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研究生:黃慶凱
研究生(外文):C. K. Huang
論文名稱:不同口腔進食效率早產新生兒之非營養吸吮動作特性
論文名稱(外文):Nonnutritive sucking in premature neonates with different oral feeding status
指導教授:孟令夫孟令夫引用關係
指導教授(外文):L. F. Meng
學位類別:碩士
校院名稱:長庚大學
系所名稱:臨床行為科學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
論文頁數:245
中文關鍵詞:職能治療早產新生兒口腔進食進食效率吮吸非營養吸吮口腔動作陣發吸吮中樞型態形成器
外文關鍵詞:occupational therapypremature neonateoral feedingsucklingfeeding efficiencynonnutritive sucking(NNS)oral-motornonnutritive sucking burstcentral pattern generator (CPG)
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口腔進食是早產新生兒照護上重要的議題,本研究以非營養口腔動作、非營養吮吸力量、非營養陣發吸吮型態的特性,探討非營養吮吸動作能力與口腔進食能力的關係。以自行設計有好的信、效度包含口腔動作與吸吮力量的非營養吸吮動作量表( nonnutritive sucking motor assessment scale)(一致性信度r= 0.97;內在一致性Cronbach’sα= 0.988;效標效度r= 0.44- 0.52),以及非營養陣發吸吮吮吸參數(一致性信度r=0.977- 1;再測信度r= 0.997- 1)進行測量。本研究選取小於GA34排除嚴重併發症之健康早產新生兒36位,在PMA34未滿PMA37時,以進食時效率3 ml/min為切節點分為進食效率差與進食效率好兩組,每組18位新生兒,控制出生體重、妊娠週數、矯正年齡、性別,並施測非營養吸吮前後呼吸率與新生兒神經行為等變項。
結果顯示除了施測時體重(p= .019)與神經行為功能(p= .009)呈現顯著差異,其他控制變向相似(p> .05),於良好的組間控制下,以獨立變項T檢定得到結果如下:1.進食效率差的新生兒非營養吸吮動作能力較差(t = 3.48, p= .001) 而不同進食效率的早產新生兒在無吸吮的口腔動作表現類似(t = 1.63, p= .113);2.進食效率差的新生兒的非營養吮吸動作中舌部(t = 2.95, p= .006)、頜部(t =2.61, p= .013)、舌部(t =2.31,p= .027)等口腔動作控制都較差;3.進食效率差的新生兒非營養吮吸所產生的吮吸力量(t = 4.15,p= .000)也顯著較差;4.在陣發非營養吮吸指數比較,不同進食效率的新生兒在刺激誘發與自發陣發吮吸動作中吮吸的次數、週期、刺激誘發與自發平均間距時間並無差異(p > .05),但進食效率差的新生兒陣發非營養吮吸調節的恆定性較差,三次自發陣發吮吸動作吮吸週期的變異係數(t = -3.01,p= .005)與三次間距時間之變異係數(t = -2.10, p= .044)較大,而三次刺激誘發陣發吮吸動作吮吸週期的變異係數(t = -1.99,p = .075)沒有顯著差異。以Pearson相關檢定,非營養吸吮動作能力與口腔進食效率呈現較低的相關(r =0.44, p= .007),應該還有其他因素影響健康早產兒口腔進食效率的。以多重回歸分析得知,非營養吸吮動作能力、自發陣發吮吸頻率之變異係數、單次誘發與自發陣發吮吸後呼吸率為健康早產兒口腔進食效率的重要預測變項(R2 = .442)。
本研究發現雖然非營養吸吮並不同於口腔進食所發生的營養吸吮,但非營養吸吮的動作能力表現確實會影響早產新生兒口腔進食的表現,而影響分為三個層次:一是透過口腔動作的控制,唇部、頜部與舌部動作之間有好的協調,產生有效的吸吮動作,提供進食所需的吮吸力量;二是透過吮吸中樞成熟的調節,提供穩定的陣發吸吮吮吸節律,產生長時間、有效、連續的吮吸動作,使新生兒可以有長時間、有效、連續的口腔進食表現;三是吮吸中樞與呼吸中樞在非營養吸吮時仍然具有相互調節的能力,使呼吸與吸吮的節律可以獲得好的協調。所以非營養吸吮動作能力是重要的一項指標。
Oral feeding is the most important issue during the development of the premature neonate. The purpose of our study was to assess nonnutritive sucking ability, including oral-motor control, sucking burst, and suckling power, in premature neonates with different oral feeding status. The measure equipments, nonnutritive sucking motor ability scale (NNSMAS) and nonnutritive sucking burst parameters (NNS burst parameters), designed by us with good reliability and validity, were used to measure nonnutritive sucking ability. Eighteen infants with inefficient feeding performance (feeding efficiency < 3ml / min) and eighteen gender matched controls (feeding efficiency≧3ml / min) were compared. All participants were premature neonates without severe complication. Gestation age (≦GA 34 week ), birth body weight (840 to 2660 gw ), corrected age (PMA 34 to 36+ weeks), and behavioral state (state 4 to 5) were treated as controlled variables. The Neurobehavioral characteristic, neuromotor function and the respiration rate during NNS tasks were also evaluated and recorded.
Two groups were significantly different in body weight (p= .019) and neurobehavioral outcome (p= .009), and other controlled variables were controlled well (p>.05). The findings demonstrated that (1) NNS motor ability (t = 3.48, p= .001) and oral motor control during suckling (t =1.63, p= .113), (2) tongue (t =2.31, p= .027), jaw (t =2.61, p= .013), lip (t =2.95, p= .006) movement, and (3) the suckling power (t =4.15, p= .000) of the inefficient feeders were significantly poorer than those of the efficient ones. Two groups were not significantly different in suckling times and durance within facilitated and spontaneous NNS burst, and intervals between facilitated and spontaneous NNS bursts (p > .05). The coefficient of variance (CV) of suckling duration within spontaneous NNS burst (t =-3.01, p= .005) and intervals between bursts (t =-2.10, p= .044) of the inefficient feeders were higher than the efficient ones, but CV of suckling duration within facilitated NNS burst were not significantly different between two groups (t =-1.99, p = .075). Because the correlation between NNS motor ability and feeding efficiency was not strong (r =0.44, p= .007), there were some other factors, which would affect feeding efficiency of infants. We also used multiple linear regression (MLR) method, to find that three factors, including NNS motor ability, CV of suckling duration within spontaneous NNS burst, and respiration rate during single stimulation to NNS burst, were the most significant predictive indicators(R = .442).
Though NNS was different from nutritive sucking (NS), NNS were certainly correlated to the oral feeding performance of premature neonates. In this present study, NNS motor ability reflected the effects in three situations: (1) When lip, tongue, and jaw movement were well controlled, infants would appear efficient suckling and produce good suckling power for feeding. (2) Through maturation of rhythmic mechanism, sucking central pattern generator produced steady bursts, which made infants perform prolong, and efficient oral feeding performance. (3) During oral feeding, the integration of sucking and respiration centers made suckle-breath coordination perform well. Therefore the NNS motor ability was an important indicator for oral feeding performance.
