本研究探討腦性麻痺與典型兒童的手側化發展特質，共分成三個子研究進行，分別為（1）以建構效度為主的「手側化量表」信效度研究，（2）比較腦性麻痺與典型兒童手側化表現與發展趨勢，以及（3）以實驗研究探討情境脈絡效應（物品位置與規格效應）對手側化表現的影響。
在子研究一中，研究者發展出手側化量表，並建立滿意的表面效度、「前-後測信度」、內在一致性、與「父母 「兒童一致性」，並藉由專家檢核方式建立內容效度。建構效度部份則由研究者分別採用介於4歲至12歲從小班到小六共九個年級的385, 728, 以及744位樣本進行兩階段探索性因素分析與一階段的驗證性因素分析（共三階段），並確認手側化量表具有兩種因素成分，分別為因素一的「多步驟/複雜」活動與因素二的「單步驟/簡單」活動。
子研究二分析101位腦性麻痺與801位典型兒童（介於4歲至12歲從小班到小六等共九個年級）的資料。兩組兒童於從事因素一活動時的側化商數以及使用右手的頻率均顯著比從事因素二活動時高，這樣的結果反映出活動特質不同會影響手側化表現。腦性麻痺組的側化商數與使用右手的人數頻率比典型兒童低，反映出早期腦傷可能導致非典型的偏側化表現。在典型兒童中，四歲組與五歲組（小班與中班）有比較多的非右手使用者，而且他們的側化商數也比其他從6歲到12歲等七組兒童低，因此六歲大班階段於手側化從不穩定到穩定發展歷程中是重要的關鍵期，社會壓力於此可能扮演重要的角色。
子研究三以手側化的近代觀點設計實驗研究，以探討物品「規格效應」與「位置效應」對於非側化手使用次數的影響，樣本包括32位腦性麻痺與26位典型兒童參與本研究。所有的樣本均需執行推球到桌前紙箱中的動作，每位分別經歷位於三種不同位置兩種規格共六種的推球情境，三種位置為非慣用手的對側、中間、以及同側，兩種規格是指排球與棒球。每位個案重複此六種情境三次，因此每人均推球十八次。二因子變異數分析的結果發現位置與規格效應沒有交互作用，但是不同位置影響非慣用手的使用次數，規格則未產生影響。因此情境脈絡效應（尤其是位置效應）可以被調控作為治療或教學上的因子以誘發腦傷者使用他們的不利手。
本論文獲至以下三點結論：（1）有兩個因素的手側化量表具備好的信效度，（2）活動特質、腦傷、以及社會壓力等因子對於手側化表現具有關鍵的影響力，（3）建議未來可以深入分析情境脈絡效應（包括活動特質與物品位置），作為協助動作不利孩子的策略之一。

This study (with three sub-studies) examined the issue based on traditional and contemporary perspectives of handedness development. They are "a reliability and validity study of the handedness inventory (mainly focusing on construct validity)", "handedness development: a comparison of cerebral palsied and typically developed children", and "the effects of object position and size on manual asymmetries in cerebral palsied and typically developed children".
In sub-study I, the handedness inventory was developed. The inventory demonstrated satisfactory surface validity, test-retest reliability, internal consistency (Cronbach α), and parent-child agreement. Content validity was established by the use of expert panel and construct validity was studied by using two-stage exploratory factor analysis and one-stage confirmatory factor analysis with 385, 728, and 744 subjects (ages ranging from 4- to 12-years) respectively. Two factors were identified finally: sequenced/complex tasks (factor 1) and non-sequenced/simple tasks (factor 2).
In sub-study II, 101 data from cerebral palsies and 801 typical children with ages from 4- to 12-years were analyzed. The higher laterality quotient and the frequency of right handedness were found on factor I activities than on factor II activities for both groups. The results indicated significant effects for different tasks in manual preference. Cerebral palsies' laterality quotient and frequency of right handedness were significantly lower than typical children; the association between early brain injuries and atypical lateral preference was strong. Four and five-old-years are more non-right handed and lower scored than other groups in typical children. It was also noted that there was no difference in handedness performance among other 7 groups from 6- to 12-old-years. The year in the senior class of kindergartens (6-year-old) was the most critical period in the process of establishing stable hand preference; social stress was important to substantiate this phenomenon.
