比(9.75±2.01)分,t=-6.643,P<0.01]、同时性加工测验中的言语-空间关系[(10.05±2.79)分比(11.23 ±3.19)分,t=-2.382,P<0.05]以及注意测验中的表达性注意[(9.02±2.47)分比(10.34±3.03)分,t=-2.938,P<0.01]、数字检测[(8.16±2.31)分比(10.08±1.86)分,t=-5.028,P<0.01]、接受性注意[(9.34±3.68)分比(10.78±3.20)分,t=-3.215,P<0.01]的量表分差异均有统计学意义.ADHD组与健康对照组的计划测验量表分、注意测验量表分及总量表分的百分等级分布差异均有统计学意义(P均<0.05).结论 ADHD儿童存在认知过程缺陷,以计划功能和注意功能缺陷为主要特征.DN:CAS在ADHD儿童认知过程的评估方面具有一定的应用价值.

刘豫鑫, 王玉凤 .

注意缺陷多动障碍儿童认知特点的研究

[J]. 中华医学杂志, 2002a,82(6):389~ 393.

URL     [本文引用: 3]

目的 探索注意缺陷多动障碍 (ADHD)儿童认知功能特点。方法 对 6 0例ADHD门诊患儿 ,以及按年龄、性别、母亲文化程度配对的 6 0名正常儿童进行认知功能评定。结果 ADHD儿童言语智商、操作智商、全量表智商及A、B、C因子 (分别为 10 4± 13,98± 14 ,10 2± 13,10 4± 13,10 0± 15 ,10 2± 15 )均低于对照组 (分别为 112± 11,10 8± 13,112± 12 ,111± 12 ,10 7± 13,116± 13) ,差异有非常显著意义 (P均 0 0 1) ;韦氏记忆测验中 ,ADHD儿童长时、短时、瞬时记忆、记忆商及倒背数字得分 (分别为 4 0± 7,5 8± 12 ,7± 3,95± 15 ,4 2± 1 7)亦明显低于对照组 (分别为 4 9± 5 ,6 3± 10 ,8± 3,10 9± 12 ,5 0± 1 4 ) ,差异有显著意义 (P均 0 0 5 ) ;ADHD儿童数字划消测验总分低于对照组 ,平均失误率高于对照组 ,差异有非常显著意义 (P均 =0 0 0 0 ) ;Stroop测验中 ,ADHD组A、B、C、D部分完成时间及字义干扰时明显延长 (P均 =0 0 0 0 ) ,C、D部分的错误数显著增加 (P均 0 0 1) ;瑞文测验标准分等级也低于对照组 (P =0 0 0 0 )。结论 ADHD儿童智力、记忆力、注意力水平低于正常儿童 ,且具有选择性抑制、语音信息的工作记忆和计划的执行功能缺陷。

刘豫鑫, 王玉凤 .

伴与不伴学习困难的注意缺陷多动障碍患儿认知特点的比较

[J]. 中华精神科杂志, 2002b,35(4):220~ 223.

URL     [本文引用: 1]

目的:探讨伴与不伴学习困难(LD)注意缺陷多动障碍(ADHD)患儿认知特点的异同。方法:运用韦氏儿童智力量表(C-WISC)、韦氏记忆量表,数字划消测验、Stroop测验和瑞文标准推理测验,对66例仅患ADHD患儿(ADHD组)生29例合并LD的ADHD患儿(ADHD+LD组)的智力、记忆力、注意力及执行功能进行比较。结果:(1)ADHD组的平均年龄[(9.5±2.0)岁]小于ADHD+LD组[(11.3±2.3)岁],差异有显著性(P<0.05);(2)ADHD组在C-WISC中仅注意/不分心因子分[(102±13)分]高于ADHD+LD组[(96±13)分],差异有显著性(P=0.028),其余各项测验结果两组间的差异均无显著性(P>0.05)。结论:ADHD+LD组注意/不分心因子受损更严重,其余认知模式与ADHD组相似。

卢又燃, 耿道颖, 冯晓源, 杜亚松, 赵志民 .

注意缺陷多动障碍儿童语义工作记忆的功能MRI研究

[J]. 中华放射学杂志, 2006,40(11):1129~ 1113.

[本文引用: 1]

帅澜, 王玉凤 .

共患学习困难的注意缺陷多动障碍男孩的执行功能特点

[J]. 北京大学学报(医学版), 2007,39(5):526~ 530.

