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研究生:黃佩珍
研究生(外文):Pei Chen Huang
論文名稱:注意力缺失過動孩童於工具運用之表現:握把方向與操弄時期效應
論文名稱(外文):Tool-use praxis in children with attention-deficit/hyperactivity disorder: the effects of handle orientation and manipulation phase.
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:115
中文關鍵詞:注意力缺失過動症發展性動作協調障礙動作失用工具使用及物握把方向操弄時期錯誤類型
外文關鍵詞:attention-deficit/hyperactivity disorderdevelopmental coordination disordercomorbiditydyspraxiatool-usetransitiveend state comfort effecterror typegesture
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本研究試圖從動作運用的觀點探討注意力缺失過動疾患(ADHD)在工具使用上的表現。為控制共病性,因此選擇注意力缺失過動疾患組、注意力缺失過動疾患合併發展性協調障礙(ADHD+DCD)組以及於年齡、性別、慣用手相配對的正常控制組各15位。實驗中藉由操弄工具的握把方向(前、後、左、右),分析各組在觸接期與使用期的錯誤類型。本論文獲得三點主要結果:(1)注意力缺失過動疾患組與注意力缺失過動疾患合併發展性協調障礙組在動作運用的表現上均無顯著差異;(2)不管是在任何握把方向上三組的時間錯誤類型均無差異;(3)在握把方向左和前時,注意力缺失過動疾患組和注意力缺失過動疾患合併發展性協調障礙組則比正常控制組有較多的空間錯誤錯型。結果顯示注意力缺失過動疾患的動作運用不佳與DCD共病性無關,應與注意力缺失過動疾患本身有關,且在刺激-反應契合度較低時,注意力缺失過動疾患較不會為了達到結束狀態舒適作用而旋轉手勢,因此容易犯下空間錯誤錯型。
This study aimed to discuss tool-using performance of children with attention-deficit/hyperactivity disorder (ADHD) from the aspect of praxis. Since the children with ADHD are at high risk of having the symptoms of developmental coordination disorder (DCD), this factor was considered and controlled in this present study. Therefore, two groups of children with ADHD were selected: ADHD without DCD (pure ADHD group with 15 children) and ADHD with DCD (combined group with 15 children). Fifteen age- and gender- matched children served as controls. All children were right handed with age from 5-7 years. In the experiment, each child had to grasp (the contact phase) and use (the use phase) 12 different tools under four handle-orientation conditions (forward, backward, right, and left). The method used to evaluate praxis was applied to analyze the error types of each grasp during two manipulation phases (the contact phase and the use phase).
Results showed : 1) In the condition of the left and forward handle orientation, the children of pure ADHD group and combined group had more spatial error types than those in the control group. 2) There were no significant differences in tool-use praxis performances between the pure ADHD and the combined groups.
The consequence displayed as bellowing: 1)ADHD have difficulties in praxis performances, especially under the unfamiliar condition. They do not like that control children tend to achieving the end state comfort effect. ADHD do not rotate their hand to match the handles of tools during the contact phase, and they have more spatial error types; 2) poor praxis performances of ADHD are not relate to the comorbidity of DCD, but related to the syndrome of ADHD.
目 錄
指導教授推薦書………………………………………………………...
口試委員會審定書………………………………………………………
授權書…………………………………………………………………...iii
誌謝……………………………………………………………………...iv
中文摘要…………………………………………………………………v
英文摘要………………………………………………………………...vi
目錄…………………………………………………………………….viii
表目錄……………………………………………………………………x
圖目錄…………………………………………………………………xi
第一章 緒論………………………………………………………………1
第一節 研究緣起與研究動機……………………………………..……1
第二節 研究目的………………………………………………..………2第三節 重要名詞解釋…………………………………………………2
壹、 注意力缺失過動疾患………………………………………..2
貳、 動作運用……………………………………………………..2
參、 工具使用-伸手取物的預期性控制………………………….3
第二章 文獻回顧…………………………………………………………4
第一節 注意力缺失過動疾患伴隨動作問題的比例與特質……………4
壹、 注意力缺失過動疾患伴隨動作問題的比例…………………4
