臺灣博碩士論文加值系統

目標：許多關於未成年母親之小孩（未成年組）的研究結果紛紛指出，相較於成年母親之小孩（成年組），在學齡早期（6-8歲）時，其智力測驗得分較低、學習成就較差，且有較多的行為問題，如品行問題或過動性等。這些問題主要是與母親早期生育所引發的相關因子有關，如：低教育程度、社會經濟不利條件、未成年母親不成熟之心理狀態及家庭環境因素不佳等。這些研究主要來自於約有40％的未成年母親選擇作為單親媽媽的西方社會，然而在台灣的未成年少女懷孕後有超過85％以上的人選擇結婚。此外，由於國內外在社會福利制度、家庭支持情況以及母親角色的文化類型皆有所差異，而諸如此類差異皆有可能導致未成年母親的小孩在智力、行為發展與學習成就結果的不同。因此，本研究主要在描述國小一、二年級學童發展的重要標記，並發現其重要的相關因子。

方法：本研究於2002年2月至4月中時在台南市安南區之各國小進行，分別於12所小學中篩選出為母親20歲以下生育者之國小一、二年級學童，做為本研究之研究對象，並於所篩選出學童之同班級中，選取等數且同性別之其他學童作為本研究之對照組，以比較兩組間智力、行為發展與學習成就之情況。若兒童有先天性心智發展遲緩的現象，則不列入本研究樣本中。在研究工具方面，採用瑞文氏彩色圖形推理測驗來測量智力；以Conners行為評估量表中文版與家長版來評估行為發展；且以兒童的班級老師將在較之各科成績依其排名為班上之前15％、15-50％、50-85％或最後15％來評估學習成就。此外，亦收集父母親之基本資料、家庭環境資料，並評估其家庭功能情況，以進行相關性研究。而家庭功能情況乃是藉由測量兒童的家庭關懷度指數而得知。連續性資料採用平均值±標準差呈現，類別性資料則以頻率分配表來呈現。家庭關懷度指數、智力測驗得分百分等級和行為評估結果在未成年組與成年組間、男生與女生間之單變量分析則以t檢定來比較平均值，以log-rank檢定與Wilcoxon-Gehan檢定來比較累加分佈情況。學習成就之單變量分析則採用邏輯式迴歸來分析。多變量方面以迴歸分析來瞭解母親是否未成年生育、小朋友的性別、父母親的人口學資料及家庭相關因子與智力測驗、行為發展的關係；而與學習成就之關係則以邏輯式迴歸所求得之危險對比值呈現。然由於變項數目多且有研究樣本數有限，所以在自變項的選取上，除母親是否未成年生育與小朋友性別一定納入外，其他變項則採用正向選擇法，而其篩選之條件為p<0.05。本研究主要使用SAS v8.01和SPSS 9.0軟體來進行資料分析，若p<0.05表有統計上顯著意義存在。