Magsci     [本文引用: 1]

目的:探讨共患学习困难(LD)的注意缺陷多动障碍(ADHD)男孩的执行功能特点.方法:以年龄、ADHD亚型相匹配的符合美国《精神障碍诊断与统计手册(第4版)》(DSM-Ⅳ)诊断标准的ADHD共患LD,单纯ADHD和正常对照各22例男孩为研究对象,采用Stroop色词命名、Rey复杂图形记忆、数字广度、连线测试、汉诺塔和言语流畅性任务,对研究对象执行功能的各个层面进行评估.结果:(1)两病例组在数字字母连线时间及错误数、转换耗时,言语流畅性重复数的测验成绩均明显比正常对照组差,但两病例组之间的差异无统计学意义.(2)共患组在Stroop1试和2试的耗时及错误数、4试耗时、字义干扰时,Rey复杂图形即时记忆和延迟回忆的细节得分,数字连线时间,汉诺塔犯规次数的测验成绩均明显比正常对照组差.(3)共患组和单纯组在Stroop4试的错误数显著多于正常组,且共患组的错误数显著多于单纯组.结论:单纯ADHD组和ADHD共患LD组与正常儿童相比,在反应抑制、工作记忆、定势切换和言语流畅性的执行功能层面上存在明显受损;共患LD组与单纯ADHD组相比,其执行功能受损的范围更广、程度更重.

隋雪, 马立波, 王彦 .

汉语发展性阅读障碍儿童语素理解研究

[J]. 中国特殊教育, 2009(5):93~ 96.

URL     [本文引用: 1]

本研究通过比较汉语发展性阅读障碍儿童和阅读正常儿童完成同音语 素理解任务的情况,来测查汉语发展性阅读障碍儿童的语素理解能力.结果发现,不同年级、不同性别的阅读障碍组判断成绩都比阅读正常组差,且差异显著.研究 的结果提示我们,汉语发展性阅读障碍儿童语素理解存在缺陷,支持汉语的语素意识缺陷是汉语发展性阅读障碍的原因.

陶沙 .

语音加工技能在汉语为母语个体英语学习中的作用

[J]. 北京师范大学学报(社会科学版), 2004(3):38~ 45.

[本文引用: 2]

童连, 史慧静, 臧嘉捷 .

中国儿童ADHD流行状况meta分析

[J]. 中国公共卫生, 2013,29(9):1279~ 1283.

URL     Magsci     [本文引用: 1]

<p><strong>目的</strong> 了解中国儿童注意缺陷多动障碍(ADHD)的流行水平和特点,探讨影响其发病率因素。<strong>方法</strong> 通过对1983&mdash;2011年已正式发表的中文调查研究资料进行系统回顾,采用Meta分析对其原始数据进行定量分析,并用Meta回归探索发病率的影响因素。<strong>结果</strong> 共33篇论文纳入分析,结果显示,我国儿童ADHD总体发病率为5.7%(95%<em>CI</em>=4.9%~6.6%),男童总发病率为7.5%(95%<em>CI</em>=6.4%~8.8%),女童总发病率为3.4%(95%<em>CI</em>=2.7%~4.4%);我国近年儿童ADHD发病率呈逐渐上升趋势,不发达地区发病率最高,小学生大于学龄前儿童;Meta回归结果显示,调查时间、地区、受调查对象年龄、样本量大小和诊断标准均是影响发病率的重要因素。<strong>结论</strong> 规范研究设计,制定&quot;筛查&quot;和&quot;诊断&quot;的不同标准,并严格执行;应重视不发达地区儿童及学龄前儿童ADHD的流行情况。</p>

王恩聪, 孙黎, 宋艳, 吴占良, 何华, 陈进, 曹庆久, 赵希希, 王玉凤 .

注意缺陷多动障碍儿童阅读能力初探

[J]. 中国心理卫生杂志, 2014,28(6):434~ 439.

[本文引用: 2]

王璐, 范国光, 于兵, 麻宏伟, 潘学霞, 郭启勇 .

ADHD儿童反应时和DTI部分各向异性值相关性研究

[J]. 中国医学影像技术, 2008,24(4):489~ 492.

URL     [本文引用: 1]

目的初步探讨注意缺陷多动障碍(ADHD)儿童反应时和大脑主要投射、联络和连合纤维的DTI部分各项异性(FA)值间相关性,以及这种相关性和正常对照组间有无不同,为揭示ADHD儿童反应时改变的可能神经基础提供帮助。方法以16名ADHD儿童和性别、年龄、利手及受教育程度方面相匹配的正常儿童为研究对象,采用分类n-Back工作记忆任务和DTI成像,对两组平均正确反应时和FA值进行统计学分析。结果与正常对照相比,ADHD组平均正确反应时[对照组为(626.92±41.28)ms;ADHD组为(700.45±66.98)ms]明显延长(P0.01),其双侧扣带束(CB)(右侧CB:P0.05;左侧CB:P0.05)、右侧胼周额部深部白质(PCF)(P0.01)的平均FA值显著减低。ADHD儿童右侧CB、双侧小脑中脚(MCP)的mFA和mRT间呈显著负相关;对照组右侧PCF、双侧内囊前肢(AIC)的mFA和mRT间亦呈显著负相关。结论在执行工作记忆任务时,ADHD儿童参与的神经网络可能与正常儿童不同。ADHD儿童的白质纤维束的结构异常可能介导着其行为学异常。

王淑玉, 赵丽, 张秋河, 潘玉夏, 吕朝霞 .

