影響自閉症兒童中文寫字表現的知覺動作相關因素探討

寫字是學齡兒童學業表現的重要基礎能力，自閉症兒童卻經常面臨寫字困難的問題。然而目前仍缺乏對於自閉症兒童中文寫字表現的探討，也不清楚影響自閉症兒童中文寫字表現的知覺動作要素為何。本研究旨在探討國小三到六年級自閉症兒童中文寫字表現與自閉症行為特質及知覺動作能力之間的關係，以及自閉症行為特質與知覺動作能力對中文寫字表現的預測情形。本研究對象為34名智力約在85分以上，且經「曾氏寫字問題檢核表」篩檢為有寫字問題的國小三到六年級自閉症兒童。以「國民小學學童寫字測驗」、「高功能自閉症/亞斯柏格症兒童行為檢核表」、「漢字視知覺測驗」、「圖形設計測驗」、「布魯茵克斯－歐西瑞斯基動作精練度評量—第二版，簡版」以及「拜瑞－布坦尼卡視覺－動作整合發展測驗」為研究工具，將測驗結果以皮爾遜（Pearson）積差相關，分析自閉症兒童中文寫字表現與自閉症行為特質、視知覺、精細動作以及視覺動作整合能力之間的關聯性，並透過多元階層迴歸方法分析自閉症行為特質、視知覺、精細動作以及視覺動作整合能力對中文寫字表現的預測情形。研究結果摘要如下：一、自閉症兒童之自閉症行為特質與中文寫字表現、視覺記憶以及視覺動作整合能力呈顯著負相關，尤其是社會領域之自閉症行為特質。二、自閉症兒童之聽寫與視覺記憶、視覺動作整合能力呈顯著正相關；抄寫及抄寫速度則與精細動作、視覺動作整合能力呈顯著正相關。三、自閉症兒童之視覺記憶能力與社會領域之自閉症行為特質可以顯著預測其聽寫表現。四、自閉症兒童之精細動作能力與社會領域之自閉症行為特質可以顯著預測其抄寫表現與抄寫速度。綜合上述結果可知，自閉症兒童的社會領域之自閉症行為特質與寫字表現有關，也可以顯著預測其中文寫字表現。在知覺動作能力與寫字的關係部分，可顯著預測自閉症兒童聽寫表現的能力為視覺記憶；可顯著預測抄寫及抄寫速度的能力則是精細動作。因此在分析兒童的寫字問題時，應考量視知覺、精細動作以及視覺動作整合等各方面的知動能力。當兒童早期有社會性互動或社交技巧等方面的困難時，也應留意其知覺動作能力的發展，並追蹤未來書寫動作的表現。

關鍵字

自閉症；寫字；知覺動作；社會行為

並列摘要

Handwriting is an essential skill in the academic performance of school-age children, but it is also a weakness in children with autism spectrum disorder. Currently, no study has examined the Chinese handwriting performance of children with autism spectrum disorder, and the perceptual-motor factors contributing to this crucial skill. This study investigates the relationship between Chinese handwriting performance, core symptomology, and perceptual-motor abilities in children with autism spectrum disorder, and aims to predict their handwriting performance based on core symptomology and perceptual-motor abilities. Children with autism spectrum disorder, who were between 3rd and 6th grade in primary school, were recruited for this study. Using the Tseng handwriting problem checklist, handwriting difficulties were identified in 34 subjects. Evaluation tools used in this study included the Chinese Writing Assessment of Pupils, Autism/Asperger Behavior Rating Scale, Test of Visual Perception of Chinese Characters, Block Design test, the fine motor precision and manual dexterity subtests of the Bruninks-Oseretsky Test of Motor Proficiency- Second Edition, short form (BOT-2), and The Beery-Buktenica Development Test of Visual-Motor Integration (VMI). Pearson’s correlation coefficients were computed, and data were analyzed with multiple hierarchical regression models. Findings suggest the following: 1. Chinese handwriting performance negatively correlated with autistic core symptomology (particularly, the social perspective), visual memory, and visual-motor integration. 2. Positive correlations were identified between dictation, visual memory, and visual-motor integration. Fine motor and visual motor integration positively correlated with far copying and copying speed. 3. Visual memory and social behavior were significant predictors of dictation performance. 4. Fine motor and social behavior were significant predictors of far copying and copying speed. The results of this study clearly showed that the social perspective of autistic core symptomology has a strong relation with, and is a predictor of, Chinese handwriting performance. Regarding the relationship between perceptual-motor abilities and handwriting, visual memory is a significant predictor of dictation performance in autistic children, while fine motor is predictive of far copying and copying speed. Therefore, visual perception, fine motor, and visual-motor integration are crucial parameters to consider while analyzing children’s handwriting difficulties. If children experience difficulties in social integration and social skill during early childhood, it is important to pay attention on their visual-motor development, and follow the development of graphomotor skill.