結果：本研完成家庭關懷度指數與智力測驗者，共包含141位未成年母親的小孩與139位成年母親的小孩，性比例於兩組分別為82：59與78：61。家長部分的問卷包含未成年組131份（92.9％），成年組137份（98.6％）；老師部分的問卷則包含未成年組138份（97.9％），成年組135份（97.1％）。在人口學資料方面，未成年組的父母親低教育程度、工作的技術性與專業性低、低社經地位以及婚姻破裂的比例均比成年組高。然而，未成年組在兒童照護與經濟上得到來自於（外）祖父母方面的支持較多。未成年組傾向於居住在較大的家庭，且有較高比例與其親戚同住。在生物學上的資料方面，未成年組的平均出生體重（3.1±0.5 kg）較成年組（3.2±0.4 kg）低，早產的比例在未成年組中也相對較高（16.1% vs. 3.7%）。此外，父母親在生此胎時的年齡於兩組間亦有統計上顯著之差異存在（父親：23.4±4.5 vs. 29.5±3.9歲，p<0.001；母親：18.2±1.3 vs. 27.1±3.1歲，p<0.001）。在單變量分析結果顯示出，家庭關懷度指數在男生與女生間有差異（t test：6.5±1.6 vs. 7.0±1.5，p<0.01；log-rank test：p<0.01），但在未成年組與成年組間無統計上顯著差異存在（6.7±1.6 vs. 6.7±1.5）。智力測驗結果在未成年組與成年組間，無論是在原始得分（23.7±7.1 vs. 26.6±6.1，t test：p<0.001）或經對照調整過性別和年齡之常模的百分等級（47.8±26.5% vs. 60.4±25.9%，t test：p<0.001、log-rank test：p<0.001），皆有統計上顯著之差異存在，然於男生與女生間則無差異存在。老師所評估的行為表現方面，所測量的4個行為困擾指標（conduct problem, inattention-passivity, hyperactivity, and hyperactivity）皆顯示出在未成年組與成年組、男生與女生間皆有統計上顯著之差異存在。然而，家長所評估的行為表現方面，僅焦慮（anxiety）和行為困擾2指標顯現出在未成年組與成年組間有統計上顯著之差異存在；而僅品行問題（conduct problem）、過動性指標（hyperactivity index）、發展困擾、行為困擾、低紀律及健康抱怨顯現出在男生與女生間皆統計上顯著之差異存在。學習成就方面，經邏輯式迴歸分析則顯現出國語（p<0.001）、數學（p<0.001）、自然（p<0.001）、社會（p<0.001）、生活（p<0.001）成績在未成年組與成年組間皆達統計上顯著之差異，然男生與女生間則無差異存在。在多變量分析結果方面，女生的家庭功能滿意度較男生高（p<0.01），且父親工作等級為第二類者其家庭功能滿意度明顯較第一類者高，母親是否為未成年生育與家庭功能滿意度間則無關係存在。智力測驗得分百分等級與母親是否未成年生育和性別無統計上顯著之關係，而與父親的教育程度（p<0.01）、小朋友的主要照顧者（p<0.01）間有統計上顯著關係。父親教育程度為高中以上者較教育程度為國中或小學以下者之小朋友智力測驗得分百分等級高（p<0.05）；兒童之主要照顧者為雙親照護者相對於其他之小朋友智力測驗得分百分等級高（p<0.05）。在行為表現方面，家長所評估的行為現結果明顯與小朋友的手足數、父親的社經地位、父親的管教態度及生產情況有關；老師所評估的行為現結果則明顯與母親是否未成年生育、小朋友的性別、父親的管教態度及小朋友的居住型態有關。而母親是否未成年生育、智力測驗得分百分等級明顯與國語（p<0.0001；p<0.01）和數學（p<0.0001；p<0.01）成績表現有關。未成年組的國語（OR = 4.28；OR的95％信賴區間 = 2.35 ~ 7.80）和數學（OR = 3.31；OR的95％信賴區間 = 1.76 ~ 5.87）成績明顯較成年組差；智力測驗得分百等級愈高者，其國語（OR = 0.98；OR的95％信賴區間= 0.97 ~ 0.99）和數學（OR = 0.98；OR的95％信賴區間= 0.97 ~ 0.99）成績表現愈好。而性別則與小朋也在校成績表現間無統計上顯著之關係存在。
結論：兒童於學齡早期時，相對於成年組，未成年組的智力測驗得分百分等級較低、在方面有較高的行為困擾傾向且在校各科成績表現較差。而母親是否未成年生育於多變量分析中，在控制人口學資料、家庭相關因子、與生物因素後，仍與老師所評估的行為表現及在校各科成績表現間有關。父親方面的影響力則藉由透過教育程度、職業、管教態度等因素來影響學齡早期兒童之家庭功能、智力發展和行為表現。

Purpose: Several studies of the children born to adolescent mothers (adolescent group) have indicated that they have lower intelligence scores, poorer academic performance and more behavioral problems such as conduct problem or hyperactivity at early school age (6-8 years of age) as compared with the children born to adult mothers (adult group). These problems are mainly related to lower educational levels, worse socio-economic conditions, psychological immaturity of the adolescent mothers, and poorer family environment associated with early childbearings. However, these studies were mainly conducted in western societies where nearly 40% of adolescent mothers chose to become a single mother, whereas over 85% of adolescent mothers in Taiwan chose to get married. In addition, social welfare system, contents of family support, and cultural stereotype of a mother’s ‘roles’ in these two societies are quite different. All these differences may lead to different results in intelligence, behavioral development and academic performance among the children born to adolescent mothers. We aim to describe these important makers of children’s development among the first and second graders in elementary schools, and find their significant correlates.

