研究生: |
吳亭芳 Tingfang Wu |
---|---|
論文名稱: |
肢體障礙者電腦輔具評量以訓練成效之研究 Assessments and interventions of computer access for persons with physcial disabilities |
指導教授: | 吳武典 |
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: | 2002 |
畢業學年度: | 90 |
語文別: | 中文 |
論文頁數: | 188 |
中文關鍵詞: | 肢體障礙者 、腦性麻痺 、脊髓損傷 、電腦輔具 、輔具評量 、輔具訓練成效 |
英文關鍵詞: | persons with physical disabilities, cerebral palsy, spinal cord injury, computer access, computer access assessments, treatment efficacy |
論文種類: | 學術論文 |
相關次數: | 點閱:290 下載:100 |
分享至: |
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報 |
本研究探討肢體障礙者電腦輔具的評量與訓練成效,主要分為三個研究進行,分別為研究一「肢體障礙者電腦輔具評量表」之發展,研究二腦性麻痺患者電腦輔具訓練成效之探討,以及研究三脊髓損傷患者電腦輔具訓練成效之探討。
在研究一中,研究者利用文獻資料以及個人臨床工作經驗編纂「肢體障礙者電腦輔具評量表」。內容包括四部分:操作電腦評量、電腦鍵盤操作評量、身體操控部位評量和滑鼠操作評量。本量表經八位專家檢核有其內容效度,信度則以施測者間對項目勾選之一致性來建立。其施測者間一致性介於 .76至1.00,顯示此量表有良好的信度。
研究二之目的在於探討電腦輔具介入是否可以增進腦性麻痺患者電腦輸入的效能。研究者利用單一受試跨受試多探試處理,以三位腦性麻痺患者為研究對象,依據「肢體障礙者電腦輔具評量表」評量結果提供腦性麻痺個案電腦輔具訓練。結果顯示,三位腦性麻痺受試者在輔具提供並經過一段時間的練習後,電腦輸入的速度以及輸入的正確率都明顯優於基線階段並且可以保留到維持階段。研究二之結果可以顯示「肢體障礙者電腦輔具評量表」之評量結果可以有效作於臨床介入之參考依據。
研究三之目的在於探討電腦輔具介入是否可以增進脊髓損傷患者電腦輸入的效能。研究者利用單一受試跨受試多探試處理,以三位脊髓損傷患者為研究對象,依據「肢體障礙者電腦輔具評量表」評量結果提供脊髓損傷個案電腦輔具訓練。結果顯示,三位脊髓損傷受試者在輔具提供後,電腦輸入的速度以及輸入的正確率都明顯優於基線階段,並且可以保留到維持階段。子研究三之結果可以顯示「肢體障礙者電腦輔具評量表」之評量結果可以有效作於臨床介入之參考依據。
依據三個研究的結果,可獲得以下結論:(1)「肢體障礙者電腦輔具評量表」是一個信、效度良好的評量工具,可以有效提供肢體障礙者合適的電腦輔具;(2)透過合適的輔具以及訓練,腦性麻痺以及脊髓損傷患者可以有效執行電腦輸入。
Computer technology has developed rapidly and become essential for people’s daily lives. However, persons with physical disabilities usually experience obstacles in computer access through conventional input apparatus because of their abnormal postures and movements. Computer adaptation technology, a specific access technology that meet clients’ needs to access computers, have been emerged recently. How to choose a proper computer access apparatus to fit special needs for individuals with physical disabilities is a critical issue in computer adaptation technology.
In this dissertation, a systematic evaluation procedure, called computer access assessment (CAA) for therapists, are developed to perform holistic assessment and interventions. With the aid of such evaluation procedure, appropriate devices and intervention strategies will be recommended for individuals with physical disabilities to access computers. Effectiveness of such assistive devices on accuracy and speed of computer inputs for persons with physical disabilities were also been investigated.
This dissertation contributes to three fundamental topics. First, an innovative decision procedure of CAA will be proposed. CAA was developed through extensive literature review and clinical experiences of researchers. Content validity was established through a panel of expertise in this area. Eight faculties from occupational therapy, special education, and computer education, are involved in reviewing assessment items. According to clients’ special needs, we reconstruct a new procedure with the following four major steps: (1) seating and positioning needs, (2) keyboard adaptation needs, (3) potential anatomical control site allocations, and (4) mouse adaptation needs. Advices about special equipment needs will be provided at the end of the evaluation. The interrater reliability of CAA was investigated through case studies of two senior occupational therapists by evaluating 23 clients simultaneously and administrating the CAA independently. Interrater agreements of two rates were between .76 and 1.00.