In sub-study III, an experimental study of handedness based on contemporary view was conducted to examine the size and position effects on the use of non-preferred hand in 32 cerebral palsies and 26 typical children. The subjects were asked to execute upper extremity movements 18 times; they pushed balls forward into a box. Two kinds of different ball size (volleyball and baseball) with three different positions (contralateral, middle and ipsilateral sides relative to the non-preferred hand) were experienced by each subject (2×3 = 6 different pushing situations) ; six situations were repeated 3 times (6×3 = 18). Results of two-way ANOVA (2×3) suggested that no interaction existed between position and size effects in both groups. However, the differences in object position did influence the use of non-preferred hand and the object size did not demonstrate the same effect in cerebral palsies and typical children. Context effects, especially the position effect, can be manipulated as a therapeutic and educational strategy to facilitate the use of impaired hand for the children with cerebral palsy.
In summaries, the handedness inventory demonstrated good reliability and validity and included two factors. Task property, brain damage, and social stress might influence manual asymmetries. Context variables including task property and object position can be analyzed and utilized to help the children with motor deficiency.

參考文獻
壹、中文參考文獻
王錦滿、陳正岳、梁秋萍、黃美涓（民81）。南部地區腦性麻痺患童之探討。中華民國復健醫學會雜誌，20卷，113-117頁。
王天苗、蘇建文、廖華芳、林麗英、鄒國蘇、林世華 (民85)。嬰幼兒綜合發展測驗編製報告。台北：國立台灣師範大學特殊教育系。
吳裕益、陳振宇、謝淑蘭、成戎珠、黃朝慶、洪碧霞、櫻井正二郎、邱上真、陳小娟、曾進興 (民85)。兒童認知功能綜合測驗使用手冊。台南：國立台南師範學院特殊教育系。
毛連塭、陳英豪、嚴慧玲、與林明雲（民66）。左右偏用測驗指導手冊。省立高雄師範學院教育系。
吳武典、蔡崇建、胡致芬、王振德、林幸台、郭靜姿（民79）。托尼非語文智力測驗指導手冊。台北：心裡出版社。
林雨亭、沈淵瑤、黃富源（民76）。小兒腦性麻痺之臨床觀察。中華民國小兒醫學會雜誌，28卷，457-468頁。
林德隆（民86）。側化動作練習對雙手左右擊球技能表現的影響。國立台灣師範大學體育研究所博士論文。
孟令夫（民83）。聽覺刺激對上肢動作記憶的影響〔摘要〕。中華民國職能治療學會第十四次學術研討會手冊 (第16-17頁)。台北:職能治療學會。
孟令夫（民84）。手的慣用傾向、握筆姿勢和手部操作表現三者之關係〔摘要〕。中國心理學會第二十八次學研討會手冊 (第13頁)。台北：中國心理學會。
孟令夫、林幸台（民87）。預防第二類型錯誤與推演效果值於量化研究中的重要性。特殊教育學會三十週年刊（第219頁到238頁）。台北：中華民國特殊教育學會。
孟令夫、林幸台（民88）。以後設分析研究法探討新生兒抓握反射之側化現象。手稿製作中。
孟令夫、洪儷瑜（民89）。以文獻分析方式探討閱讀障礙兒童大腦型態學基礎。手稿製作中。
孟令夫、祝旭東、陳美香（付梓中）。單側大腦中風病患站姿傾倒趨勢之信度研究與特質分析。復健醫學會雜誌，27，97-102頁。
黃美涓（民73）。台灣地區腦性麻痺500例之分析。中華民國復健醫學會雜誌，12期，5-13頁。
陳榮華（民85）。魏氏智力測驗第三版指導手冊。台北：中國行為科學社。
教育部統計處（民88）。台閩地區國民中小學概況統計：八十七年度。台北：教育部。
葉瓊華編譯（民74）。腦性麻痺兒童的機能發展評量表。彰化：台灣省立彰化仁愛實驗學校。
廖華芳（民76）。不同類型腦性麻痺兒童之粗動作功能。物理治療學會雜誌，12卷，40-45。
廖華芳、孫雯萍、宋維村、連倚南（民76）。不同類型腦性麻痺兒童之發展。台灣醫學會雜誌，86卷，997-1003頁。
廖華芳、黃惠聲、李素菁、鄭素芳、周文博（民86）。台北市兩醫學機構腦性麻痺兒童復健相關資料之調查。台灣醫學會雜誌，1卷，274-287頁。
貳、英文參考文獻
Abdullaev, Y. G. & Posner, M. I. (1998). Event-related brain potential imaging of semantic encoding during processing single words. Neuroimage, 7, 1-13.