目 錄
指導教授推薦書……………………………………………………………………
口試委員會審定書…………………………………………………………………
授權………………………………………………………………………………iii
誌謝………………………………………………………………………………iv
中文摘要…………………………………………………………………………vi
英文摘要…………………………………………………………………………ix
目錄………………………………………………………………………………xi
第一章 緒論……………………………………………………………………1
第一節 前言……………………………………………………………………1
第二節 研究動機………………………………………………………………2
第三節 研究目的………………………………………………………………3
第四節 研究提問與假設………………………………………………………4
壹、 研究提問………………………………………………………………4
貳、 研究假設………………………………………………………………5
第五節 名詞釋義………………………………………………………………5
壹、 經後年齡………………………………………………………………5
貳、 早產兒…………………………………………………………………6
參、 口腔進食效率…………………………………………………………6
肆、 吮吸……………………………………………………………………7
伍、 非營養吸吮……………………………………………………………7
陸、 口腔動作控制…………………………………………………………7
柒、 陣發吸吮………………………………………………………………8
捌、 吮吸力量………………………………………………………………8
玖、 變異係數………………………………………………………………8
第二章 文獻回顧………………………………………………………………11
第一節 前言……………………………………………………………………11
壹、 足月新生兒的進食表現………………………………………………11
貳、 獨立口腔進食功能對早產新生兒的重要性…………………………12
參、 新生兒加護病房中早產新生兒營養獲取的特性……………………13
肆、 早產新生兒口腔進食的挑戰…………………………………………14
第二節 新生兒的口腔進食功能表現…………………………………………14
壹、 新生兒口咽解剖生理特性……………………………………………14
一、 口腔、咽部與喉部的解剖構造………………………………………14
(一) 口腔咽部與喉部………………………………………………………14
(二) 口、咽、喉部的感覺與動作神經支配………………………………17
(三) 進食時肌肉組織與動作控制…………………………………………20
(四) 進食時骨骼系統與關節的功能………………………………………22
二、 反射機制在進食功能的角色…………………………………………23
(一) 尋根反射………………………………………………………………24
(二) 咬合反射………………………………………………………………25
(三) 吸吮反射………………………………………………………………26
(四) 作噁反射………………………………………………………………26
(五) 吞嚥反射………………………………………………………………27
貳、 新生兒口腔動作與腔室調節的特性…………………………………29
一、 新生兒口腔動作控制…………………………………………………29
(一) 唇部與唇部運動………………………………………………………29
(二) 頜部與頜部運動………………………………………………………30
(三) 舌部與舌部運動………………………………………………………30
(四) 頰部與頰部運動………………………………………………………31
(五) 顎部與顎部運動………………………………………………………32
二、 腔室的改變對進食的影響……………………………………………32
參、 新生兒吸吮吞嚥呼吸的特性…………………………………………33
一、 吮吸……………………………………………………………………33
二、 吞嚥的動作機制………………………………………………………35
三、 吸吮、吞嚥、呼吸協調………………………………………………36
肆、 影響早產新生兒進食功能表現的因素………………………………37
一、 生理穩定的控制………………………………………………………37
(一) 中樞神經系統持續發育中……………………………………………38
(二) 呼吸器官仍未發育完全………………………………………………39
(三) 消化道消化吸收功能未發育完全……………………………………40
二、 早產新生兒的行為狀態………………………………………………41
三、 動作與姿勢控制………………………………………………………43
四、 矯正年齡的影響………………………………………………………43
(一) 年齡對口腔動作的影響………………………………………………44
(二) 年齡對吸吮、吞嚥、呼吸的影………………………………………45
(三) 年齡對口腔內壓的影響………………………………………………46
(四) 年齡對進食效率的影響………………………………………………46
伍、 早產新生兒口腔進食能力的表現……………………………………47
一、 進食方式 ……………………………………………………………47
二、 進食量…………………………………………………………………48
三、 進食時間………………………………………………………………49
四、 進食速率………………………………………………………………50
陸、 非營養吸吮動作能力與口腔進食能力的關係………………………50
第三節 非營養吸吮動作能力的特質…………………………………………52
壹、 非營養吸吮的口腔動作的特質………………………………………52
一、 非營養吸吮唇部動作…………………………………………………53
二、 非營養吸吮頜部動作…………………………………………………53
三、 非營養吸吮舌部動作…………………………………………………54
貳、 非營養吸吮的吮吸型態的特質………………………………………56
參、 非營養吸吮與口腔內壓的關係………………………………………57
肆、 非營養吸吮與吞嚥、呼吸的關係……………………………………58
第四節 進食能力評量工具的分類與評析……………………………………59
壹、 感覺動作評估…………………………………………………………59
一、 Schedule for oral motor assessment ……………………59
二、 Early feeding skill assessment …………………………60
三、 Harris clinical assessment…………………………………61
四、 Oral-motor and feeding evaluation………………………61
五、 Clinical feeding evaluation for infants ……………62
六、 Neonatal oral-motor assessment scale …………………62
七、 Routine glove-finger test …………………………………63
貳、 影像醫學檢測口腔進食功能…………………………………………64
一、 Cineradiographic study ………………………………………64
二、 Vediofluoroscopic swallowing study ……………………64
三、 Ultrasonographic study ………………………………………65
四、 Micro-video-camera ……………………………………………65
參、 吸吮型態節律性評估…………………………………………………65
一、 感覺動作評估…………………………………………………………66
二、 口腔內部動作影像的偵測……………………………………………67
三、 肌肉活動的偵測………………………………………………………67
四、 口腔內壓力的偵測……………………………………………………68
五、 聲波的偵測……………………………………………………………69
肆、 結論……………………………………………………………………70
第三章 研究方法………………………………………………………………71
第一節 研究方法………………………………………………………………71
壹、 研究設計與變項定義…………………………………………………71
