以中等以上運動強度之大肌肉活動探討普通班一般幼兒與自閉症幼兒注意力與肥胖問題改善之成效

Abstract

摘 要 身心健康狀態為幼兒重要的社會適應指標之一。就目前已知研究中，增加身體活動機會被視為改善幼兒注意力及肥胖問題的有效策略。近年來與幼兒健康相關的研究顯示，過重和肥胖會導致心理社會問題、認知與注意力缺失問題以及大量的負面健康後遺症，以致制定同時針對肥胖、注意力因素的介入措施至關重要。然而，自閉症挑食和體重不足問題與對正常發展幼兒的肥胖趨勢已進行大量實證研究，但對自閉症幼兒肥胖與注意力間問題相關研究匱乏。因此，希望透過本研究驗證在融合情境中以運動介入方式並加入注意力線索提示，期望能同時有效增進一般幼兒與自閉症幼兒注意力及改善肥胖問題，使特殊生及一般生同時受惠。 本研究採準實驗研究法實驗組在普通班進行8周中等以上強度之大肌肉活動、對照組在普通班進行8周輕度強度之大肌肉活動以探討注意力長期表現之成效。同時，針對實驗組一般幼兒以組內相依樣本t檢定的統計方法，自閉症幼兒及肥胖幼兒以單一受試研究法ABABAB設計，探究此運動介入改善注意力立即表現的成效並觀察肥胖幼兒身體質量指數（Body Mass Index，簡稱BMI）改變情形。 研究結果顯示，實驗組與對照組幼兒之注意力長期整體表現(p=.305）及專注表現(p=.125）組間未達顯著差異，但實驗組內均達顯著差異(p=.000)；注意力成效追蹤組間整體表現(p=.003）及專注表現(p=.000）有達顯著差異，實驗組組內有顯著差異且表現較對照組好，而對照組組內未達顯著差異。故，輕度與中等以上強度之大肌肉活動於注意力長期表現方面均有成效，然而僅有中等以上強度之大肌肉活動有追蹤成效。在注意力立即表現方面，實驗組一般幼兒連續八周單次前後測在第四周(p=.016)及第八周(p=.000）有成效有統計顯著成效；針對其中的2位自閉症及2位肥胖幼兒之注意力立即表現，雖然在視覺分析上整體有上升之趨勢，但單次介入試探資料穩定高於基線試探資料。因此，中等以上強度大肌肉活動能普遍改善一般、自閉症、肥胖之幼兒注意力立即表現。在BMI變化方面，本研究發現實驗組2位肥胖幼兒介入前後無明顯變化，由界定肥胖至維持界定肥胖(平均百分位數下降約0.15)，然而對照組5位肥胖幼兒有3位由界定肥胖至維持界定肥胖，其餘2位由界定過重增為界定肥胖(平均百分位數上升約3.88)。 本研究建議未來幼兒園的班級作息在學習區活動、團體討論活動前可安排連續出汗性大肌肉活動，其運動強度至少為輕度，但若能提供幼兒進行中等以上運動強度之活動，能讓幼兒在後續的學習上表現更佳。未來研究宜繼續探究不同運動強度對注意力長期表現延宕成效之影響。

Physical and mental health is one of the important social adaptation indicators for young children. In the currently known studies, increasing the chance of intensity gross motor is an effective strategy to improve children's attention and obesity problems. Studies related to the health of young children have shown that overweight and obesity can cause psychosocial problems, cognitive and attention deficit problems, and a large number of negative health sequelae. Therefore, it is very important to formulate intervention measures for obesity and attention factors at the same time. However, a large number of empirical studies have been conducted on the problems of picky eating and underweight in Autism Spectrum Disorder (ASD) and the obesity in typically developing children, but there is a lack of research on the problems between obesity and attention in children with ASD. Therefore, this study attempted to verify the use of moderate-to-high intensitiy gross motor acitivties and attention cues to young children with and without obesity and those with and without ASD on their long-term and imdediate attention in the inclusive preschool classroom. The author also measured the change of body mass index. This study was used the quasi-experimental research method for the experimental group to perform 8 weeks of moderate-to-high intensity gross motor activities in the class, and the control group to perform 8 weeks of light-intensity gross motor activities in the ordinary class to explore the effectiveness of long-term attention performance. Statistical method of t-tests was used for analyzing typical children in the experimental group. As for the children with ASD and children with obesity, singe case research ABABAB design was utilized to explore the effectiveness of this exercise intervention to improve attention performance and to observe the change of Body Mass Index (BMI) of children with obesity. The results showed the long-term overall performance of attention (p=.305) and concentration performance (p=.125) of the children in the experimental group and the control group did not reach significant differences, but there were significant differences in the experimental group (p=.000). Note there are significant differences in overall performance (p=.003) and concentration performance (p=.000) between groups on tracking. There were significant differences in the experimental group and the performance was better than the control group, while there was no significant difference in the control group. Therefore, light and moderate-to-high intensity gross motor activities were both effective in the long-term performance of attention, but only the latter had mantainance effect. In terms of immediate attention performance, the typical children in the experimental group had a statistically significant effect in the fourth week (p=.016) and the eighth week (p=.000) in a single pre- and post test for eight consecutive weeks. For 2 of them, the attention performance of the children with ASD and children with obesity showed an overall upward trend in visual analysis, but the intervention probing data was stable and higher than the baseline trial data. Therefore, moderate-to-high intensity gross activities can improve the immediate performance of typical children as well as children with ASD and those with obesity. In terms of changes in BMI, this study found that the 2 children in the experimental group did not change significantly before and after intervention (the average percentile decreased by 0.15). However, 3 of 5 children in the control group changed their obese level catogory from overweight to obesity, and overall the average percentile increased by 3.88. In the future, kindergarten classes can arrange continuous moderate-to-high intensity gross motor activities before learning activities in the learning area and group discussion. The exercise intensity should be at least light intensity. However, if children can be provided with activities of moderate or higher intensity activities, they may perform better in subsequent learning and obtain mantainance effect. Future research should continue to explore the effects of different exercise intensities on the effectiveness of long-term attention delay effects.