臺灣博碩士論文加值系統

本研究主要開發一款結合腦波儀發展視聽專注力評估系統(Visual and Audio Attention Test System, VAAT)用來評估視覺與聽覺的注意力，研究目的為驗證本研究研發之VAAT的同時效度，並探討ADHD(Attention Deficit Hyperactivity Disorder)兒童在VAAT與克氏持續度表現測驗(Conners Continuous Performance Test 3rd Edition, CPT 3)以及克氏兒童持續度表現測驗(Conners Kiddie Continuous Performance Test 2rd Edition, K-CPT 2)各參數分數表現的相關性及腦波變化的情形。研究對象由16位過動症兒童和2位其他障礙及正常兒童組成幼兒組，年齡為4至7歲。由11位過動症兒童和6位其他障礙兒童組成兒少組，年齡為8至13歲。幼兒組每位兒童接受測量K-CPT 2和VAAT；另外，在兒少組每位兒童接受測量CPT 3和VAAT，測量VAAT時使用Neurosky腦立方移動版(MindWave Mobile)測量腦波。
本研究結果發現VAAT與K-CPT 2有一半以上的參數呈現顯著正相關，VAAT與CPT 3大部分參數呈現顯著正相關，因此認為VAAT具有良好的同時效度，可適用於注意力評估。在過動症兒童視聽能力比較方面，幼兒組過動症兒童利用聽覺辨別目標物與非目標物能力還有反應能力都比視覺能力差;兒少組過動症兒童視聽能力比較中，容易遺漏聽覺目標物及較慢的聽覺反應。在過動症兒童答對與答錯非目標物當下腦波之差異，幼兒組過動症兒童當Beta波下降、呈現不專心時，容易答錯(誤按)非目標物;兒少組過動症兒童在測驗中沒有發現到，由於個案數過少。參數與腦波表現相關性分析中，發現幼兒組過動症兒童辨別能力與Alpha波呈現負相關，代表辨別能力表現越差，則Alpha波下降，呈現緊張的現象。另外反應區段的變化與Delta波呈現負相關，代表反應區段的變化表現越差，Delta波下降、有不專心與認知下降的現象。兒少組過動症兒童錯誤率中，與Theta波及Delta波呈現負相關，表示錯誤率分數越高，則Theta與Delta波下降，有不專心與認知下降的現象。幼兒組不同類型過動症兒童在K-CPT 2表現中發現，不專心類型測出有不專心問題;衝動類型測出有警覺問題，但沒有測出衝動問題;混合類型測出有不專心問題，但沒有測出衝動問題。兒少組不同類型過動症兒童在CPT 3表現中發現，不專心類型測出有不專心以及持續性注意力的問題;衝動類型測出有持續性注意力問題，但沒有測出衝動問題;混合類型測出有不專心、持續性注意力及警覺問題，但沒有測出衝動問題。
本研究開發之VAAT不只用來評估視聽注意力的能力，也能探討測驗表現與腦波統計顯著相關性。因此，未來若能擴大測試健康兒童與過動症兒童，持續增進VAAT信效度，相信以VAAT的獨特性與立即性的特性，應可普及於兒童注意力測試，並提供醫生當臨床應用參考。

