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ADHD 아동용 작업기억 훈련 프로그램 개발과 효과 검증

Development of Working Memory Training Program for ADHD Children and Effectiveness Verification

정은주|이명진|김초복|손영돈|홍선주
한국교육과정평가원 (Korea Institute for Curriculum and Evaluation)|2015.11|교육과정평가연구 (The Journal of Curriculum and Evaluation)|제18권 제3호|pp. 209-232

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참고문헌

키워드

executive functionworking memory training기능성자기공명영상(fMRI)주의력결핍과잉행동장애(ADHD)Attention Deficit Hyperactivity Disorder (ADHD)functional Magnetic Resonance Imaging (fMRI)작업기억(Working Memory) 훈련실행기능(Executive Function) 증진
주제분류교육학

초록

이 논문에서는 ADHD 초등학생들을 위한 작업기억 훈련 프로그램을 개발하고 이 훈련 프로그램이 ADHD 초등학생의 작업기억을 포함한 실행기능의 향상에 기여했는지를 알아보기 위하여 기능성자기공명영상을 활용한 뇌영상 연구를 수행하였다. 기존의 ADHD 아동을 위한 작업기억 훈련 프로그램이 작업기억의 기능영역적 특성과 개별 훈련자에 따른 적응적 과제 난이도 제공이 어려운 점을 보완하여 작업기억 훈련 프로그램 K-WEP을 개발하였다. 초등학교 4～5학년의 ADHD 진단을 받은 연구 참여자들은 주 2～3회씩 8주에 걸친 작업기억 훈련을 실시하였고, 이후 이들의 실행기능 과제 동안의 뇌 영상을 획득하여 과제 조건별 활성화 패턴을 분석하였다. 분석결과 K-WEP 훈련 이전에는 발견되지 않았던 전전두피질의 활성화가 두드러지게 나타났으며, 특히 과제에서 요구하는 특정 인지기능에 관여하는 것으로 알려진 영역의 활성화가 발견되었다. 이는 작업기억 훈련 프로그램이 ADHD 아동의 실행기능과 같은 인지기능의 전반적인 향상을 가져올 수 있는 가능성을 시사한다.

Abstract

We examined the effectiveness of the working memory training program for ADHD children called ‘K-WEP’. The K-WEP was developed as online training program for 4th and 5th graders to improve their executive functions including working memory. In this program, the difficulty levels of the tasks are adaptive for individual trainee based on trainees’ responses in order to maximize the training effectiveness. Trainees were guided to use the program twice or three times a week during eight weeks, then we compared their brain activation patterns using fMRI between before and after training. After eight-week training, the Prefrontal Cortex (PFC) regions were activated while trainees preforming executive function-measure-task. The significant activation of the PFC while trainees preforming tasks might be meant that the trainees have payed attention and inhibited the Default Mode Network (DMN) effectively. We carefully suggested that working memory training like K-WEP could improve ADHD children’s cognitive functions including working memory, and large-scale follow-up study is needed to confirm the effectiveness of the working memory training program.

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