第五章 討論
第二節 建議與未來研究之方向
6-2-1 建議
根據 DSM-IV 所述，發展協調障礙兒童除了動作協調能力不足之 外，其動作障礙會明顯影響其學業表現或日常生活活動，為了符合上述 標準採取兩階段的篩檢方式是相當適合的。第一階段先由學校老師和家 長填寫觀察式問卷，再由問卷中篩選出疑似動作有問題之兒童進行動作 量表測試，如此不僅節省人力物力，更能增加篩檢的精確度。目前國內 已有 Movement ABC 測驗之台灣常模建立，及本土化的台灣動作評估測 驗 ， 而 問 卷 部 分 雖 有 DCDQ （ Developmental Coordination Disorder Questionnaire）中文版（傅中珮，2005），但其並未建立與其他測驗之 同時效度，因此即使 DCDQ 中文版量表有良好之信效度，但其是否能 夠有效鑑別發展協調障礙兒童仍有待商確。故若能建立本土化之教師與 家長觀察問卷，配合本土化動作評估工具一起使用，更能提升發展協調 障礙兒童診斷之準確度。
6-2-2 研究之應用
雖然發展協調障礙兒童具有很高的異質性，但藉由本研究結果之次 族群模式，可將這類兒童依其動作特性做分類，進而應用到評估與治療 上。在評估方面可以針對每個面向選擇分群能力較佳的測驗項目進行測 試；在治療上則根據每組次族群之特質設計合適的介入訓練計畫，例 如：球類操控特別差的則加強此方面再配合整體協調能力的訓練，整體 障礙類型的就全方位皆加強訓練，如此一來更能增加治療的效益。
6-2-3 未來研究之方向
發展協調障礙兒童除了動作問題之外其學業表現亦較一般兒童 差，但不同特性之次族群是否在學業表現也會有所不同？因此後續研究 可探討不同次族群之發展協調障礙兒童在智力商數、學科表現和體育活 動等是否有所差異。此外，文獻已證實發展協調障礙兒童的動作問題會 一直持續到青少年或成人時期，但其動作表現可能會轉變成為其他的行 為模式，若當初某位發展協調障礙兒童是被歸類在平衡能力特別差的次 族群，其次族群特性是否會隨著年齡增長而改變？不同的次族群其長大 後的行為表現或情緒問題是否也會有所不同？因此若能進行縱向研究
（longitudinal study）不僅可檢驗次族群之穩定性，更可藉著長期追蹤與 定期評估瞭解兒童動作特性與行為模式之相關。
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吳昇光、蔡輔仁（2002）我國發展協調障礙學童之體適能及動作能力研究。
附錄一
Movement ABC 測驗 年齡層三（9-10 歲）之測驗項目
項目一
項目名稱：移動珠子（shifting pegs by rows）
測驗面向：手部操作靈活度
施測方式：將板子放在桌面的止滑墊上，將第二、三、四排插滿珠子，
兒童採取坐姿分別使用慣用手與非慣用手將珠子由左而 右、由上而下往上一排移動。練習一次，測驗二次。
記錄方式：紀錄完成的秒數，取最好的成績。測試過程中若一次移動一 個以上的珠子或換手、使用雙手均視為失敗。
圖五、移動珠子測驗
項目二
項目名稱：轉螺絲（threading nuts on bolt）
測驗面向：手部操作靈活度
施測方式：螺絲棒頭朝向兒童放在桌面止滑墊上，三個螺絲帽隨意放 好。兒童採取坐姿一隻手固定螺絲，另一隻手將螺冒依序旋 入。一次只能旋入一顆，將一顆旋到底才能再旋第二顆。練 習一次，測驗二次。
記錄方式：紀錄完成的秒數，取最好的成績。若一次旋入一顆以上或以 任何方式都無法將螺帽旋入均視為失敗。
圖六、轉螺絲測驗
項目三
項目名稱：描花邊（flower trail）
測驗面向：手部操作靈活度
施測方式：兒童採取坐姿使用慣用手持筆，沿著花邊的內外線間一筆畫 到底，描繪過程不可碰觸到邊線，亦不可將筆尖離開紙張。
允許兒童移動紙張但以 45 度為限。練習一次，測驗二次。
記錄方式：紀錄錯誤的次數，取最好的成績。若筆尖離開紙張則紀錄為 錯誤。
圖七、描花邊測驗
項目四
項目名稱：雙手接球（two-hand catch）
測驗面向：球類技巧
施測方式：兒童距牆面二公尺，以單手上手或下手方式將球丟在牆上，
在球落地前以雙手將球接起。練習五顆，測驗十顆球。
記錄方式：紀錄十次中成功接住的球數。若是丟球時超線或以身體輔助
記錄方式：紀錄十次中成功接住的球數。若是丟球時超線或以身體輔助