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研究生:何明哲
研究生(外文):HO, MING-CHE
論文名稱:四歲到六歲學齡前兒童舌頭肌肉力量及耐力探討
論文名稱(外文):Tongue Muscle Strength and Endurance in 4 to 6 Years Old Children
指導教授:童寶娟童寶娟引用關係
指導教授(外文):TORNG, PAO-CHUAN
口試委員:陳維佳戴世光
口試委員(外文):CHAN, ROGER W.TAI, SHIH-KUANG
口試日期:2017-06-20
學位類別:碩士
校院名稱:國立臺北護理健康大學
系所名稱:語言治療與聽力研究所
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2017
畢業學年度:105
語文別:中文
論文頁數:78
中文關鍵詞:舌頭肌肉力量舌頭肌肉耐力Iowa Oral Performance Instrument(IOPI)舌頭動作協調能力
外文關鍵詞:tongue strengthtongue endurenceIowa Oral Performance Instrument (IOPI)tongue coordination
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舌頭肌肉力量及耐力是言語功能中重要的生理功能之一,良好的言語功能需要足夠的舌頭肌肉力量及耐力支持,並讓舌頭產生良好的協調性、穩定性、正確及精準的移動能力,以達到言語能力的需求。幼童時期,舌頭肌肉力量及耐力已經有相當的發展,依循感覺動作理論,四到六歲的兒童在發展言語技巧須要足夠舌頭肌肉力量及耐力給予感覺回饋,以提供動作能力發展所需,此時兒童在口腔協調動作的發展也開始越來越穩定,若是舌頭肌肉力量及耐力不足,則可能造成發展延遲及言語功能問題。因此,舌頭肌肉力量及耐力在兒童的言語功能及動作控制發展上是個重要的指標。為了對於言語功能有客觀的數據測量個體能力,Iowa Oral Performance Instrument(IOPI)是個相當優良及客觀的測量工具,IOPI是用以測量口腔肌肉力量及耐力。國外研究中,IOPI多用在成人上,並且已建立起其舌頭肌肉力量及耐力的常模數據。但是,兒童的舌頭肌肉力量及耐力數據是相對缺乏的。IOPI在三歲兒童以上的使用也在研究中顯示出是個安全的測量工具。除此之外,過去對於兒童口腔協調動作發展狀況已有相當的了解。為了將IOPI應用於兒童個案,建立兒童舌頭肌肉力量及耐力的數據常模對於了解舌頭肌肉力量及耐力是相當重要的先驅步驟。
本研究將探討桃園市公立幼稚園中四歲到六歲學齡前兒童舌頭肌肉力量及耐力的狀態對於言語功能及動作協調能力發展上的影響,根據過去研究指出,三歲之後的神經進步空間會越來越少,而在這時的言語能力發展是相當快速地,但三歲到四歲時期的發展上仍不穩定,而四歲到六歲兒童會發展出穩定掌握言語功能的能力,因此四歲到六歲時期更顯其言語能力的發展重要性。因此,本研究藉由方便選樣方式在桃園市公立幼稚園中挑選64位四歲八個月到六歲四個月的學齡前兒童進行舌頭肌肉力量及耐力與舌頭動作協調能力之相關性研究,包括兩個研究問題:(1)四歲到六歲學齡前兒童舌頭肌肉力量及耐力的分布狀況。(2)四歲到六歲學齡前兒童舌頭肌肉力量及耐力與動作協調能力的關係。結果發現四歲到六歲學齡前兒童舌頭肌肉力量及舌頭動作協調能力隨著年紀增加,舌頭肌肉力量及耐力與部分口腔動作協調能力有顯著相關,並且能夠預測部分口腔動作協調能力。

Tongue muscle strength and endurance are essential for speech and swallowing function. To acquire effective speech function, such as motor coordination, movement stability and movement accuracy, sufficient muscle strength and endurance are absolutely necessary. In the early developmental periods, children need sufficient tongue muscle strength and endurance for providing sensory feedback to establish the tongue movement function and to improve movement stability during of 4 to 6 years old. That is tongue muscle strength and endurance are playing an important role for speech function and motor control development. The Iowa Oral Performance Instrument (IOPI)is an effective and objective measurement tool for measuring the muscle strength and endurance of the tongue. IOPI’s norm, reliability and validity of the adult populations had been well established in studies. Besides, IOPI also had been applied for children over 3 years old. Howerver, studies for estblishing the norms for chilren are limited.
This study recruited 64 children of 4 years 8 months to 6 years 4 months old and discussed the relationship between tongue muscle physiology and motor coordination from Taoyuan city with convenience sampling. In addition, this study also aimed to establish the tongue muscle strength and endurance status of 4 to 6 years old children. Results showed that tongue strength and coordination increased with age, and there was significant correlation between tongue strength and coordination. Tongue strength and endurence also could partially predict the ability of tongue coordination.

目錄
中文摘要………………………………………………………………………………2
英文摘要………………………………………………………………………………4
目錄……………………………………………………………………………………5
圖目錄…………………………………………………………………………………7
表目錄…………………………………………………………………………………8
第一章 緒論…………………………………………………………………………9
第一節 研究背景與動機…………………………………………………………9
第二節 研究目的及研究問題……………………………………………………11
第三節 名詞釋義…………………………………………………………………12
第二章 文獻探討……………………………………………………………………13
第一節 舌頭肌肉生理對於言語能力的影響……………………………………13
第二節 舌頭肌肉力量及耐力與動作協調能力的發展…………………………16
第三節 舌頭肌肉力量及耐力與動作協調常模…………………………………20
第四節 四歲到五歲的舌頭肌肉力量及耐力與動作協調能力…………………23
第三章 研究方法……………………………………………………………………25
第一節 研究參與者………………………………………………………………25
第二節 研究工具…………………………………………………………………26
第三節 施測流程及指導語………………………………………………………27
第四節 統計分析…………………………………………………………………31
第四章 研究結果……………………………………………………………………34
第一節 四歲到六歲兒童基本資料………………………………………………34
第二節 兒童舌頭肌肉力量分布狀況及單因子多變量變異數分析……………35
第三節 兒童舌頭肌肉耐力分布狀況及單因子多變量變異數分析……………38
第四節 兒童舌頭肌肉力量對於口腔協調動作之相關及迴歸分析……………41
第五節 兒童舌頭肌肉耐力對於口腔協調動作之相關及迴歸分析……………44
第五章 討論…………………………………………………………………………48
第一節 四歲到六歲兒童的舌頭肌肉力量分布狀況……………………………48
第二節 四歲到六歲兒童的舌頭肌肉耐力分布狀況……………………………51
第三節 四歲到六歲兒童舌頭肌肉力量及耐力與口腔協調動作的相關性……51
第四節 四歲到六歲兒童舌頭肌肉力量及耐力對於口腔協調動作的預測能力…………………………………………………………………………………53
第六章 結論…………………………………………………………………………55
第一節 研究發現…………………………………………………………………55
第二節 研究限制…………………………………………………………………55
第三節 研究建議…………………………………………………………………56
參考文獻……………………………………………………………………………57
中文部分…………………………………………………………………………57
外文部分…………………………………………………………………………57
附錄…………………………………………………………………………………68
附錄一 研究參與者知情同意書…………………………………………………68
附錄二 基本資料調查表…………………………………………………………71
附錄三 學齡前兒童舌頭肌肉力量、耐力及動作協調能力表現紀錄表………73


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