有無發展協調障礙之寫字困難兒童的寫字表現與原因之探討

Analysis of Handwriting Deficits for the Comparison of Children With/Without Developmental Coordination Disorder

張韶霞(Shao-Hsia Chang) ； 余南瑩(Nan-Ying Yu)

《職能治療學會雜誌》 28卷1期 (2010/01) Pp. 13-28

https://doi.org/10.6594/JTOTA.2010.28(1).02

摘要

發展協調障礙兒童動作障礙的特徵已被視為寫字困難的高危險群，且其會影響學校活動的參與。本研究的目的，是比較發展協調障礙與非發展協調障礙的寫字困難兒童在寫字困難表現向度與寫字相關知動能力上的差異，以釐清發展協調障礙兒童的寫字問題。
1,258位國小低年級兒童，經過「視覺－動作統整發展測驗」與「中文寫字困難評估問卷」的評估，確認有72位寫字困難兒童。再以「兒童動作評估測驗組合」與「發展協調障礙問卷」評估，33位確定為發展協調障礙，而39位確定為非發展協調障礙，兩組兒童均接受基本讀寫字綜合測驗及漢字視知覺測驗。
結果顯示發展協調障礙與非發展協調障礙的寫字困難兒童呈現出不同的寫字問題，發展協調障礙兒童偏向「寫字速度」及「握筆工學」等向度的問題；而非發展協調障礙兒童的寫字問題則在「正確性」及「方向性」向度上較為嚴重。字體的工整性或可讀性不佳則是所有寫字困難兒童的問題。此外，發展協調障礙兒童在精細動作能力明顯落後非發展協調障礙的寫字困難兒童；在視知覺能力方面，兩組兒童的表現都明顯偏低。
本研究結果建議臨床工作者在處理寫字困難兒童的寫字問題時，能分析兒童的主要缺陷與其寫字困難的問題類別進而提供適當的介入策略，以提昇學校寫字活動的參與度。

關鍵字

發展協調障礙 ； 寫字困難 ； 知動能力

並列摘要

Developmental coordination disorder (DCD) is characterized by motor impairment that is particularly at risk for handwriting deficiency and hinders the children's participation in school activities. With an aim to clarify the handwriting problems of children with DCD, this study compared the characteristics of handwriting performance and the related perceptual-motor skills between children with and without DCD.
A total of 1,258 grade 1 and 2 children were screened by the VMI test and confirmed by the CHEQ for the identification of handwriting dysfunction, 72 children with handwriting deficits were recruited for this study. After tested by the Movement-ABC and DCDQ, a total of 33 and 39 children were identified and designated the DCD and non-DCD groups respectively. The handwriting performance and the related perceptual skills of these 72 children were assessed with Elementary Read/Write Test and Chinese Visual Perceptual Test.
The results indicated that there is significant difference between DCD and non-DCD children on the problems manifested on the CHEQ. Children with DCD were prone to the problems of speed and grip ergonomics, whereas non-DCD children were inferior in the dimensions of accuracy and directionality. Both groups have the problems on the construction of characters and overall legibility. Furthermore, the DCD children fell behind the non-DCD children on the fine motor skill. The visual perceptual function was also found to be inferior in both groups.
This study suggested that clinical practitioners focus on children's main deficits and types of handwriting deficits to provide effective intervention strategies so as to promote DCD children's participation in handwriting related activities.

並列關鍵字

DCD ； handwriting deficit ； perceptual-motor ability