• 沒有找到結果。

6-2-1 建議

根據 DSM IV 之描述,發展協調障礙兒童除了動作協調能力出現明 顯障礙,其動作障礙亦將影響兒童日常生活活動以及學業上之表現。因 此Wright 與 Sugden(1996a)指出,如果要診斷出完全符合 DSM IV 定義之發展協調障礙兒童,那麼評估過程採用兩步驟程序(two-step procedure)將是合乎邏輯的,也就是先使用家長或教師用篩檢量表,

其次再進行動作協調能力之測驗,如此一來將可有效且準確地診斷出發 展協調障礙兒童。參考 Wright 與 Sugden(1996a)的建議,本研究 另外提出診斷發展協調障礙之三步驟程序(three-step procedure)。

由於Movement ABC 測驗項目較少,相對地所花費的時間也將較為節 省,此外使用其美國常模進行評估將可發現較多動作協調能力可能有問 題之兒童,因此第一步驟即為使用 Movement ABC 測驗進行全面篩 檢;第二步驟則進行項目較為完整之台灣動作評估測驗之施測,藉由台 灣常模定義出動作協調能力明顯落後同儕之兒童;最後,這些被定義出 來之兒童將發與家長或教師自填之問卷量表,以確定兒童之動作協調能 力缺失是否影響其日常生活活動執行或是學業上之表現。而透過三步驟 程序診斷出來之兒童,將可完全符合DSM IV 所定義之發展協調障礙。

6-2-2 未來研究之方向

一、台灣動作評估測驗之修正

儘管本研究已探討許多台灣動作評估測驗信度與效度方面之議 題,但其中仍有少數未臻理想之部分,例如再測信度與內聚效度,更待 進一步研究加以證實其效力。此外本研究透過施測人員訓練過程的標準 化來假設測試者間信度與測試者內信度,以科學研究觀點而言,證據略 嫌薄弱,因此測試者間與測試者內信度亦是未來必須加以證實的部份。

二、台灣動作評估測驗之研究應用

過去常用之Movement ABC 測驗是由英國學者所建立,所建構之 參考常模為美國與英國兒童之資料,另外Movement ABC 測驗價格極 高,基於這些原因,使用Movement ABC 測驗對於我國進行全面發展 與應用發展協調障礙之研究將會有極大的限制。而台灣動作評估測驗涵 蓋了四大面向共十個測驗項目,且建立台灣地區之常模,因此就研究的 觀點,台灣動作評估測驗將提供寬闊的研究空間。例如:未來之研究能 夠使用台灣動作評估測驗,以四大面向為基礎,進行發展協調障礙之次 族群的探討,或是台灣動作評估測驗面向與其他動作協調能力測驗面向 之間的因素相關。

此外當台灣動作評估測驗常模累計更多人數之後,本研究強烈建議 未來之研究能夠比較不同世代兒童的動作協調能力,這樣的研究不僅能 夠發現台灣兒童動作協調能力發展之趨勢,亦能回答「多久的時間要重 新修正常模分數之定義?」之類的問題。

因而本研究亦強烈建議全面推廣台灣動作評估測驗,並以此工具進 行發展協調障礙之研究。

三、發展協調障礙之未來研究

如同建議裡所談論到之「三步驟程序」,關於評估發展協調障礙兒 童之家長或教師自填式問卷量表為不可獲缺之評估工具,目前已知國內 已有研究群進行DCDQ 中文量表與常模之建立(傅中珮,民 94),然 而其並未建立 DCDQ 中文版量表與其他測驗之同時效度,因此雖然 DCDQ 中文版量表有良好之信度與效度,但其是否能夠有效鑑別發展協 調障礙兒童仍有待商確。有鑑於此,本研究認為現階段發展協調障礙之 研究,應朝向建立完整本土化發展協調障礙家長或教師問卷量表之方向 前進。

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