臺灣博碩士論文加值系統

背景與目的：研究指出部分孩童有書寫鏡像字的現象，而其中慣用左手孩童書寫鏡像字比例高於慣用右手者，且有些孩童因轉換慣用手後亦出現寫鏡像字的情形。鏡像字的機制目前仍具有爭議，雖有三大假說(運動假說、空間方位假說、視覺優勢假說)欲探討鏡像字的形成機制，但其與慣用手的關係仍不清楚；且寫字認知模型並未提及鏡像字確切的路徑與歷程，更遑論其與慣用手的關係。因此，鏡像字是否與慣用手相關至今仍未定論。本研究藉由事件相關電位來探討不同慣用手孩童執行寫字與識字的伴隨性負電位變化(CNV)，與其辨識正像字及鏡像字時各相關波形成份的異同，來了解不同慣用手孩童在寫字與識字的行為及大腦特性。
方法：參與者為(1)未轉換之慣用左手、(2)慣用右手與(3)轉換慣用手孩童等三組，每組各14位(男女各7位，平均年齡8.09歲)，執行「聽寫中文字」與「辨識正像字及鏡像字」兩種任務。以無母數克-瓦二氏檢定與魏克森符號等級檢定統計三組間行為表現的異同，並分析事件相關電位資料中兩種任務的伴隨性負電位變化(CNV)、正像字及鏡像字出現後組內的N170、P300及N300–N400 complex波形成份的平均振幅、波峰振幅及潛伏時間等，以了解不同慣用手孩童於各波型及電極間的差異。
結果：在三組有良好的組間控制下，可發現(1)三組間執行寫字與識字兩種任務的行為資料均無達顯著差異；而事件相關電位資料中，(2)寫字任務的CNV於三組間各電極均無達顯著差異；(3)識字任務的CNV僅P8電極在三組間達顯著差異，且三組間之CNV (T8-T7)、N170 (CP2-CP1)、P300 (CP2-CP1、CP6-CP5、P8-P7)、N300–N400 complex (FC2-FC1)，均呈現不同的大腦側化性。另外，(4)三組內不同慣用手孩童辨識鏡像字之N170均較正像字小，且鏡像字之P300及N300–N400 complex均較正像字大；慣用右手組的N170於枕葉區(O1、O2、Oz)，P300於O1和P7電極，N300–N400 complex於T8電極達顯著差異；慣用左手組的N170於CP6，P300於枕葉區(O1、O2、Oz)和CP6達顯著差異；轉換慣用手組的N170於O1，P300於O2和CP6，N300–N400 complex於額葉中央區(F4、F8、Fz、FC1、FC2、FC5、FC6、T7、T8)達顯著差異。
討論與結論：不同慣用手組在寫字任務與識字任務的伴隨性負電位變化於三組間的差異均不明顯，推論可能是孩童的大腦專擅化仍未發展成熟；而比較三組間對稱的左右電極，可發現不同慣用手組仍具有不同的側化性。另外，在識字任務中，鏡像字的文字意涵較正像字不明顯，又需較大的認知負荷及來處理，且鏡像字有較大的語意整合衝突的情形。慣用右手組在早期的視覺處理階段，枕葉區即能辨識正像字與鏡像字，而在頂葉區需要多一些認知負荷辨識鏡像字之空間屬性；慣用左手組則於中央頂葉區先處理視覺空間屬性，枕葉區需要多一些認知負荷才可辨識兩種字；轉換慣用手組在早期的視覺處理較不明顯，大部分是在晚期階段額葉中央區才處理鏡像字。融合視覺優勢假說與區辨鏡像字的大腦區域，可推測相較於慣用右手孩童，慣用左手與轉換慣用手孩童可能為雙側大腦彼此溝通較強烈，較難建立單側大腦的專擅化，因此可能容易產生鏡像字。

