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系統識別號 U0026-0907201017491000
論文名稱(中文) 五歲極低體重早產兒之眼球運動、視覺掃描與功能性視覺搜尋表現
論文名稱(英文) Eye movements, visual scanning, and functional visual search performances of five-year-old preterm children with very low birth weight
校院名稱 成功大學
系所名稱(中) 職能治療學系碩博士班
系所名稱(英) Department of Occupational Therapy
學年度 98
學期 2
出版年 99
研究生(中文) 黃琦婷
研究生(英文) Chyi-Tyng Hwang
學號 t7697101
學位類別 碩士
語文別 中文
論文頁數 101頁
口試委員 指導教授-徐永玟
口試委員-蔡佩倫
口試委員-郭乃文
口試委員-何自欣
中文關鍵字 極低體重早產兒  眼球運動  視覺搜尋 
英文關鍵字 very low birth weight  eye movements  visual search 
學科別分類
中文摘要 極低體重早產兒(very low birth weight, VLBW; 出生體重小於1500克)即使出生時無明顯之腦傷,仍可能有輕微的視知覺問題,影響其學習與日常表現。目前缺乏以量性、客觀的方式探討學齡前VLBW的眼球運動能力之研究,故本研究目的為探討5歲VLBW與同齡足月產兒童之眼球運動、視覺掃描,以及功能性視覺搜尋表現之差異。
受試者共67位5足歲的兒童,分為早產組(n = 30)及足月組(n = 37)。兩組均排除有腦傷或重大疾病者且視力及視野正常,早產組為出生體重小於1500克,懷孕週數在32週以下的早產兒童;足月組為出生體重大於2500克,懷孕週數在37週以上的足月產兒童。利用眼球追蹤系統記錄眼球動作控制測驗、泰迪熊刪除測驗與功能性視覺搜尋測驗的眼球運動資料。眼球動作控制測驗共分為平順追視、掃視及反掃視三項子測驗;泰迪熊刪除測驗之目標物為15個泰迪熊圖案,畫面等分為5個垂直區塊,目標物以偽隨機排列的方式等比例分佈在區塊內,受試者需盡快找出所有目標物;功能性視覺搜尋測驗共有三個情境,模擬孩童日常生活會遇到的情境,受試者需在各情境中找出指定的目標物。
研究結果發現早產組的平順追視能力較差,但兩組孩童之眼球掃視與反掃視能力並無明顯不同。在泰迪熊刪除測驗中,早產組之遺漏個數明顯較多,搜尋品質明顯較差,平均單一凝視時間、總凝視時間、總完成時間及總掃視長度均較長,但未達顯著差異;早產組進行有組織搜尋的比例明顯偏低;大約50%的受試者,其第一個刪除的目標物與第一凝視點落在不同區塊。VLBW孩童在功能性視覺搜尋測驗的情境一和情境二中,眼球運動表現明顯比同年齡之足月產孩童差,早產組的凝視點數目明顯較多,總凝視時間和總完成時間明顯較長,總掃視長度亦明顯較長,搜尋品質明顯較差。
本研究首次針對學齡前VLBW之眼球運動與視覺搜尋表現,提供量化的實驗證據,發現即使沒有明顯腦傷,VLBW之視知覺能力仍可能有輕微損傷。因此,臨床職能治療師應針對學齡前VLBW之視知覺能力,積極進行早期評估與介入。
英文摘要 Even though without major disabilities or cerebral lesions, preterm infants with very low birth weight (VLBW) are still frequently characterized as having subtle perceptual problems. Numerous studies have noted that visual acuity, visual fields and higher level visual perception skills in VLBW are at a significantly increased risk of being impaired. However, there is currently no any research focusing on oculomotor control, visual scanning, and functional visual search performances in preschool-aged VLBW. The purpose of this study is to investigate differences in oculomotor control, visual scanning, and functional visual search performances between 5-year-old VLBW and age matched full-terms.
30 VLBW children aged 5 years were recruited, and compared to 37 full-term children. Eye movements were registered by the Head Mounted Scene Camera EyeTracker Systems. The subjects were tested on oculomotor control tasks, Teddy Bear Cancellation Test (TBCT), and functional visual search tasks. The oculomotor control tasks include smooth pursuit, saccade, and antisaccade paradigms. The Teddy Bear Cancellation Test includes 15 targets and 60 distractors. The targets are teddy bears. The subjects will be asked to cross out all of the targets as fast as possible. The functional visual search tasks include three contexts which simulate real daily contexts that preschooler may have been experienced. The subjects will be asked to find out all of the targets as fast as possible.
The results show that full-term group performed better than VLBW group in smooth pursuits, but there are no any significant differences between two groups in saccades and antisaccades. In TBCT, there are significant differences in number of omissions, search quality, and scanning pattern between two groups. In functional visual search tasks, there are significant differences in context 1 and context 2 between two groups.
In summary, eye movements, visual scanning abilities, and functional visual search performances of preschool-aged VLBW children were slightly impaired. Therefore, early evaluation and intervention is of importance for VLBW children.
論文目次 目錄
中文摘要 1
英文摘要 3
誌謝 5
目錄 6
表目錄 10
圖目錄 11
附錄目錄 13

