目的：本研究期望能建立一簡單快速的注意力篩檢工具，結合既有衡鑑工具及神經心理測驗，建立國中校園ADHD篩檢介入三級模式，並評估青少年ADHD注意力缺損模式，探討青少年ADHD注意力缺損類型之流行率。最後試探針對確定診斷之ADHD青少年在校內接受個別化訓練方案之可行模式，協助國中校園正確篩檢出青少年ADHD並提供適當協助。
方法：以日常生活自我注意力問卷之總分與敏感題分數、導師主觀評估及追蹤是否曾因注意力問題而就醫等四類指標對兩所國中七年級學生共675名進行初級篩檢；接著以精緻問卷、神經心理測驗及兒童青少年精神科醫師之診斷性晤談進行臨床診斷，並依診斷結果探討此簡短注意力問卷之適當運用。接著依受試者注意力缺損模式探討青少年ADHD注意力缺損類型之流行率。最後進行試探性個別化注意力訓練方案，以建立國中ADHD學生在校內接受個別化訓練方案之參考模式。
結果：研究結果篩檢出23名確診之ADHD，其中僅6名曾因注意力問題就醫，僅7名被老師評估可能為ADHD，其餘為問卷篩檢出之ADHD。23名ADHD中，ADHD-I，ADHD-H及ADHD-C的比例為17：1：5。經校正後推估七年級ADHD之盛行率約9.42%。若同時使用本研究建議之四項篩選指標，敏感度為0.671，特異性為0.887。注意力缺損模式部份，青少年ADHD呈現出注意力持續度不佳、反應時間明顯較慢及監控注意力資源不足等缺損模式。在試探性注意力訓練方案部份，初步發現受試者在訓練程式上的反應時間和正確率均有進步。
討論：以本研究七年級學生約9.42%的盛行率來看，顯示青少年階段仍有相當高比例的ADHD，但以目前依賴導師轉介或由家長主動帶孩子就醫的方式，仍有高比例(52%)之ADHD青少年未被發現；且本研究中ADHD-I的人數為ADHD-C的3.4倍，但曾就醫的比例僅為17.7%與40%，顯示在青少年中有許多ADHD-I患者沒有被發現並接受適當診斷及治療。本研究建議之初篩量表及切分點雖簡易，但已可找出82.6%的ADHD學生，若再結合概有校園轉介系統及醫療體系，將可大幅提昇ADHD青少年的被診斷率。研究最後以8位有意願之ADHD學生為例，進行四週試探性個別化注意力訓練，提供臨床心理師進入校園進行神經心理衡鑑及認知功能訓練之參考模式。

Objective： This study expects to develop a simple attention-screening questionnaire (The Student Attention Rating Scale) and establish a model to screen and intervene the students with ADHD in junior high schools. The study also assesses the attention deficit patterns on those teenagers with ADHD and explores the prevalence of ADHD subtypes. Finally, the study develops a pilot training program to assist adolescent with ADHD to improve attention performance.
Method：At the beginning, there were 675 7th grade students participating the primary screening by using The Student Attention Rating Scale, teachers’ reports and reviewing medical history related to attention problems. The participants were gradually given the elaborate questionnaire, neuropsychological test and interview conducted by Psychiatrists. In order to confirm the appropriate use of the Student Attention Screening Scale, the screening results have been crossly reviewed with the psychiatric reports. At the end, investigating the prevalence of different subtype of ADHD and administrating individual attention training programs to explore an available school-based intervention model of adolescent with ADHD.
Results：There were 23 students being diagnosed with ADHD in this study. Six out of 23 students showed medical history because of attention problem. Seven students were reported as possible ADHD by their teachers. The rest of the students were found in ADHD by the Student Attention Rating Scale. Among these 23 students, the ratio of ADHD-I, ADHD-H and ADHD-C is 17：1：5. The estimated prevalence of ADHD in adolescence is 9.42%. The sensitivity of the screening model is 0.671, and the specificity is 0.887. The teenagers with ADHD present poor sustained attention, require long reaction time and perform insufficient attention resource. The reaction time and the correct reaction rate of the subjects were in improved after the individual attention training programs.