Although mirror writing has long been observed in converted left-handers and other children in primary schools, its underlying mechanism remains unclear. Current neuropsychological models do not account for mirror writing, and the relationship between handedness and mirror writing is still controversial. In this study, we used the ERP technique to explore writing preparation and mirrored character recognition in children with different handedness.
Behavioral (writing performance, accuracy, and reaction time) and ERP data (CNV, N170, P300, and N300–N400 complex) were collected from 14 converted left-handers and 28 consistent left-/right-handers to analyze and explore differences among handedness groups.
We found no significant differences for the behavioral data among three groups in both tasks. ERP data further showed no statistically significant differences in writing task among the three groups for the late CNV at all electrodes. A significant difference in recognizing task was found only at the P8 electrode, and reversed lateralization was noted (CP2-CP1 in the N170 component; CP2-CP1, CP6-CP5, and P8-P7 in the P300 component). In addition, all groups had larger N170 amplitudes, less P300 amplitudes, and less N300–N400 complex amplitudes for normal characters than for mirrored characters. In right-handers, there were significant differences between both characters for N170 (O1, O2, and Oz), P300 (O1 and P7), and N300–N400 complex (T8). In left-handers, there were significant differences between both characters for N170 (CP6) and P300 (O1, O2, and Oz). In converted left-handers, there were significant differences between both characters for N170 (O1), P300 (O2 and CP6), and N300–N400 complex (F4, F8, Fz, FC1, FC2, FC5, FC6, T7, and T8).
Less significant differences among the three groups for the late CNV were observed because language experience and development are not yet fully specialized in children. However, the different handedness groups showed reversed lateralization for characters. Additionally, significantly larger N170 amplitudes are elicited by normal character recognition in children, more cognitive effort for P300 is needed to process mirrored characters, and stronger N300–N400 complex amplitudes are evoked by mirrored characters. Furthermore, right-handed children distinguish between characters in the early visual processing of the occipital areas (N170) and exert more cognitive effort at P7 (P300), whereas left-handed children distinguish between characters at CP6 (N170) and exert more cognitive effort in the occipital areas (P300). Converted left-handers are particularly strong in the late language processing of the frontal areas, particularly at the right hemisphere (N300–N400 complex). Left- and converted left-handers perhaps have more intense inter-hemispheric communication and cannot specialize one hemisphere, so they produce mirror writing more frequently than right-handers do.

Table of Contents
論文指導教授推薦書
論文口試委員審定書
長庚大學授權書-------------------iii
致謝-------------------iv
中文摘要-------------------vi
Abstract-------------------viii
Table of Contents-------------------x
List of Figures-------------------xv
List of Table-------------------xvii
Introduction-------------------1
Research Background-------------------1
Research Purpose-------------------2
Definitions of Terms-------------------3
Literature Review-------------------5
Characteristics of Writing in Different Handedness Groups----------5
Writing posture-------------------5
Writing direction-------------------6
Brain lateralization of writing-------------------6
Mirror writing studies-------------------8
Mirror Writing Mechanism and Related Studies----------------10
Mirror writing-------------------10
Motor hypothesis-------------------11
Spatial orientation hypothesis-------------------12
Visual dominance or visual word-form hypothesis------------12
Writing Mechanisms and Neuropsychological Models-----------------13
Event-related Potential when Writing and Recognizing Character------20
Contingent negative variation(CNV)-------------------20
N170-------------------22
P300-------------------23
N300–N400 complex-------------------23
Summary-------------------24
Research Questions and Hypotheses-------------------25
Method-------------------27
Research Framework and Design-------------------27
Research framework-------------------27
Definition of variables-------------------28
Research method-------------------30
Subjects-------------------30
Population-------------------30
Criteria-------------------30
Sample size planning-------------------31
Materials and Apparatus-------------------32
Assessment for screening-------------------32
Control variables of characters in tasks-------------------36
Electrophysiological recording and capturing-------------------37
Experimental Procedures and Conditions-------------------38
Experimental procedure-------------------38
Experimental condition-------------------40
Tasks and Procedures-------------------40
Experiment 1: writing tasks-------------------40
Experiment 2: recognizing tasks-------------------42
Results-------------------45
Demographic Characteristics-------------------45
Behavioral Data-------------------45
Independent variables-------------------45
Control variables-------------------47
Dependent variables-------------------47
ERP Data-------------------50
Experiment 1: writing task-------------------50
Experiment 2: recognizing task-------------------52
Discussion-------------------63
Subject Selection and Control Variables-------------------63
Brain Electrophysiology when Recognizing and Writing Characters-------64
CNV-------------------64
N170-------------------65
P300-------------------66
N300–N400 complex-------------------67
Behavioral Performance of Different Handedness Groups--------------68
Accuracy and reaction time--------------68
Chinese character writing performance-------------------69
Brain Lateralization of Character Writing and Recognition-------------71
Limitations of the Study-------------------73
Recommendations for Future Research-------------74
Conclusion-------------------75
References-------------------76
Appendixes-------------------88
Appendix 1 The survey questionnaires-------------------88
Appendix 2 The Edinburgh handedness inventory-------------------92
Appendix 3 The hand preference questionnaires-------------------92
Appendix 4 Assessment of eye preference-------------------93
Appendix 5 The basic information questionnaires-------------------94
Appendix 6 Assessment of Wechsler Intelligence Scale for Children (WISC-III):
verbal intelligence quotation-------------------98
Appendix 7 Assessment of Dynamic Occupational Therapy Cognitive Assessment
for Children (DOTCA-Ch): spatial perception test-------------------98
Appendix 8 Assessment of Rey Complex Figure Test (RCFT): copy and immediate
recall tests-------------------99
Appendix 9 Assessment of Beery-Buktenica Developmental Test of Visual-
Motor Integration (VMI): motor coordination-------------------99
Appendix 10 The 200 simple characters literacy scale------------100
Appendix 11 The characteristics of characters-------------------101
Appendix 12 Institutional review board-------------------102
Appendix 13 Informed consent document-------------------104
Appendix 14 The demographic characteristics and behavioral data
(right- handed children)-------------------106
Appendix 15 The demographic characteristics and behavioral data
(left-handed children)-------------------107
Appendix 16 The demographic characteristics and behavioral data
(converted left-handed children)-------------------108
Appendix 17 ERP Data: recognizing tasks (Among groups)-------------------109
Appendix 18 ERP Data: recognizing tasks (Within groups)-------------------123
Appendix 19 The proof of training for WISC-------------------131
Appendix 20 Result- parametric method-------------------132

