腦性麻痺兒童常有數學學習障礙。本研究旨在探究此種學習障礙的成因，理解腦性麻痺兒童的需求，為其開發學習輔具。研究目標在制定設計準則，以期能引導設計者開發腦性麻痺兒童數學學習輔具。本研究先由文獻分析歸納，因為動作失能而難以使用手指數數，是腦性麻痺兒童的數學學習障礙的重要原因。並進行腦性麻痺兒童教育機構的實地觀察，紀錄分析四位腦性麻痺兒童在數學學習、手部動作與學習認知能力。對照整理數學學習的需求在基本加減法算術的練習，並提出九項設計準則。依此設計準則，本研究設計了三個數學學習活動，並開發一個運用平板電腦的數學學習軟體。也進一步在腦性麻痺兒童教育機構，測試一個數學學習活動的教學；結果顯示對腦性麻痺兒童的學習有助益。歸納研究貢獻主要為腦性麻痺兒童數學學習輔具的設計準則，其次為指認無法以手指數數導致數學學習障礙，再則是示範開發的數學學習活動與軟體。後續研究可望對設計準則有進一步評估，以其引導進階數學學習輔具的開發，增進腦性麻痺兒童的數學學習。

Children suffering from cerebral palsy often show difficulties in mathematics compared to their typically developing peers. Assistive technology provides cerebral palsy children receiving special education with significant physical and psychological improvement by helping them communicate and express themselves and also by enhancing their social and life skills. This study explores the needs, requirements and problem areas behind their mathematics learning with the aim to develop a set of guidelines to design assistive mathematics learning aids for them.
These children suffer from gross and fine motor skill disorders, cognitive dysfunction, and uncontrolled and uncoordinated movements. Their cognitive difficulties, in addition to their motor skill impairments, cause hindrance in their finger-counting strategies, which strongly affects their number counting and basic arithmetic problem solving abilities. It was found that a number of assistive devices are widely used to support computing, organizing, aligning of math problems or provide visual or audio support, but the area of learning how to solve simple problems by counting numbers, i.e. basic finger-counting practices has not received much attention.
Four children with a formal diagnosis of spastic athetoid cerebral palsy, studying in Junior Academics Section at Indian Institute of Cerebral Palsy, Kolkata, India participated in the study. Their mathematics learning behaviour, strengths, weaknesses, motor abilities and cognitive abilities were studied. In agreement with previous studies, the results showed that the inability to use finger-counting practices indeed affects the children’s problem solving skills.
Furthermore, it was found that assistive devices enable these children to work around their difficulties by banking on their strengths. Therefore, to meet their needs with basic problem solving abilities, the idea was to help them circumvent the actual physical task of counting fingers to solve simple addition and subtraction problems. The proposed guidelines focus on how their most common strengths (e.g. pressing buttons, pushing or hitting objects, pointing at objects) can be used to enhance or support their sense of appreciation of increase or decrease in quantity corresponding to a repetitive action in order to substitute for finger-counting and assist their arithmetic problem solving.
A mathematics educational app and three activity games were developed based on these guidelines, and one of the games was tested with the participants. To conclude, these guidelines can be beneficial for designing assistive learning aids that would enable cerebral palsy children to learn counting by using their most common abilities and thus make learning an easier and enjoyable experience for them.

References
Abascal-González, J., Arrue-Recondo, M., Garay-Vitoria, N., Tomás-Guerra, J., &
Velasco-Nuñez, C. A. (2003). USERfit Tool: A Design Tool Oriented towards
Accessibility and Usability. UPGRADE, IV(1), 5-10. Retrieved July 26, 2013, from
http://www.upgrade-cepis.org/
Apple Inc. (2011). Talking Calculator. Retrieved July 26, 2013, from
https://itunes.apple.com/us/app/talking-calculator/id424464284?mt=8
Apple Inc. (2013). iOS Human Interface Guidelines. Retrieved July 21, 2013, from https://developer.apple.com/library/ios/#documentation/UserExperience/Conceptual/MobileHIG/Introduction/Introduction.html#//apple_ref/doc/uid/TP40006556-CH1-SW1
Beckung, E., & Hagberg, G. (2000). Correlation between ICIDH handicap code and gross
motor function classification system in children with cerebral palsy. Developmental
Medicine and Child Neurology, 42(10), 669-673.
Beckung, E., & Hagberg, G. (2002). Neuroimpairments, activity limitations, and
participation restrictions in children with cerebral palsy. Developmental Medicine and
Child Neurology, 44(5), 309-316.
Booth, C., Cortina-Borja, M., & Theologis, T. (2001). Collagen accumulation in muscles
of children with cerebral palsy and correlation with severity of spasticity. Developmental
Medicine and Child Neurology, 43(5), 314-320.
