研究背景與目的：由於感覺調節障礙孩童(sensory modulation disorder，簡稱SMD)常伴隨有平衡控制的問題，導致日常生活功能的障礙，因此其平衡能力的訓練也是臨床治療師著重的治療焦點之一，然而探討關於孩童感覺調節能力以及該能力對平衡能力影響的文獻相當有限。因此本研究的目的為：(1) 調查SMD與一般孩童的感覺調節能力，以了解兩組孩童感覺調節能力上的差異；(2) 比較兩組孩童之平衡能力，以在不同感覺情境下的平衡狀況，探討感覺訊息輸入對SMD與一般孩童平衡能力的影響；(3)檢驗感覺調節能力與平衡能力的相關性。研究方法：本研究在台南地區招募SMD以及一般發展的孩童及其家長參與研究，並利用治療師的觀察評估與中文化感覺史量表(簡稱SP)的評估結果等方式，將受測個案分成SMD組及控制組，最後共有SMD組14人、控制組17人。平衡能力量測的部分，研究中把加速規固定在孩童身體重心位置上，以測量孩童在感覺互動與平衡臨床測驗(Clinical Test of Sensory Interaction and Balance，簡稱CTSIB)中六種不同情境下的姿勢擺動加速度，以了解兩組孩童在不同感覺情境下平衡表現細微的差異。同時，本研究分別以行為表現和生理性反應的觀點，測量孩童的感覺調節能力，使用SP與感覺訊息處理評估表(簡稱ESP)可以測量孩童在日常生活中所表現的感覺調節能力，而透過感覺挑戰計畫所測量的皮電位反應(electrodermal reactions，簡稱EDR)可以藉由孩童對感覺刺激所產生的EDR來偵測感覺調節方面的生理性反應。結果：(1) 以SP與ESP問卷量測孩童個感覺調節能力，可發現SMD組孩童之得分均顯著低於控制組孩童；而以感覺挑戰計畫中的EDR來量測孩童的感覺調節能力，可發現SMD組孩童之平均EDR量值顯著高於控制組孩童。 (2) 對所有孩童而言，當有感覺輸入遭到改變時，其姿勢擺動加速度都比基準點情境(CTSIB中的情境ㄧ)下的姿勢擺動量大，當分析感覺情境對平衡表現的作用時發現，除了視覺情境因子對控制組孩童影響比SMD組大以外，其他情境因子對兩組孩童姿勢擺動加速度的作用是一致的，然而，一般而言，SMD組之姿勢擺動加速度顯著大於控制組孩童(除了在干擾視覺情境以外)。 (3) 以SP、ESP問卷的結果進行感覺調節能力與平衡表現的相關分析可發現，問卷分數越低，姿勢擺動加速度越高；而以感覺挑戰計畫中的EDR結果進行感覺調節能力與平衡表現的相關分析可發現，EDR量值越大，姿勢擺動加速度越高。結論：(1) 無論採用行為表現或是生理性檢測的方式，均可發現沒有其他正式診斷的SMD孩童，其感覺調節能力顯著較一般孩童差。 (2) 一般而言，SMD孩童的平衡能力比一般孩童差，這個結果有助於我們了解SMD孩童平衡能力與一般孩童的差異，並作為未來規劃SMD孩童平衡能力訓練計畫的參考。 (3)無論採用行為表現或是生理性檢測的方式量測感覺調節能力，均可發現感覺調節能力與孩童平衡能力有顯著的正相關，且可作為解釋SMD孩童平衡表現較差的因素之一。

　Background and Purpose：The Children with sensory modulation disorder (SMD) often have the deficit of the balance performance that may lead to the problems in the activities of the daily life, so that improving balance ability is usually one of the therapeutic goals for the children with SMD. However, the researches that explored the SMD and the influences of sensory modulation ability on the balance performance in children were very limited. This study aimed to: (1) measure sensory modulation ability of the children, and explore the difference of that between the two studied groups, (2) investigate the balance performance of children with SMD in the different sensory situations, and to compare with that in typically developing children, and (3) examine the correlation between the sensory modulation ability and balance ability in children. Method: This study recruited the children with SMD and typically developing children in Tainan. The subjects were divided into two groups by clinical observation from experienced occupational therapists and the scores from the Chinese version of Sensory Profile (SP). SMD group had 14 children, and control group had 17 children.In this study, we used the accelerometer that was fixed around the center of body mass to measure children’s acceleration of postural sway in six different conditions of Clinical Test of Sensory Interaction and Balance (CTSIB). The accelerometer was designed to find the fine differences of balance performance in six conditions between the two groups. In addition, the sensory modulation ability was measured as the behavioral performance and the physiological reactions. We used the Sensory Profile (SP) and the Evaluation of Sensory Processing Questionnaire (ESP) to measure sensory modulation ability that gauge children’s behavioral responses for sensory inputs during daily activities. Also, we used the electrodermal reactions (EDR) to detect the sensory modulation ability. The EDR obtained through the Sensory Challenge Protocol (SCP) were used to present the children’s physiological responses to sensory stimulation. Results：(1) The scores of SP and ESP of the SMD group were significantly lower than the control group , and the EDR magnitude in SCP of the SMD group were significantly higher than the control group. (2) Compared with the baseline, the postural sway was increased when sensory inputs were getting more complicated. Except the control group was more affected by the visual situation factor, the effects of the other sensory situations were the same to the children’s balance performance of the two groups. However, in general the postural sway of the SMD group were greater than the control group. (3) The total scores of SP and ESP had negative correlation with postural sway, and the average of EDR magnitude in SCP and postural sway in CTSIB had positive correlation. Conclusion：(1) Either using the behavior performance or physiological reactions to measure sensory modulation ability, we found that the SMD children with no other medical diagnosis had worse sensory modulation ability than the typically developing children. (2) Generally, the children with SMD had the worse balance ability than the typically developing children. This might be useful to realize the differences of balance performance between SMD and typically developing children, and helped the therapists to set the therapeutic plans to train the balance ability of SMD children. (3)In the both perspectives of behavior performance and physiological reactions, we found that the balance ability of children was positively correlated with their sensory modulation ability. This result might explain that why the SMD children had worse balance ability than the typically developing children.

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