In the second part, we use a single-subject multiple probe design to examine the effectiveness of using computer input devices on children with cerebral palsy. Three children with cerebral palsy participated in this study. Two were spastic quadriplegia and one is athetosis. In the baseline phase, test subjects used the regular mouse to move the cursor and click the target. In the intervention phase, the researcher provided subjects the computer input devices based on the results of administrating the CAA. Experimental results suggested that each subject’s accuracy and speed of input improved during intervention phase. Children with cerebral palsy are beneficial significantly after this study.
Finally, we duplicate the research design to examine the effectiveness of using computer input devices on persons with spinal cord injury. Three persons with spinal cord injury participated this study. The subject’s levels of the lesion were cervical 3-4, cervical 4-5 and cervical 5-6. Test results indicated that persons with spinal cord injury indeed improved the accuracy and the speed of computer inputs after the assitive equipment provided.
In summary, computer access assessment for persons with physical disabilities is a valid and reliable evaluation tool for clinical prationioners. Through appropriate input devices, clients with cerebral palsy and clients with spinal cord injury are able to operate computer effectively
中文部分
王華沛(民86):肢體障礙者之就學就業之科技支援。載於陪你踏出第一步:身心障礙者就學就業之科技支援研討會會報(73-79頁)。台北:國家科學委員會。
王華沛(民91):各類障礙者的綜合性需求:善用電腦科技。載於王華沛主編:輔助科技之應用(25-32頁)。台北:中華民國輔助科技促進職業重建協會。
朱經明(民86):特殊教育與電腦科技。 台北:五南出版社。
李天佑(民88):中小學電腦無障礙環境之簡介。資訊與教育雜誌,70期,9-13頁。
李天佑、何榮桂、王華沛(民89):中小學無障礙電腦環境之規劃研究:特殊學校與特殊班電腦輔具使用現況與師資素養調查。台北:教育部委託專案報告。
李天佑、孟令夫、林雲龍、古艾巧(民91):電腦作業系統windows的協助工具。載於王華沛主編:輔助科技之應用(43-73頁)。台北:中華民國輔助科技促進職業重建協會。
李進寶、周二銘、王華沛(民86):電腦相關輔具分析調查研究報告。 台北:內政部委託資訊工業策進會調查報告。
吳武典、王華沛(民88):加強身心障礙者輔助性科技建議。特殊教育學刊,72期,1-9頁。
吳亭芳、侯嘉怡、陳明聰(民89):輔助性科技在特殊教育之應用。載於林寶貴主編,特殊教育理論與基礎(595-652頁)。台北:心理出版社。
吳亭芳、孟令夫、王華沛、吳典武、李天佑(民91):肢體障礙者電腦輔具評量表之法展與應用。2002縮短身心障礙者數位落差研究成果研討會論文,台北。
杜正治譯(民83):單一受試研究法。台北:心理出版
社。
身心障礙者保護法(民86):中華民國86年4月23日華總(一)義字第8600097810號修正公布。
林克忠、葉蘭蓀(民81):單一對象實驗設計在臨床研究上之運用。職能治療學會雜誌,10期,9-17頁。
林淑美、邱文達、黃雅莉、屈蓮、洪清霖、劉敏英、李良雄著(民85):脊髓損傷之描述性流行病學研究。北醫學報,25(1)期,27-32頁。
科技輔具文教基金會(民89):整合型無障礙電腦系統。台北:作者。
孟令夫、吳亭芳、李天佑、周二銘、陳明聰、朱繼農、張千惠、林雲龍(民90):專業版電腦可及性需求評量(未出版)。
孟令夫、李天佑、朱繼農、陳明聰、張千惠、周二銘、楊朝鈞、胡志成、古艾巧、林雲龍、翁佩庭、施育君、呂宗螢、葉乃賢(民91a):「可 及性策略」影響「四肢偏癱疾患」電腦操作之效應。2002年第五屆「工程科技與中西醫學應用」研討會論文,台中。
孟令夫、李天佑、朱繼農、陳明聰、張千惠、周二銘、楊朝鈞、胡志成、古艾巧、林雲龍、翁佩庭、施育君、呂宗螢、葉乃賢(民91b):以電腦可及性策略促進滑鼠與鍵盤操作效能之再探。2002縮短身心障礙者數位落差研究成果研討會論文,台北。
高為澎(民88):身心障礙者人機介面-紅外線頭控/眨眼滑鼠系統之研製。國立台灣大學電機工程研究所碩士論文。
特殊教育法(民86):中華民國86年5月14日華總(一)義字第860011282號修正公布。
教育部特殊兒童普查執行小組(民82):中華民國第二次特殊兒童普查報告。台北: 教育部教育研究委員會。
陳明聰(民90):身心障礙者中文替代鍵盤與輸入法輔助學習系統之設計與應用。國立台灣師範大學特殊教育學系博士論文。
施清添(民86):殘障用摩斯碼溝通輔助系統。國立成功大學電機工程研究所碩士論文。
施清祥(民86):殘障用電腦溝通輔助系統之設計與實現。國立成功大學電機工程研究所碩士論文。
施雅彬(民87):從肌肉萎縮症談DMD與BMD亞型,特殊教育季刊,66期,13-19頁。
