关键词: ADHD, 注意缺陷多动障碍, 干预, 元分析

Abstract: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurobehavioral disorder for children. They are at high risk relative to the normal population with respect to scholastic and social failure in school settings. Practice calls for effective interventions to decrease the developmental risk of ADHD. So a comprehensive evaluation on all the existing interventions is needed. There have been many descriptive and meta-analytic reviews on this topic in the West. However, the results from western reviews cannot be applied to China directly. First, the diagnostic criteria are different between the West and China; second, Traditional Chinese Medicine is an important intervention that is not used in the West; third, parents in China have more apprehensions on drug treatment and attach more importance on academic performance. So a meta-analytic approach was used to examine the effects of treatment with Attention deficit/hyperactivity disorder children in China.
A search was made of the CNKI (National Knowledge Infrastructure) databases. In order to decrease the heterogeneity among different treatment outcomes, we limited the search to articles published from 1994 to 2005 (the year in which the meta-analysis was commenced). Criteria for including studies in the sample were that the type of intervention and outcome measures be sufficiently well described to enable classification and that it be possible to calculate an effect size. Additional criteria for selection of studies were that if children have more than one disorder, ADHD should be primary. Besides, the study should employ pretest-posttest design or control group design. We were able to locate 62 unique studies that met these criteria. Studies that met inclusion criteria were systematically coded based on specific features of the article. Coded variables included: number of participants, sex of participants, age range of participants, treatment time, type of intervention, and outcome relating to the type of treatment. The effect size is the difference between the mean of outcome measures at the end of the program and the mean prior to commencing the intervention (post-pre means) or the mean of the outcome measures administered in a treatment group compared to the mean of the outcome measures administered to a control group. In all cases, this difference between the mean is divided by the appropriate pooled group standard deviation.
The results showed that: (1) The interventions aimed to improve the behavioral, academic, cognitive and/or social functioning of children with attention deficit/hyperactivity disorder have obvious effects. (2) Overall, the combined interventions have the largest effects, then larger for medical interventions and smaller for behavioral or cognitive-behavioral interventions. (3) Overall, there were larger effects of the various interventions on academic than on other outcomes, which is not consistent with foreign meta-analysis results. (4) Among indicators from different resources, the objective observations have the largest effects, then the parental rating, and then the teacher’s rating. (5) Various interventions have different effects on different effect indices.
The quality of intervention approaches, effect indexes and study quality were discussed according to the results described above

Key words: ADHD, attention-deficit/hyperactivity disorder, intervention, meta-analysis