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系統識別號 U0026-1407202019295200
論文名稱(中文) ADHD兒童動機學習之療效研究:單一個案研究設計
論文名稱(英文) Treatment Effectiveness of Motivational Learning in Children with ADHD: A Single-Case Experimental Design
校院名稱 成功大學
系所名稱(中) 行為醫學研究所
系所名稱(英) Institute of Behavioral Medicine
學年度 108
學期 2
出版年 109
研究生(中文) 郭秉心
研究生(英文) Bing-Hsin Guo
學號 S86061048
學位類別 碩士
語文別 中文
論文頁數 96頁
口試委員 指導教授-黃惠玲
共同指導教授-林君昱
召集委員-林健禾
口試委員-紀美宏
中文關鍵字 注意力不足過動症  動機學習  價值導向記憶  單一個案研究設計 
英文關鍵字 attention deficit hyperactivity disorder (ADHD)  value-directed task  motivational learning  single-case experimental designs (SCEDs) 
學科別分類
中文摘要 研究背景與目的:注意力不足過動症(Attention-Deficit Hyperactivity Disorder, ADHD)是一種神經發展障礙症,其核心症狀為不專注、過動及衝動等,ADHD兒童亦經常合併認知缺陷、抑制、記憶等問題,使其在學校或家中產生許多行為困難。過去研究顯示ADHD兒童可能是由於對高價值訊息的注意力分配以及抑制低價值訊息方面的障礙以至於在選擇性地編碼和維持高價值訊息的價值導向記憶作業表現顯著低於一般對照組兒童,影響動機學習。本研究以黃惠玲教授實驗室等人在ADHD兒童價值導向的研究結果為基礎,延伸發展出針對ADHD兒童動機學習的治療方案,以單一個案實驗設計進行初探性研究,初步驗證此治療方案之療效。
方法:本研究於台灣南部地區招募3名經精神科醫師診斷為ADHD的國民小學之中、高年級男童。使用單一個案實驗設計中的延遲多基線跨參與者設計,獨變項為治療介入方案,依變項則為參與者之行為表現。每個研究參與者皆採用三個階層,分為基線期、治療期與維持期。資料分析部分採用圖示法、目視分析、C統計分析,以及行為資料進行分析,探討參與者在價值導向作業中的選擇性表現和日常生活中的行為表現。
結果:在治療介入後,三名研究參與者在治療期皆能發展出因應個人工作記憶廣度選擇高價值字詞作記憶的策略,且經目視分析與C統計分析結果發現三名研究參與者經過治療期的介入後,在價值導向記憶作業中的選擇性指標(Selectivity Index, SI)有明顯的進步,並能持續至維持期。在Go/No-Go作業中能使用自我指導或實現意圖的策略來協助自己進行抑制,而價值導向記憶作業中則使用了覆誦或語意組織等策略來輔助記憶。但適應行為資料結果顯示三名參與者未有一致明顯改善的趨勢。
結論:研究結果顯示三名研究參與者皆在治療方案介入後,在選擇性記憶的表現有顯著的改善,反映此治療方案可提升研究參與者於價值導向記憶作業中的動機學習,但可能受參與者本身的狀態及生態環境中的不同因素所影響,適應行為資料結果較不一致。據此,建議未來的研究可進一步探討參與者的症狀嚴重度、生活壓力事件等因素對其動機學習之影響,以修改治療介入方案,或以標準多基線設計或多探測設計來解決複製功能的限制,亦可增加研究參與者數量以進行實驗組與對照組之組間療效比較,加以驗證治療成效。
英文摘要 Objective: This study is based on results from confirmed pathophysiology and psychological process of attention-deficit hyperactivity disorder (ADHD), extending to the program for motivational learning of children with ADHD. We conducted a preliminary study to initially examine the treatment efficacy of this program. Methods: Participants are 3 middle and senior students of elementary school diagnosed as ADHD in Southern Taiwan, ranging from 8 to 11 years old. Delayed multiple baseline design across subjects was used and 3 phrases including baseline, intervention and maintenance were contained. Treatment intervention is independent variable and behavioral performance of participants is dependent variable. The study use graphics, visual analysis, C statistic and behavioral data for analysis and then discuss about selective performance in value-directed task and behavior during daily life of participants. Results: All 3 participants developed strategies to recall high-value words corresponding to their working memory span. As indicated by visual analysis and C statistic, their selective performance in value-directed task had obvious improvement and even continued to maintenance phrase after intervention of the therapeutic program. However, their adaptive behavioral data showed no consistent improvement. Conclusions: This program can increase motivational learning of value-directed memory task of participants, while results of adaptive behavioral data are inconsistent, which may be affected by individual status of participants and different factors from living environment.
論文目次 摘要 I
ABSTRACT III
誌謝 VI
目錄 VII
表目錄 IX
圖目錄 X
第一章 緒論 1
第一節 注意力不足過動症概述 1
第二節 注意力不足過動症成因之探討 3
第三節 注意力不足/過動症治療之探討 6
第四節 單一個案研究設計 16
第五節 研究目的與假設 19
第二章 研究方法 20
第一節 研究參與者 20
第二節 研究材料與工具 22
第三節 研究設計 25
第四節 研究程序 27
第五節 資料分析 32
第三章 研究結果 36
第一節 參與歷程 36
第二節 GO/ NO-GO 作業紀錄與抑制能力表現 38
第三節 正確回憶比率之療效分析 40
第四節 SI之療效分析:延遲多基線跨參與者研究設計結果 42
第五節 適應行為之療效分析: 行為評量改變量與教師的上課行為觀察 51
第四章 討論與結論 55
第一節 研究結果摘要 55
第二節 研究結果討論 56
第三節 研究結論與未來方向 61
參考文獻 62
附錄一、抑制能力作業計分表 75
附錄二、價值導向記憶作業計分紙 79
附錄三、研究指導語 93

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