Materials and Methods: This study was conducted between February and mid April, 2002 in An-Nan school district of Tainan city. Children in the first and second grade of total 12 elementary schools in this school district born to adolescent mothers were recruited. A group of children born to adult mothers matched by sex and class was also recruited for comparison in intelligence, behavioral development, and academic performance. Children presented with mental retardation were excluded from this study. The intelligence was measured by Raven’s Colored Progress Matrices (CPM), behavioral development was rated by both the parents and teachers using Conners Parental and Teacher Rating Scales (CPRS-48 and CTRS-28), and academic performance was categorized either in the top 15%, 15%-50%, 50%-85%, or the bottom 15% of the classes and determined by the teachers. Demographic characteristics of both the parents and measurements of family environment and family function were also collected for correlational study. The family function was measured by The Family APGAR Index and the responders were children. Continuous data were expressed as mean±sd, and categorical data were summarized by frequency tables. The APGAR Index, CPM, CPRS-48, and CTRS-28 were compared in univariate analysis using mainly t test for comparison of means. Log rank test and Wilcoxon-Gehan test was used for comparison of cumulative distribution functions only between the adolescent and adult groups and between the boys and girls. Academic performance was compared in univariate analysis using logistic regression for ordinal response. Maternal age at conception of the children (< 20 vs. ³ 20 years old), sex of the children, demographic characteristics of both parents, and family-related factors were correlated to the intelligence scores and behavioral development by the regression analysis for normally distributed data. The academic performance data were analyzed by logistic regression for ordinal response where the measure of association was odds ratio (OR), and the numerators were the cumulative proportions of the lower performance categories. Due to the large number of possible variables and limited sample size, selection of independent variables was performed using the forward selection method after inclusion of the maternal age at conception and sex. The entry criterion was P<0.05. Both SAS v8.01 and SPSS 9.0 were utilized for computation. P<0.05 indicates statistical significance.

Results: Total 141 children born to adolescent mothers and 139 children born to adult mothers completed the APGAR index and CPM. Sex ratios of boys to girls were 82:59 and 78:61 respectively. Among their families, 131 (92.9%) of the adolescent group and 137 (98.6%) of the adult group returned the questionnaires and the ratings of behavioral development by CPRS-48. Teachers’ ratings of behavioral development by CTRS-28 and academic performance were received for 138 (97.9%) of the adolescent group and 135 (97.1%) of the adult group. On demographic variables, the mothers and fathers of the adolescent group had higher percentages of lower educational levels, lower skilled jobs, lower socio-economic status (SES), and broken marriage as compared with the adult group. However, the adolescent group received more help in childcare and financial support from the grandparents. The adolescent group tended to live in larger family sizes and had higher percentage of living with their relatives. On biological variables, the adolescent group had mean birth weight (3.1±0.5 kg) significantly lower than the adult group (3.2±0.4 kg). In addition, the percentage of preterm delivery was significantly higher in the adolescent group (16.1% vs. 3.7%). Age difference at time of conception of children was observed between the fathers of the adolescent and adult groups (23.4±4.5 vs. 29.5±3.9 years old, P<0.001) and the mothers (18.2±1.3 vs. 27.1±3.1 years old, P<0.001). Univariate analysis shows that APGAR Index differs between boys and girls (6.5±1.6 vs. 7.0±1.5, P<0.01 by t test and P<0.01 by log rank test), but not between the adolescent and adult groups (6.7±1.6 vs. 6.7±1.5). The CPM differs between the adolescent and adult groups in both raw scores (23.7±7.1 vs. 26.6±6.1, P<0.001 by t test) and percentage of national norms adjusted for age and sex (47.8±26.5% vs. 60.4±25.9%, P<0.001 by t test and P<0.001 by log rank test), but not between the boys and girls (raw scores: 25.3±6.8 vs. 24.9±6.8, percentages: 53.2±29.4% vs. 55.1±26.1%). The CTRS-28 show significant differences in all the dimensions, namely conduct problem, inattention-passivity, hyperactivity, and hyperactivity scores between the adolescent and adult groups and between boys and girls, but significant differences in CPRS-48 were found only in anxiety and behavioral scores between the adolescent and adult groups and only in conduct problem and hyperactivity index scores between boys and girls. Academic performance differs between the adolescent and adult groups in Chinese (P<0.001), mathematics (P<0.001), natural science (P<0.001), social study (P<0.001) and life science (P<0.001) by logistic regression, but sex differences were not observed. In multivariate analysis, girls perceived more positively in family function than boys (P<0.01) and children whose fathers had jobs of class II or higher levels perceived more positively than class I level. Maternal age at conception was not a significant correlate. Both maternal age at conception and sex were not significant correlates of CPM percentage. Significant correlates of the CPM percentage were fathers’ education levels (P<0.01) and primary caregivers (P<0.01). Children whose fathers had at least senior high education had higher mean CPM percentage than those whose fathers had lower education (P<0.05). Children with both parents as primary caregivers had higher mean CPM percentage than the others (P<0.05). On behavioral development, the significant correlates of CPRS were the number of children in a family, fathers’ SES, a father’s parenting attitude and gestational age and CTRS were maternal age at conception, sex of the children, a father’s parenting attitude, and family type. Maternal age at conception, and CPM percentage were significantly associated with the academic performance in Chinese (P<0.0001, and P<0.001, respectively) and in mathematics (P<0.0001, and P<0.001, respectively). The adolescent group performed more poorly than the adult group in Chinese (OR=4.28, 95% CI=2.35~7.80), and in mathematics (OR=3.31, 95% CI=1.76~5.87). The higher was the CPM percentage, the better was the performance in Chinese (OR=0.98, 95% CI=0.97~0.99), and in mathematics (OR=0.98, 95% CI=0.97~0.99). Sex was not a significant correlate of academic performance.
Conclusions: At early school age, the adolescent group had lower CPM percentage, higher CTRS, and poorer academic performance as compared with the adult group. However, the maternal age at conception was an independently significant correlate of these developmental measurements at early school age in CTRS and academic performance after adjusting for demographic, family-related, and biological variables in multivariate analysis. The influence of fathers on the family function, the intelligence and behavioral development of the children at early school age was determined by their job class, education level , and childrearing attitude.