貳、 注意力缺失過動疾患的動作障礙……………………………4
第二節 注意力缺失過動疾患和動作計畫的關聯性……………………5
壹、 Barkley理論…………………………………………………5
貳、 執行功能的相關研究………………………………………..8
參、 動作控制相關研究…………………………………………..9
肆、 執行功能與動作控制相關研究之限制……………………..10
第三節 注意力缺失過動疾患和動作運用的關聯性…………………..11
壹、 動作運用理論—工作記憶觀點……………………………..11
貳、 Barkley理論與動作運用理論之異同……...………………..11
參、 動作運用上的相關發現……………………………………..13
第四節 動作運用相關理論模式………………………………………..14
壹、 三感覺刺激路徑觀點………………………………………14
貳、 視覺-動作路徑觀點………………………………………..15
參、 體感覺-聽覺路徑觀點..........................................................16
肆、 身體基模觀點………………………………………………17
伍、 Praxicon觀點……………………………………………….18
第五節 動作運用相關評估工具與方法………………………………..19
壹、 動作運用相關評估工具……………………………………..19
貳、 動作運用評估工具之限制…………………………………..22
第六節 發展動作運用評估之實驗典範………………………………..22
第七節 注意力缺失過動疾患與發展性運動協調障礙之比較………25
第八節 研究提問與研究假設…………………………………………..26
第三章 研究方法………………………………………………………..28
第一節 研究法…………………………………………………………28
第二節 實驗設計………………………………………………………28
第三節 研究對象………………………………………………………30
第四節 研究工具………………………………………………………32
壹、 控制變項之評估工具……………………………………….32
貳、 對照變項之評估工具……………………………….………35
參、 自變項之評估工具………………………………………….36
肆、 依變項之評估工具………………………………………….37
第五節 研究流程………………………………………………………40
壹、 步驟流程……………………………………………………..33
第六節 資料分析………………………………………………………42
壹、 控制變項與對照變項……………………………………….42
貳、 依變項……………………………………………………….42
第四章 研究結果………………………………………………………..44
第一節 人口學資料……………………………………………………44
第二節 第二節 組別特性……………………………………………..45
壹、 注意力/過動表現…………………………………….………...45
貳、 動作協調表現…………………………..……………………..46
第三節 控制變項………………………………………………………48
壹、 觸覺………………………………………………………….48
貳、 運動覺……………………………………………………….49
參、 視知覺……………………………………………………….49
肆、 手指辨識………………………………………………….....50
伍、 認知/語言能力………………………………………………51
陸、 側化趨勢……………………………………………………51
柒、 組間控制總結……………………………………………….51
第四節 肢體失用症測驗之組間比較…………………………………52
第五節 動作運用與錯誤類型分析之組間比較………………………53
壹、 錯誤類型總數………………………………………………..55
貳、 內容錯誤類型………………………………………………..58
參、 時間錯誤類型………………………………………………..60
肆、 空間錯誤類型……………………………………………….64
第六節 動作運用與錯誤類型分析之組內比較………………………55
壹、 正常控制組在兩個操弄時期的動作運用表現之比較………64
貳、 注意力缺失過動疾患組在兩個操弄時期的動作運用表現之
比較……………………………………………………………65
參、 注意力缺失過動疾患合併發展性協調障礙組在兩個操弄時期的動作運用表現之比較……………………………………….67
第五章 討論…………………………………………………….………69
第一節 組別特質…………………………………………………….69
第二節控制變項……………………………………………………...70
壹、 年齡、性別…………………………………………………70
貳、 運動覺………………………………………………….….71
參、 視知覺……………………………………………………..71
肆、 手指辨識…………………………………………………..72
第三節對照變項-肢體失用症測驗………………………………….72
第四節共病性對動作運用的影響…………………………………..72
第五節注意力缺失過動疾患與正常控制組在動作運用表現上之
異同…………………………………………………………...73
壹、 注意力缺失過動疾患與正常控制組相似處……………..73
貳、 注意力缺失過動疾患與正常控制組相異處……………..76
第六節注意力缺失過動疾患動作運用表現不佳之可能
原因…………………………………………………………...77
壹、 注意力/過動衝動症狀影響………………………………77
貳、 手指辨識的影響………………………………………….77
參、 動作運用模式與Barkley理論……………………………80
第六章結論與建議……………………………………………………..83
第一節結論…………………………………………………………..83
壹、 注意力缺失過動症動作運用表現不佳…………………83
貳、 注意力缺失過動症時間錯誤類型的表現與正常控制組無異……………………………………………………….…83
參、 注意力缺失過動症空間錯誤類型與正常控制組有異……………,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,…84
肆、 注意力缺失過動症的動作運用表現不佳與DCD共病無關…………………………………………………………..84
伍、 注意力缺失過動症的動作運用表現與症狀有關………..84
第二節研究限制與未來建議………………………………………...85
壹、 組別類型…………………………………………………..85
貳、 任務屬性與時間錯誤類型之評量……………………….85
參、 樣本數與樣本代表性…………………………………….86
肆、 工作記憶…………………………………………………..86
参考文獻………………………………………………………………..87
附錄…………………………………………………………………….95
中文參考文獻
臧汝芬、吳光顯、劉秋平 (民91年)。台灣某國小注意力不足過動兒
童之盛行率。台灣精神醫學,16,202-212。
劉昱志、劉士愷、商志雍、林建禾、杜長齡與高淑芬 (民95)。注意
力缺陷過動症中文版Swanson, Nolan, and Pelham, Version IV
(SNAP-IV)量表之常模及信效度。台灣精神醫學,20,290-304。
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