The Treatment Effectiveness of Top-down Approaches for Children with Developmental Coordination Disorder: A Meta-analysis

由上而下的治療模式對發展性協調障礙兒童的療效：後設分析

陳秀芬(Hsiu-Fen Chen)

《職能治療學會雜誌》 21卷 (2003/01) Pp. 16-28

https://doi.org/10.6594/JTOTA.2003.21.02

摘要

本研究的目的，是使用後設分析，來驗證由上而下的治療模式對於發展性協調障礙兒童是否有療效。根據自1987年至2002年的文獻搜尋，發現有六篇研究是用此治療模式來治療發展性協調障礙兒童，本研究運用後設分析，來驗證此治療模式，是否可改善發展性協調障礙兒童的動作技巧獲得及技巧轉移。結果發現，由上而下的治療模式和動作技巧獲得之間，有極大且顯著的相關。其中發現，針對日常職能表現的認知取向治療，比其它由上而下的治療模式有療效；此後設分析並且發現，此治療模式對發展性協調障礙兒童在技巧轉移上也同樣有療效。經由文獻回顧，建議未來這樣的治療模式研究應有對照組，並評估技巧訓練的長期療效，且比較由上而下與由下而上的治療模式(例如:感覺統合治療和運動感覺訓練)療效是否有差益異。

關鍵字

証據醫學 ； 有效程度 ； 介入處置

並列摘要

The purpose of this meta-analysis was to address whether existing studies of top-down treatment approaches support the effectiveness of motor skill acquisition and skill transfer for children with developmental coordination disorder (DCD). Based on a review of literature from 1987 to 2002, six studies of top-down approaches for children with DCD were identified and examined using a meta-analysis. A large and statistically significant relationship between top-down approaches and motor skill acquisition (rw= .91) was found. The Cognitive Orientation to daily Occupational Performance (CO-OP) approach was superior to other top-down approaches (g= .92). The meta-analysis also suggests that children with DCD benefited from top-down approaches in skill transfer (rw = .52). Future studies of top-down approaches need to include a control group, examine the long term effects of skill training, and compare effects between top-down approaches and bottom-up approaches, such as sensory integration and kinesthetic training.

並列關鍵字

evidence-based practice ； effect size ； intervention