ADHD 아동과 청소년의 실행기능 향상에 효과적인 중재에 대한 체계적 고찰 = A Systematic Review of Effective Interventions to Improve Executive Function of Children and Adolescents With ADHD

다국어 초록 (Multilingual Abstract)

Objective: The aim of this systematic review was to examine the effect of intervention on the executive function inchildren and adolescents with Attention Deficit Hyperactivity Disorder(ADHD) and to provide evidence regardingoccupational therapy.
Methods: Studies for this review were collected by searching the Proquest, Scopus, and Pubmed databases forarticles from 2009 to 2018 using the following keywords: “ADHD” AND “Executive function” AND “InterventionOR Therapy OR Effect OR Occupational therapy” AND “RCT OR Randomized control trial.” A total of 13 studieswere included in this review paper.
Results: The 13 studies were analyzed regarding their level of quality, general characteristics, types of interventions,measuring instruments, and areas of intervention effects as measured using dependent variables. The types ofinterventions included ten studies on cognitive intervention and three studies on physical intervention. Workingmemory among the areas of execution functions was most frequently used. The measurement tools for each areaappeared to vary widely, including the Behavior Racing Inventory of Executive Function(BRIEF) and the Trail MakingTest. Among the included studies, seven showed effectiveness in terms of working memory.
Conclusion: This review showed the trends in interventions used to improve the executive function of children andadolescents with ADHD, as well as the assessment tools and areas of executive function that were effective. Thisstudy will provide a clinical basis for occupational therapists. Further studies should be actively conducted in thefield of occupational therapy based on the results of this review.

국문 초록 (Abstract)

목적 : 본 연구는 ADHD 아동 및 청소년을 대상으로 한 실행기능 향상을 위한 중재특성과 동향을 체계적으로 분석함으로써 그 근거를 제공하는 것을 목적으로 한다.
연구방법 : 전자 데이터베이스인 Proquest, Scopus, Pubmed 데이터베이스를 사용하여 국외 학술지에 2009년1월부터 2018년 4월까지 게재된 문헌을 수집하였다. 검색어는 “ADHD” AND “Executive function” AND“intervention OR therapy OR effect OR occupational therapy” AND “RCT OR Randomized controltrial”를 사용하였다. 최종적으로 13편의 논문을 본 연구의 분석대상으로 선정하였다.
결과 : 선정된 연구는 연구의 질적 수준, 일반적 특성, 중재종류, 종속변인으로 측정된 실행 기능영역, 측정도구, 중재효과 영역 중심으로 분석하였다. 실행기능에 대한 중재는 인지적 중재를 한 연구가 10편, 신체적 중재를 한 연구가 3편이었으며, 종속변인으로 많이 사용된 실행기능 영역은 작업기억이었다. 각영역별 측정도구는 매우 다양하게 나타났는데 대표적으로 많이 사용하는 도구로는 Behaviour RatingInventory of Executive Function(BRIEF), Trail Making Test(TMT)가 있었다. 실행기능의 효과를나타낸 중재결과의 영역은 작업기억 영역이 7편으로 가장 많았다.
결론 : 본 연구를 통해 ADHD 아동ᆞ과 청소년의 실행기능 중재에 대한 동향 및 다양한 중재법, 평가도구와중재효과 영역에 대해 알 수 있었다. 이는 작업치료사에게 임상적 근거를 제공하고자 하였으며, 추후에는 본 연구결과를 바탕으로 ADHD 아동ᆞ과 청소년의 실행기능에 관련된 평가도구 및 중재와 관련된 다양한 연구들이 활발하게 이루어져야 할 것이다.

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