持续性注意测验在注意缺陷多动障碍儿童中的应用

[J]. 中华行为医学科学, 2005,14(8):718~ 720.

URL     [本文引用: 1]

本研究采用持续性操作测验(CPT)对注意缺陷多动障碍(ADHD)儿童进行注意力检测,以了解注意缺陷多动儿童的注意特点.

吴思娜, 舒华, 王彧 .

4~6年级小学生发展性阅读障碍的异质性研究

[J]. 心理发展与教育, 2004,20(3):46~ 50.

[本文引用: 1]

吴思娜, 舒华, 刘艳茹 .

语素意识在儿童汉语阅读中的作用

[J]. 心理与行为研究, 2005,3(1):35~ 38.

URL     Magsci     [本文引用: 2]

文章考察了语音意识、语素意识和命名速度在儿童汉语阅读中的作用。结果发现:语素意识和命名速度对汉字命名组词具有显著的预测作用;而语素意识和语音意识对同音字识别具有显著的预测作用。语素意识是唯一显著预测两种不同阅读任务的认知变量。对阅读障碍儿童所存在的缺陷进行分析,结果发现:76%的阅读障碍存在语素缺陷;相比之下,分别有43%和41%的阅读障碍存在语音缺陷和命名速度缺陷。结果表明汉语的语素意识在儿童阅读中具有重要作用,语素缺陷有可能成为儿童汉语阅读困难的主要原因。

杨斌让, 李建英, 杨思渊, 彭刚, 叶妙婷 .

注意缺陷多动障碍儿童的工作记忆损害特征

[J]. 中国心理卫生杂志, 2012,26(1):41~ 45.

[本文引用: 1]

张洁 .

小学儿童汉语词素意识的发展与促进

[D]. 北京:北京师范大学, 2004.

[本文引用: 1]

张微, 宋红艳 .

ADHD儿童的解码能力及与语音记忆关系的研究

[J]. 中国学校卫生, 2010,31(1):51~ 52.

URL     [本文引用: 2]

目的测查ADHD儿童的解码能 力和语音短时记忆及工作记忆能力,探讨语音记忆与解码的关系。方法使用《小学生标准识字量测查》测查64名儿童(32名ADHD儿童,32名正常儿童)的 识字水平,使用韦氏记忆测验测查被试的语音记忆广度。结果与正常儿童相比,ADHD儿童的识字水平明显落后,ADHD儿童在正背数字任务上成绩正常,但是 在倒背数字任务上成绩落后。倒背数字任务成绩与解码成绩相关有统计学意义。结论ADHD儿童解码能力明显落后,可能与其缺损的语言工作记忆有关。

赵鑫, 付丽, 周仁来 . 我国注意缺陷多动障碍儿童工作记忆研究的文献计量分析[J]. 中国特殊教育, 2011(

12):

43, 73~ 76.

[本文引用: 1]

赵微, 陈泊蓉 .

影响小学生汉语阅读的认知因素

[J]. 心理与行为研究, 2015,13(3):367~ 374.

URL     Magsci     [本文引用: 1]

以287名3-6年级小学生为被试,分析影响汉语阅读理解的语言学认知因素。结果表明:(1)语素意识、语音意识和正字法意识与汉语阅读理解均有显著相关,语素意识是汉语阅读理解最显著的预测变量;(2)阅读困难组和阅读水平匹配组的语音意识、语素意识和正字法意识的差异不显著;阅读困难组的语素意识和正字法意识显著低于年龄匹配组,语音意识差异不显著。研究结果提示了汉语阅读困难是一种发展迟滞,该研究结果对汉语学习困难的评估与教育干预有重要意义。

钟毅平 .

中国香港双语儿童初步阅读能力与语音、文字加工关系的研究

[J]. 心理科学, 2002,25(2):173~ 176.

[本文引用: 1]

周勤学, 张群会 .

注意缺陷多动障碍儿童认知状况对照研究

[J]. 精神医学杂志, 2013,26(6):409~ 411.

[本文引用: 1]

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