Publication:

發展協調障礙兒童之本土化動作篩檢量表之建立與應用分析

背景：兒童動作發展及功能研究領域中，許多影響動作表現的疾病已被深入的探討，然而尚有一部份動作上有缺陷但是從神經理學檢查或染色體結構檢查中卻無法檢測出問題的兒童存在，美國精神科學會統一稱之為「發展協調障礙」（Developmental Coordination Disorder）兒童；而這些兒童因其動作上的問題，不僅影響其生理及身體狀況，甚至影響所及可能廣泛到其生活自理、學習能力、以及社交關係，並且這些影響會一直持續到他們進入青少年時期，甚至到成年時期。過去我國關於發展協調障礙兒童的研究且在過去五年內開始重視此問題，也開始嘗試建構完整的評估系統及本土化的評量工具，但是並無學校教師之評估觀察量表以快速且正確篩檢發展協調障礙兒童，以致評量我國兒童的動作協調能力結果仍缺乏一致性。目的：本研究計畫的目的在於發展評量發展協調障礙兒童動作能力之教師觀察評估量表，並分析其信效度與建立我國本土化量表之參考常模。方法：本兩年期之研究擬隨機取樣篩檢及觀察我國600名國小三年級至六年級（第一年200名，第二名400名），年齡分佈於九至十二歲之男女學童，用於兒童動作評估的國外工具為Movement ABC測驗，及我國之本土化評量工具（本研究群於九十三及九十四年度國科會計畫所建立發展）之台灣動作協調能力進行測驗，並將於本研究計畫所欲建立本土化之教師版台灣兒童動作協調能力量表(Taiwanese Chindren Coordination Questionnaire- Teacher edition)以於學校快速評估及篩檢發展協調障礙兒童。之後將使用Movement ABC動作測驗所檢測之結果、台灣動作協調能力測驗結果，及本研究所欲建立之兒童動作協調能力量表結果進行效度分析，同時使用台灣兒童動作協調能力量表之再測信度與測驗者內信度也將予以建立；另外本研究也將使用因素分析分類台灣動作協調能力量表之主要面向及決定合適之問題，以取得最重要的評量觀察項目當成我國未來教師觀察台灣兒童動作協調能力與應用建立我國本土量表之常模。預期成果：期望經由本計畫於第一年建構之本土化評估觀察量表，並將此觀察量表建立起具有客觀的信度與效度分析，第二年將可廣泛應用於評量我國更多學童之動作協調能力以及確認發展協調障礙之兒童，並建立起本土化量表常模；經由老師及物理治療師正確確認兒童之動作協調問題方可予以特殊性之介入訓練，如此將可使兒童功能進步並且更健康，父母與學校老師能夠認知此動作協調能力的重要性，同時本研究將直接有助於發展協調障礙學童相關理論之建構與本土化之兒童篩檢推廣應用。

Background: In the research field of child development and function, factors influencing movements in many diseases have been examined. However, some children have the problems in motor and coordination performance influencing their physical conditions, daily routine activities, learning opportunities and social interactions. We cannot directly detect them from the routine neurological

examinations or chromosome structure examinations. According to American Psychiatric Association, those children were called as- ‘DevelopmentalCoordinationDisorder’(DCD).Inthepreviousresearch studies, there was no consensus on the causal factors or on the management programs, because teacher-screening questionnaires did not exist for identification of DCD in Taiwan. Purpose: To develop a teacher questionnaire - the Taiwanese Children Coordination Questionnaire- Teacher edition (TCCQ)

and to examine the reliability and validity of this questionnaire. Method: The Movement ABC test, the Taiwan Movement Assessment Test (TMA test) and the TCCQ were used to evaluate 198 children aged 9

to 12. Results of the Movement ABC test, the TMA test and TCCQ were compared to establish a series of reliability and validity of the TCCQ. Results: The sensitivity and specificity of TCCQ were 29.6%~31.8% and 74.9%~77.3%, respectively, while using the Movement ABC test as a gold standard. The sensitivity and specificity of TCCQ were 25% ~ 36.8% and 74.2% ~ 75.4%, respectively, while using the TMA test as a gold standard. In addition, the Cronbach’salphacoefficientof the TCCQ was 0.9305 indicating a strong internal consistency. According to the results of factor analysis, the TCCQ could be divided into four dimensions: ball control domain, visual motor integration domain, fine motor and handwriting domain, and general coordination domain. Conclusion: The TCCQ proved to meet standards for most aspects of reliability and validity. It may be used by teachers not only for screening children with

movement difficulties but also for discovering children with athletic potentials.