发展性协调障碍与书写困难个案研究

该研究对一个14岁书写困难儿童zl的动作和认知技能进行了系统的考察。zl的书写困难主要表现在以下几方面：书写速度慢，字与字之间的空间距离非常近，字迹难以辨认，笔画顺序混乱。该研究首先测查了zl的基本智能和一系列精细动作技能、视觉、视空以及序列加工能力。结果发现他的基本智能、视觉加工能力正常，动作技能和视空加工能力皆显著落后于控制组儿童。语言能力测试发现，他的识字量、阅读理解和听力理解均正常。他在汉字单字、双字词、数字和图片命名上的正确率与控制组没有显著差异，但命名速度明显慢于控制组。神经生理检查发现，他的脑电波轻度异常，核磁共振扫描(MRI)显示双侧脑室体后部和枕角周围白质和小脑发育异常。这些结果表明该儿童的书写困难是更广泛的动作协调障碍的一种体现，并可能以他的脑神经发育状况为基础。文章讨论了zl书写障碍的认知神经机制及对书写障碍早期鉴别和训练的意义。

DEVELOPMENTAL COORDINATION DISORDER AND DYSGRAPHIA:A CASE STUDY

This study examined the cognition and motor skills in a 14-year-old boy with s evere writing difficulties. This case, zl wrote very slowly, his handwriting was bad and hard to be recognized. The study showed that his intelligence, reading comprehension and listening comprehension were normal. There were no differences between zl's performance on accuracy of naming single characters, two-characte r words, numbers, and objects with that of same-aged controls. But his speed wa s significantly slower than that of the controls. This study focused on zl's fin e motor, visual-spatial, visual, and sequential processing skills. The results showed that his visual memory, sequential processing abitities and motion detect ion was normal. His motor skill, and visual-spatial were significantly worse th an those of the controls. Neurophysiology examination found that his brain wave was abnormal, MRI scans indicated that myelinated corpus callosum and cerebellum developed abnormally. These findings suggested that zl's writing difficulti es reflected his general motor coordination disorders , and had neurophysiolo gic foundations. The implications for cognitive neurology mechanism and early di agnosis of writing difficulties were discussed.