第一章、緒論 14
第一節、研究動機與重要性 14
第二節、研究目的 18
第二章、文獻回顧 19
第一節、視知覺 19
壹、視覺接收要素 19
貳、視覺認知要素(Visual-cognitive components) 20
第二節、視知覺評估 24
壹、視覺接收要素之評估 24
貳、視覺認知要素之評估 25
第三節、極低體重早產兒 28
壹、定義與簡介 28
貳、視知覺問題 31
第四節、總結與研究假設 37
第三章、研究方法 39
第一節、研究參與者 39
第二節、研究工具 41
壹、眼球追蹤系統 41
貳、眼球動作控制測驗 42
參、泰迪熊刪除測驗 45
肆、功能性視覺搜尋測驗 46
伍、測驗設計與視知覺技巧發展階層式模式之相關性 50
第三節、研究程序 52
第四節、資料收集與分析 55
壹、資料收集 55
貳、資料分析 58
第四章、結果 60
第一節、基本人口學資料 60
第二節、眼球動作控制能力 61
壹、平順追視 61
貳、掃視 61
參、反掃視 62
第三節、泰迪熊刪除測驗之眼球運動與視覺掃描表現 64
第四節、功能性視覺搜尋表現 68
第五節、泰迪熊刪除測驗與功能性視覺搜尋表現之比較 75
第五章、討論 76
第一節、兩組孩童眼球動作控制能力的差異性 76
壹、平順追視能力 76
貳、掃視能力 78
參、反掃視能力 78
第二節、兩組孩童在泰迪熊刪除測驗表現的差異性 80
第三節、兩組孩童功能性視覺搜尋能力的差異性 84
第四節、綜合討論 87
第五節、研究限制 89
第六章、結論 90
第七章、參考文獻 91

表目錄
表1、基本人口學資料 40
表2、兩組受試者在眼球動作控制測驗之結果比較(以全量表智商分數為共變項) 62
表3、各組在速度5°/秒與10°/秒平順追視結果之組內差異(以全量表智商分數為共變項) 63
表4、兩組受試者在泰迪熊刪除測驗之結果比較(以全量表智商分數為共變項) 64
表5、兩組受試者在泰迪熊刪除測驗之搜尋模式 66
表6、兩組受試者在泰迪熊刪除測驗之刪除策略 67
表7、兩組受試者在功能性視覺搜尋測驗之結果比較(以全量表智商分數為共變項) 69
表8、兩組受試者在功能性視覺搜尋測驗三情境之比較(以全量表智商分數為共變項) 70
表9、功能性視覺搜尋測驗三情境之凝視點數目成對比較(以全量表智商分數為共變項) 71
表10、兩組受試者在泰迪熊刪除測驗(TBCT)與功能性視覺搜尋測驗三情境之平均單一凝視時間比較(以全量表智商分數為共變項) 75
表11、泰迪熊刪除測驗(TBCT)與功能性視覺搜尋測驗三情境之平均單一凝視時間的成對比較(以全量表智商分數為共變項) 75

圖目錄
圖1、Warren (1993)提出的視知覺技巧發展階層式模式之說明 23
圖2、眼球追蹤系統的眼鏡式支架 42
圖3、眼球追蹤系統其他硬體設備 42
圖4、眼球動作控制測驗示意圖 44
圖5、泰迪熊刪除測驗 46
圖6、功能性視覺搜尋測驗的練習試驗 47
圖7、功能性視覺搜尋測驗的正式測驗 47
圖8、功能性視覺搜尋測驗的正式測驗場景俯視圖 48
圖9、功能性視覺搜尋測驗的施測場景 49
圖10、測驗設計與視知覺技巧發展階層式模式之相關性 51
圖11、研究流程圖 54
圖12、泰迪熊刪除測驗第一凝視點位置分佈情形 65
圖13、泰迪熊刪除測驗第一刪除目標物位置分佈情形 65
圖14、足月組(左圖)和早產組(右圖)孩童在泰迪熊刪除測驗之掃描軌跡 66
圖15、功能性視覺搜尋測驗之第一凝視點分佈情形 72
圖16、功能性視覺搜尋測驗之第一個找到的目標物分佈情形(垂直分區)73
圖17、功能性視覺搜尋測驗之第一個找到的目標物分佈情形(水平分區)74

附錄目錄
附錄 1、眼科醫師檢查表 101
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