Agostini, M. D., Pare, C., Goudot, D., & Dellatolas, G. (1992). Manual preference and skill development in preschool children. Developmental Neuropsychology, 8, 41-57.
Annett M. (1970). A classification of hand preference by association analysis. Brtish Journal of Psychology, 61, 303-321.
Ayres, J. (1989). Sensory Integration and Praxis Tests (SIPT). Los Angeles, CA: Western Psychological Services.
Bayley, N. (1993). Bayley Scales of Infant Development, 2nd Edition (BSID-II). San Antonio, TX: Psychological Corporation.
Bishop, D. V. M. (1990). Why handedness? In D. V. M. Bishop (Eds.), Handedness and developmental disorder (pp. 1-17). London: Mac Keith Press.
Bishop, D. V. M. (1990). The definition and measurement of handedness. In D. V. M. Bishop (Eds.), Handedness and developmental disorder (pp. 69-81). London: Mac Keith Press.
Bishop, D. V. M. (1990). Early brain damage and pathological left-handedness. In D. V. M. Bishop (Eds.), Handedness and developmental disorder (pp. 90-100). London: Mac Keith Press.
Bradshaw-McAnulty, G., Hicks, R., Kinsbourne, M. (1984). Pathological left-handedness and familial sinistrality in relation to degree of mental retardation. Brain & Cognition, 3, 349-356.
Brito, G. N. O., Lins, M. F. C., Paumgartten, F. J. R., & Brito, L. S. O. (1992). Hand preference in 4- to 7-year-old children: An analysis with the Edinburgh inventory in Brazil. Developmental Neuropsychology, 8, 59-68.
Brown, J. K., Rensburg, F. V., Walsh, G., Lakie, M., & Wright, G. W. (1987). A neurological study of hand function of hemiplegic children. Developmental Medicine and Child Neurology, 29, 287-304.
Brown, K. W. (1983). Language laterality in five-year old females: A comparison of consistent and nonconsistent handedness groups. Unpublised Master Thesis. Department of Psychology, California State University, Fullerton.
Bryden, M. P. (1977). Measuring handedness with questionnaires. Neuropsychologia, 15, 617-624.
Bryden, M. P., MacRae, L., Steenhuis, R. E. (1991). Hand preference in school children. Developmental Neuropsychology, 7, 477-486.
Bryden, M. P. & Steenhuis, R. (1991). The assessment of handedness in children. In J. E. Obrzut & G. W. Hynd (Eds.), Neuropsychological foundation of learning disabilities: A handbook of issues, methods, and practice (pp. 411-436). San Diego, CA: Academic Press, Inc.
Burden, V., Bradshaw, J. L., Nettleton, N. C. & Wilson, L. (1985).
Hand and hemispace effects in tactual tasks in children. Neuropsychologia, 23, 515-525.
Carlsson, G., Hugdahl, K., Uvebrant, P., Wiklund, L. M., & Wendt, L. V. (1992). Pathological left-handedness revisited: Dichotic listening in children with left vs right congenital hemiplegia. Neuropsychologia, 30, 471-481.
Carlsson, G., Uvebrant, P., Hugdahl, K., Arvidsson, J., Wiklund, L. M., & Wendt, L. V. (1994). Verbal and non-verbal function of children with right- versus left- hemiplegic cerebral plasy of pre- and perinatal origin. Developmental Medicine and Child Neurology, 36, 503-512.
Case-Smith, J., Bigsby, R., & Clutter, J. (1998). Perceptual-motor coupling in the development of grasp. American Journal of Occupational Therapy. 52, 102-10.
Chen, R., Gerloff, C., Hallett, & Cohen, L. G. (1997). Involvement of ipsilateral motor cortex in finger movements of different complexities. Annals of Neurology, 41, 247-254.
Churchill, J. A. (1968). A study of hemiplegic cerebral palsy. Developmental Medicine and Child Neurology, 10, 453-459.
Clark, M. M. (1957). Left-handedness: Laterality characteristics and their educational implications. London: University of London Press LTD.
