背景與目的：肢體間協調（inter-limb coordination）及知覺動作結合（perception-action coupling）是個體適應複雜環境不可或缺的兩個重要能力。過去少有研究探討發展性協調障礙兒童上下肢同時進行雙重粗大動作任務時之肢體間動作協調表現，更缺少關於發展性協調障礙兒童聽覺與動作結合能力之文獻。本研究目的為探討發展性協調障礙兒童在不同聽覺訊息與動作複雜度的環境下，其肢體間協調與知覺動作結合之能力：(1)不同的聽覺訊息對於肢體間動作協調能力與知覺動作結合能力之影響；(2)不同的任務困難度對於肢體間動作協調與知覺動作結合能力之影響；(3)不同的聽覺訊息對於不同的肢體(上肢或下肢)與聲音訊息結合的知覺動作結合表現。方法：24名發展性協調障礙兒童與24名正常發展兒童參與本實驗。受試者在三種聽覺訊息情況下，分別進行單獨拍手、單獨踏步或是拍手同時踏步三種動作，其聽覺訊息包含無聽覺訊息、喜好踏步頻率與喜好拍手頻率。肢體間協調以動作頻率變異係數、上下肢相位結合值與結合值之變異係數探討，知覺動作結合能力以知覺動作相位結合的精準度與穩定度探討。以混合設計變異數分析探討組別、作業複雜度、肢體動作、聽覺訊息對肢體間協調與知覺動作結合的影響。結果：整體而言發展性協調障礙兒童的動作頻率比正常兒童不穩定，踏步之動作頻率變異係數不受作業複雜度的影響，而拍手動作頻率變異係數則會隨作業複雜度的增高而增加。在有或無聽覺訊息情況下，發展性協調障礙兒童在上下肢動作相位結合精準度顯著小於正常發展兒童。當聽覺訊息為喜好踏步頻率時，發展性協調障礙兒童的知覺動作結合的變異係數也較正常發展兒童小。當聽覺訊息為喜好拍手頻率時，兩個組別之間則無顯著差異。結論：發展性協調障礙兒童肢體間動作協調的表現相較於同年齡正常發展兒童變異性較大，作業複雜度對肢體動作的穩定度則有不同影響，踏步動作頻率穩定度不受作業複雜度的影響，但拍手的動作頻率穩定度卻因作業複雜度的增加而下降。顯示發展性協調障礙兒童在較不熟悉的作業下，作業表現的穩定度控制較差，會受作業複雜度影響；此外他們較無法利用聽覺訊息，執行動作的即時修正，因此他們的知覺動作結合的精準度較小外，變異係數也較小；相對而言，正常發展兒童會利用外在聲音訊息產生預期性的動作，所以他們有較大的知覺動作相位結合變異係數。

Background and purpose: A series of motor behavior changes after birth developed to adapt the environmental and task demands. The abilities of inter-limb coordination and perception-action coupling are important for an individual to adapt in environment. Children with developmental coordination disorder (DCD) have deficits in motor control. Limited study has examined the gross motor inter-limb coordination and coordination between limb action and external auditory cues in children with DCD. The aims of the study were to investigate the inter-limb coordination and perception-action coupling in children with DCD: (1) the effect of external cue on inter-limb coordination; (2) the effect of task complexity on inter-limb coordination; (3) the effect of limb movements on inter-limb coordination and perception-action coupling. Methods: twenty-four children with DCD and 24 age- and gender-matched typically developing (TD) children participated in the study. They performed tasks of marching or clapping alone and marching together with clapping in three auditory cue conditions (no cue, cue with preferred clap frequency and cue with preferred step frequency). The coefficient of variances (CVs) of action frequency and step-clap phasing value within-trials were used to examine the performance of inter-limb coordination. The mean and CV of perception-action phasing value were adopted as indicators of perception-action coupling ability. Results: The CV of action frequency was significantly larger in DCD group than in TD group. The CV of clap frequency increased with increased task complexity, but the CV of step frequency did not change. The mean of step-clap phasing value was also significantly larger in DCD group than in TD group. Significant cue and group interaction effect of the CV of perception-action phasing was noted. The CV of perception-action phasing was larger in TD group compared to that in DCD group. Conclusion: Children with DCD were less stable than TD children in an action and in the inter-limb coordination. Our study showed that children with DCD were more stable than TD children in the action-perception phase. This suggests that children with DCD reflect poor adaption to a cue and have problem in correcting on-going movements. Children with DCD tend to entrap in an attractor status. However, TD children tend to couple their limbs in adaptation and anticipation to the external cue.

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