| Abstract: | 本研究目的是探討不同類型學障孩子在情緒行為問題的表現。試以神經生理功能機轉為基礎，將學習障礙生略分為語文型學習障礙（Verbal learning disabilities, VLD）及非語文型學習障礙（Nonverbal learning disabilities, NLD），探討不同類型障礙所引發的適應困難類型，以期能夠及早預測學障生在生活上可預見之適應問題，繼而能減少學障生發展出後續之情緒及行為問題。
This study intends to compare emotional and behavioral problems between children with different learning difficulties. Children are assigned to “Verbal learning disabilities (VLD)” group and “Nonverbal learning disabilities (NLD)” group based on their performance on neurophysiology function mechanism. The study compare adaptive difficulties between two groups, and try to forecast adaptive problems these children face in their development.
Child Behavior Checklist (CBCL) from Achenbach System of Empirically Based Assessment (ASEBA) is used to assess and compare emotional and behavioral conditions of children. There are two stages of sampling. In the first stage, participants are recruited from clinic, and the sample includes 161 children aging from 6 to 15 years old. They are assigned to NLD group (N=72) and VLD group (N=70) by difficulties type and school grade, and further divided into three school grade groups (G13, G46 and G79). In the second stage, participants are captured from sample of first stage. They are studying at Grade 4 to 9, with learning disabilities and have participated psychological assessment on the disabilities at least twice (N=19). 7 children in VLD group and 12 children in NLD group. In this study, their performance on CBCL taken in their past assessments are adopted and compared. Also, score on CBCL taken at and after Grade 4 of children who are informed of having learning disabilities at before Grade 1-3 are analyzed and compared with who are diagnosed with difficulties at Grade 4-9. The sample size is 36 children in total and 18 participants for each group of early-diagnosed group and late-diagnosed group. Same distribution within groups, 10 children in VLD group and 8 children in NLD group.
The result illustrates no significant difference exists between VLD and NLD groups in the rating scores on scales of CBCL. The obvious discrepancy happens on emotional problem children with different difficulties have at school grades. Overall, VLD group has more internalizing emotional problem and less externalizing behavioral problem when growing old; while NLD group shows another pattern. Both internalizing problem and externalizing problem get worse for NLD group. For children who have been diagnosed at Grade 1-3 (G13), there is no significant change on emotional and behavioral problem before and after their diagnosis of VLD. However, it is different story for those get diagnosed with NLD. After being diagnosed with NLD, children’s emotional and behavioral problem decrease. Besides, there is no significant difference on emotional and behavioral problem between early and later diagnosis. But children who get diagnosis earlier are found to behave more aligning to normal in further development.
In conclusion, children with different learning difficulties have inconsistent emotional and behavioral problems. The pattern correlates to their school grade. In addition, early diagnosis shows positive impact on both groups. Therefore it is highly suggested children who are suspected to learning difficulties should go for medical assistance and psychological treatment as early as it can be.
本研究以兒童心智科常用量表阿肯巴克實證衡鑑系統之兒童行為檢核表(CBCL)為依變項，觀察學障生在情緒行為問題的表現。採納個案分為兩部分，第一部分透過整理門診之6-15歲學習障礙生，共161人（男128人，女33人），以學障類型及年級分組為自變項，分為語文型學習障礙91名（男72人，女19人）及非語文型學習障礙的學生70名（男56人，女14人），再細分為三個年級組（G13、G46、G79），比較兩組學障生在不同年級組表現之情緒行為問題的表現。第二部分由第一部份中選取適當個案，以就讀國小四年級至國中的學障生為對象，採納有2次以上心理衡鑑報告之學障生為對象，共19人（VLD=7，NLD=12）比較前後兩次之CBCL表現。另一方面，低年級前已得知本身有學習障礙診斷者與中高年級後才接受診斷者，各18人（VLD=10，NLD=8），共36人，在中年級以上時的CBCL表現。
研究結果顯示，兩組學障類型在CBCL整體表現上無顯著差異，但不同類型之學障生隨年級有不同的變化趨勢，呈現出不同的情緒行為問題。整體來說，VLD隨年級增加內化情緒問題增加，外化行為問題減少；NLD隨年級內化、外化問題都增加。低年級（G13）前已診斷之個案來說，VLD診斷後情緒行為問題改變不大，但NLD診斷後內外化問題皆減少，部分可低於邊緣臨床範圍。低年級（G13）前與中高年級（G4-9）後表現未達顯著差異，但提早診斷者在CBCL達邊緣臨床範圍的量尺較少。
綜合上述，不同類型學障之情緒行為問題表現方式不同，且年級階段有關。及早診斷對於兩類型的學障生皆會有幫助。因此在教育現場或生活當中，若遇到疑似學障的學生時應儘早建議其接受診斷。 |