蔡美華、李偉俊、王碧霞、莊勝、劉斐文、許家吉、林巾凱、蔡文標譯(民88):單一受試者設計與分析。台北:五南出版社。
劉文義(民85):以眼球電訊號控制之殘障者人機介面設計。國立台灣大學電機工程研究所碩士論文。
劉相志(民89):腦性麻痺學生電腦輔具科技之發展與應用成效研究。國立高雄師範大學特殊教育學系碩士論文。
廖華芳、孫雯萍、宋維村、連倚南(民76):不同類型腦性麻痺兒童之發展,台灣醫學會雜誌,86期,997-1003頁。
廖華芳、吳雪玉、徐中盈譯(民85): 促進年幼腦性麻痺兒童的發展:中階層復健工作人員指引。台北:中華民國腦性麻痺協會。
謝明哲(民88):適應性六鍵式摩斯碼鍵盤與肢體障礙者個案訓練研究。國立成功大學電機工程研究所博士論文。
蘇木春、黃海、劉原志、王國樺、陳一元(民89):手功能障礙者之另類電腦輸入系統。中華醫學工程學刊,20期,53-58頁。
英文部分
Alliance for Technology Access (2000). Computer and web resources for people with disabilities. Alameda, CA: Hunter House.
Anson, D. (1993). The effect of word prediction on typing speed, American Journal of Occupational Therapy, 47, 1039-1042.
Anson, D. (1994). Finding your way in the maze of computer access technology. American Journal of Occupational Therapy, 48, 121-129.
Anson, D. K. (1997). Alternative computer access: A guide to selection. Philadelphia: F. A. Davis.
Atrice, M. B., Gonter, M., Griffin, D. A., Morrison, S. A., & McDowell, S. L. (1995). Traumatic spinal cord injury. In D. A. Umphred (Ed.), Neurological Rehabilitation (3rd ed., pp.484-534). St. Louis: Mosby.
Bain, B. K., Dooley, K. F., & Leger, D. (1997). Assistive technology: An interdisciplinary approach. In B. K. Bain, & D. Leger (Eds.), Assistive technology: An interdisciplinary approach (pp. 1-7). New York: Churchill.
Battenberg, J. K., Merbler, J. B. (1989). Touch screen versus keyboard: A comparison of task performance of young children. Journal of Special Education Technology, 5(1), 24-28.
Bergen, A. F., Presperin, J., & Tallman, T. (1990). Positioning for function: Wheelchairs and other assistive technologies. Valhalla, NY: Valhalla Rehabilitation Publications.
Cook, A. M., Hussey, S. M. (2002). Assistive technology: Principles and practice ( 2nd ed.). Baltimore: Mosby.
Dalton, J. R., & Peterson, C. Q. (1997). The use of voice recognition as a control interface for word processing. Occupational Therapy in Health Care, 11, 75-81.
Derer, K., Polsgrove, L., & Rieth, H. (1996). A survey of assistive technology applications in schools and recommendations and practice. Journal of Special Education Technology, 8, 63-80.
Dow, P. W., & Rees, N. P. (1995). High-technology adaptations to overcome disability. In C. C. Trombly (Ed.). Occupational therapy for physical dysfunction (4th ed., pp. 611-643 ) . Baltimore: Williams & Wilkins.
Esposito, L. (1993). Computer and individuals with severe and physical disabilities. In J. D. Lindsy (Ed.). Computers and exceptional individuals (2nd ed., pp.159-177). Austin, TX: PRO-ED.
Folio, M. R., & Fewell, R. R. (2000). Peabody developmental motor scales (2nd ed.). Austin, TX: PRO-ED..
Fraser, B. A. (1995). Determining device access for persons with physical disabilities. (ERIC Document Reproduction Service No. 380976)
Fraser, B. A., Mcgregor, G., Arango, G. A., & Kangas, K. (1994). Physical characteristics assessment: Computer access for individuals with cerebral palsy. Wauconda, IL: Don Johnston.