List of Figures
Figure 1 Writing posture-------------------5
Figure 2 Drawing a circle with both hands-------------------6
Figure 3 Positron emission tomography study on writing-------------------7
Figure 4 Cognitive model of spelling and writing-------------------15
Figure 5 Neuropsychological model of writing-------------------17
Figure 6 Cognitive model of linguistic processing component-------------------19
Figure 7 Research framework-------------------27
Figure 8 The distribution of electrodes-------------------38
Figure 9 Experimental procedure-------------------39
Figure 10 Design and procedure of Experiment 1 and Experiment 2-----------44
Figure 11 The head view of grand average of late CNV in right- (blue line),
left- (red line), and converted left-handers (green line)
in writing task---------52
Figure 12 The head view of grand average of late CNV in right- (blue line),
left- (red line), and converted left-handers (green line)
in recognizing task----------54
Figure 13 The head view of grand average of ERP in normal (blue line),
and mirrored characters (red line) for right-handed children--------61
Figure 14 The head view of grand average of ERP in normal (blue line),
and mirrored characters (red line) for left-handed children---------62
Figure 15 The head view of grand average of ERP in normal (blue line),
and mirrored characters (red line) for converted left-handed
children-------------------62
Figure 16 Laterality quotient of handedness groups-------------------63
Figure 17 Subdivisions in callosal area by Witelson’s method-------------------65

List of Tables
Table 1 Central spelling routes of spelling and writing-------------------15
Table 2 Definition of variables-------------------27
Table 3 Included criteria-------------------31
Table 4 Sample size suggested in the literatures-------------------32
Table 5 The characters in tasks-------------------37
Table 6 Demographic characteristics and independent variables
among three groups-------------------46
Table 7 The control variables among three groups-------------------47
Table 8 The dependent variables among three groups-------------------49
Table 9 Wilcoxon signed ranks test (p value) in recognizing task---------50
Table 10 Kruskal-Wallis test for the mean amplitudes of the late CNV
among different handedness groups in writing task-----------------51
Table 11 Kruskal-Wallis test for the mean amplitudes of the late CNV at channels
difference among different handedness groups in writing task--------51
Table 12 Kruskal-Wallis test for the mean amplitudes of the late CNV among
different handedness groups in recognizing task-------------53
Table 13 Kruskal-Wallis test for the mean amplitudes of the late CNV at
channels difference in different handedness groups---------------53
Table 14 Kruskal-Wallis test for mean amplitude, peak amplitude and latency of
N170, P300, and N300–N400 complex in different handedness groups----56
Table 15 Kruskal-Wallis test for mean amplitude, peak amplitude and latency of
N170, P300, and N300–N400 complex at channels difference in
different handedness groups----------56
Table 16 Wilcoxon signed ranks test for the amplitudes (μV) and latency (ms) in the mirrored and normal characters among three groups-------------------60

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