注意缺陷多动障碍儿童人际关系与学业表现的关系.pdf

142校园心理2 0 2 4年4月第2 2 卷第2 期Journal of Campus Life&Mental Health,April 2024,Vol.22,No.2注意缺陷多动障碍儿童人际关系与学业表现的关系李静1于晓丹1张晓敏1中国海洋大学教育系，山东青岛2 6 6 10 0；2 荣成市第三十五中学，山东威海2 6 430 0通信作者：于晓丹，Email：y u x i a o d a n o u c.e d u.c n【摘要】目的探讨注意缺陷多动障碍（attention deficit hyperactivity disorder，A D H D）儿童不同类型人际关系与学业成绩的关系，以期为ADHD儿童的人际关系改善和学业提升提供科学依据。方法使用注意缺陷多动障碍筛查量表父母问卷（SNVP-IV）人际关系量表和科学成就测验对山东省青岛市选取的6 452 名四年级儿童进行调查，对筛查出的338 名ADHD儿童进行统计分析。结果城市的ADHD儿童学业表现高于农村儿童（P0.01）；A D H D 儿童人际关系与学业表现呈正相关（r=0.23，P 0.0 1），其中亲子关系、同伴关系及师生关系均与学业表现呈正相关（r=0.22，P 0.0 1；r=0.2 4，P 0.0 1；r=0.13，P0.05），同伴关系与ADHD儿童学业表现的相关性最高（r=0.24，P 0.0 1）；在控制性别、户口性质、独生子女因素后，ADHD儿童同伴关系能够正向预测学业表现（=0.17，P 0.0 5）。结论农村ADHD儿童学业表现较差，ADHD儿童人际关系与学业表现有关，同伴关系对ADHD儿童学业表现的影响最大。【关键词】注意缺陷多动障碍；人际关系；学业表现；儿童基金项目：山东省青岛市社会科学规划研究项目（QDSKL2001017）D0I:10.19521/ki.1673-1662.2024.02.010Effects of interpersonal relationships on academic performance in children with ADHDLi Jing,Yu Xiaodan,Zhang XiaominDepartment of Education,Ocean University of China,Qingdao,Shandong 266100,China;Rongcheng 35 th MiddleSchool,Weihai,Shandong 264300,ChinaCorresponding author:Yu Xiaodan,Email:Abstract Objective To explore the relationship between different types of interpersonal relationshipsand academic achievement in children with Attention deficit hyperactivity disorder(ADHD),and to provide ascientific basis for the improvement of interpersonal relationship and academic enhancement in children withADHD.Methods A total of 6,452 randomly selected fourth-grade children in Qingdao,Shandong Province,were surveyed using the Screening Scale for the Attention Deficit Hyperactivity Disorder Screening Scale-ParentQuestionnaire(SNVP-IV),Interpersonal Relationship Scale and Scientific Achievement Test,and screened 338children with ADHD were statistically analyzed.Results The academic performance of urban children withADHD was significantly higher than that of rural children(P0.01).There was significant positive correlationbetween interpersonal relationship and academic performance of ADHD children(r=0.23,P0.01),with parent-child,peer and teacher-student