Galvin, J. C., &Scherer, M. J. (1996). Evaluating, selecting and using appropriate assistive technology. Gaithersbury, MD: Aspen.
Gardner, M. F. (1996). Test of visual-perceptual skills(non-motor). Log Angeles: Western Psychological Services.
Hertel, C., Kallam, M. L., & Retting, M. (1989). Touch window versus Powerpad:A comparison of response rates by 3- and 4-year-old handicapped and nonhandicapped children. (ERIC Document Reproduction Service No. 349116)
Holler, L. D. ( 1995 ). Spinal Cord Injury, In C. A. Trombly (Ed.), Occupational therapy for Physical Dysfunction (4th ed., pp.795-813). Baltimore: Williams& Wilkins.
Hutinger, P., Johanson, J., & Stoneburner, R. (1996). Assistive technology application in education programs of children with multiple disabilities: A case study report on the state of the practice. Journal of Special Education Technology, 8, 17-35.
Kollodge, B. S. (1997). Specialized computer applications. In B. K. Bain & D. Leger (Eds.), Assistive technology: An interdisciplinary approach (pp. 149-166). New York: Churchill.
Lance, G. D. (1996). Computer access in higher education: A national survey of service providers for students with disabilities. Journal of College Student Development, 37, 279-288.
Lau, C., & O’Leary, S. (1993). Comparison of computer interface devices for persons with sever physical disabilities. American Journal of Occupational Therapy, 47 , 1022-1029.
Lewis, R. B. (1993). Special education technology classroom applications. Pacific Grove, CA: Cole.
Male, M. (1997). Providing access. In M. Male (Ed.). Technology for inclusion : Meeting the special needs of all student (3rd.ed. ,pp153-177). Boston: Allyn & Bacon.
Mann, W. C., & Lane, J. P. (1995). Technology and higher education. In W. C. Mann & J. P. Lane (Eds.), Assistive technology for persons with disabilities (2nd. ed., pp.167-194). Montgomery, MD: American Occupational Therapy Association.
McCormack, D. (1990). The effect of keyguard use and pelvic positioning on typing speed and accuracy in a boy with cerebral palsy, American Journal of Occupational Therapy, 44, 313-315.
Nelson, C. A. (1995). Cerebral palsy. In D. A. Umphred (Ed.), Neurological rehabilitation (3rd ed., pp. 263-286). St. Louis: Mosby.
Neuman, D. (1991). Technology and equity. (ERIC Document Reproduction Service No. 339400)
O’Leary, S. (1996). Computer access for persons with spinal cord injury: High tech and low tech assistive devices, techniques, and resources for independence. Santa Barbara, CA: Disability Information Resources.
Parette, H. P., Hourcade, J. J., & Vanbiervliet, A. (1993). Selection of appropriate technology for children with disabilities. Teaching Exceptional Children, 25(3), 18-22.
Pell, S. D., Gillies, R. M. & Carss, M. (1997). Relationship between use of technology and employment rates for people with physical disability in Australia: Implications for education and training programmes. Disability and Rehabilitation, 19(8), 332-338
Pell, S. D., Gillies, R. M., & Carss, M. (1999). Use of technology by people with physical disabilities in Australia. Disability and Rehabilitation, 21(2), 56-60.
Reese, N. B. (1999). Muscle and sensory testing. Philadelphia: W. B. Saunders.
Roger, S. H., Gordon, C. Y., Schanzenbacher, K. E., & Case-Smith, J. (2001). Common diagnosis in pediatric occupational therapy practice. In J. Case-Smith (Ed.), Occupational therapy for children (4th ed., pp.136-187). ST. Louis: Mosby.
Scherzer, A. L., & Tscharnuter, I. (1990). Early diagnosis and therapy in cerebral palsy: A primer on infant developmental problems (2nd ed.). New York: Marcel Dekker.
Shuster, N. E. (1993). Addressing assistive technology needs in special education. American Journal of Occupational Therapy, 47, 993-997.
Struck, M. (1996). Computer access: A link to classroom learning . OT Practice, 1(8), 18-25.
Treviranus, J. , & Tannock, R. (1987). A scanning computer access system for children with severe physical disabilities. American Journal of Occupational Therapy, 41, 1031-1038.
Wright, C., & Nomura, M. (1985). From toys to computer: Access for the physically disabled child. San Jose: Authors.
Wu, T. F., Meng, L. F., Wang H. P., Wu, W. T., Li, T. Y. (2002). Computer access assessment for persons with physical disability: A guide to assistive technology interventions. In k. Miesenberger, J. Klaus., & W. Zagler(Eds) Computer helping people with special needles(pp.204-211). Bergin: Springer- Verlag.