貳、 研究架構………………………………………………………………71
第二節 研究對象………………………………………………………………73
壹、 研究個案來源…………………………………………………………73
貳、 樣本選擇標準…………………………………………………………73
參、 個案排除條件…………………………………………………………73
肆、 個案數量………………………………………………………………74
第三節 評量工具………………………………………………………………75
壹、 口腔進食能力評量……………………………………………………75
貳、 臨床非營養吸吮動作能力評估………………………………………76
參、 非營養吸吮中呼吸頻率測量…………………………………………77
肆、 新生兒神經動作行為評量……………………………………………78
一、 新生兒神經行為評估…………………………………………………78
二、 新生兒行為狀態………………………………………………………79
三、 新生兒神經動作評估…………………………………………………79
第四節 研究步驟………………………………………………………………80
壹、 臨床非營養吸吮動作能力評量表評量信度效度測試………………80
一、 NNSMAS 量表理論效度………………………………………………80
二、 NNSMAS 量表施測者間一致性信度測試……………………………80
三、 非營養陣發吸吮吮吸參數施測者間一致性與再測信度測試………81
四、 NNSMAS 量表同時效標效度測試……………………………………81
貳、 不同口腔進食效率早產新生兒之非營養吸吮動作特性研究程序…82
第五節 資料分析………………………………………………………………83
壹、 人口學資料……………………………………………………………83
貳、 信度效度測試…………………………………………………………84
一、 NNSMAS 量表施測者間一致性信度測試……………………………84
二、 非營養陣發吮吸參數測量施測者間信度與再測信度測試…………84
三、 NNSMAS 量表效標效度測試…………………………………………84
參、 兩組新生兒非營養吸吮動作能力表現………………………………85
肆、 進食效率相關因素測試………………………………………………85
一、 兩組新生兒神經行為功能與神經動作功能比較……………………85
二、 兩組新生兒施測NNSMAS 前後呼吸率比較…………………………86
三、 口腔進食效率的影響因子分析………………………………………86
第四章 研究結果………………………………………………………………87
第一節 受試者人口學分析……………………………………………………87
壹、 非營養吸吮動作評估量表量表分數信度測試受試者人口學分析…87
貳、 非營養陣發吸吮吮吸參數信度測試受試者人口學分析……………88
參、 不同口腔進食效率早產新生兒非營養吸吮動作特性人口學分析…90
第二節 非營養吸吮動作評估量表信效度測試………………………………95
壹、 施測者間一致性信度測試分析………………………………………95
一、 施測者間評分一致之百分比…………………………………………95
二、 非營養吸吮動作評估量表各項目施測者間Kappa一致性檢定……98
三、 非營養吸吮動作評估量表同項目中三次施測的變異係數…………101
四、 非營養吸吮動作評估量表各次系統施測者間一致性檢定…………102
五、 非營養吸吮動作評估量表原始分數施測者間一致性檢定…………104
六、 非營養吸吮動作評估量表最適分數施測者間一致性檢定…………105
貳、 非營養吸吮動作能力量表內在一致性信度測試分析………………105
一、 非營養吸吮動作能力量表原始分數內在一致性……………………105
二、 非營養吸吮動作能力量表最適分數內在一致性……………………106
三、 非營養吸吮動作能力量表吮吸下最適分數內在一致性……………107
參、 非營養吸吮動作能力非營養陣發吸吮參數測量信度測試分析……108
一、 非營養陣發吮吸參數測量單一施測者再測信度測試分析…………108
二、 非營養陣發吮吸參數測量施測者一致性信度分析…………………108
肆、 NNSMAS 量表效度測試分析…………………………………………109
一、 效標效度………………………………………………………………109
二、 NNSMAS 與進食效率之接受操作特質曲線分析……………………110
第三節 不同進食效率早產新生兒非營養吸吮動作特質之分析……………112
壹、 進食速率差的新生兒與控制組非營養吸吮動作能力之比較分析…112
一、 不同進食效率新生兒NNSMAS 量表原始分數之比較………………112
二、 不同進食效率新生兒NNSMAS 量表最適分數之比較………………114
三、 不同進食效率新生兒有無吮吸NNSMAS 量表最適分數之比較……115
四、 不同進食效率新生兒NNSMAS 量表各項最適分數之比較…………116
貳、 不同進食效率新生兒非營養陣發吸吮吮吸參數比較結果分析……118
一、 不同進食效率新生兒誘發 NNS Burst吮吸參數比較分析………118
二、 不同進食效率新生兒自發 NNS Burst吮吸參數比較分析………121
三、 不同進食效率新生兒誘發與自發 NNS Burst吮吸次數比較分析124
四、 不同進食效率新生兒誘發與自發 NNS Burst間時距比較分析…130
五、 不同進食效率新生兒 NNS Burst連續吮吸比較分析……………132
參、 實驗組與控制組吮吸力量之比較分析………………………………134
第四節 相關因素結果分析……………………………………………………135
壹、 不同進食效率新生兒呼吸率之結果分析……………………………135
一、 非營養吸吮動作評估期間制組間呼吸率之比較……………………135
二、 不同進食效率新生兒分別在評估期間不同時段呼吸率之比較……136
貳、 不同進食效率新生兒神經行為動作表現之結果分析………………138
一、 不同進食效率新生兒關節活動評估結果比較分析…………………138
二、 不同進食效率新生兒神經行為評估結果比較分析…………………140
三、 早產新生兒非營養吸吮動作能力與神經行為功能相關分析………141
參、 口腔進食效率影響因素線性複回歸分析……………………………142
第五章 討論……………………………………………………………………147
第一節 非營養吸吮動作評估量表信度 ……………………………………147
壹、 非營養吸吮動作評估量表的建立……………………………………147
一、 NNSMAS的施測項目的建立 …………………………………………147
二、 NNSMAS的評分系統 …………………………………………………148
貳、 非營養吸吮動作評估量表量表評分一致性…………………………148
一、 影響NNSMAS各項目施測者間評分一致性的原因 …………………148
(一) NNSMAS 無吮吸口腔動作中施測者間一致性低度至極高度………149
(二) NNSMAS 吮吸的唇部動作中施測者間一致性低度至高度…………149
(三) NNSMAS 吮吸的舌部動作中施測者間一致性低度至極高度………150
(四) NNSMAS 吮吸的頜部動作中施測者間一致性中度至極高度………152
(五) NNSMAS 吮吸力量中施測者間一致性中度至極高度………………152
二、 吮吸動作的項目多次施測對NNSMAS一致性的影響 ………………153
三、 有無吮吸動作對NNSMAS內在信度的影響 …………………………154
參、 非營養陣發吸吮吮吸參數測量的一致性……………………………155
一、 影響連續吮吸動作次數判定的因素…………………………………155
二、 影響非營養陣發吸吮連續吮吸動作起迄時間判定的因素…………157
肆、 非營養吸吮動作評估量表量表效度…………………………………158
一、 NNSMAS 各項目的表面與理論效度…………………………………158
二、 NNSMAS 的效標效度…………………………………………………159
三、 NNSMAS 與進食效率之接受操作特質曲線…………………………160
伍、 非營養吸吮動作量表與非營養陣發吸吮吮吸參數信效度檢測建議161
第二節 不同口腔進食效率的早產新生兒非營養吸吮能力之差異…………162
壹、 不同口腔進食效率的早產新生兒人口學的差異……………………162
一、 不同口腔進食效率的早產新生兒人口學的差異……………………162
二、 不同口腔進食效率的早產新生兒併發症的分佈……………………163
貳、 非營養吸吮能力中口腔動作的差異…………………………………164
