臺灣博碩士論文加值系統

本研究旨在發展全面性的中文成人口吃嚴重度評估工具。研究者修訂Riley（1994）的口吃嚴重度評估工具第三版（Stuttering Severity Instrument-3, SSI-3）成人評量部分，以評定說中文成人口吃者的外顯行為，並參考國內外文獻編製成人溝通焦慮量表，以評定口吃者的內隱行為。
研究者先自行繪製兩幅彩色圖片：「郊遊」和「過新年」，供無法閱讀者看圖說話，並編寫兩篇適合國小以上學歷之成人閱讀的中文短文：「玉山」、「冬季」，作為收集語言樣本的材料。之後，依照北、中、南、東四區人口比率招收滿18歲以上成人口吃者80名，收集口吃者兩種情境1000音節以上之自然對話和閱讀的語言樣本，最後填寫成人溝通焦慮量表。
語言樣本依照Riley認定口吃事件的方式評分，再分別將口吃外顯行為和內隱行為的原始分數建立百分等級對照表，並以標準九將口吃區分為非常輕微、輕度、中度、重度和極重度口吃，完成本土化的常模。本工具的信、效度如下：
效度方面，1.口吃外顯行為：在建構效度上成人口吃者和非口吃者不論在口吃發生頻率、時長、身體伴隨的行為和總分方面皆達顯著差異；本工具以愛荷華口吃嚴重度量表（Iowa Scale for Rating Severity of Stuttering）及Yairi之SLD（Stuttering-Like Dysfluency）為效標，效標關連效度分別達.92和.94。 2.口吃內隱行為：成人溝通焦慮量表由三位不同領域之大學教授評定題目的適切性，以建立內容效度。再進行因素分析建構本量表的構念，分為生心理和逃避行為兩個分量表；且成人口吃者和非口吃者在總量表和分量表得分皆達顯著差異。
信度方面， 1.口吃外顯行為：無論是口吃發生頻率、時長和身體伴隨的行為和總分，評定者間信度皆達.95以上，評定者內信度皆達.97以上。2.口吃內隱行為：成人溝通焦慮量表的Cronba’α內在一致性，總量表為.89，生心理分量表為.89，逃避行為分量表為.73；二週後總分的重測信度為.92。
中文成人口吃嚴重度評估工具包括外顯行為及內隱行為兩部分，可作為評估與診斷說中文成人口吃者之口吃嚴重度及溝通焦慮的標準化工具。

The prupose of this study is to develop a complete assessment instrument for Mandarin speaking adults with stuttering. The researcher revised Riley’s (1994) Stuttering Severity Instument-3 (SSI-3) for adults to assess their overt features of stuttering, and constructed a communication anxiety inventory for adults to assess their covert features of stuttering, seperately.
The 2 colorful pictures, Picnic and Chinese New Year, was drawed for the stuttering adults who could not read to speak out, and the 2 reading articles, Jade Mountain and Winter, for them could read. In addition, 80 stuttering adults were recruited from 4 different areas in Taiwan. Their over 1000- syllable conversation speech samples and reading spamples were collected. The Riely’s stuttering events, duration and physical concominants were measured. The data was analized and turned into percentile ranks and 5 severity levels. Also, the scores of the Communication Anxiety Inventory for adults were calculated and changed into percentile ranks and 5 severity levels.
The reliability and validity informations of the 2 parts of The Complete Stuttering Assessment Instrument for Mandarin Speaking Adults in term of overt and covert stuttering features were as follows:
The validitiy
1. Overt feature of stuttering:
(1) construct validigy:the stuttering and the nonstuttering adults were significantly different on stuttering frequency, duration, and physical concomitants and the total scores.(2) The criterion-related validities are .92 and .94 for Iowa Scale for Rating Severity of Stuttering, and for SLD（Stuttering-Like Dysfluency）, separately.
2. Covert feature of stuttering
(1) Content Validity: All the items of the Communication Anxiety Inventory for adults were considered as appropriate by 3 professors. (2) Construct validity: The Communication Anxiety Inventory for adults was divided into two domains by using Factor analysis. They were physical-psychological domain and escape behavior domain. Furthermore, there were significant differences on the two domains and the total score between stuttering and nonstuttering adults.
The reliability
1. Overt features of stuttering: The Intra-judge reliability is above .95, and the inter-judge reliability is above .97.
2. Covert features of stuttering: the cronbach’ α internal consistency of Communication Anxiety Inventory for Adults is .89 for total scores, .89 for the physical-psycho domain, and .73 for the escape behavior domain. Besides, the 2 week test-retest reliability for total score is .92.
In sum, the overt and covert features of stuttering can be assessed by The Complete Stuttering Assessment Instrument for Mandarin Speaking Adults. It is a reliable and sensitive overall tool for evaluating stuttering behaviors by researchers and therapists. And, some suggestions for using this instrument were proposed.