Conclusions：According to the prevalence of this study, there are still high percentage of ADHD occurred in adolescent. But many of them have not been found. In this study, the occurrence of ADHD-I is 3.4 times greater than ADHD-C. However, the diagnosis ratio is 17% and 40%. It shows that there are fewer ADHD-I being diagnosed and treated. The screening model suggested in this study is simple, but effectively discovers 82.6% adolescent with ADHD who were ignored by parents and teachers. This study also suggested an available school-based neuropsychological attention assessment and training model for school clinical psychologists.

王甦、汪安聖(2004)。認知心理學。台北：五南出版社。
孔繁鐘譯(1997)。精神疾病的診斷與統計(DSM-Ⅳ)。台北：合記出版社。
吳武典(2000)。「三級預防處理的金字塔」。學校心理學專題研究，課堂口述。
宋維村(1997)。「台灣地區兒童精神疾病流行病學研究先導研究(Ⅰ)」。行政院國家科學委員會專題研究計畫成果報告。
洪儷瑜(1994)。注意力缺陷及過動學生的認識與教育。台北：台北市立師範學院特殊教育中心。
洪儷瑜、張郁雯、丘彥南、蔡明富、孟瑛如(2004a)。「問題行為篩選量表指導手冊」。台北：台灣師範大學特殊教育中心。
洪儷瑜、張郁雯、丘彥南、蔡明富、孟瑛如(2004b)。「學生行為評量表指導手冊」。台北：台灣師範大學教殊教育中心。
洪儷瑜、張郁雯、丘彥南、蔡明富(2004)。「學生適應調查表指導手冊」。台北：台灣師範大學特殊教育中心。
郭乃文(2002)。「非語文性注意力與記憶力測驗指導手冊」。台北：台灣師範大學特殊教育中心。
郭乃文(2003)。「以Cohen認知神經心理學概念探討注意力功能測量研究」。博士論文，國立台灣大學，台北市，台灣。
郭乃文、鄭中平(2005)。「非語文注意力與記憶力測驗之修訂與應用」。教育部社教司研究報告。
郭乃文、余麗樺(1999)。「以廣泛性非語文注意力測驗組來衡鑑青少年注意力功能之發展研究報告」。行政院國家科學委員會專題研究計畫成果報告。
郭乃文、余麗樺、黃惠玲、莊妙芬(1997)。「非語文注意力與記憶力測驗編製研究」。台北：教育部社教司研究報告。
陳宛汶(2005)。「音樂輔導活動應用於國小注意力缺陷過動症學童生活適應之研究」。碩士論文，屏東師範學院，屏東市，台灣。
陳信昭、王璇璣、張巍鐘、蔡盈盈(2006)。當你的孩子需要精神藥物治療。台北：心理出版社。
陳蒂勻(2005)。「知覺動作訓練課程對ADHD兒童動作能力影響之個案研究」。碩士論文，屏東師範學院，屏東市，台灣。
陳嘉鳳(1997)。心理衛生工作與學校。學生輔導，49，24-35。
黃政昌(2001)。學校三級預防策略之探討。諮商與輔導，184，19-23。
黃舜琪(2005)。「以兒童行為檢核表與教師報告表評估注意力缺陷過動症兒童之認知行為親子治療團體成效」。碩士論文，高雄醫學大學，高雄市，台灣。
黃瑞瑛(1995)。「注意力疾患兒童在注意力向度表現上之初探」。碩士論文，輔仁大學，台北縣，台灣。
詹雅雯(2007)。「注意力缺失/過動疾患-不注意型與複合型之多面向注意力功能分析」。碩士論文，國立成功大學，台南市，台灣。
詹雅雯、陳信昭、郭乃文(2006)。注意力缺失/過動疾患不注意型與合併型之多面向注意力功能分析。臨床心理學刊，3(2)，85-92。
鄭昭明(1993)。認知心理學。台北：桂冠出版社。

Applegate, B., Lahey, B. B., Hart, E. L., Biederman, J., Hynd, G. W., Barkley, R. A., et al. (1997). Validity of the age-of-onset criterion for ADHD: a report from the DSM-IV field trials. J Am Acad Child Adolesc Psychiatry, 36(9), 1211-1221.