一、 口腔進食效率差的早產新生兒非營養吸吮動作能力較差…………164
二、 口腔進食效率差的早產新生兒唇部、頜部、舌部動作控制較差…165
三、 不同口腔進食效率早產兒無吮吸動作時口腔動作控制無差異……166
四、 口腔進食效率差的早產新生兒在吮吸動作過程中口腔動作控制差167
五、 影響健康早產新生兒進食效率的六項非營養吸吮指標動作………168
六、 非營養吸吮中舌部與頜部動作出現與節律性的指標意義…………169
參、 非營養吸吮能力中陣發吮吸型態的特質與差異……………………169
一、 早產新生兒透過吮吸中樞產生穩定的非營養陣發吮吸動作………169
二、 神經與呼吸功能對非營養陣發吮吸的影響…………………………172
三、 口腔刺激對非營養陣發吮吸的影響…………………………………173
四、 不同進食效率的健康新生兒非營養陣發吸吮調節的特質…………174
(一) 進食效率差的新生兒對口腔刺激的反應慢且調節差………………174
(二) 缺乏刺激回饋時進食效率差的新生兒非營養陣發吮吸調節………175
(三) 非營養陣發吮吸間的調節……………………………………………176
(四) 長時間非營養陣發吮吸的調節………………………………………176
肆、 非營養吸吮能力中吮吸力量的差異…………………………………178
伍、 非營養吸吮動作能力與非營養陣發吸吮對早產新生兒介入的影響180
第三節 影響口腔進食表現的其他因素………………………………………181
壹、 非營養吸吮能力無法解釋所有口腔進食效率的差異………………181
貳、 同進食效率的早產新生兒在神經行為表現的差異…………………184
參、 不同進食效率的早產新生兒在神經行為表現的差異………………184
第四節 結論……………………………………………………………………186
第五節 研究限制與建議………………………………………………………187
參考文獻 …………………………………………………………………………189
附錄一 ……………………………………………………………………………207
附錄二 ……………………………………………………………………………208
附錄三 ……………………………………………………………………………211
附錄四 ……………………………………………………………………………212


圖表目錄
表3.1.1 研究變項………………………………………………………………72
表3.2.1 文獻回顧效應值大小…………………………………………………74
表3.3.1 Brazelton infant’s state……………………………………79
表4.1.1 施測者間一致性測試17位受測新生兒人口學資料…………………88
表4.1.2 非營養陣發吸吮吮吸參數信度測試受試新生兒人口學基本資料…89
表4.1.3 不同口腔進食效率早產新生兒非營養吸吮動作特性人口學資料…90
表4.1.4 實驗組與對照組新生兒人口學獨立樣本t 檢定……………………92
表4.1.5 實驗組與對照組新生兒合併症分佈…………………………………93
表4.1.6 實驗組與對照組新生兒進食能力特質分析…………………………94
表4.1.7 實驗組與對照組個案相關進食能力獨立樣本t 檢定分析結果……94
表4.2.1 NNSMAS 量表分數兩治療師分別施測評分之一致性分析…………97
表4.2.2 NNSMAS 量表分數一位治療師施測兩治療師同時評分一致性分析98
表4.2.3 NNSMAS 量表分數(唇部)兩治療師分別施測Kappa分析…………99
表4.2.4 NNSMAS 量表分數(舌部)兩治療師分別施測Kappa分析…………99
表4.2.5 NNSMAS 量表分數(頜部)兩治療師分別施測Kappa分析…………100
表4.2.6 NNSMAS 量表分數(吸吮力量)兩治療師分別施測Kappa分析……100
表4.2.7 NNSMAS 量表分數一位治療師施測兩治療師同時評分Kappa分析100
表4.2.8.a. NNSMAS 同項目中三次施測的變異係數………………………101
表4.2.8.b. NNSMAS 同項目中三次施測的變異係數………………………102
表4.2.9 NNSMAS 各次系統第一次分數施測者間信度相關係數分析………103
表4.2.10 NNSMAS 各次系統第二次分數施測者間信度相關係數分析……103
表4.2.11 NNSMAS 各次系統第三次分數施測者間信度相關係數分析……104
表4.2.12 NNSMAS 各次系統原始分數施測者間信度相關係數分析………104
表4.2.13 NNSMAS 各次系統量測最適分數施測者間信度相關分析………105
表4.2.14 NNSMAS 量表分數內在一致性Cronbach’s α分析……………106
表4.2.15 NNSMAS 量表最適分數內在一致性Cronbach’s α分析………107
表4.2.16 NNSMAS 吸吮下最適分數內在一致性Cronbach’s α分析……107
表4.2.17 非營養陣發吸吮吮吸參數單一施測者再測信度相關係數分析 …108
表4.2.18 非營養陣發吸吮吮吸參數施測者一致性信度相關係數分析 ……109
表4.2.19 NNSMAS 效標效度分析 ……………………………………………110
表4.2.20 NNSMAS 作為檢定結果變數之ROC曲線正確選取與錯誤選取率 111
表4.2.21 NNSMAS 以174.5分為診斷切節點與進食效率好壞二聯表 ……112
表4.3.1 不同進食效率新生兒NNSMAS 原始分數之獨立樣本T檢定 ………113
表4.3.2 不同進食效率新生兒NNSMAS 最適分數之差異……………………115
表4.3.3 不同進食效率新生兒有無吸吮動作NNSMAS 最適分數之差異……116
表4.3.4 不同進食效率新生兒非營養吸吮動作能力評估量中各項分數比較117
表4.3.5 不同進食效率新生兒刺激誘發NNSBurst吮吸次數獨立樣本T檢定119
表4.3.6 不同進食效率新生兒刺激誘發NNSBurst吸吮週期獨立樣本T檢定120
表4.3.7 不同進食效率新生兒自發NNSBurst吮吸次數之獨立樣本T檢定…122
表4.3.8 不同進食效率新生兒自發NNSBurst吸吮週期獨立樣本T檢定……123
表4.3.9 刺激誘發與自發NNSBurst吮吸次數之成對樣本T檢定……………125
表4.3.10.a.進食效率差組誘發自發NNSBurst吮吸次數之成對數本T檢定127
表4.3.10.b.對照組刺激自發NNSBurst吸吮次數之成對樣本T檢定………127
表4.3.11 刺激誘發與自發NNSBurst吮吸次數之成對樣本T檢定…………128
表4.3.12.a.進食效率差組誘發自發NNSBurst間時距之獨立樣本T檢定…129
表4.3.12.b.對照組誘發自發NNSBurst吮吸週期之成對樣本T檢定………129
表4.3.13 不同進食效率新生兒誘發與自發NNSBurst間時距獨立T檢定…131
表4.3.14.a.進食效率差組三次激誘發與自發Burst間時距之ANOVA分析131
表4.3.14.b.對照組三次誘發與自發NNSBurst間時距ANOVA分析…………132
表4.3.15 不同進食效率新生兒連續吸吮三分鐘吸吮次數獨立樣本T檢定…133
表4.3.16 不同進食效率新生兒吮吸力量項目1分析之列聯表………………134
表4.3.17 不同進食效率新生兒吮吸力量項目2分析之列聯表………………134
表4.3.18 不同進食效率新生兒吮吸力量項目3分析之列聯表………………135
表4.4.1 不同進食效率新生兒施測前、施測時呼吸速率之獨立樣本T檢定136
表4.4.2 進食效率差組施測前後三時段呼吸率ANOVA分析…………………136
表4.4.3 進食效率差組施測前後三時段呼吸速率事後Boferronia 檢定 137
表4.4.4 對照組施測前後三時段呼吸速率ANOVA分析………………………138
表4.4.5 不同進食效率新生兒關節活動Mann-whitney U 檢定之結果 …139
表4.4.6 不同進食效率新生兒神經行為評估結果獨立樣本T檢定 …………141
表4.4.7 NNSMAS與神經行為功能之Pearson 相關係數分析………………142
表4.4.8 自變項與進食效率單變量分析………………………………………143
表4.4.9 進食效率線性複回歸模式I之模式摘要 ……………………………143
表4.4.10 進食效率線性複回歸模式I之變異數分析…………………………144
表4.4.11 進食效率線性複回歸模式I之回歸係數……………………………144
表4.4.12 進食效率線性複回歸模式II之模式摘要…………………………145
