Studies Of Verbal Working Memory In Children With ADHD

Objective: To study the characteristics of verbal working memory in children with Attention-Deficit/Hyperactivity Disorder(ADHD)through Test of Narrative Language(TNL)in Chinese,and which was compared among normal children.We discussed the characteristics of verbal working memory(VWM),outcome of different treatment methods and the relationship between VWM and IQ,intervention and some other factors respectively.Methods: 97 children were recruited.Children aged from 5 to 11 years who were typically developing or diagnosed with ADHD according to American Diagnostic and Statistical Manual,Version V(DSM-V)were admitted.The average age was 7.98±1.11 years old.All children were divided into 4 groups,in detail,33 typically developing children,19 children with ADHD who had behavioral intervention,19 children with ADHD who had short-time medical intervention,26 children with ADHD who had long-time medical intervention.All of them were asked to have the test of TNL,Wechsler Intelligence Scale for Children-R(WISC-R),Wechsler Preschool and Primary Scale of Intelligence(WPPSI),SNAP-IV and so on.TNL was tested before to permit the feasibility,and it was used to evaluate the VWM of children with ADHD during the follow-up study.All data was analyzed by SPSS 19.0(Chinese).Results: There was difference of narrative-language ability and oral narration among children in groups with comparative age(population percentage P<0.05,level P<0.05)while there was no difference of the narrative comprehension(population percentage P>0.05,level P>0.05),and it trended that the control group was better than the ADHD long-term medical intervention group,short-term intervention one and behavioral intervention one.ANOVA showed that ADHD children’s deficits of oral-narration ability was more obvious than narrative-comprehension one.There was difference of oral-narration ability(P<0.05)while narrative-comprehension one went by contraries(P>0.05).Different therapies had different effects on the promotion of VWM among groups(P<0.05).The influence of behavioral intervention on the improvement of VWM was limited,and long-term medical intervention did better than short-term one.ADHD children’s VWM could catch up with normal children’s one after long-term medical intervention.ANOVA showed that there was no difference of improvement of narrative-comprehension ability(P>0.05)while that of oral-narration ability went by contraries(P<0.05).Analysis of the related factors:1)the parents’ educational level influenced ADHD children’s VWM,and there was difference of parents’ educational level among groups(P<0.05).Parents in ADHD medical intervention group had the highest educational level,undergraduate and above accounted for 61.1% of the total number in the same group;2)there was no difference of IQ(P>0.05).In the intelligence test which included arrangement,count,decoding,puzzle,it showed that the ADHD behavioral intervention group fell behind ADHD medical intervention group(P<0.05);3)the ADHD type of each group was different(P<0.05).ADHD behavioral intervention group was mainly made up of with attention-deficit type(57.9%),short-term medical intervention group was mainly made up of with mixed type(42.1%),long-term medical interventiongroup was mainly made up of with attention-deficit type(72%);4)the promotion of ADHD children’s VWM had negative relationship with children’s primary ability.Besides,there were some other influential factors which included verbal IQ(r2=-0.406),hyperactivity degree(r2=-0.257),parents’ educational level(father r2=-0.246,mother r2=-0.225);5)VWM’s improvement was related with the improvement of inhibition,and there was difference of the promotion of SNAP-IV average scores among groups(P<0.05);6)children’s age,grade,care-giver,extra classes didn’t influence VWM(P>0.05).Conclusion: Children with ADHD had deficits in the ability of narrative language as well as VWM.However,the deficits can’t be recognized by regular WISC-R and WIPPSI.The deficits were characterized by ‘oral-narration more obvious than narrative-comprehension’.Intervention brought promotion of the narrative-language to children with ADHD.The influence of behavioral intervention on the improvement of VWM was limited,and long-term medical intervention did better than short-term one.ADHD children’s VWM could catch up with normal children’s one after long-term medical intervention.It was more difficult to improve oral narration than narrative comprehension,and long-term medical intervention was helpful to the promotion of oral narration.The difference of educational level affected the compliance of children with ADHD during the follow-up.The higher the educational level was,the better the compliance was.Parents in ADHD long-term medical intervention group had the highest educational level,so we should pay more attention to the education and guidance of low educational level parents,and guide the parents to make reasonable and effective diagnosis and treatment.We suggested to add TNL into regular clinical assessments for ADHD children and to improve the specificity and efficiency of intervention.