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研究生: 單延愷
Ian-Kai Shan
論文名稱: 非語文學習障礙篩選量表效度研究
A Study on the Validity of Screening Checklist for Nonverbal Learning Disabilities
指導教授: 洪儷瑜
Hung, Li-Yu
學位類別: 博士
Doctor
系所名稱: 特殊教育學系
Department of Special Education
論文出版年: 2007
畢業學年度: 95
語文別: 中文
論文頁數: 261
中文關鍵詞: 非語文學習障礙學習障礙神經心理篩選鑑定
英文關鍵詞: nonverbal learning disabilities, learning disabilities, neuropsychology, screening, identifying
論文種類: 學術論文
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  • 非語文學習障礙是學習障礙的一種亞型,基於目前在學習障礙鑑定流程中,可能忽略這亞型。本研究目的在以非語文學習障礙相關的行為症狀為基礎,編製一份「非語文學習障礙篩選量表」(簡稱非語文學障量表),並分別由二個子研究,以神經心理測驗以及台北市鑑定的學習障礙學生亞型,考驗非語文學障量表的效度,期證實本量表在內容與臨床應用的正確性。
    在研究一,本研究以台北縣市國小四至六年級953位普通班學生家長填答非語文學障量表,依量表分數抽選27位高危險組學生以及30位正常組學生,進行神經心理測驗評估,並比較兩組學生表現的差異。在研究二,從台北市國小四至六年級學生取得17位語文類型學障以及15位非語文類型學障個案,進行非語文學障量表之比較。主要發現如下:(一)在神經心理功能的表現上,非語文學障高危險組學生在語文與操作智商、知覺組織、視覺注意力、視覺與聽覺工作記憶、語文與非語文記憶、視覺空間建構、以及臉部情緒表情辨識等功能表現比正常組學生差;而在語文理解以及聽覺注意力的表現則和正常組學生無明顯不同。(二)在語文—非語文或是聽覺—視覺等神經心理差距組型的表現上,高危險組學生在聽覺—視覺注意力、聽覺—視覺工作記憶、語文—非語文記憶等差距組型表現的人數比例和一般群體所期望的人數比例不同,呈現出語文或聽覺優勢的人數較多;而在正常組學生中,神經心理差距組型表現的人數比例則和一般群體所期望的人數比例無明顯不同。(三)非語文類型學障學生在非語文學障量表的分數明顯高於語文類型學障學生。(四)非語文類型學障學生達到量表切截分數的人數明顯比語文類型學障學生達到的人數多。上述研究結果大致肯定非語文學障量表的效度。
    基於上述結果,也進一步提出非語文學習障礙研究與實務工作相關的建議。

    Nonverbal learning disability (NLD) is a subtype of specific learning disability. However, it has been neglected in the existing tools and process for identifying learning disabilities. The study aims to conduct a “Screening Checklist for Nonverbal Learning Disabilities” (SCNLD) that is based on the behavioral symptoms of NLD, and to validate the SCNLD by tow studies. In the first study, high- risk NLD students screened by the SCNLD are compared with the matched group with neuropsychological assessments. Additionally, two subtypes of learning disabled students identified by special education system are compared with the SCNLD in the second.
    In the first study, the parents of 953 fourth-to-sixth graded students in elementary schools in Taipei County and Taipei City filled out the SCNLD. There were 27 students selected as high risk and 30 students as normal group on the basis of the SCNLD. All the selected students were administrated neuropsychological tests and the difference of the assessment of two groups were analyzed. In the second study, the SCNLD of 17 verbal type learning disabled students and 15 nonverbal type learning disabled students, who were identified by Bureau of Education in Taipei City were compared.
