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系統識別號 U0026-0812200915354922
論文名稱(中文) 功能性構音障礙兒童的動作能力:比較第二版布魯茵克斯-歐西瑞斯基動作精練度評量工具與兒童動作評估測驗
論文名稱(英文) The Motor Ability of Children with Functional Articulation Disorders: The Comparison of BOT-2 and Movement-ABC
校院名稱 成功大學
系所名稱(中) 物理治療研究所
系所名稱(英) Department of Physical Therapy
學年度 97
學期 2
出版年 98
研究生(中文) 陳虹伊
研究生(英文) Hung-Yi Chen
電子信箱 t6695107@ccmail.ncku.edu.tw
學號 t6695107
學位類別 碩士
語文別 中文
論文頁數 48頁
口試委員 口試委員-卓瓊鈺
召集委員-陳永榮
指導教授-成戎珠
中文關鍵字 功能性構音障礙  發聲障礙  動作測驗  發展性言語-語言障礙 
英文關鍵字 Developmental speech-language disorder  Functional articulation disorder  Phonological disorder  Motor test 
學科別分類
中文摘要 背景及目的:功能性構音障礙兒童的特徵為構音與發聲之缺失。構音與發聲需要整合協調多部位的構造與肌肉,因此可視為動作協調能力的一種。過往的文獻對於功能性構音障礙兒童是否有也有身體其他部位之動作協調能力缺失此一問題並未有一致的結果。第二版布魯茵克斯-歐西瑞斯基動作精練度評量工具(Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition, 簡稱BOT-2)與兒童動作評估測驗(Movement Assessment Battery for Children, 簡稱Movement-ABC)皆為臨床與研究中常使用的動作評估工具,雖BOT-2測驗包含的動作面向較為完整,但Movement-ABC 在使用上較為快速簡便。因此在本篇研究中,使用BOT-2與Movement-ABC來檢驗功能性構音障礙的兒童在各類動作面向的表現,並探討這兩種動作測驗之間的相關性。
方法:30位功能性構音障礙組兒童是由成大醫院轉介,30位與功能性構音障礙組在年齡與性別配對的正常發展兒童則是徵招自台南地區的幼稚園與國小。每位受試兒童皆接受認知功能與動作的測驗。認知功能的評估是使用中文版的修訂畢保德圖畫詞彙測驗與托尼非語文智力測驗第三版,動作功能的評估則是使用BOT-2與Movement-ABC,統計分析使用獨立t檢定、曼-惠特尼U檢定與Spearman等級相關係數。
結果:結果顯示在整體的動作表現(總分)上兩組兒童表現並無顯著的差異,然而功能性構音障礙組兒童在BOT-2中精細動作控制 (功能性構音障礙兒童: 59.60 ± 9.16;正常發展兒童: 64.93 ± 8.77, p = .026)、精細動作精準分測驗(功能性構音障礙兒童: 18.53 ± 4.22;正常發展兒童: 21.70 ± 5.09, p = 0.11)與Movement-ABC的球類技巧分測驗(Z = -2.256, p = .021)的表現顯著較正常發展兒童差。而兩動作測驗與其分測驗之間分數的相關性僅有中等至良好的相關(r = -.264 ~ -.645)。
結論:功能性構音障礙兒童在整體動作表現與正常發展兒童類似,但在動作中之精準控制能力較一般兒童差。BOT-2與Movement-ABC兩種動作測驗與其分測驗之間僅有中等到良好的相關,顯示兩動作測驗在本質上仍有不同,並不能互相取代,因此在使用時應考慮受試者的特質與目的等因素,以期使用最合適之評估工具。
英文摘要 Background and Purposes: Children with functional articulation disorders (FAD) are characterized with articulation and sound production deficits. Articulation and sound production depends on activation and coordination of many muscles and vocal structures. It could be considered as one type of motor coordination tasks. Inconclusive results were noted in the literature regarding if children with functional articulation disorders (FAD) have deficits in the motor coordination performance of other parts of body. Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2) and Movement Assessment Battery for Children (M-ABC) are two mostly frequently used assessment tools of motor performance in researches and clinical practices. Whether the scores of these two tests are correlated is seldom examined. The purposes of this study were to answer the questions 1) if children with FAD also had other body parts motor coordination deficit; 2) if the scores of BOT-2 and M-ABC were correlated.
Methods: Thirty children with FAD referred from NCKUH (5.40 ± 0.90 years old), and age- and gender-matched typically-developing children recruited from local community participated in the study. Each child first received cognitive assessments (Peabody Picture Vocabulary Test-Revised, PPVT-R and Test of Nonverbal Intelligence 3rd edition, TONI-3) to exclude the possible conditions of insufficient mental ability, and then received motor assessments with BOT-2 and M-ABC in a counterbalanced order. Independent t test and Mann-Whitney U test were adopted for comparison of motor performance between groups.
Results: The overall motor performance (total score) was not significantly different between the groups. However, children with FAD had significant lower scores in Fine manual control category of BOT-2 (FAD: 59.60 ± 9.16 vs. TD: 64.93 ± 8.77, p = .026), fine motor precision subtest of BOT-2 (FAD: 18.53 ± 4.22 vs. TD: 21.70 ± 5.09, p = 0.11) and ball skills subtest of M-ABC (Z = -2.256, p = .021). The correlations of the scores of two motor tests and their subtests were fair to good (r = -.264 ~ -.645 ) .
Conclusion: Children with FAD present similar overall motor performance except of lower scores of fine motor precision and ball skills. The correlations of scores of two motor tests are only fair to good. Clinical Relevance: Clinical therapists should be cautious that children with FAD may have a comorbid motor problem, especially the fine motor precision and ball skills. Only fair to good correlations of scores of the two most commonly used clinical tests indicates that it should be cautious when choosing a motor test for certain purpose.
論文目次 中文摘要 I
Abstract III
誌謝 V
目錄 VI
表目錄 IX
圖目錄 X
第一章 緒論 1
1.1 正常兒童的說話發展與功能性構音障礙兒童 1
1.2 功能性構音障礙兒童的動作表現 3
1.3 兒童動作能力的評估工具 5
1.4 研究背景 8
1.4.1 研究動機 8
1.4.2 研究目的 8
第二章 研究方法 9
2.1 研究對象 9
2.2 使用設備 9
2.2.1 認知功能評估工具 10
2.2.2 動作表現的評估工具 11
2.3 研究流程 14
2.4 資料處理 15
2.5 統計分析 16
第三章 研究結果 18
3.1 受試兒童之基本資料 18
3.2 比較兩組兒童在兩種動作評估工具的表現 19
3.3 兩種動作評估工具的相關性 26
第四章 討論 29
4.1 功能性構音障礙兒童的動作能力 30
4.1.1 兒童的整體動作表現 30
4.1.2 兒童的精細動作表現 31
4.1.3 兒童的粗大動作表現 33
4.1.4 功能性構音障礙兒童之動作表現與發展性言語-語言障礙兒童之動作表現差異 35
4.2 兒童動作評估工具之比較 36
4.3 本研究之限制及未來方向 37
第五章 結論 39
第六章 參考文獻 40
附錄1:BOT-2動作測驗之測驗項目內容 45
附錄2:人體試驗委員會審核通過證明 47
自述 48
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