Cornwell, K. S., Harris, L. J., & Fitzgerald, H. E. (1991). Task effects in the development of hand preference in 9-, 13-, and 20-month-old infant girls. Developmental Neuropsychology, 7, 19-34.
Curt, F., Maccario, J. & Dellatolas, G. (1992). Distribution of hand preference and hand skill asymmetry in preschool children: Theoretical implication. Neuropsychologia, 30, 27-34.
Dean, R. S., Rattan, G., & Hua, M. S. (1987). Patterns of lateral preference: An American-Chinese comparison. Neupsychologia, 25, 585-588.
Flament, F. (1975). Manual lateralization and task lateralization among 1-sup-4 year old children. [French] [On-line]. Journal de Psychologie Normale et Pathologique, 72, 291-310. Abstract from: OVIDWEB File: PsyClit Assession number: 1981-12471-001
Fennel, E. B. (1995). The role of neurological assessment in learning disabilities. Journal of Child Neurology, 10, S36-S41.
Folio, R., & Fewell, R. (1983). Peabody Development Motor Scales (PDMS). Chicago: Riverside Publishing.
Gisel, E. G. (1988). Development of oral side preference during chewing and its relation to hand preference in normal 2- to 8-year-old children. American Journal of Occupational Therapy, 42, 378-384.
Gordon, A. M., Charles, J., & Duff, S. V. (1999). Fingertip forces during object manipulation in children with hemiplegic cerebral palsy. II: Bilateral coordination. Developmental Medicine and Child Neurology, 41, 176-185.
Gordon, A. M. & Duff, S. V. (1999). Fingertip forces during object manipulation in children with hemiplegic cerebral palsy. I: Anticipatory scaling. Developmental Medicine and Child Neurology, 41, 166-175.
Green, A. & Vaid, J. (1986). Methodological issues in the use of the concurrent activities paradigm. Brain and Cognition, 5, 465-476.
Grote, C. & Salmon, P. (1986). Spatial complexity and hand usage on the block design test. Perceptual and Motor Skils, 62, 59-67.
Gudmundsson, E. (1993). Lateral preference of preschool and primary school children. Perceptual and Motor Skills, 77, 819-828.
Hackney, C. S. (1997). The left-handed child in a right-handed World (ED406692).
Han, Z., & Fu, J. (1992). A re-investigation of the distribution of left and right handedness in the Jinou nationality. Acta Psychologica Sinica, 3, 254-260.
Halpern, D. F., & Coren, S. (1990). Laterality and longevity: Is left-handedness associated with a younger age at death? In S. Coren (Eds), Left-handedness: Behavioral implications and anomalies (pp. 509-546). Amsterdam: North-Holland.
Hayashi, T., Ichiyama, T., Nishikawa, M., Furukawa, S. (1998). Correction of left handedness worsed mirror writing in a girl with spastic diplegia. [Japanese] [On-line]. No to Hattasu (Brain and Development), 30, 339-45. Abstract from: OVIDWEB File: Medline Unique Identifier: 98360744
Herron, J. (1980). Neuropsychology of left-handedness. NY: Academic Press Inc.
Hiscock, C. K., Hiscock, M., Benjamin, D., & Hillman, S. (1989). Motor asymmetries in hemiplegic children: Implications for the normal and pathological development of handedness. Developmental Neuropsychology, 5, 169-186.
Hiscock, M. & Hiscock, C. K. (1990). Laterality in hemiplegic children: Implications for the concept of pathological left-handedness. In S. Coren (Ed.), Left-handedness: Behavioral implications and anomalies (pp.131-152). Amsterdam: North Holland.
Hoosain, R. (1990). Left handedness and handedness switch amongst the Chinese. Cortex, 26, 452-454.
Issacs, E., Christie, D., Vargha-Khadem, F., & Mishkin, M. (1996). Effects of hemispheric side of injury, age at injury, and presence of seizure disorder on functional ear and hand asymmetries in hemiplegic children. Neuropsychologia, 34, 127-137.
Kelly, E. B. (1996). Left-Handed Students: A Forgotten Minority. Fastback 399 (ED405996).
Levander, M., Tegner, R., & Caneman, G. (1993). Tactile line-bisection in normal subjects. Perceptual and Motor Skills, 76, 831-836.