relationship all being significantly positively correlated with academic performance(r=0.22,P0.01;r=0.24,P0.01;r=0.13,P0.05),peer relationship had the highest correlation with the academicperformance of ADHD children(r=0.24,P0.01).After controlling for gender,household registration and onlychild,peer relationship of ADHD children could significantly positively predicted academic performance(=0.17,P0.05）；独生子女在学业表现、人际关系的得分比非独生子女高，其中亲子关系、同学关系得分高于非独生子女，师生关系低于非独生子女，但差异无统计学意义（P0.05）；城市ADHD儿童人际关系得分低于农村儿童，其中亲子关系、同学关校园心理2 0 2 4年4月第2 2 卷第2 期JJournal of Campus Life&Mental Health,April 2024,Vol.22,No.2系得分高于农村儿童，师生关系低于农村儿童，但差异无统计学意义（P0.05）。城市ADHD儿童的学业成绩高于农村ADHD儿童（P0.01）。2.2ADHD儿童人际关系与学业表现的相关分析ADHD儿童人际关系与学业表现呈正相关（r=0.2 3，P 0.0 1），其中亲子关系、同学关系、师生关系与学业表现均呈正相关（r=0.22，P0.01;r=0.24,P0.01;r=0.13,P0.05）。2.3ADHD儿童人际关系与学业表现的回归分析在排除性别、户口性质、独生子女因素的干扰后，ADHD同学关系能够正向预测学业表现，线性回归模型有统计学意义（=0.17，P 0.0 5），说明ADHD同学关系对其学业表现具有非常显著的正向预测作用，见表2。3 讨 论3.1农村ADHD儿童学业成绩比城市低研究发现，与城市ADHD儿童相比，农村患儿的学业表现较低，与以往研究结果大致相同2 3。造成这种结果的主要原因是不同地理位置的差异，农村患儿能力发展和取得卓越成就的机会有限2 4。第一，城乡社会资源不均衡。生活在贫困或主要城市以外地区的ADHD儿童患病率高，可能因为医疗条件跟不上从而病情加重2 5，教育资源的缺乏也使得农村ADHD儿童无法获得优质教育条件导致较差的学业成绩2 6。第二，农村教育者相关意识薄弱。Calthorpe 和 Pantell27 的研究表明，与城表1注意缺陷多动障碍儿童的人际关系和学业表现的人口学特征（XS）性别男性女性t值P值是否独生子女人数是26374t值P值户口性质城市农村t值P值人数204134人数40297亲子关系3.06 0.493.08 0.550.470.64亲子关系3.09 0.493.00 0.591.220.22亲子关系3.13 0.563.06 0.510.870.39同学关系3.09 0.683.18 0.70-1.190.24同学关系3.13 0.693.11 0.680.210.84同学关系3.19 0.693.12 0.690.590.56师生关系3.28 0.673.33 0.61-0.710.48师生关系3.28 0.663.35 0.60-0.780.44师生关系3.17 0.693.31 0.64-1.300.20人际关系3.15 0.493.20 0.49-0.940.35人际关系3.18 0.493.17 0.480.110.91人际关系3.16 0.523.18 0.49-0.180.86学业表现476 111453 1011.860.06学业表现471 108452 1071.320.19学业表现513 100461 1082.900.01处理交往问题的技巧不成熟，对ADHD儿童包容性较低。因此，在ADHD儿童人际交往中，同伴校园心理2 0 2 4年4月第2 2 卷第2 期Journal of Campus Life&Mental Health,April 2024,Vol.22,No.2表2 注意缺陷多动障碍儿童学业表现相关因素的回归分析模型未标准化系S标准化系数数阝值值t值P值常量354.39自变量亲子关系18.87同学关系26.89师生关系7.22控制变量性别-25.02户口性质-46.66独生子女-9.23市相比，农村儿童不良童年经历更高。受资源条件限制，农村ADHD儿童的家长或老师教育水平较低，对特殊疾病的知识储备较薄弱2 8，儿童出现相关症状时无法及时辨别，更易出现误判、漏判的现象从而延误治疗和干预，这不仅使得农村患儿的病情恶化，也会对其学业表现产生不良影响。