Arnold, L. E., Elliot, M., Sachs, L., Bird, H., Kraemer, H. C., Wells, K. C., et al. (2003). Effects of ethnicity on treatment attendance, stimulant response/dose, and 14-month outcome in ADHD. J Consult Clin Psychol, 71(4), 713-727.
Association, A. P. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Barkley, R. A. (1998). Attention-deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (second ed.). New York: The Guilford Press.
Barkley, R. A., Anastopoulos, A. D., Guevremont, D. C., & Fletcher, K. E. (1991). Adolescents with ADHD: patterns of behavioral adjustment, academic functioning, and treatment utilization. J Am Acad Child Adolesc Psychiatry, 30(5), 752-761.
Barkley, R. A., DuPaul, G. J., & McMurray, M. B. (1990). Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. J Consult Clin Psychol, 58(6), 775-789.
Barkley, R. A., Fischer, M., Edelbrock, C. S., & Smallish, L. (1990). The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study. J Am Acad Child Adolesc Psychiatry, 29(4), 546-557.
Biederman, J., Mick, E., & Faraone, S. V. (2000). Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry, 157(5), 816-818.
Conners, C. K., Epstein, J. N., March, J. S., Angold, A., Wells, K. C., Klaric, J., et al. (2001). Multimodal treatment of ADHD in the MTA: an alternative outcome analysis. J Am Acad Child Adolesc Psychiatry, 40(2), 159-167.
DuPaul, G. J., & Stoner, G. D. (2003). ADHD in the Schools: Assessment and Intervention Strategies. New York: The Guilford Press.
Evans, S. W., Axelrod, J., & Langberg, J. M. (2004). Efficacy of a school-based treatment program for middle school youth with ADHD: pilot data. Behav Modif, 28(4), 528-547.
Evans, S. W., Langberg, J., Raggi, V., Allen, J., & Buvinger, E. C. (2005). Development of a school-based treatment program for middle school youth with ADHD. J Atten Disord, 9(1), 343-353.
Faigel, H. C. (1995). Attention deficit disorder in college students: facts, fallacies, and treatment. J Am Coll Health, 43(4), 147-155.
Faraone, S., Biederman, J., & Monuteaux, M. C. (2002). Further evidence for the diagnostic continuity between child and adolescent ADHD. J Atten Disord, 6(1), 5-13.
Faraone, S. V., Biederman, J., Doyle, A., Murray, K., Petty, C., Adamson, J. J., et al. (2006). Neuropsychological studies of late onset and subthreshold diagnoses of adult attention-deficit/hyperactivity disorder. Biol Psychiatry, 60(10), 1081-1087.
Fischer, M., Barkley, R. A., Fletcher, K. E., & Smallish, L. (1993). The adolescent outcome of hyperactive children: predictors of psychiatric, academic, social, and emotional adjustment. J Am Acad Child Adolesc Psychiatry, 32(2), 324-332.
Fischer, M., Barkley, R. A., Smallish, L., & Fletcher, K. (2005). Executive functioning in hyperactive children as young adults: attention, inhibition, response perseveration, and the impact of comorbidity. Dev Neuropsychol, 27(1), 107-133.
Gau, S. S., Chong, M. Y., Chen, T. H., & Cheng, A. T. (2005). A 3-year panel study of mental disorders among adolescents in Taiwan. Am J Psychiatry, 162(7), 1344-1350.
Greene, R. W., Beszterczey, S. K., Katzenstein, T., Park, K., & Goring, J. (2002). Are Students with ADHD More Stressful to Teach? Patterns of Teacher Stress in an Elementary School Sample. Journal of Emotional and Behavioral Disorders, 10(2), 79-89.