Li, X. (1992). The distribution of left and right handedness in Chinese people. Acta Psychologica Sinica, 24, 254-259.
Li, X., Li, M., Ge, H., & Jin, K. (1984). Experimental study on grasping with left or right hand by 6-mo to 3-year-old children. Acta Psychologica Sinica, 16, 214-222.
Lin, K. C., Wu, C. Y., & Trombly, C. A. Effects of task goal on movement kinematics and line bisection performance in adults without disabilities. American Journal of Occupational Therapy, 52, 179-187.
Maehara, K., Negishi, N., Tsai, A., Iizuka, R., Otsuki, N., Suzuki, S., Takahashi, T., & Sumiyoshi, Y. (1988). Handedness in the Japanese. Developmental Neuropsychology, 4, 117-127.
Mandell, R. J., Nelson, D. L., & Cermak, S. A. (1984). Differential laterality of hand function in right-handed and left-handed boys. American Journal of Occupational Therapy, 38, 114-120.
Mao, Y. & Zhang, Z. (1991). An experimental study of the handedness of mentally retarded children. Acta Psychologica Sinica, 23, 225-235.
McManus, I. C., Sik, G., Cole, D. R., Wong, J., & Kloss, J. (1988). The development of handedness in children. Journal of Developmental Psychology, 6, 257-273.
Meng, L.F. (1994). The relations among handedness, pencil grasp posture and in-hand manipulation. Unpublished master thesis. Department of Occupational Therapy, New York University, New York.
Oldfield, R. C. (1971). The assessment and analysis of handedness: The Edinburgh inventory. Neuropsychologia, 9, 97-113.
Palmer, F. B., & Hoon, A. H. (1995). Cerebral Palsy. In S. Parker, & B. Zuckerman1 (Eds.), Behavioral and developmental pediatrics (pp. 88-94). New York: Little, Brown & Company.
Pehoski, C. (1992). Central nervous system control of precision movements of the hand. In J. Case-Smith & C. Pehoski (Eds), Developemnt of hand skills (pp. 1-12). Rockville, MD: The American Occupational Therapy Association, Inc.
Peters, M. (1981). Handedness: Coordination of within- and between-hand alternating movements. American Journal of Psychology, 94, 633-643.
Peters, M. & Murphy, K. (1992). Cluster analysis reveals at least there, and possible five distinct handedness groups. Neuropsychologia, 30, 373-380.
Peters, M. & Pang, J. (1992). Do "right-armed" lefthanders have different lateralization of motor control for the proximal and distal musculature？ Cortex, 28, 391-399.
Petersen, P. & Petersen, C. E. (1984). Bilateral handskills in children with mild hemiplegia. Physical and Occupational Therapy in Pediatrics, 4, 77-87.
Porac, C. & Coren, S. (1981). Lateral preferences and human behavior. New York: Springer-Verlag.
Previc, F.H. (1991). A general theory concerning the prenatal orogins of cerebral lateralization in humans. Psychological Review, 98, 299-334.
Previc, F.H. (1996). Nonright-handedness, central nervous system and related pathology, and its lateralization: A reformulation and synthesis. Developmental Neuropsychology, 12, 443-515.
Raczkowski, D., Kalat, J. W., & Nebes, R. (1974). Reliability and validity of some handedness questionnaire items. Neuropsychologia, 12, 43-47.
Riva, D. & Cazzaniga, L. (1986). Late effect of unilateral brain lesions sustained before and after age one. Neuropsychologia, 24, 423-428.
Riddoch, M. J., Edwards, M. G., Humphreys, G. W., West, R., & Heafield, T. (1998). Visual affordances direct action: Neuropsychological evidence from manual. Cognitive Neuropsychology, 15, 645-683.
Ross, G., Lipper, E., & Auld, P.A. (1992). Hand preference, prematurity and developmental outcome at school age. Neuropsychologia, 30, 483-94.
Scheirs, J.G.M. (1990). Relationships between the direction of movements and handedness in children. Neuropsychologia, 28, 743-748.
Sieratzki, J. S., & Woll, B. (1996). Why do mothers cradle babies on their left? Lancet, 347, 1746-1748.
Smith, S. M. (1983). Performance difference between hands in children on the motor accuracy test-revised. American Journal of Occupational Therapy, 37, 96-101.