Bryant, D.P. (2009). Math disability in children: An overview. Retrieved June 1, 2012,
from http://www.greatschools.org/special-education/LD-ADHD/526-math-disability-in-
children-an-overview.gs
Buhler, C., & Schmidt, M. (1993). User involvement in evaluation and assessment of assistive technology. In Proceedings of the European Conference on the Advancement of Rehabilitation Technology, ECART2, Stockholm (pp. 26-28).
Butterworth, B. (2005). The development of arithmetical abilities. Journal of Child
Psychology and Psychiatry, 46(1), 3-18.
Cook, A.M., & Hussey, S.M. (2002). Assistive technology: Principles and practice (2nd
edition). St. Louis, MO: Mosby.
Deary, J., Strand, S., Smith, P., & Fernandes, C. (2007). Intelligence and educational
achievement. Intelligence, 35(1), 13-21.
Dehaene, S., Piazza, M., Pinel, P., & Cohen, L. (2003). Three parietal circuits for number
processing. Cognitive Neuropsychology, 20(3), 487-506.
De Smedt, B., Janssen, R., Bouwens, K.,Verschaffel, L., Boets, B., & Ghesquiere, P.
(2009).Working memory and individual differences in mathematics achievement: A
longitudinal study from first grade to second grade. Journal of Experimental Child
Psychology, 103(2), 186-201.
Di Luca, S., Grana, A., Semenza, C., Seron, X., & Pesenti, M. (2006). Finger-digit
compatibility in Arabic numeral processing. Quarterly Journal of Experimental
Psychology, 59(9), 1648-1663.
Duncan, J., Dowsett, C.J., Claessens, A., Magnuson, K., Huston, A.C., Klebanov, P. (2007).
School readiness and later achievement. Developmental Psychology, 43(6), 1428-1446.
Fennell, .B., & Dikel, T.N. (2001). Cognitive and neuropsychological functioning in
children with cerebral palsy. Journal of Child Neurology, 16(1), 58-63.
Frampton, I., Yude, C., & Goodman, R. (1998). The prevalence and correlates of specific
learning difficulties in a representative sample of children with hemiplegia. British
Journal of Educational Psychology, 68(1), 39-51.
Geary, D.C. (2004). Mathematics and learning disabilities. Journal of Learning Disabilities,
37(1), 4-15.
Goldin-Meadow, S., Nusbaum, H., Kelly, S.D., & Wagner, S. (2001). Explaining math:
Gesturing lightens the load. Psychological Science, 12(6), 516-522.
Hecht, S.A., Torgesen, J.K., Wagner, R.K., & Rashotte, C.A. (2001). The relations between
phonological processing abilities and emerging individual differences in mathematical
computation skills: A longitudinal study from second to fifth grades. Journal of
Experimental Child Psychology, 79(2), 192-227.
Himmelmann, K., Beckung, E., Hagberg, G., & Uvebrant, P. (2006). Gross and fine
motor functions and accompanying impairments in cerebral palsy. Developmental
Medicine and Child Neurology, 48(6), 417-423.
Indian Institute of Cerebral Palsy. (2012). Indian Institute of Cerebral Palsy. Retrieved July
22, 2013, from http://www.iicpindia.org/index.php
IntelliTools. (n.d.). MathPad. Retrieved July 15, 2013, from
http://www.intellitools.com/mathpad.html

Jenks, K., de Moor, J., van Lieshout, E., Maathuis, K., Keus, I., & Gorter, J.W. (2007). The
effect of cerebral palsy on arithmetic accuracy is mediated by working memory,
intelligence, early numeracy, and instruction time. Developmental Neuropsychology,
32(3), 861-879.
Jenks, K., de Moor, J., van Lieshout, E., & Withagen, F. (2010). Quality of arithmetic
education for children with cerebral palsy. International Journal of Rehabilitation
Research, 33(1), 19-25.
Jenks, K.M., van Lieshout, E.C.D.M., & de Moor, J. (2009). The relationship between
medical impairments and arithmetic development in children with cerebral palsy.
Journal Child Neurology, 24(5), 528-535.
Jordan, N.C., Kaplan, D., Ramineni, C., & Locuniak, M.N. (2008).Development of number
combination skill in the early school years: When do fingers help? Developmental
Science, 11(5), 662-668.
Kirschenbaum, A.E. (2011). Offsetting Hand and Upper Limb Problems in Cerebral Palsy.
Retrieved July 21, 2013, from http://www.pediatric-
orthopedics.com/Treatments/CP_Hand/cp_hand.html
Klouche, K. (2012). Knock Knock. Retrieved July 20, 2013, from
http://www.klouche.com/knock-knock/
Kroesbergen, E.H., Van Luit, J.E.H., Van Lieshout, E.C.D.M., Van Loosbroek, E., &
VandeRijt, B.A.M. (2009). Individual differences in early numeracy: The role of
executive functions and subitizing. Journal of Psychoeducational Assessment, 27(3),
226-236.