Gultin, T., & Renolds, C. R. (1999). The handbook of school psychology (3nd ed.). New York: John Wiley & Sons.
Hervey, A. S., Epstein, J. N., & Curry, J. F. (2004). Neuropsychology of adults with attention-deficit/hyperactivity disorder: a meta-analytic review. Neuropsychology, 18(3), 485-503.
Hinshaw, S. P., Owens, E. B., Wells, K. C., Kraemer, H. C., Abikoff, H. B., Arnold, L. E., et al. (2000). Family processes and treatment outcome in the MTA: negative/ineffective parenting practices in relation to multimodal treatment. J Abnorm Child Psychol, 28(6), 555-568.
Ingram, S., Hechtman, L., & Morgenstern, G. (1999). Outcome issues in ADHD: Adolescent and adult long-term outcome. Mental Retardation and Developmental Disabilities Research Reviews, 5(3), 243-250.
Keogh, B. K. (1971). Hyperactivity and Learning Problems: Implications for Teachers. Intervention in School and Clinic, 7(1), 47-50.
Kerns, K. A., Eso, K., & Thomson, J. (1999). Investigation of a direct intervention for improving attention in young children with ADHD. Developmental Neuropsychology, 16, 273-295.
Milich, R., Balentine, A. C., & Lynam, D. R. (2001). ADHD Combined Type and ADHD Predominantly Inattentive Type Are Distinct and Unrelated Disorders. Clinical Psychology: Science & Practice, 8(4), 463.
Molina, B. S., Smith, B. H., & Pelham, W. E., Jr. (2005). Development of a school-wide behavior program in a public middle school: an illustration of deployment-focused intervention development, stage 1. J Atten Disord, 9(1), 333-342.
Reid, J. B., Patterson, G. R., & Snyder, J. J. (2002). Antisocial behavior in children and adolescents: a developmental analysis and model for intervention: American Psychological Association.
Rohde, L. A., Biederman, J., Busnello, E. A., Zimmermann, H., Schmitz, M., Martins, S., et al. (1999). ADHD in a school sample of Brazilian adolescents: a study of prevalence, comorbid conditions, and impairments. J Am Acad Child Adolesc Psychiatry, 38(6), 716-722.
Rohde, L. A., Biederman, J., Zimmermann, H., Schmitz, M., Martins, S., & Tramontina, S. (2000). Exploring ADHD age-of-onset criterion in Brazilian adolescents. Eur Child Adolesc Psychiatry, 9(3), 212-218.
Seidman, L. J., Biederman, J., Monuteaux, M. C., Valera, E., Doyle, A. E., & Faraone, S. V. (2005). Impact of gender and age on executive functioning: do girls and boys with and without attention deficit hyperactivity disorder differ neuropsychologically in preteen and teenage years? Dev Neuropsychol, 27(1), 79-105.
Seidman, L. J., Biederman, J., Weber, W., Hatch, M., & Faraone, S. V. (1998). Neuropsychological function in adults with attention-deficit hyperactivity disorder. Biol Psychiatry, 44(4), 260-268.
Sohlberg, M. M., & Mateer, C. A. (1987). Effectiveness of an attention-training program. Journal of Clinical & Experimental Neuropsychology, 9, 117-130.
Stahl, S. M. (2008). Stahl's essential psychopharmacology: neuroscientific basis and practical applications: Cambridge University Press.
Topolski, T. D., Edwards, T. C., Patrick, D. L., Varley, P., Way, M. E., & Buesching, D. P. (2004). Quality of life of adolescent males with attention-deficit hyperactivity disorder. J Atten Disord, 7(3), 163-173.
Weiss, G., & Hechtman, L. T. (1993). Hyperactive children grown up: ADHD in children, adolescents, and adults: Guilford Press.
Weist, M. D., Evans, S. W., & Lever, N. A. (2003). Handbook of School Mental Health: Advancing Practice and Research: Kluwer Academic/Plenum Publishers.
Weisz, J. R. (2004). Psychotherapy for children and adolescents: Evidence-based treatments and case examples. Cambridge, UK: Cambridge University Press.