拒絕上學和學校恐懼症的生理基礎——腦神經生理上感覺統合失常

PHYSIOLOGICAL BASIS OF SCHOOL PHOBIA AND SCHOOL REFUSAL–SENSORY INTEGRATIVE DYSFUNCTION–

臺北市立師專實小學生在七十四學年度中尋求輔導協助並接受感覺統合核對表調查，表上填「曾拒絕上幼稚園或小學、有原因或沒原因患學校恐懼症」的學童26人，與30名未拒絕上學的對照組學童做比較研究。家長對各種感覺統合失常綜合症狀所勾失常項目，在前庭和雙側大腦分化失常症、觸覺防禦和腦神經生理抑制困難、發育期運用障礙、以及視覺空間和形狀感覺失常等情況中，各有百分之七十以上的項目顯示兩組在統計上有意義的區别。重力不安全症中的項目，只有百分之三十顯示明顯的差異。本研究指出這些學童在腦神經生理上，除了手脚和眼睛協調的困難之外，觸覺跟其他感覺的過度敏感和容易激動不安，很可能為分離焦慮和拒絕上學的背後原因。學校功課和考試的督導或其他環境壓力，只間接誘使這些神經生理上平衡很脆弱的學童，面臨瓦解的邊緣，因而採取拒絕上學和退縮舉動。在治療和預防上，需考慮如何讓父母瞭解孩童在神經生理上的因難並積極參與診治，特别要增進孩童四週的溫暖感覺，同時要增強神經生理上的抑制和統整力量，才會有廣泛和長遠的效果。

We studied 26 pupils of Taipei Municipal Teacher College Affiliated Elementary School, who consulted us for emotional and learning disorders in the academic year of 1985, and showed symptoms of school phobia and/or school refusal in the checklist of Sensory Integrative Dysfunction in the past history checked by their parents. When the school refusal group was compared with 30 pupils of the control group, who showed no symptoms of school refusal in the past, the former checked much more items and more than 70% of items showed a statistically significant difference in Vestibular Bilateral Disorder, Tactile Denfensiveness and Disinhibition Disorders, Developmental Dyspraxia, as well as Visual Perception Disorders. However, only 30% (4 out of 13 items) of Gravitational Insecurity have statical significance. This study showed that the most basic etiologies of seperation anxiety and school refusal were oversensitivity and irritability of tactile and other sensory systems, in addtion to clumsiness or incoodination between eyes and limbs in some of them. It is urgd, for effective treatment and prevention of school phobia and school refusal, that some programs are necessary for parents to understand the physiological difficulties of the pupils and to participate in treatments.