    The major findings are following: 1) The students of the high risk group performed not as well as the students of normal group in the functions such as verbal and performance intelligent quotient (IQ), perceptual-organization, visual attention, visual and auditory working memory, verbal and nonverbal memory, visual-spatial construction, and the identification of facial emotional expressions, but there was no significant difference between high risk group students and normal group students in verbal-comprehension and performance of auditory attention; 2) on the performance of verbal—nonverbal or auditory—visual neuropsychological discrepancy pattern, the high-risk students were different from the expectation by general populations in the ratios of number in auditory—visual attention, auditory—visual working memory, verbal—nonverbal memory, showing that more students had verbal or auditory advantages in high risk group whereas there were not significant difference between the ratios of number on the performance of neuropsychological discrepancy pattern in the normal group and the ratios of number on the performance expected by general populations; 3) the marks of nonverbal type learning disabled students were significantly higher than the verbal type learning disabled students in the SCNLD; 4) the number of nonverbal type learning disabled students were significantly more than verbal type learning disable students who reached the cutting-off of the SCNLD. The aforementioned results confirmed the validity of the SCNLD.
    The recommendations to the further studies and practices on NLD are made on the basis of the results.

    目 錄 中文摘要 I 英文摘要 III 目 錄 V 圖目次 VII 表目次 IX 第一章 緒 論 1 第一節 研究動機 3 第二節 研究目的與問題 8 第三節 名詞詮釋與界定 11 第二章 文獻探討 12 第一節 非語文學習障礙的現象觀察與成因假說 13 第二節 非語文學習障礙臨床特徵與相關的醫療診斷 26 第三節 非語文學習障礙在學習障礙概念架構與定義中的身分位置 45 第四節 非語文學習障礙的篩選與鑑定 67 第五節 效度研究與本論文的研究架構 89 第三章 非語文學習障礙篩選量表編製與試探性研究 95 第一節 非語文學習障礙篩選量表之編製 96 第二節 試探性研究:臨床個案在非語文學習障礙篩選量表之表現 113 第四章 研究一:「非語文學習障礙篩選量表」高危險組與正常組學生在 神經心理測驗表現之差異 119 第一節 研究問題與假設 120 第二節 研究方法 122 第三節 研究結果 139 第四節 討 論 159 第五章 研究二:語文類型與非語文類型學習障礙學生在「非語文學習 障礙篩選量表」分數之差異 177 第一節 研究方法 178 第二節 研究結果 182 第三節 討 論 189 第六章 綜合討論 194 第一節 非語文學習障礙篩選量表特徵與效度證據 195 第二節 非語文學習障礙鑑定流程 209 第七章 結論與建議 218 第一節 研究結論 219 第二節 研究限制 223 第三節 建 議 225 參考文獻 232 附錄一 非語文學習障礙篩選量表(預試版) 253 附錄二 非語文學習障礙篩選量表(正式版) 257 附錄三 測驗同意書 261 圖 目 