Characteristics Of Executive Function And Effectiveness Of Rule Play Intervention In Preschool Children With ADHD

Attention-deficit/hyperactivity disorder(ADHD)is one of the common neurodevelopmental disorders in children,which have serious challenges for parents and teachers to educate because of its inattention and hyperactivity behaviors.Early discovery and early intervention can significantly reduce the secondary problems in children’s later life,which has realistic need for children with ADHD.At the same time,studies of school-age children and adults have demonstrated that executive dysfunction is a core cognitive deficit of ADHD,but whether this conclusion applies to preschool children with ADHD remains controversial.Little research has systematically discussed the executive function of preschool children with ADHD in China,and the global characteristics,age characteristics,and subtype characteristics of executive functioning in preschool children with ADHD need to be revealed by research.Two main contents are set out in this study.In the first part,quantitative method is adopted to explore the executive function characteristics which include inhibitory control(response inhibition and interference inhibition),working memory(verbal working memory and visual working memory)and cognitive flexibility(simple cognitive flexibility and complex cognitive flexibility).Response inhibition was measured by the Fish-Shark GO/NO-GO task,interference inhibition was tested by the yellow-blue strip task,verbal working memory was explored by the digit span task,visual working memory was evaluated by the picture working memory task,simple cognitive flexibility was appraised by the single-dimension card dimension classification task,complex cognitive flexibility was assessed by double-dimension card dimension classification task.This part is systematically described from three aspects: global characteristics,age characteristics and subtype characteristics.In the second study,nested mixed design which combine quantitative method and qualitative method was used to investigate the effectiveness of the circle time game intervention on preschool children with ADHD.The performance of executive function,ADHD symptoms,and school behaviors of preschool children with ADHD were analyzed to illustrate the effectiveness of the circle time game intervention.The study analysed the scope of pre-test and post-test between the intervention group and control group in executive function,teachers’ and parents’ Conner’s scale,SNAP-IV scale,and the teacher’s report of the School Behavior.This study found:(1)Executive dysfunction exists in preschool children with ADHD.Compared with TD children,there were significant deficits in response inhibition,interference inhibition,verbal working memory and complex cognitive flexibility in preschool children with ADHD,but no significant deficits in visual working memory and simple cognitive flexibility.(2)There are differences between preschool ADHD children and TD children in executive function development.There were significant age main effects on response inhibition,verbal working memory,visual working memory,simple cognitive flexibility and complex cognitive flexibility in ADHD children,while there were no age main effects on interference inhibition.There were significant age main effects on response inhibition and interference inhibition in TD children,but there were no age main effects on verbal working memory,visual working memory,simple cognitive flexibility and complex cognitive flexibility.(3)There were subtype differences in executive function of preschool children with ADHD.After controlling IQ and gender,children with ADHD-C had significant deficits in response inhibition,interference inhibition and verbal working memory.Children with ADHD-HI had significant deficits in response inhibition and interference inhibition.Children with ADHD-IN had significant deficits in response inhibition and verbal working memory.(4)The rule play intervention improved executive function in preschool children with ADHD.There was significant time-group interaction effects on response inhibition and verbal working memory.There was no significant difference in the intervention effect of other executive function components between the two grades,but complex cognitive flexibility.The current finding demonstrates that the intervention effect of senior class children with complex cognitive flexibility was significantly higher than that of middle class children.There was no significant difference in the effect of executive function intervention among the three subtypes of ADHD children.(5)The rules play intervention reduced ADHD symptoms.There were significant time-group interaction effects in the scores of hyperactivity index,hyperactivity/impulsivity scores and the scores of hyperactivity index by teachers.Thid study also found significant time-group interaction effects in the scores of hyperactivity index and attention deficit by parents.There was no significant difference in intervention effect between senior class children and middle class children.There was no significant difference in intervention effect among the three subtypes of ADHD children.(6)The rule play intervention promoted the adaptive behavior of preschool children with ADHD in school.The results of "School Behavior Evaluation Form for Preschool Children" and teacher interviews showed that the children in the intervention group had significantly promoted their classroom-related behaviors,their awareness of rules,and their social integration.The duration of intervention and the ecology of intervention system will affect the intervention effect.