表4.4.13 進食效率線性複回歸模式II之變異數分析………………………145
表4.4.14 進食效率線性複回歸模式II之回歸係數…………………………146
圖3.1.1 研究架構圖……………………………………………………………72
圖4.1.1 不同口腔進食效率早產新生兒非營養吸吮動作特性人口學盒型…91
圖4.2.1 NNSMAS作為檢定結果變數之ROC 曲線分析圖……………………111
圖4.3.1 不同進食效新生兒NNSMAS原始分數之誤差長條 …………………113
圖4.3.2 不同進食效新生兒NNSMAS最適分數之誤差長條圖 ………………114
圖4.3.3 不同進食效新生兒有無吸吮動作NNSMAS最適分數之誤差長條圖 116
圖4.3.4 不同進食效新生兒誘發NNSBURST吮吸次數誤差長條圖 …………119
圖4.3.5 進食效率差組與對照組在誘發NNSBurst吸吮週期誤差長條圖 …121
圖4.3.6 不同進食效率新生兒在自發NNSBurst吮吸次數誤差長條圖 ……122
圖4.3.7 不同進食效率新生兒自發NNSBurst吮吸週期誤差長條圖 ………124
圖4.3.8 刺激誘發與自發吸吮陣發吸吮吮吸次數之線形圖…………………125
圖4.3.9 不同進食效率新生兒刺激誘發與自發陣發吸吮吮吸次數線形圖…127
圖4.3.10 不同進食效率新生兒誘發與自發NNSBurst時距誤差長條圖……130
圖4.3.11 不同進食效率新生兒誘發與自發NNSBurst間時距線形圖………132
圖4.3.12 不同進食效率新生兒連續吸吮三分鐘吸吮次數之線形圖 ………133
圖4.4.1 不同進食效率新生兒施測前後三時段平均呼吸速率複線圖………138
圖4.4.2 不同進食效率新生兒關節活動誤差長條圖…………………………139
圖4.4.3 不同進食效率新生兒神經行為評估結果之誤差長條圖……………142
Ahuja, V., Yencha, M. W., & Lassen, L. F. (1999) Head and neck manifestations of gastroesophageal reflux disease. American Family Physician. 60(3): 885-886.
Amaizu, N., Shulman, R. J., Schanler, R. J. & Lau, C. (2008). Maturation of oral feeding skills in preterm infants. ACTA Paediadtrica, 97: 61-67.
American Academy of Pediatrics. (2004). Age terminology during the perinatal period. Pediatrics, 144:1362-1364.
American Academy of Pediatrics. (2008). Hospital discharge of the high-risk neonate. Pediatrics, 122: 1119-1126.
Ardran, G. M., Kemp, F. H., & Lind, F. (1958). A cineradiographic study of bottle feeding. The british journal of radiology, 31: 11-22.
Ardran, G. M., Kemp, F. H., & Lind, F. (1958). A cineradiographic study of breast feeding. The british journal of radiology, 31: 156-162.
Anderson, M.S., Townsend, S. F., Johnson, C. B., & Hay, W. W. (2002). Enteral Nutrition. In Merenstein, G. B. & Gardner, S. L(Ed.). Handbook of Neonatal Intensive Care (5th ed., pp. 314-340). St. Louis, MS: Mosby-Year Book inc..
Arvedson, J. C. & Brodsky, L. (2002). Pediatric swallowing and feeding: assessment and management(2nd ed.). Albany, NY: Singular Publishing Group.
Bamford, O., Taciak, V., & Gewolb, I.H. (1992) The relationship between rhythmic swallow and breathing during suckle feeding in term neonates. Pediatric Research, 31, 619-24.
Bastian, R. W., & Riggs, L. C. (1999). Role of sensation in swallowing function. Laryngoscope, 109,1947-1977.
Bazyk, S. (1990). Factors associated with trasition to oral feeding in infants fed by nasogastric tubes. American journal of occupational therapy, 1990, 44: 291-295.
Boiron, M., Nobrega, L. D., Roux, S., Henrot, A., & Saliba, E. (2007). Effects of oral stimulation and oral support on non-nutritive sucking and feeding performance in preterm infants. Developmental medicine & child neurology, 49: 439-445.
Bosma, J. F., Hepburn, L. G., Josell, S. D., & Baker, K. (1990). Ultrasound demonstration of tongue motions during suckle feeding. Developmental medicine & child neurology, 32: 223- 229.
Braun, M. A., & Palmer ,M. M. (1985). A pilot study of oral-motor in high-risk infants. Physical and occupational therapy in pediatrics, 5, 13-25.
Brazelton, T. B., & Nugent, J. K. (1995). Neonatal behavioral assessment scale (3rd ed.). London: Mac Keith Press.
Bromiker, R., Arad, I., Loughran, B., Netzer, D., Kaplan, M. & Medoff-Cooper, B. (2005). Comparison of sucking patterns at introduction of oral feeding and at term in Israeli and American preterm infants. Acta Pædiatrica, 94: 201–204.
Bu’lock, F., Woolridge, M. W., & Baum, J. D. (1990). Development of coordination of sucking, swallowing, and breathing: ultrasound study of term and preterm infants. Developmental medicine of children neurology, 32: 66- 75.
Case-Smith, J., Cooper, P., & Scala, V. (1989). Feeding efficiency of premature neonates. American journal of occupational therapy, 43: 245-250.
