注意力缺陷過動疾患（Attention-Deficit/Hyperactivity Disorder, 簡稱ADHD）因不專注、衝動和過動的症狀，常導致認知行為功能缺失。其中注意力與工作記憶的問題皆與ADHD 孩童之課業學習和日常生活表現相關。「適度大腦警醒模式」（Moderate Brain Arousal model）主張ADHD 孩童因持續性多巴胺（tonic dopamine）量過少，使神經系統無法正常運作，而造成警醒程度低下與認知表現問題。因此假設若能提供適度的外在雜訊以滿足神經系統所需的雜訊量，可幫助ADHD 孩童的神經系統運作而提升警醒程度，促進認知表現。然而，相關的研究迄今仍十分有限。故本研究之目的為針對ADHD 孩童，探討外在聽覺刺激的雜訊—「白噪音」對其聽覺與視覺的工作記憶和注意力的影響。本研究共招募28 位ADHD 孩童以及28 位典型發展孩童，比較兩組在白噪音與安靜情境下之四項認知測驗的表現，包括順序與逆序之數字廣度測驗、密碼轉換測驗、記憶為導向的掃視測驗以及地圖搜尋測驗。在後兩項測驗中同時使用眼球追蹤系統收集受試者之眼球動作數據，以提供視覺注意力及工作記憶表現的客觀指標。本研究結果主要發現雖然無論在安靜或白噪音情境，ADHD 組之所有測驗的表現均顯著較典型發展組差；但在白噪音情境中，ADHD 組僅在數字廣度測驗的表現有顯著提升的現象，而在地圖搜尋任務中的視覺搜尋效率亦有較佳的趨勢：其再凝視目標物和總掃視時間比例較低。此外，白噪音對ADHD-PI 孩童的助益似乎較其他亞型明顯。因此，本研究的結果僅部分支持「適度大腦警醒模式」的主張：白噪音對於ADHD 孩童之聽覺工作記憶具有正向效益，但對聽覺注意力以及視覺工作記憶與注意力則無顯著的影響；然而，白噪音亦有促進ADHD 孩童之視覺搜尋效率的趨勢。本研究成果提供白噪音對ADHD 孩童之臨床應用的實證基礎，可協助臨床治療人員將白噪音應用於臨床做為治療媒介，對ADHD孩童發展有效的個別治療策略。未來研究可再針對白噪音於ADHD 孩童之各種認知功能的效益進行深入的驗證，並進一步探討白噪音效應的生態效度。

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) are characterized by inattention, hyperactivity and impulsivity. These symptoms often result in cognitive behavioral dysfunction, including attention and working memory deficits, and further influence academic and daily activity performance. The Moderate Brain Arousal model has proposed that the low level of tonic dopamine in ADHD is associated with dysfunction of the neural system, which leads to a hypoarousal state and poor cognitive performance. Therefore, the model suggests that moderate external noise modulated by levels of dopamine, is required for optimal performance in cognitive tasks for ADHD. However, few studies have been done on the effects of external noise on ADHD. The aims of the present study were to investigate the effects of external auditory noise – white noise on working memory and attention performance in children with ADHD. A total of 28 children with ADHD and 28 children with typically developing (TD) were recruited to participate in this study. All participants completed the forward and backward digit span test, the code transmission test, a memory-guided saccade task, and a map search task under two conditions (white noise and silent conditions). Eye movements in both the memory-guided saccade and map search tasks were recorded simultaneously as objective indexes of visual working memory and attention. Results revealed that although ADHD group performed poorer than TD group in all tests under silence or white noise conditions, ADHD group only demonstrated significant improvement on the digit span tests and better visual search efficiency in the map search task while they listening to white noise. In addition, it seemed that the white noise had more positive effects on ADHD children with Predominantly Inattentive type than ADHD children with Hyperactive/Impulsive type or Combined type. These findings partially support the Moderate Brain Arousal model and suggest that white noise can enhance auditory working memory of children with ADHD and may facilitate visual search performance as well, but it have no benefits to auditory attention and visual working memory and attention. The results of this study not only provide the evidence-based clinical use of white noise for children with ADHD, but also facilitate therapists to develop more efficient individualized treatment strategy for ADHD children by using white noise. Future research is required to investigate the effects of with noise on other cognitive functions of children with ADHD, and to further explore the ecological validity of the positive effects of white noise in children with ADHD.

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