臺灣博碩士論文加值系統

本研究旨在編製「中文版三至六歲兒童口語動作評估量表」及建立該量表之中部四縣市地區常模、探討量表信效度之情形及執行常模背景變項的量性統計分析。本量表係以英文版的口語動作評估量表VMPAC（Verbal Motor Production Assessment of Children）為編製的工具基礎，並加以修定而成。
本研究所得之結果如下：
一、「中文版三至六歲兒童口語動作評估量表」之信度
總量表之信度係數為.929，顯示極佳的內部一致性；五個分量表信度係數分佈範圍為.664-.882。量表之評分者間信度亦良好，於局部口語動作控制、順序的維持和連續性語言的口語動作控制三個分測驗的評分為高度相關（＞.700），而語言特性上則為低度相關（＜.400）。再測信度分析上亦顯示良好，本測驗於局部口語動作控制、順序的維持及連續性語言的口語動作控制三個分測驗中其相關係數分別為.718、.743及.774。
二、「中文版三至六歲兒童口語動作評估量表」之效度
不同年齡層兒童在局部口腔動作控制、順序的維持、連續性語言的口語動作控制及語言特性這四個分測驗中的平均數差異值均達到統計上的顯著水準，顯示本研究所進行的「中文版三至六歲兒童口語動作評估量表」符合發展的趨勢。構音障礙組於各分測驗中的平均得分均低於對照組，兩組分數的差異於各分測驗上皆達統計上的顯著程度，顯示本量表有良好的既知團體效度可以明顯區別兩組。內聚效度的探討中可以得知連續性口語的動作控制與該分測驗中各題項得分的相關性最高，表示此分測驗的內聚效度最佳。而整體動作控制分測驗中則顯示了中至高度的相關性，局部口語動作控制和順序維持兩個分測驗的總分與各項目得分的相關係數則顯示低至中度相關，係數範圍皆在可接受的程度。至於內部效度的探討則如原本預期的結果，「局部口腔動作控制」部份與「順序維持」部份的相關居冠，為高度相關，而「連續性的語言控制」所評估的層面與「局部口腔動作」和「順序維持」也相近，因此都有中等程度的相關；「整體動作控制」和「語言特性」兩分測驗與其它部份的測驗也如預期的結果顯示較低的相關。
三、變項統計分析
以年齡變項來說，不同年齡層在局部口腔動作控制、順序的維持、連續性語言的口語動作控制及語言特性這四個分測驗中的平均數差異均達到統計上的顯著水準，但在整體動作控制這一分測驗中，則四組間的平均數差異則未達統計上的顯著水準。利用薛費法進行事後比較，呈現在局部口腔動作控制和順序的維持兩分測驗中，年齡較大和較小組的差異達顯著水準。再以獨立樣本t-test進行性別變項的考驗，全體男女生在五個分測驗中平均分數差異不大，男女生在各分項測驗中其平均數的差異檢定，均無顯著差異，顯示男女生於各測驗分項上的得分均無明顯差異。以雙親教育程度來看，不同的父親教育程度僅在局部口腔動作測驗的得分有顯著差異存在，而其它分測驗則無顯著差異。母親的教育背景則無明顯的影響，顯示兒童測驗得分並無隨著母親教育程度昇高而增加的現象。
研究者最後根據研究結果，針對「中文版三至六歲兒童口語動作評估量表」之編製研究、常模取樣、施測人員及後續的研究發展提出進一步之建議，以供參考。

The purpose of this study was to build up an assessment tool on verbal motor production system of children aged 3-6. The aim of this study included acquiring the norm data of children aged 3-6 in the central part of Taiwan and exploring the reliability and validity of this assessment scale and finally conducting a statistical analysis of the background variables . Our assessment scale was based on the English version of VMPAC (Verbal Motor Production Assessment of Children) and modification was made according to the language context.
The main findings of this study were as follows:
1. Reliability of the “Chinese Version of the Verbal Motor Production Assessment of Children Aged 3-6”:
The Chronbach’s alpha coefficient of the whole scale is .929 which showed excellent internal consistency. The range of the reliability coefficient of the 5 subtests is 0.664-0.882. The inter-rater reliability score is also good. The correlation is high (>.700) in regard to focal oromotor control、sequence maintenance and connected speech control. However, the correlation coefficient is lower in speech characteristics . Test-retest reliability showed good results in the following 3 subtests: focal oromotor control、sequence maintenance and connected speech control. The coefficient is .718、.743 and .774 separately.

2. Validity of the “Chinese Version of the Verbal Motor Production Assessment of Children Aged 3-6”:
When grouped by age, the 4 groups displayed a significant difference in the following 4 subtests: focal oromotor control、sequence maintenance、connected speech control and speech characteristics. This finding is compatible with the developmental trend. Known-group validity is evidenced by significant difference of the mean scores on the 5 subtests between the clinical group and the matched control group. The exploration of internal validity revealed that the connected speech control had the best correlation between the items score and the subtotal score. The item-total correlation of the global motor control was fair to high but lower correlation was noted on the subtests of focal oromotor control and sequence maintenance. However, the range of correlation coefficient was still within acceptable level. The results of correlation study between each subtests was as predicted originally. The correlation between focal oromotor control and sequence maintenance was highest. Because of the proximity of the assessment content, fair correlation was noted between connected speech 、focal oromotor control and sequence maintenance. Lower correlation was revealed as expected between global motor control/speech characteristics and the other subtests.

3.Statistical analysis of the background variables:
4 different age groups showed significant differences on the mean scores of the 4 following subtests: focal oromotor control、sequence maintenance、connected speech control and speech characteristics. But no significant difference was achieved on the general motor control subtest. Scheffe method was used to conduct post hoc comparison which showed higher age group performed better than the lower age group. When grouped by gender, the boys and girls did not show significant score differences on the 5 subtests. In terms of parental educational level, the father’s educational level had significant impact on the scores of focal oromotor control subtest only while the other subtest did not reveal such tendency. As for mother’s educational level, there was no major impact found.

Based on the above findings, appropriate recommendations were offered in terms of the scale development、the sampling method and sampling region 、the process of standardization、the selection and training of testing personnel and further directions of research.

第一章 緒論
第一節 研究背景與動機 1
第二節 研究目的 4
第三節 名詞釋義 5

第二章 文獻探討
第一節 兒童言語動作系統的發展 7
第二節 兒童常見的說話-語言障礙 14
第三節 發展性言語失用症的定義、歷史及病理 35
第四節 發展性言語失用症的臨床表現與鑑別診斷 45
第五節 發展性言語失用症的評估 56

第三章 研究方法
第一節 研究架構 66
第二節 研究對象 68
第三節 研究程序 70
第四節 研究工具 78
第五節 資料分析與統計方法 88

第四章 研究結果與討論
第一節 預試樣本的統計分析 91
第二節 常模的建立 95
第三節 測驗信效度的統計分析 114
第四節 構音障礙兒童與對照組之測驗結果的統計分析 142

第五章 研究結論與建議
第一節 結論 145
第二節 建議 154
參考文獻 157
附錄
附錄一 專家學經歷 168
附錄二 受試者家長同意書 169

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