Comrie, J. D., & Helm, J. M. (1997). Common feeding problem in the intensive care nursery: maturance, organization, evaluation, and management strategies. Seminars in speech & language, 18: 239-260.
Conway, A. (1994). Instruments in neonatal research: measuring preterm infant feeding ability, part 1:bottle feeding. Neonatal network, 13(4), 71-75.
Cowett, R. M., Lipsitt, L. p., Vohr, B. & Oh, W. (1978). Abrrations in sucking behavior of low-birthweight infants. Developmental medicine & child neurology, 20: 701- 729.
Daniels, H., Devlieger, H., Casaer, P., Callens, M., & Eggermont, E. (1986). Nutritive and non-nutritive sucking in preterm infants. Journal of the development physiology, 8: 117-121.
Daniels, L., & Worthingham, C. (1986). Muscle testing: techniques of manual examination (5th ed.). Philadelphia, PA: W. B. Saunders Company.
Doty, R. W., & Bosma, J. F. (1955). An electromyographic analysis of reflex deglutition. Journal of neurophysiology, 19: 44-60.
Dematteo, C., Matovich, D., & Hjartarson, A. (2005). Comparison of clinical and videofluoroscopic evaluation of children with feeding and swallowing difficulties. Developmental medicine & child neurology, 47: 149-157.
Dubowitz, L. M., Dubowitz, V., & Mercuri, E. (1999). Neurological Assessment of the Preterm and Fullterm Newborn Infant. London: Mac Keith Press.
Ellison, P. H. (1994). Infant neurological international battery. San Antonio, TX: Therapy Skill Builders.
Ertekin, C., & Aydogdu, I. (2003). Neurophysiology of swallowing. Clinical Neurophysiology, 114: 2226–2244.
Estep, M., Barlow, S.M., Vantiplli, R., Finan, D. & Lee, J. (2008). Non-nutritive sucking parameters in preterm infants with RDS. Journal of neonatal nursing, 14: 28-34.
Finan, D. S., & Barlow, S. M. (1998). Intrsic dynamics and mechanosensory modulation of non-nutritive sucking in human. Early human development, 52: 181-197.
Fucile, S., Gisel, E., & Lau, C. (2002). Oral stimulation accelerates the transition from tube to oral feeding in preterm infants. The Journal of Pediatrics, 141, 230-236.
Gradner, S. L., (1993). The neonate and the environment: impact on development. In G. B. Merenstein, & S. L. Gradner (Eds.). Handbook of neonatal intensive care (3rd ed., pp 570). St. Louis: Mosby- Year Book inc..
Gray , H. (1825-1861), & Clemente, C. D. (1985). Anatomy of human body (30th ed.).Philadelphia, PA: Lea & Febiger.
Gray , H. (1825-1861),Standring, S., Ellis, H. & Berkovitz, B. K. B. (2005). Gray’s Anatomy :the anatomical basis of clinical practice (39th ed.). Edinburgh, NY: Churchill Livingstone.
Gewolb, I.H., Bosma, J. F., Taciak, V. L., & Vice, F. L. (2001). Abnormal developmental patterns of suck and swallow rhythms during feeding in infants with bronchopulmonary dysplasia. Developmental medicine & child neurology, 43: 454–459.
Gewolb, I.H., Bosma, J. F., Reynolds, E. W., & Vice, F. L. (2003). Integration of suck and swallow rhythms during feeding in preterm infants with and without bronchopulmonary dysplasia. Developmental medicine & child neurology, 45: 344–348.
Gewolb, I. H., & Vice, F. L. (2006). Maturational changes in the rhythms, patterning, and coordination of respiration and swallow during in preterm and term infants. Developmental medicine & child neurology, 48: 589-594.
Gewolb, I. H., Vice, F. L. Schwietzer-Kenney, E. L., Taciak, V. L., & Bosma, J.F.(2001). Developmental patterns of rhythmic suck and swallow in preterm infants. Developmental Medicine & Child Neurology, 43(1): 22-27.
Glass, R., P. & Wolf, L., S. (1994). A global perspective on feeding assessment in the NICU. American journal of occupation therapy, 48: 514- 526.
Greer, J. J., & Funk, G. D. (2005). Perinatal development of respiratory motoneurons. Respiratoryphysiology & neurobiology,149:43-61.
Hagedorn, M. I. E., Gardner, S. L., & Abman, S. H. (2002). Respiratory Diseases. In Merenstein, G. B. & Gardner, S. L (Ed.). Handbook of Neonatal Intensive Care (5rd ed., pp. 485-575). St. Louis, MS: Mosby-Year Book inc..
Hack, M., Estabrook, M. M., & Robertson, S. S. (1985). Development of sucking rhythm in preterm infants. Early human development : 133-140.
Hanlon, M.B., Tripp, J.H., Ellis, R.E., Flack, F.C., Selley, W.G., & Shoesmith, H.J. (1997). Deglutition apnea as indicator of maturation of suckle feeding in bottle-fed infants. Developmental Medicine and Child Neurology, 39, 534-542.
Hafstorm,M., & Kjellmer, I. (2000). Non-nutritive sucking in healthy pre-term infant. Early human development, 60: 13-24.
Hafstorm,M., & Kjellmer, I. (2001). Non-nutritive sucking in sick preterm infants. Early human development, 63: 37-52.
Harris, M. (1986). Oral-motor management of high-risk neonate. Physical and occupational therapy in pediatrics, 6, 231-253.
Hida, W., Kurosawa, H., Okabe, S., Kikuchi, Y., Chung, Y., & Takishima, T. (1995). Hypoglossal nerve stimulation affects the pressure-volume behavior of the upper airway. American respiratory critical care medicine, 151:455-460.
Howe, T. H., Shen, C., Hsieh, Y., & Hsieh, C. (2007). Psychometric characteristics of the Neonatal Oral-Motor Assessment Scale in healthy preterm infants. Developmental medicine & child neurology, 49: 915-919.
Howe, T. H., Sheu, C. F., & Holzman, I. R. (2007). Bottle-feeding behaviors in preterm infants with and without bronchopulmonary dysplasia. American Journal of Occupational Therapy. 61(4):378-83.
Hunter, J. G. (1990). Pediatric feeding dysfunction. In C. J. Semmler, & J. G. Hunter (Eds). Early occupational therapy intervention: neonate to three years.(pp.124- 184). Gaithersburg, MD: Aspen publishers Inc..
Hunter, J.G. (2005). Neonatal intensive care unit. In J.Case-Smith(Ed.). Occupational therapy for children (5th ed., pp. 688-770). St. Louis, MO: Elsevier Inc..
Jean, A. (2001). Brain stem control of swallowing: neuronal network and cellular mechanism. Physiological reviews, 81: 929-969.