In this study, we focus on the development of visual and auditory attention test system (VAAT), which is used to evaluate the visual and auditory focus. The purpose of this study is to verify the concurrent validity of VAAT in this study, and to explore the effects of ADHD (Attention deficit hyperactivity disorder) on VAAT and Conners Continuous Performance Test 3rd Edition (CPT 3) and the Conners Kiddie Continuous Performance Test 2rd Edition, K-CPT 2). We also study the correlation between the scores of the parameters and the state of the brain waves. The subjects were by the 16 ADHD children and 2 other symptomatic and healthy children consisting of preschool group, the age from 4 to 7 years old; 11 ADHD children and 6 other symptomatic children consisting of kid group (age from 8 to 13 years old). Each child in the preschool group received K-CPT2 and VAAT. Each child in the kid group received CPT 3 and VAAT. To use the Neurosky brain cube mobile version (MindWave Mobile) measures the brain waves.
The results of this study show that VAAT and K-CPT 2 have significantly positively correlated with more than half of the parameters. VAAT and CPT 3 have significantly positively correlated with most of parameters. Therefore, VAAT has good concurrent validity, it can be applied to the attention assessment. In compared with the children with ADHD of the visual and auditory ability, the preschool group of children with ADHD have poor auditory ability to identify target and non-target ability, and slower auditory response than the visual ability; the kid group of children with ADHD in visual and audio ability comparison, easy to omission auditory target and slower auditory response. The children with ADHD do right and woring brain wave difference, preschool group of children with ADHD when the Beta wave is reduced, showing inattention, and easy to do wrong (mistakenly press) non-target, but kid group of children with ADHD were not found in the test, because the number of cases is too small. In the analysis of the correlation between the parameters and brain wave performance, it was found that preschool group of children with ADHD in the identification ability and Alpha wave were negative correlattion, and the identification ability was lower, the Alpha wave will reduce and showed a tense phenomenon. The change of the reaction block and Delta wave were a negative correlation, representing the worse performance of change of the reaction block, the Delta wave will reduce, showed inattention and cognitive decline phenomenon. The kid group of children with ADHD in error rate, the Theta wave and Delta wave were negative correlation, indicating that the higher error rate score, the Theta and Delta wave will reduce, showed inattention and cognitive decline phenomenon. Preschool group with different types of ADHD children found in the K-CPT 2 performance, inattentive type was detected inattentive problem; impulsive type was detected vigilant problem, but wasn’t detected impulsive problem; combined type was detected inattentive problem, but wasn’t detected impulsive problem. Kid group with different types of ADHD children found in the CPT 3 performance, inattentive type was detected inattentive and sustained attention problems; impulsive type was detected sustained attention problem, but wasn’t detected impulsive problem; combined type was detected inattentive, sustained attention and vigilant problems, but wasn’t detected impulsive problem.
This study developed VAAT not only to evaluate audio and visual attention, but also to explore the significant correlation between test performance and brain wave statistics. Therefore, if we can expand the test of normal children and ADHD children in the future, continued to verify and improve its reliability and validity. We believe by immediately and unique features of VAAT, it should be universal in children's attention tests and provide children's medical clinical application reference.

目錄
中文摘要 I
ABSTRACT III
目錄 VI
圖目錄 IX
表目錄 X
第一章 緒論 1
1.1 研究背景與動機 1
1.2 研究目的 2
1.3 論文架構 3
第二章 文獻探討 4
2.1 認識過動症兒童與持續性能測驗 4
2.1.1 何謂注意力 4
2.1.2 過動症兒童之症狀 6
2.1.3 持續性能測驗(Continuous Performance Tests, 簡稱CPT) 8
2.1.4 過動症兒童在持續性能測驗表現 16
2.2 大腦與腦波 16
2.2.1 過動症兒童的腦波表現 19
第三章 研究方法 21
3.1 研究工具 21
3.2 系統架構及流程 24
3.3 測驗設計與比較 28
3.4 基本資料與前測 33
3.5 測驗介紹 33
3.6 VAAT向度與參數介紹 35
3.7臨床實驗 41
3.7.1受測者 41
3.7.2實驗工具 44
3.7.3實驗流程 44
第四章 研究結果與討論 46
4.1 VAAT與CPT 3、K-CPT 2相關性實驗數據 46
4.2 過動症兒童視覺與聽覺參數原始分數之差異探究 51
4.3 過動症兒童在VAAT答對與答錯非目標物中當下腦波之差異 55
4.4 過動症兒童之VAAT腦波與參數相關性分析 56
4.5 過動症兒童在K-CPT 2與CPT 3參數表現 63
第五章 結論 68
5.1 系統修正建議 70
5.2 研究限制 70
5.3 後續研究建議 70
參考文獻 72
附錄一 VAAT詳細分數 80
附錄二 K-CPT 2詳細分數 96
附錄三 CPT 3詳細分數 99

