本論文目的為初步檢驗聽知覺概念辨識測驗（AAPCR，分為單純環境聲音辨識測驗-T1與複雜環境聲音辨識測驗-T2）工具之信度與效度，以招募的40位病患組與年齡和教育程度相配對的39位健康組（病患組平均年齡為55.1歲，平均受教年數為12.3年；健康組平均年齡為53.8歲，平均受教年數為11.9年）作為研究對象。每位受試者皆進行蒙特利爾認知評估台灣版（MoCA-T）與AAPCR的測驗。MoCA-T在本研究作為外在效標，以檢驗AAPCR的概念知覺能力與認知能力間之相關性。所有病患與其中10位健康受試者在第一次受測後七天，進行第二次AAPCR測驗，以檢驗AAPCR之再測信度。研究結果顯示AAPCR之答題一致性良好，T1平均答題一致性表現病患組為88.8%， T2則為83%。另外AAPCR運用於病患組時內部一致性信度（internal consistency reliability）為 .942。效度方面，T1與T2兩者分數呈現出中高度正相關（r= .703，p< .05）。效標關聯效度方面，T1與MoCA-T呈現中度正相關（r= .530，p< .05）；T2與MoCA-T則為中高度正相關（r= .707，p< .05），代表AAPCR測驗之得分與受試者之認知能力具有中高度相關性。另外，本研究在T1、T2兩分測驗與AAPCR全測驗之得分皆有顯示最佳之切截分數(55分)，可提供臨床工作者作為進一步對照並解釋受試者之得分意義。最後由研究結果得知，電腦版的AAPCR測驗運用於神經性腦傷患者時，具有良好的信效度及敏感度、特異性的表現，可作為未來臨床工作者瞭解神經性腦傷患者之概念知覺性方面的選擇，並期待此工具的問世可提昇腦傷者之語言/言語治療的成效。

This study aims to initially measure the reliability and validity of the Assessment of Auditory Perception for Conceptual Recognition (AAPCR; including the two subtests of Test 1 & Test 2—T1 & T2) in patients with neurological brain damage. There were 40 neurologically- impaired patients and 39 controls matched by age and education in the study (Mean age and Education years：Patients= 55.1 & 12.3; Controls= 53.8 & 11.9). All participants received a screening test of the Montreal Cognitive Assessment-Taiwanese version (MoCA-T) and the AAPCR. Test-retest reliability, internal reliability, construct validity, and criterion related validity were applied to establish the clinical effectiveness of the tool. KR 20 and Pearson’s correlation were used to measure the psychometrics of the AAPCR. The results demonstrated consistent responses, test reliability and a high correlation among the scores obtained from T1 and T2 subtests, and the AAPCR, as well as meeting the consistency with the results of the MoCA-T in both groups. With the exceptions found in control group, low internal consistency and mild correlation in T1 and MoCA-T were noted. Using an optimal cut-off score of 55, the AAPCR had a sensitivity 89.5% and acceptable specificity of 65% for detecting a disorder of central conceptual structures and/or perceptual deficit post brain damage, especially for patients post stroke. These findings indicate the AAPCR has good psychometrics and could be a valid and reliable tool for detecting a mild to moderate -severe disorder of central conceptual structures in neurologically-impaired patient populations.

目錄
中文摘要i
英文摘要ii
第一章 緒論 1
第一節 研究背景與目的 1
第二節 名詞解釋 3
第二章 文獻探討 5
第一節 環境聲音 5
第二節 神經性語障患者的環境聲音辨識能力 12
第三節 環境聲音與認知工具 19
第三章 研究方法 29
第一節 研究設計 29
第二節 研究問題 30
第三節 研究對象 32
第四節 研究工具 35
第五節 研究程序 40
第六節 資料處理與統計分析 41
第四章 研究結果 45
第一節 信度 45
第二節 效度 49
第三節 T1、T2題目隨機分配結果 62
第五章 研究討論 64
第一節 信度之討論 64
第二節 效度之討論 68
第三節 T1題目類別分配性之討論 75
第六章 結論 76
第一節 研究發現與工具優點 76
第二節 研究限制 77
第三節 未來研究建議 78
參考文獻 79
附錄 89
附錄一 90
附錄二 91
附錄三 98
附錄四 99
附錄五 101

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