目錄
頁數
誌謝............ I
中文摘要........ III
英文摘要 ........V
目錄............ VIII
圖表目次........ XI
第一章 緒論
第一節 研究動機與目的........... 1
第二節 研究問題 ................6
第二章 文獻探討
第一節 口吃的定義............... 7
第二節 口吃的內涵............... 10
第三節 口吃的流行病學........... 18
第四節 口吃和其他類別的不順暢.... 34
第五節 成人口吃的評估........... 38
第六節 口吃嚴重度評估工具........ 47
第七節 中英文語言特性和口吃評定的關係..... 56
第三章 研究方法
第一節 研究對象................ 58
第二節 研究工具.................61
第三節 評估步驟.................65
第四節 統計方法.................71
第四章 研究結果
第一節 口吃外顯行為............. 80
第二節 口吃內隱行為............. 85
第三節 口吃內隱行為和外顯行為總分之常模... 92
第五章 討論與建議
第一節 結果討論.................96
第二節 應用與建議............... 107
第三節 結論.................... 112
參考文獻
中文部份........................ 114
英文部份........................ 116
附錄
附錄一 SSI-3分數對照表........... 133
附錄二 愛荷華口吃嚴重度量表....... 135
附錄三 伊利諾大學口吃研究計畫分數對照表.... 136
附錄四 中文短文「冬季」、「玉山」......... 137
附錄五 施測圖片「新年」、「郊遊」......... 137
附錄六 成人溝通焦慮量表.................. 138
附錄七 發展中文成人口吃嚴重度評估工具研究同意書..... 139
附錄八 成人口吃個案基本資料............... 140
附錄九 發展中文成人口吃嚴重度外顯行為原始分數、
百分等級及嚴重度對照表..................... 143
附錄十 發展中文成人口吃嚴重度內隱行為(成人溝通焦慮量表)原始分數、
百分等級及嚴重度對照表............. ........144

圖表目次
圖3-1 評估步驟.......... 65
表2-1 迅吃和口吃之比較... 37
表3-1 全國四大區域分別收取之成人口吃者人數表....... 59
表3-2 成人口吃者和非口吃者配對資料表.............. 60
表3-3 常態曲線百分比和標準九分數之轉換............ 53
表4-1 口吃外顯行為之評定者間信度................. 81
表4-2 口吃外顯行為之評定者內信度................. 82
表4-3 口吃者和非口吃者口吃外顯行為獨立樣本t檢定分析摘要表.... 83
表4-4-1 生理層面因素分析摘要表.................... 88
表4-4-2 心理層面因素分析摘要表.....................89
表4-4-3 逃避行為層面因素分析摘要表................. 89
表4-4-4 成人溝通焦慮量表三個構面的相關矩陣.......... 90
表4-4-5 成人溝通焦慮量表刪題後斜交轉軸之因素分析摘要表....... 90
表4-4-6 成人溝通焦慮量表之因素相關矩陣表................... 90
表4-5 成人口吃者和非口吃者在成人溝通焦慮量表獨立樣本t檢定之摘要表..... 91
表4-6 口吃外顯行為和內隱行為皮爾森積差相關之摘要表.......... 92
表4-7-1 不同口吃嚴重度成人口吃溝通焦慮之平均數與標準差摘要表.......... 93
表4-7-2 不同口吃嚴重度成人口吃溝通焦慮之單因子變異數分析摘要表........ 93
表5-1 國內外三個口吃評估工具在外顯行為之評定者內信度比較............. 100
表5-2 國內外三個口吃評估工具在外顯行為之評定者間信度比較............. 100

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