發展協調障礙兒童心理健康問題之可能機轉及其應用

發展協調障礙兒童在執行需要動作協調能力的任務時經常遇到困難，後續可能影響到這些兒童的身體活動參與及體適能的表現。近來年，已有越來越多的研究開始關注這些兒童的心理健康問題，而研究也顯示，除了生理健康的問題之外，發展協調障礙兒童出現內化問題，如焦慮或是憂鬱等症狀之機率也較一般兒童高。因此，環境壓力假說被提出來用以解釋發展協調障礙兒童的內化問題，以及此關係如何受到其他生理與心理社會健康因素的影響。本文的目的是將透過文獻回顧，綜整現今針對發展協調障礙兒童內化問題的可能機制之相關研究結果，並根據現有之研究證據，提出針對發展協調障礙兒童動作協調困難所導致心理健康問題之相關介入策略擬定的建議與應用。分析結果發現：環境壓力假說可能為一動態過程，不同發展階段導致內化問題的機轉或許不盡相同，但兒童的自我概念與社會支持可能為較重要的中介因子。因此，未來若欲改善發展協調障礙兒童之心理健康問題，在進行動作協調能力介入時，應思考如何同時整合自我概念與社會支持的提升，如此一來才能有效降低發展協調障礙兒童內化問題的產生。

關鍵字

動作協調能力；焦慮；憂鬱；環境壓力假說

並列摘要

Children with developmental coordination disorder (DCD) often encounter difficulties performing tasks requiring motor coordination. This may subsequently impact participation in physical activity or physical fitness. Recently, much attention has been drawn to mental health in these children, and the existing evidence has shown that, in addition to physical health problems, children with DCD are also at greater risk for internalizing problems, such as symptoms of anxiety or depression. The environmental stress hypothesis was accordingly developed to illustrate the underlying mechanisms of internalizing problems in the DCD population and to better understand how the relationship between DCD and internalization of problems may be affected by physical and psychosocial health factors. The purpose of this article is to conduct a literature review and summary of the existing evidence regarding the underlying mechanisms of internalizing problems in children with DCD. Based on the existing evidence, this article also proposes the potential application for the development of interventions in children with DCD to mitigate internalizing problems resulting from motor difficulties. Our findings show that the environmental stress hypothesis may be a dynamic framework, indicating that the mechanisms may differ between developmental stages. However, children's self-concept and social support were more consistently found to mediate the relationship between DCD/ motor difficulties and internalizing problems. To sum up, these findings inform further interventions targeting the improvement in mental health problems in children with DCD. Specifically, in order to reduce internalizing problems in children with DCD, improvements in self-concept and social support should be integrated into motor coordination training.

並列關鍵字

motor coordination ； anxiety ； depression ； environmental stress hypothesis

參考文獻

Blank, R., Smits-Engelsman, B., Polatajko, H., & Wilson, P. (2012). European Academy for Childhood Disability (EACD): Recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Developmental Medicine & Child Neurology, 54(1), 54-93. doi:10.1111/j.1469-8749.2011.04171.x

Caçola, P. M., Romero, M., Ibana, M., & Chuang, J. (2016). Effects of two distinct group motor skill interventions in psychological and motor skills of children with developmental coordination disorder: A pilot study. Disability and Health Journal, 9(1), 172-178. doi:10.1016/j.dhjo.2015.07.007

Cairney, J., Hay, J., Veldhuizen, S., Missiuna, C., Mahlberg, N., & Faught, B. E. (2010). Trajectories of relative weight and waist circumference among children with and without developmental coordination disorder. Canadian Medical Association Journal, 182(11), 1167-1172. doi:10.1503/cmaj.091454

Cairney, J., Kwan, M. Y. W., Velduizen, S., Hay, J., Bray, S. R., & Faught, B. E. (2012). Gender, perceived competence and the enjoyment of physical education in children: A longitudinal examination. International Journal of Behavioral Nutrition and Physical Activity, 9, 26. doi:10.1186/1479-5868-9-26

Cairney, J., Rigoli, D., & Piek, J. (2013). Developmental coordination disorder and internalizing problems in children: The environmental stress hypothesis elaborated. Developmental Review, 33(3), 224-238. doi:10.1016/j.dr.2013.07.002

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發展協調障礙兒童心理健康問題之可能機轉及其應用

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