南台灣國小學童握筆姿勢之調查研究

The Survey of Incidence of Pencil Grasps among School-aged Children in Southern Taiwan

張韶霞(Shao-Hsia Chang)

《職能治療學會雜誌》 22卷 (2004/09) Pp. 35-42

https://doi.org/10.6594/JTOTA.2004.22.03

摘要

關心手功能與精細動作的發展是職能治療專業服務的特色之一，在職能治療專業服務逐漸深入學校系統後，有不少的個案是由於寫字功能不彰或不良的握筆姿勢等原因而由學校老師轉介給職能治療師。職能治療師所關心學童們寫字能力最重要的部分之一就是握筆姿勢，當對正常成熟的握筆姿勢的相關知識缺乏時，很難對異常的握筆姿勢作判斷或建議介入策略。由於中西方文化的不同，導致握筆成熟速度會有差異；又由於中國文字是較特殊的方塊字，截然不同於西方拼音字的文字系統，亦有可能運筆方式的不同而導致最有效率的握筆姿勢也會不同於西方國家學童的握筆方式。
本研究觀察國小學童不同握筆姿勢的盛行率，研究對象為555結果發現國小學童的握筆姿勢，以動態三點握姿佔最高的比例（593%),其次是側邊三點握姿（22.9%）及四點握姿（14.4%）。典型三點握法的比例依低中高年級的順序逐漸升高（45.6%,56.3%,72.0%)，非典型握法則依低中高年級順序逐漸下降（54.4%,43.7%,27.9%)，可能是由於學習的因素所造成。此外，典型與非典型握筆姿勢的比例在不同的性別或不同的慣用手之問並沒有明顯的不同。名國小低、中及高年級的學童，他們來自高雄及台南地區的三所小學。進行寫字測驗時，將學童握筆姿勢以照相法紀錄，並同時觀察紀錄學童所使用的慣用手。

關鍵字

手功能 ； 握筆姿勢評估 ； 書寫

並列摘要

The development of hand function and fine motor represents a special feature of occupational therapy services. Many school-aged children with handwriting deficits or awkward pencil grasp are often referred to occupation therapy since occupational therapy practice is expanded to school systems. Optimal pencil grasp pattern is an important aspect of handwriting that has been concerned in occupational therapy practice. However, the limited knowledge of typical development of pencil grasp patterns in school-aged children interferes with effective pencil grip assessment and intervention for children with maladaptive grip pattern. Literature indicates that children from different cultures develop at different rates in pencil grips. In addition, the nature of Chinese “square writing” characters is entirely different from the English writing system. The complexity in manipulation of strokes of the Chinese characters may develop to other optimal grasp patterns which are different from the English writing system.
The purpose of this study is to survey the incidence of atypical pencil grasps among school-aged children in Southern Taiwan. There are 555 school-aged children selected from three elementary schools in Kaohsiung and Tainan area. A copy task is administered to a each child. While students are copying, the researcher records the grip pattern by camera and the writing hand for each subject. All 555 grip pattern pictures are coded according to 5 types adapted by Tseng’s Scale and Schneck and Henderson’s pencil grip assessment.
Among the 555 school-aged children, the most frequently used grasp was the dynamic tripod grasp (59.3%), and followed by the lateral tripod grasp (22.9%). The third was the quadrupod grasp (14.4%). The prevalence of the dynamic tripod grasp increased and lateral tripod grasp decreased with 7-12 age. A possible reason for changing the grip pattern is learning effect. In addition, there are no significant differences in the proportion of typical and atypical grip-form between genders or right handed and left handed.

並列關鍵字

hand function ； pencil grasp assessment ； handwriting