Publication:

臺灣兒童動作協調能力觀察量表之建立

【背景與目的】雖然國內已發展出一套適用於國人檢測發展協調障礙兒童的工具，但關於評估發展協調障礙兒童之家長或教師自填式問卷量表為不可或缺之評估工具；且為了能大量篩檢，達到「及早發現，及早治療」之目的，故本研究旨在建立符合我國文化背景且具備我國常模之兒童動作協調能力篩檢量表，並且探討此篩檢量表之信效度。【方法】本研究先以方便取樣，選取中部地區之國中、小學，再採隨機取樣，使用Movement ABC測驗工具、TMA測驗工具（Taiwan Movement Assessment Test）及本研究所建立之台灣兒童動作協調能力觀察量表，篩檢我國412名9-12足歲之學童，並以Movement ABC測驗工具和TMA測驗工具之評估結果與台灣兒童動作協調能力觀察量表之評估結果進行一連串之信度與效度分析，以確立台灣兒童動作協調能力觀察量表評估結果之正確性，同時建立我國中部地區之常模。【結果】根據Movement ABC測驗工具台灣常模之定義，國內9-12歲國小學童發展協調障礙之盛行率為3.2%，與Movement ABC測驗工具評估結果比較，本篩檢量表之敏感度與專一度分別為0.4與0.873；而根據TMA測驗工具之定義，國內9-12歲國小學童發展協調障礙之盛行率為4.9%，與TMA測驗工具評估結果比較，本篩檢量表之敏感度與專一度分別為0.258與0.865。台灣兒童動作協調能力觀察量表內部一致性高達0.907-0.933，整體之再測信度介於0.431-0.914之間。根據因素分析之結果，本篩檢量表可歸納為四個主要面向，分別為球類操控能力、手部操作技巧、平衡整合能力與日常生活技能。台灣兒童動作協調能力觀察量表除了同時效度有待進一步檢驗外，其餘所探討之信度與效度皆在可接受範圍之內。【結論】本研究所建構之台灣兒童動作協調能力觀察量表除了有良好之信度與效度外，亦具台灣中部地區之常模，未來將可廣泛應用於評估我國中部地區學童之動作協調能力，及發展協調障礙兒童之初步診斷，經由初步診斷之結果，再進行更進一步的詳細評估，以診斷出真正具有發展協調障礙之兒童，並給予適當之介入。

【Background & Purpose】Although there have already developed a local evaluation tool for developmental coordination disorder (DCD) in Taiwan, we still need teachers or parents questionnaire to quickly evaluate for children. In order to early identify of children with DCD, the aims of this study were to develop the Taiwan Children Coordination Questionnaire (TCCQ), a systematic evaluation instrument with the validity and reliability through analyzing DCD children’s motor coordination performances. 【Methods】The Movement ABC test, Taiwan Movement Assessment Test (TMA test), and Taiwan Children Coordination Questionnaire were used to evaluate 412 children aged 9 to 12 years old. The results of the Movement ABC test and TMA test were compared with the results of the TCCQ to establish a series of reliability and validity. The local norms of the TCCQ were also developed in this study. 【Results】According to the Taiwan norm of the Movement ABC test, the prevalence of DCD aged 9 to 12 was 3.2% in Taiwan. This result was also compared with the TCCQ to establish the concurrent validity that sensitivity and specificity were 0.4 and 0.873, respectively. According to the Taiwan norm of the TMA test, the prevalence of DCD aged 9 to 12 was 4.9% in Taiwan. This result was also compared with the TCCQ to establish the concurrent validity that sensitivity and specificity were 0.258 and 0.865, respectively. In addition, the Cronbach’s alpha coefficients of the TCCQ were 0.907-0.933, indicating a strong internal consistency, and the ICC values of test-retest reliability was 0.431-0.914. Through the factor analysis, the result revealed that the TCCQ test could be divided into four dimensions: ball control ability domain, manual manipulation ability domain, balance integration ability domain, and the ability of activities of daily livings domain. Except the concurrent validity needing to recheck, the other reliability and validity of the TCCQ were considered as acceptable levels. 【Conclusions】The TCCQ has good reliability, validity and the central Taiwan norm. It may be widely applied to asses the motor coordination of children in Taiwan and to initiatively diagnose children with DCD. According to the results, the suspected DCD children can receive further evaluation to make sure their problems and so the appropriate intervention may be conducted.