握筆與長時間書寫表現間關係之探究

Abstract

背景與目的：書寫技巧是兒童在學習過程中的重要技能。相關文獻回顧整體上顯示著握筆的差異並不影響書寫的表現，然而這些研究中用來分類握筆的方法，以及本身的研究設計等，都有需多值得保留與有待商議之處。此外，根據臨床的實際觀察，則可發現許多有書寫困難與相關問題的兒童，在握筆姿勢上仍有許多普遍共同之處，例如使用近端關節握筆以及握筆筆尖方向朝內等等，這些不同於有正常書寫表現兒童的握筆姿勢，暗示著握筆對於書寫表現仍應當存在一定的關係。因此，本次研究的主要目的在於以新的觀點分類握筆並探討握筆對於長時間書寫表現的影響。 方法︰一百二十位來自於三所位於大台北都會地區幼稚園的大班孩童，在根據日常書寫可讀性的表現下(最好與最差的10%)，由班級老師建議來參加此次研究。所有參與研究孩童都沒有知覺動作發展障礙相關之診斷或歷史。每個孩童分別進行120個字且至少576筆劃的書寫測驗，每人平均需要花費約10分鐘。由於測驗中途發生變換握筆方式之事件，三位孩童的資料被剔除，最後以177 (62名女生、55名男生)為孩童的資料進入後續資料分析。 結果︰多重迴歸模式分析結果顯示所有握筆相關特徵(例如握筆方式、筆尖方向以及筆尖與握筆點間距)都可能對書寫速度有顯著影響效果，並藉由複雜相互關係與其他變項共同產生影響效果。至於書寫可讀性部份，只有一個握筆相關的交互反應(筆尖與握筆點間距x男生)呈現顯著影響但僅有極低的部份決定值(partial r square <0.0336)，這顯示握筆與書寫可讀性間極其有限的相關性。其中書寫效率多重迴歸模式分析的決定值為20.59%, 書寫可讀性多重迴歸模式分析的決定值則為34.89%。 結論︰本研究的結果顯示部分握筆相關因子對於書寫速度有顯著的影響，但與書寫可讀性卻呈現極低相關。此外結果亦顯示書寫速度與書寫可讀性呈現低度相關，這可能因兩者間存在著某種交換機制。握筆相關因子解釋了部份的書寫速度的變異量。其他潛在影響因子，諸如知覺動作功能以及高階心智執行功能，可能可協助解釋其他握筆所無法解釋的變異量，並幫助做出更正確的預測，因此建議於未來的研究將之列為研究變項。

Backgroundand and Purpose: Writing skill is one of the most important skills for children during their learning process. The results of previous studies concluded that there was no significant effect of pen grips on writing performance in general. However, the classification of pen grips and fundamental designs of those studies were controversial. Besides, according to clinical observations, there seems to be many traits of pen grip in common among children who have writing difficulties and related problems, such as using proximal grips and inward direction of penpoint, which strongly implies that there should be certain relationships between pen grip and writing performance. Thus, the main purpose of this study was to systematically investigate the effects of pen grip, using a classification method from a new perspective, on long writing performance. Method: one hundred and twenty kindergarteners came from three kindergartens located in Taipei metropolis were recruited for this study basing on their legibility (best and worst 10%). All of them had no history and related diagnosis of sensorimotor disabilities. Writing test was performed individually without stop which took an average of 10 minutes. Due to changes of grips during the test, data of three were excluded and 117 (62 females and 55 males) children’s data were finally collected and then analyzed Results: Multiple regression model analysis revealed significant effects of all grip related factors such as pen grip style, direction of penpoint and distance between penpoint and pen holding point on writing speed via complex interrelationship with each other and other non grip related variables. As for writing legibility, only one grip related interaction (distance between penpoint and pen-holding point x boy) was shown significantly but with extremely low r-square value (<0.0336), revealing limited effect on writing legibility. R-square value was 20.59% for writing efficiency analysis and 34.89% for writing legibility analysis. Conclusion: The finding of this study might demonstrate significant effects of pen grips on writing speed, but limited correlation to writing legibility. A low correlation between writing speed and legibility was noted, but it might be due to a trade-off mechanism between them. Pen grip might partially explain the performance of writing speed, but other potential covariates, such as sensorimotor and executive functions, might help explain the rest and make better prediction, which were suggested to be taken into account in future studies.