3.2ADHD儿童人际关系与学业表现呈正相关研究结果显示，ADHD儿童人际关系与其学业表现有关。可能的原因是：良好的人际关系提供情绪支持。社会认知理论认为积极的人际关系是儿童情感支持的主要来源，是社会情感发展和自我实现的基础2 9。良性的亲子沟通会使 ADHD儿童获得情绪安全感和归属感，唤醒积极的情绪体验30，激励其更大的学业努力31。另外，生活在温馨、友爱人际关系网中的ADHD儿童会表现出更多的亲社会行为32，如合作、分享和助人，这些亲社会行为不仅有利于儿童筑牢人际关系网，还会帮助其完成学业任务。良好的人际关系利于学习动机激发。积极的人际认同直接影响ADHD儿童对学业的重视和信心3，使其具有更高水平的学习效能感和学习目标34，甚至会预测ADHD儿童成年后的临床表现和学业成绩35。正向的教师支持、家长反馈、友好的同伴交往氛围是激发学习动机的重要因素36，有利于提高ADHD儿童对学习的兴趣和积极性。3.3同伴关系对ADHD儿童学业表现具有预测作用本研究发现同伴关系对ADHD儿童学业表现的影响程度最高，能够预测其学业表现。良好同伴关系的缓冲作用会延伸到ADHD儿童成年期后37,然而，由于ADHD患儿的特殊性，他们经常会在同伴交往和友谊中受到伤害。一方面，ADHD患儿145通常表现出有问题的社交行为38。过往研究发现ADHD儿童在课堂上的干扰性、不顺从和攻击性比普通儿童严重3，如在社交互动中更好争论40。与家长和老师相比，同学对ADHD的认知不足，40.868.67014.090.0910.200.179.920.0411.53-0.1117.25-0.1413.41-0.041.340.182.640.010.730.47-2.170.03-2.710.01-0.690.49关系相对更难处理和应对。另一方面，问题性社交行为使ADHD儿童同伴交往需求得不到满足。进人学校后，同伴超越家人和老师成为ADHD儿童接触最密切的群体。由于社交技能缺陷带来的同伴问题41，患有ADHD的儿童不仅更容易被同龄人拒绝和排斥，而且朋友比普通儿童更少142 1。不良同伴交往给ADHD儿童带来挫败感，情感的缺失导致ADHD儿童在学业方面的压力更大43，因此他们的学业表现更容易受到来自同伴关系的影响。针对本研究结果，建议：关注教育平等，缩小城乡差距。虽然现阶段我国农村医疗教育水平有所提高，但依旧面临卫生资源分配不均、医疗设施和药品供应不足的劣势。不仅如此，ADHD儿童产生的社交情感障碍、学习障碍常被成人忽视，这种情况尤其在农村父母中常见。因此，我们应该关注到农村特殊儿童的治疗及教育问题，适当将医疗卫生及教育资源向农村倾斜，并为受影响的儿童和青少年提供支持。另外，还需大力普及和倡导公众学习关于ADHD症状、治疗等流行病学的相关知识，避免耽误治疗和干预的最佳时机。加强社交培训，及时干预治疗。ADHD常患有社交情感障碍，更容易出现有问题的社交行为，这使得ADHD儿童的社交训练和学业提升更加棘手。一方面，要有意识重视ADHD儿童的社交技能练习。当ADHD儿童产生人际沟通矛盾时，细心引导、耐心纠正错误行为并告知正确处理人际问题的方式。另一方面，除了行为矫正和教育干预，不能忽视药物治疗。当ADHD儿童行为无法自控并且教师和家长无法处理时，应及时就诊，寻求医生和有关专家的建议，共同商定治疗干预方案，必要时辅以药物治疗。寻求多方合作，形成教育合力。ADHD儿童的治疗和干预仅仅靠家庭或学校一方努力是不够的，社会多方应该共同参与，合作改善其人际关系和学业表现。首先，家庭中的亲子关系与儿童学业成绩之间有密切联系，家庭成员要帮助其设置一个开放、包容、有序积极的环境，提高亲子陪伴质量，耐心引导ADHD儿童学习处理人际关系的方法。其次，同伴146矛盾尖锐下的儿童学业不良情况更加严重。教育者要引导提醒ADHD儿童周围的同学和玩伴，同学之间友好相处，和睦友爱。教育者可以在学校课程中主动普及有关ADHD儿童的相关内容，让孩子们知道与ADHD儿童交往时的注意事项和处理问题的小技巧。最后，民主平等的师生关系对提高ADHD儿童学业表现是非常重要的。教师不仅要以宽容、平等、仁慈的心态教育ADHD儿童，还要重点关注ADHD儿童的有关动态，出现问题时可以及时处理。教师也应主动学习拓展关于特殊儿童教育的相关知识和技能，提高自身教育素养，以便更好地为他们提供恰当的教学方法和支持。综上所述，本研究发现ADHD儿童的人际关系质量与学业表现有关。该研究结果从人际关系角度为改善ADHD儿童学业表现提供实证研究基础。启示我们在进行ADHD儿童干预和治疗时，除药物控制之外，要为ADHD儿童健康成长营造良好的人际环境，关注人际交往情况，尤其是同伴关系，然而，本研究的局限性在于通过量表对ADHD进行筛查较为片面，而且选取的样本范围小数量不足。因此，未来研究使用量表进行筛查时应结合专业医生的建议，在完善研究设计的基础上，增加样本量，进一步揭示变量间的关系。参考文献1 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