Spreen, O., Risser, A. H., & Edgell, D. (1995). Cerebral lateralization. In O. Spreen, A. H. Risser, & D. Edgell (Eds.), Developmental Neuropsychology (pp. 81-101). New York & Oxford: Oxford University Press.
Steenhuis, R. E. & Bryden, M. P. (1989). Different dimensions of hand preference that relate to skilled and unskilled activities. Cortex, 25, 289-304.
Steingrueber, H. J. (1975). Handedness as a function of test complexity. [On-line]. Perceptual and Motor Skills, 40, 263-266. Abstract from: OVIDWEB File: PsyClit Accession number: 1993-20281-001
Stilwell, J. M. (1987a). The development of manual midline crossing in 2- to 6-year-old children. American Journal of Occupational Therapy, 41, 783-789.
Stilwell, J. M. (1987b). Relationship between manual midline crossing and hand preference. Occupational Therapy Journal of Research. 7, 131-145.
Stout, J. L. (1987). Hemispheric specialization for motor function and hemiplegic cerebral palsy: Is there a difference in function between children with right and left hemiplegia? Physical and Occupational Therapy, 7, 53-65.
Taft, L. T. (1995). Cerebral palsy. Pediatrics in Review, 16, 411-418.
Tan, L. E. (1985). Laterality and motor skills in four-year-olds. Child Development, 56, 119-124.
Tan, U. (1994). The grasp reflex from the right and left hand in human neonates indicates that the development of both cerebral hemispheres in males, but only the right hemisphere in females, is favoured by testosterone. International Journal of Psychophysiology, 16, 39-47.
Tan, U. & Zor, N. (1994). Grasp-reflex strength from right and left hands in relation to serum level and fetal position in human neonates. International Journal of Neuroscience, 74, 27-32.
Teng, E. L., Lee, P. H., Yang, K. S. & Chang, R. C. (1976). Handedness in a Chinese population: Biological, social, and pathological factors. Science, 193, 1148-1150.
Teng, E. L., Lee, P. H., Yang, K. S. & Chang, R. C. (1979). Lateral preferences for hand, foot and eye, and their lack of association with scholastic achievement, in 4143 Chinese. Neuropsychologia, 17, 41-48.
Uvebrant P. (1988). Hemiplegic cerebral palsy: Aetiology and outcome. Acta Paediatrica Scandinavica - Supplement. 345, 1-100.
Vargha-Khadem, F., Issacs, E., Werf, S. V. D., & Wilson, J. (1992). Development of intelligence and memory in children with hemiplegic cerebral palsy. Brain, 115, 315-329.
Vasconcelos, O. (1993). Asymmetries of manual motor response in relation to age, sex, handedness, and occupational activities. Perceptual and Motor Skills, 77, 691-700.
Ward, J. P. & Hopkins, W. D. (1993). Primate Laterality: Current behavioral evidence of primate asymmetries. New York: Springler-Verlag.
Warrington, E. K., James, M., & Maciejewski. (1986). The WAIS as a lateralizing and localizing diagnostic instrument: A study of 656 patients with unilateral cerebral lesions. Neuropsychologia, 24, 223-239.
Wu, C. Y., Lin, K. C., & Trombly, C. A. (1994). The relationship between occupational therapy form and occupational performance: A kinematic perspective. American Journal of Occupational Therapy, 48, 679-687.
Yokochi, K., Yokochi, M., & Kodama, K. (1995). Motor function of infants with spastic hemiplegia. Brain and Development, 17, 42-48.
Michel, G. F. (1983). Development of hand-use preference during infancy. In G. Young, S. J. Segalowitz, C. M. Corter, & S. E. Trehub (Eds.), Manual specialization and the developing brain (pp. 33-70). New York: Academic Press.
Zapotocna, O. (1990). Effect of directionality on performance in dichatic discrimination in right-left orientation. Studia Psychologica, 32, 229-238.
Zapotocna, O. (1992). Directionality in perceptual and motor tasks in relation to handedness. Studia Psychologica, 34, 211-224.
Zapotocna, O. (1996). Directionality in circle drawing: Possible underlying mechanisms. Studia Psychologica, 38, 193-198.
Zapotocna, O. (1997). Directionality in circle drawing in relation to age, sex, handedness and hand used. Studia Psychologica, 39, 187-195.