Jadcherla, S. R., & Shaker, R. (2001). Esophageal and upper esophageal sphincter motor function in babies. [Review] [35 refs]. American Journal of Medicine. 111( Suppl 8A): 64-68,
Korner, A. F., & Thom, V. A. (1990). Neurobehavioral assessment of the preterm infant manual. San Antonio, TX : The Psychological Corporation.
Katz-Salamon, M., Allert, K., Bergstrom, B. M., Ericsson, K., Hesser, U., & Forssberg, H. (1997). Perinatal risk factors and neuromotor behavior during the neonatal period. Acta Paediatrica Supplement: 27-36.
Kelly, B. N., Huckabee, M., & Jones R. D. (2006). Christopher M.A. Frampton Nutritive and non-nutritive swallowing apnea duration in terminfants: Implications for neural control mechanisms. Respiratory Physiology & Neurobiology, 154: 372–378.
Kinneer M. D., & Beachy P. (1994). Nipple feeding premature infants in the neonatal intensive-care unit: factors and decisions. J Obst Gynecol Neonatal Nurs, 23, 105-112.
Kilbride, H. W., Bendorf, K., & Wheeler, R. (1993). Total parenteral nutrition. In Merenstein, G. B. & Gardner, S. L (Ed.). Handbook of Neonatal Intensive Care (3rd ed., pp. 184-206). St. Louis, MS: Mosby-Year Book inc..
Kilbride,H. W., Leick-Rude, M. K., & Allen, N. H. (2002). Total Parenteral Nutrition. In Merenstein, G. B. & Gardner, S. L (Ed.). Handbook of Neonatal Intensive Care (5th ed., pp. 341-357). St. Louis, MS: Mosby-Year Book inc..
Kitagawa, J., Shingai, T., Takahashi, Y., & Yamada, Y. (2002). Pharyngeal branch of the glossopharyngeal nerve plays a major role in reflex swallowing from the pharynx. American Journal of Physiology - Regulatory Integrative & Comparative Physiology. 282(5):R1342-7
Koenig, J. S., Davies, A. M., & Thach, B. T. (1990). Coordination of breathing, sucking, and swallowing during bottle feeding in human infants. Journal of applied physiology, 69: 1623-1629.
Kostovic, I. & Judas, M. (2002). Correlation between the sequential ingrowth of afferents and transient patterns of cortical lamination in preterm infants. The Anatomical Record, 267:1–6 .
Lahra, M. M., Beeby, P. J., & Jeffery, H. E. (2009). Maternal versus fetal inflammation and respiratory distress syndrome: a 10-year hospital cohort study. Archives of Disease in Childhood Fetal & Neonatal Edition. 94: F13-16.
Lau, C., & Hurst, N. (1999). Oral feeding in infants. [Review] [142 refs]Current Problems in Pediatrics. 29(4):105-124.
Lau, C., & Kusnierczyk, I. (2001). Quantitative evaluation of infant’s nonnutritive and nutritive sucking. Dysphagia, 16: 58–67
Lau, C., Sheena, H. R., Shulman, R. J., & Schanler, R. J. (1997). Oral feeding in low birth weight infants. Journal of Pediatrics. 130(4):561-569.
Lau, C., Smith, E. O., & Schanler, R. J. (2003). Coordination of suck-swallow and swallow respiration in preterm infants. Acta peadiatric, 92:721-727.
Law-Morstatt, L., Judd, D. M., Snyder, P., Baier, R. J., & Dhanireddy, R. (2003). Pacing as a treatment technique for transitional sucking patterns. Journal of Perinatology. 23(6):483-488,
Lee, K. G. (2008). Indetifying the high-risk newborn and evaluating gestation age, prematurity, large-for-gestational-age, and Small-for-gestational-age infants, in J. P. Cloherty, E. C. Eichenwald, & A. R. Stark (Eds.), Manual of neonatal care (chap.3B, pp. 41-58). Philadephia, PA: Lippincott Williams &Wilkins.
Lenroot, R. K., & Giedd, J. N. (2006). Brain development in children and adolescents: Insights from anatomical magnetic resonance imaging. Neuroscience and Biobehavioral Reviews, 30 : 718-729.
Martin, J. A., Kung, H., Mathews, T. J. Hoyert, D. L., Strobino, D. M., Guyer, B., & Sutton, S. R. (2008). Annual summary of vital statistics: 2006. Pediatrics, (121) : 788-801
Mathew, O.P., Clark, M.L., Pronske, M.L., Luna-Solarzano, H.G., & Peterson, M. D. (1985). Breathing pattern and ventilation during oral feeding in term newborn infants. Journalof Pediatrics, 106: 810-813
Medoff-Cooper, B., Verklan, T., & Carlson, S. (1993). The development of sucking pattern and Physiologic correlates in very-low-birth-weight infants. Nursing research,42(2): 100-105.
Medoff-Cooper, B., McGrath, J. M., & Bilker, W. P. (2000). Nutritive sucking and neurobehavioral development in preterm infants from 34 weeks PCA to term. The American Journal of Maternal/Child Nursing, 25 : 64-70.
McCain, G. C. (1995). Promotion of preterm infant nipple feeding with nonnutritive sucking. Journal of pediatric nursing, 10: 3-9.
McCain, G. C. (1997). Behavioral state activity during nipple feedings for preterm infants. Neonatal network, 16(5): 43-47.
McCain, G. C. (2003). An evidence-based guideline for introducing oral feeding to healthy preterm infants [review]. Neonatal network,22: 45-50.
Miller, A. J. (2002). Oral and pharyngeal reflex in the mammalian nervous system: their diverse range in the complexity and pivotal role of the tongue. Critical Reviews in Oral Biology & Medicine. 13(5):409-425.
Miller, J. L., & Kang, S. M. (2007). Preliminary ultrasound observation of lingual movement patterns during nutritive versus non-nutritive sucking in a premature infant. Dysphagia, 22(2): 150-160.
Miller, J. L., Sonies, B. C., & Macedonia, C. (2003). Emergence of oropharyngeal, laryngeal and swallowing activity in the developing fetal upper aerodigestive tract: an ultrasound evaluation. Early human development,71(1): 61-87.
Miller, M. J., & Kistchoosakun, P. (2004). Relationship between respiratory control and feeding in the developing infants. Seminars in neonatology, 9 :221-227.
Mizuno, k., & Ueda, A. (2001). Development of sucking behavior in infants with Down syndrome. Acta Paediatric, 90, 1384-8.
Mizuno, k., & Ueda, A. (2003). The maturation and coordination of sucking, swallowing, and respiration in preterm infants. The journal of pediatrics, 142(1), 36-40
Nakajima, M. (1999) Brainstem segmental arrangement of sucking rhythm generators for trigeminal, facial and hypoglossal motoneurons, the Journal of the Stomatological Society, Japan. 66(1):88-97
Nowak, A. J., Smith, W. L., & Erenberg, A. (1995). Imaging evaluation of breast-feeding and bottle-feeding systems. Journal of Pediatrics. 126(6): S130-134.
