教育生物学杂志

目的探讨视听整合连续测试（integrated visual and auditory continuous performance test, IVACPT）对不同年龄注意缺陷多动障碍（attention deficit and hyperactivity disorder, ADHD）儿童的临床诊断价值。方法 对2021年3月—2022年7月因怀疑ADHD而就诊的604例6～16岁儿童，以《精神障碍诊断和统计手册（第5版）》（Diagnostic and Statistical Manual of Mental Disorders, 5th edition, DSM-5）作为诊断标准回顾性分析IVA-CPT的测评结果。将儿童按年龄分组，分析两种评估方式（DSM-5与IVA-CPT）的差异。结果 IVA-CPT诊断ADHD的灵敏度为60.00%～82.22%，特异度为51.28%～63.16%；两种评估方式在6～11岁各组中具有一般至中等的诊断一致性（Kappa=0.275～0.407, P<0.05）。IVA-CPT对各组儿童ADHD的分型结果显示：注意缺陷型的灵敏度为51.52%～75.00%，特异度为52.63%～68.89%；多动/冲动型的灵敏度为40.90%～66.67%，特异度为55.71%～92.16%；混合型的灵敏度为40.00%～62.50%，特异度为67.86%～91.38%。在6～10岁各组中，两种方式评估注意缺陷症状的一致性有统计学意义（Kappa=0.238～0.373,P<0.05）；在6岁组，两种方式评估多动/冲动症状的一致性有统计学意义（Kappa=0.374,P<0.05）。结论 IVA-CPT适合用于6～10岁儿童的ADHD筛查，对11岁以上儿童需结合临床观察及其他测试结果综合判断。在分型诊断中，IVA-CPT对6～10岁注意缺陷型ADHD儿童有一定的辅助诊断价值；对11岁以上注意缺陷型ADHD、所有年龄多动/冲动型和混合型ADHD儿童，使用IVA-CPT评估时应谨慎判断。

Objective To investigate the diagnostic value of integrated visual and auditory continuous performance test(IVA-CPT) in children with attention deficit and hyperactivity disorder(ADHD) at different ages. Methods A total of 604 children aged 6 to 16 years with suspected ADHD from March 2021 to July 2022 were collected. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition(DSM-5) was used as diagnostic criteria to retrospectively analyze the results of IVA-CPT. Children were grouped by age to compare the differences between the two evaluation methods(DSM-5 and IVA-CPT). Results The sensitivity of IVA-CPT was 60.00%-82.22% and the specificity was 51.28%-63.16%. There were average to moderate agreements between DSM-5 and IVA-CPT in the 6-11 years old groups(Kappa=0.275-0.407, P<0.05). The classification results of ADHD in each group by using IVA-CPT showed that the sensitivity of attention deficit type was 51.52%-75.00% and the specificity was 52.63%-68.89%; the sensitivity of hyperactivity/impulsivity type was 40.90%-66.67% and the specificity was 55.71%-92.16%; the sensitivity of combined type was 40.00%-62.50% and the specificity was 67.86%-91.38%. There were statistically general agreements between the two assessments in 6-10 years old groups with attention deficit type(Kappa=0.238-0.374, P<0.05) and in 6 years old group with hyperactivity/impulsivity type(Kappa=0.374, P<0.05). Conclusion IVA-CPT is suitable for screening ADHD in children aged 6-10 years. For children aged 11 and above, a comprehensive judgment should be made based on clinical observations and other test results. In classification diagnosis, IVA-CPT has certain auxiliary diagnostic value in children aged 6-10 years with attention deficit type. For children aged 11 and above with attention deficit type and children of all ages with hyperactivity/impulsivity and mixed ADHD, it should be cautious to use IVA-CPT assessment.