Leap Motion. (2013). Leap Motion Controller. Retrieved July 22, 2013, from https://www.leapmotion.com/product
Le Fevre, J.A., Fast, L., Skwarchuk, S.L., Smith-Chant, B.L., Bisanz, J., & Kamawar, D.
(2010). Pathways to mathematics: Longitudinal predictors of performance. Child
Development, 81(6), 1753-1767.
Livescribe. (2013). How smartpens help students with learning disabilities. Retrieved
July 22, 2013, from http://www.livescribe.com/en-us/solutions/learningdisabilities/
Lynn, R., & Mikk, J. (2007). National differences in intelligence and educational
attainment. Intelligence, 35(2), 115-121.
McHale, K., & Cermak, S.A. (1992). Fine motor activities in elementary school:
preliminary findings and provisional implications for children with fine motor
problems. American Journal of Occupational Therapy, 46(19), 1-6.
Medders, C. (2010). Cerebral palsy swans disorder. Retrieved June 1, 2012, from
http://www.soyouwanna.com/cerebral-palsy-swans-disorder-21877.html
NCCA. (n.d.). Mathematics Guidelines for Teachers of Students with Severe and Profound
General Learning Disabilities. Dublin, Ireland: National Council for Curriculum and
Assessment. Retrieved June 10, 2013, from
http://www.ncca.ie/uploadedfiles/P_Sev_Maths.pdf
Peeters, M., Verhoeven, L., & de Moor, J. (2009). Predictors of verbal working memory in
children with cerebral palsy. Research in Developmental Disabilities, 30(6), 1502-1511.
Raghubar, K.P., Barnes, M.A., & Hecht, S.A. (2010).Working memory and mathematics:
Are view of developmental, individual difference, and cognitive approaches. Learning
and Individual Differences, 20(2), 110-122.
Raskind, M. & Stanberry, K. (2010). Assistive technology for kids with LD: An overview.
Retrieved June 1, 2012, from http://www.greatschools.org/special-
education/assistive-technology/702-assistive-technology-for-kids-with-learning-
disabilities-an-overview.gs
Rasmussen, C., & Bisanz, J. (2005).Representation and working memory in early
arithmetic. Journal of Experimental Child Psychology, 91(2), 137-157.
Rosenbaum, P.L., Paneth, N., Leviton, A., Goldstein, M., & Bax, M. (2007).A report:
Definition and classification of cerebral palsy April 2006. Developmental Medicine and
Child Neurology, 49(109), 8-14.
Sankar, C., & Mundkur, N. (2005). Cerebral Palsy – definition, classification, etiology
and early diagnosis. Indian Journal of Pediatrics, 72(10), 865-868.
Smits, D.W., Ketelaar, M., Gorter, J.W., van Schie, P.E., Becher, J.G., Lindeman, E. (2011).
Development of non-verbal intellectual capacity in school-age children with cerebral
palsy. Journal of Intellectual Disability Research, 55(6), 550-562.
Son, S.H., & Meisels, S.J. (2006). The relationship of young children’s motor skills to later
reading and math achievement. Merill-Palmer Quarterly, 52(4), 755-778.
South Carolina Assistive Technology Program. (2013). AT and Learning Disabilities.
Retrieved July 20, 2013, from http://www.sc.edu/scatp/ld.htm
Straub, K., & Obrzut, J. (2009). Effects of cerebral palsy on neuropsychological function.
Journal of Developmental and Physical Disabilities, 21(2), 153-167.
Van Rooijen, M., Verhoeven, L., Smits, D., Ketelaar, M., Becher, J.G., & Steenbergen, B.
(2011). Arithmetic performance of children with cerebral palsy: The influence of
cognitive and motor factors. Research in Developmental Disabilities, 33(2012), 530-537.
Van Rooijen, M., Verhoeven, L., & Steenbergen, B. (2011). Early numeracy in cerebral
palsy: Review and future research. Developmental Medicine and Child Neurology, 53(3),
202-209.
Vaz, D., Mancini, M., Fonseca, S., Vieira, D., & Pertence, A. (2006). Muscle Stiffness
and strength and their relation to hand function in children with hemiplegic cerebral
palsy. Developmental Medicine and Child Neurology, 48(9), 728-733.
World Health Organization. (2002). Towards a Common Language for Functioning,
Disability and Health: ICF. The International Classification of Functioning, Disability
and Health. Geneva, Switzerland: World Health Organization. Retrieved July 21, 2013,
from http://www.who.int/classifications/icf/training/icfbeginnersguide.pdf