次 圖2-2-1 Rourke的非語文學習障礙概念架構圖 26 圖2-3-1 Kirk的「發展性-學業性」學習障礙概念架構圖 50 圖2-3-2 周台傑所提出的學習障礙鑑定流程 63 圖2-3-3 台北市國民中小學的學習障礙鑑定流程 65 圖2-5-1 本論文之研究架構圖 94 圖3-1-1 量表編製流程圖 96 圖3-2-1 試探性研究NC、RD、以及AD三組個案在篩選量表之表現 116 圖4-2-1 非語文學習障礙篩選量表總分與人數分佈圖 124 圖4-2-2 注意力操作測驗(TAP) 130 圖4-2-3 空間記憶廣度板 131 圖4-2-4 Rey氏複雜圖形測驗 134 圖4-2-5 RCFT組織策略分數成分 136 圖4-2-6 研究一之研究程序 138 圖4-3-1 篩選量表高危險組與正常組學生在字詞測驗的學習斜率表現 144 圖4-3-2 篩選量表高危險組與正常組學生在字詞測驗的序列位置效應表 現 145 圖4-3-3 篩選量表正常組三位學生RCFT圖形複製(A)與延宕回憶(B) 表現範例 149 圖4-3-4 篩選量表高危險組三位學生RCFT圖形複製(A)與延宕回憶 (B)表現範例 150 圖4-3-5 模擬常模個案在非語文學習障礙篩選量表總分與人數分佈圖 153 圖5-2-1 語文類型以及非語文類型學習障礙學生在「非語文學習障礙篩 選量表」達到切截分數以及低於切截分數的人數比例圖 185 圖5-2-2 「非語文學習障礙篩選量表」量表總分ROC曲線 187 圖6-1-1 本研究架構圖與研究結果 196 圖6-2-1 非語文學習障礙神經心理與行為症狀特徵關係圖 211 圖6-2-2 本研究提出的非語文學習障礙鑑定流程 214 表 目 次 表2-1-1 腦傷患者與學習適應問題兒童非語文學習障礙相關症狀特徵的 觀察 20 表2-2-1 非語文學習障礙神經心理層次與行為表現層次的症狀特徵 34 表2-2-2 不同醫學診斷與非語文學習障礙症狀特徵的重疊性 43 表2-3-1 不同學習障礙定義中的非語文學習障礙特徵 61 表2-4-1 不同研究對於非語文學習障礙的評量向度、測驗工具、與鑑定 標準 75 表2-4-2 神經心理功能領域與相關的測驗工具 81 表2-4-3 非語文學習障礙在學習障礙鑑定標準之相容性 86 表3-1-1 量表預試樣本人數、性別、與年齡描述 98 表3-1-2 「社會人際」的項目分析結果 99 表3-1-3 「動作協調」的項目分析結果 100 表3-1-4 「知覺組織」的項目分析結果 100 表3-1-5 第一次因素分析結構摘要表 102 表3-1-6 原始量表彼此相關較高之題目 103 表3-1-7 題目刪除判斷表 106 表3-1-8 第二次因素分析結構摘要表 108 表3-1-9 「非語文學習障礙篩選量表」Cronbach α係數 109 表3-1-10 分量表與全量表之重測信度 109 表3-1-11 四至六年級學生在「非語文學習障礙篩選量表」之分數差異 110 表3-1-12 非語文學習障礙篩選量表各分量表原始分數與量表分數之轉 換 111 表3-2-1 試探性研究各組參與者之特徵 113 表3-2-2 三組參與者在智力以及「非語文學習障礙篩選量表」的個別表 現 115 表4-2-1 參與量表篩選之人數 122 表4-2-2 非語文學習障礙篩選量表正式與預試樣本原始分數之表現 123 表4-2-3 非語文學習障礙篩選量表正式與預試研究原始分數與量表分數 之轉換 123 表4-2-4 男女不同性別在非語文學習障礙篩選量表的差異 125 表4-2-5 各年級參與神經心理測驗之篩選量表高低分組學生人數 126 表4-2-6 參與神經心理測驗之篩選量表正常組與高危險組學生基本資料 127 表4-2-7 RCFT定量計分與定性分析之成分 135 表4-3-1 篩選量表正常組與高危險組學生在魏氏兒童智力量表表現之差 異 140 表4-3-2 篩選量表正常組與高危險組學生在視覺與聽覺注意力測驗表現 之差異 141 表4-3-3 篩選量表正常組與高危險組學生在數字記憶廣度與空間記憶廣 度表現之差異 142 表4-3-4 篩選量表正常組與高危險組學生在字詞記憶測驗表現之差異 143 表4-3-5 篩選量表正常組與高危險組學生在複雜圖形測驗表現之差異 146 表4-3-6 篩選量表正常組與高危險組學生在RCFT延宕回憶錯誤類型發 生次數比較 147 表4-3-7 篩選量表正常組與高危險組學生在RCFT組織分數表現之差異 148 表4-3-8 篩選量表正常組與高危險組學生在臉部表情辨識表現之差異 151 表4-3-9 篩選量表正常組與高危險組學生神經心理功能的表現差異 152 表4-3-10 模擬常模樣本在神經心理測驗之平均數與標準差 154 表4-3-11 高危險組學生在神經心理差距組型表現人數與理論期望人數之 差異 156 表4-3-12 正常組學生在神經心理差距組型表現人數與理論期望人數之差 異 157 表5-1-1 語文類型以及非語文類型學習障礙參與者基本資料 180 表5-2-1 語文類型和非語文類型學習障礙學生在「非語文學習障礙篩選 量表」之表現 183 表5-2-2 17位語文類型以及15位非語文類型學習障礙學生在「非語文 學習障礙篩選量表」個別之表現 184 表5-2-3 ROC曲線下的面積 187 表5-2-4 「非語文學習障礙篩選量表」各切截分數之敏感度與特異度 188

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