 
圖目錄
圖 1大腦構造 17
圖 2大腦皮層的功能區 18
圖 3腦波的波形圖 19
圖 4腦立方移動版(MindWave Mobile) 21
圖 5國際10-20腦波電極配置法 22
圖 6結合腦波儀發展視聽專注力評估系統架構圖 26
圖 7結合腦波儀發展視聽專注力評估系統流程圖 27
圖 8基本資料畫面 33
圖 9測驗畫面 35
圖 10實驗流程圖 45
圖 11 VAAT的Alpha波與辨別能力分數關係圖 59
圖 12 VAAT的Delta波與反應區段的變化分數關係圖 59
圖 13 VAAT的Theta波與錯誤率分數關係圖 62
圖 14 VAAT的Delta波與辨別能力分數關係圖 62


 
表目錄
表 1視聽專注力評估系統(VAAT)、CPT 3、K-CPT 2及IVA-CPT測驗設計之比較 31
表 2幼兒組基本資料 42
表 3兒少組基本資料 43
表 4幼兒組在VAAT與K-CPT 2各參數原始分數之同時效度 48
表 5兒少組VAAT與CPT 3各參數原始分數之同時效度 50
表 6幼兒組過動症兒童視覺與聽覺參數之差異 52
表 7兒少組過動症兒童視覺與聽覺參數之差異 54
表 8幼兒組過動症兒童在VAAT答對與答錯非目標物中前一秒腦波之差異 55
表 9兒少組過動症兒童在VAAT答對與答錯非目標物中當下腦波之差異 56
表 10 幼兒組過動症兒童之VAAT腦波與參數相關性 58
表 11兒少組過動症兒童之VAAT腦波與參數相關性 61
表 12幼兒組過動症不專心類型兒童在K-CPT 2參數表現 64
表 13幼兒組過動症衝動類型兒童在K-CPT 2參數表現 64
表 14幼兒組過動症混合類型兒童在K-CPT 2參數表現 65
表 15兒少組過動症不專心類型兒童在CPT 3參數表現 66
表 16兒少組過動症衝動類型兒童在CPT 3參數表現 66
表 17兒少組過動症混合類型兒童在CPT 3參數表現 67
表 18 幼兒組VAAT參數之原始分數(1) 80
表 19幼兒組VAAT參數之原始分數(2) 81
表 20幼兒組VAAT參數之原始分數(3) 82
表 21幼兒組VAAT參數之原始分數(4) 83
表 22幼兒組VAAT參數之原始分數(5) 84
表 23幼兒組VAAT參數之原始分數(6) 85
表 24幼兒組VAAT參數之原始分數(7) 86
表 25幼兒組VAAT參數之原始分數(8) 87
表 26兒少組VAAT參數之原始分數(1) 88
表 27兒少組VAAT參數之原始分數(2) 89
表 28兒少組VAAT參數之原始分數(3) 90
表 29兒少組VAAT參數之原始分數(4) 91
表 30兒少組VAAT參數之原始分數(5) 92
表 31兒少組VAAT參數之原始分數(6) 93
表 32兒少組VAAT參數之原始分數(7) 94
表 33兒少組VAAT參數之原始分數(8) 95
表 34幼兒組K-CPT 2參數之原始分數與T分數(1) 96
表 35幼兒組K-CPT 2參數之原始分數與T分數(2) 97
表 36幼兒組K-CPT 2參數之原始分數與T分數(3) 98
表 37兒少組CPT 3參數之原始分數與T分數(1) 99
表 38兒少組CPT 3參數之原始分數與T分數(2) 100
表 39兒少組CPT 3參數之原始分數與T分數(3) 101

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