Palmer, P. M., McCulloch, T. M., Jaffe, D., & Neel, A. T. (2005). Effects of a sour bolus on the intramuscular electromyographic (EMG) activity of muscles in the submental region. Dysphagia, 20: 210–217.
Palmer, M. M., Crawley, K., & Blanco, I. A. (1993). Neonatal oral-motor assessment scale: a reliability study. Journal of Perinatology. 13: 28-35.
Paluetto, R., Robertson, S. S., & Martin, R. J. (1986 ). Interaction between nonnutritive sucking and respiration in preterm infants. Biology of the neonate, 49: 198-203.
Perlman, A. L., Palmer, P. M., Vandaele, D. J., & McCulloch, T. M. (1999). Electromyographic activity from human laryngeal, pharyngeal, and submental muscles during swallowing. Journal of applied physiology, 86: 1663-1669.
Pickler, R. H., Best, A. M., Reyna, B. A., Gutcher, G. & Wetzel P. A. (2006). Predictors of nutritive sucking in preterm infants. Journal of Perinatology. 26: 693-699.
Pickler, R. H., Frankel, H. B., Walsh, K. M., & Thompson, N. M. (1996). Effects of nonnutritive sucking on behavioral organization and feeding performance in preterm infants. Nurs Res, 45, 132-135.
Pickler, R. H., Higgins, K. E., & Crummette, B.D. (1993). The effect of nonnutritive sucking on bottle-feeding stress in preterm infants. J Obst Gynecol Neonatal Nurs, 22, 230-234.
Pickler, R. H., Mauck, A. G., & Geldmaker, B. (1997). Bottle-feeding histories of preterm infants (2nd ed.). Journal of obstetric, gynecologic, and neonatal nursing, 26: 414-420.
Portney, L. G., & Watkins, M. P. (2000). Foundations of clinical research applications to practice (2nd ed.). Upper Saddle River, NJ: Prentice-Hall Inc..
Qureshi, M. A., Vice, F. L., Taciak, V. L., Bosma, J. F., & Gewolb, I. H. (2002). Changes in rhythmic suckle feeding patterns in term infants in the first month. Developmental Medicine and Child Neurology; 44: 34-39.
Radzyminski, S. (2005). Neurobehavioral functioning and breastfeeding behavior in the newborn. JOGNN, 34, 335-41.
Ramsey, D., Smithhard, D., Donaldson, N., & Kalra, L. (2005). Is the gag reflex useful in the management of swallowing problems in acute stroke? Dysphagia, 20(2), 105-107.
Reynolds, E. W., Vice, F. L., Bosma, J. F., & Gewolb, I. H. (2002). Cervical accelerometry in preterm infants. Developmental medicine and child neurology, 44: 587- 593.
Rogers, B., & Averdson, J. (2005). The assessment of infant oral sensorimotor and swallowing function. Mental Retardation and developmental disabilities,11: 74-82.
Russell, S. A., Brinkworth, Kemal, S., Turker, Andrew, W., & Savundra, (2003). Response of human jaw muscles to axial stimulation of the incisor. J Physiol, 547: 233-245
Schanler, R. J., Shulman, R. J., Lau, C., Smith, E. O., & Heitkemper, M. M. (1999). Feeding strategies for premature infants: randomized trial of gastrointestinal priming and tube-feeding method. Pediatrics. 103(2): 434-439,
Shingai, T., Miyaoka, Y., Ikarashi, R., & Shimada, K. (1989). Swallowing reflex elicited by water and taste solutions in humans. American Journal of Physiology. 256: 822-826
Shivpuri, C.R., Martin, R.J., Carlo, W.A., & Fanaroff, A.A.( 1983). Decreased ventilation in preterm infants during oral feeding. J Pediatr, 103, 285-9.
Skuse, D., Stevenson, J., Reilly, S., & Mathisen, B.( 1995). Schedule for oral-motor assessment (SOMA): methods of validation. Dysphagia. 10(3):192-202.
sp da Costa, van den Engel–Hoek, L., & Bos, A. F. (2008). Sucking and swallowing in infants and diagnostic tools. Journal of Perinatology,28: 247–257.
Samat, H. B. (1989). Do the corticospinal and corticobulbar tracts mediate functions in the human newborn? Canadian journal of neurological sciences, 16: 157-160.
Subramaniam, K., & Reid, D. (2003). Knowledge use among occupational therapist for infant feeding assessment. Canadian Journal of Occupational therapy, 70, 243-249.
Takimoto, H., Yokoyama, T., Yoshiike,N., & Fukuoka, H. (2005). Increase in low-birth-weight infants in Japan and associated risk factors, 1980 - 2000. Journal of Obstetrics & Gynaecology Research. 31(4):314-322.
Tamura, Y., Horikawa, Y., & Yoshida, S. (1996). Coordination of tongue movements and peri-oral muscle activity during nutritive sucking. Developmental medicine and child neurology, 38: 503- 510.
Thoyre, S. M., Shaker, C. S., & Pridham, K. F. (2005). Early feeding skills assessment for preterm infant. Neonatal network, 24: 7-16.
Townsend, S. F., Johnson, C. B., & Hay, W. W. (1993). Enteral nutrition. In Merenstein, G. B. & Gardner, S. L(Ed.). Handbook of Neonatal Intensive Care (3rd ed., pp. 184-206). St. Louis, MS: Mosby-Year Book inc..
Tucker KJ & Turker KS (2001). Modulation of the periodontally evoked masseter reflexes by mechanical stimulation of the face.Exp Brain Res 139, 443-447.
van de Bor, M. Guit, G. L., Schreuder, A. M., van Bel, F., Wondergem, J., & den Ouden, L. (1990). Does very preterm birth impair myelination of the central nervous system? Neurppediatrics, 21: 37-39.
Vice, F. L., Bamford, O., Heinz, J. M., & Bosma, J. F. (1995). Correlation of cervical auscultation with physiological recording during suckle-feeding in newborn infants. Developmental medicine and child neurology, 37: 167- 179.
Weber, F. Woolridge, M. W., & Baum, J. D. (1986). An ultrasound study of organization of sucking and swallowing by newborn infants. Developmental medicine of children neurology, 28: 19- 24.
Widstrom, A. M., & Thingstrom-Paulsson, J. (1993). The position of the tongue during rooting reflexes elicited in newborn infants before the first suckle. Acta Paediatrica, 82(3):281-283.
Wolf, L. S., & Glass, R. P. (1992). Feeding and swallowing disorders in infants: assessment and management. San Antonia, TX: therapy skill builders.
Woolridge, M. W. (1986). The anatomy of infant sucking. Midwifery, 2: 172-176.
史麗珠 (2003)。進階應用生物統計學:連續資料分析。台北市。學富文化。
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