第一章 緒 論
　第一節 研究動機與重要性……………………………………………………. 1
　第二節 研究目的………………………………………………………………. 2
　第三節 研究問題………………………………………………………………. 2
　第四節 重要名詞界定…………………………………………………………. 3
第二章 文獻探討
　第一節 未成年父母親所面臨的衝擊…………………………………………. 4
　第二節 未成年生育對後代影響………………………………………………. 8
　第三節 未成年生育對兒童各項發展可能之影響因素………………………. 13
　第四節 未成年母親的小孩之認知與智力發展的可能影響因素……………. 20
第三章 研究方法
　第一節 研究設計及研究對象…………………………………………………. 22
　第二節 研究架構………………………………………………………………. 22
　第三節 研究工具………………………………………………………………. 24
　第四節 研究過程………………………………………………………………. 30
　第五節 資料處理方式…………………………………………………………. 32
第四章 研究結果
　第一節 家庭環境與人口學基本資料…………………………………………. 34
　第二節 家庭功能………………………………………………………………. 37
　第三節 智力發展………………………………………………………………. 37
　第四節 行為表現………………………………………………………………. 38
　第五節 學習成就………………………………………………………………. 41
　第六節 家庭功能、智力發展及行為表現評估間的相關……………………. 42
　第七節 家庭功能與家庭環境基本資料之關係………………………………. 44
　第八節 智力發展與家庭環境基本資料之關係………………………………. 45
　第九節 行為表現與家庭環境基本資料之關係………………………………. 46
　第十節 學習成就與家庭環境基本資料之關係………………………………. 57
第五章 討 論
　第一節 家庭環境………………………………………………………………. 60
　第二節 家庭功能………………………………………………………………. 61
　第三節 智力發展………………………………………………………………. 63
　第四節 行為表現………………………………………………………………. 65
　第五節 學習成就………………………………………………………………. 71
　第六節 健康狀態………………………………………………………………. 73
第六章 結論、研究限制與建議
　第一節 結 論…………………………………………………………………...75
　第二節 限制與建議……………………………………………………………. 76

參考文獻………………………………………………………………………… 80
表………………………………………………………………………………… 93
圖……………………………………………………………………………….. 162


附錄
附錄一：國外研究引用之大型資料庫……………………………………….. 180
附錄二：研究對象資料……………………………………………………….. 181
附錄三：兒童家庭環境、健康與行為評估問卷…………………………….. 182
附錄四：職業等級之分級內容……………………………………………….. 187
附錄五：家庭社經地位等級表……………………………………………….. 188
附錄六：管教態度分類內容………………………………………………..… 189
附錄七：家庭關懷量表……………………………………………………….. 190
附錄八：家長用Conners行為評估量表……………………………………… 191
附錄九：家長用Conners行為評估量表之行為指標分類…………………… 193
附錄十：中文版家長用Conners行為評估量表之行為指標分類…………… 194
附錄十一：教師用Conners 行為評估量表………………………………….. 195
附錄十二：教師用Conners行為評估量表之行為指標分類………………... 197
附錄十三：兒童行為評估量表……………………………………………….. 198
附錄十四：研究工具內容修訂專家名單…………………………………….. 201
附錄十五：台南市安南區人口特性資料…………………………………….. 202

自述…………………………………………………………………………….. 203

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