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高功能自閉症類群障礙兒童的執行功能之探究: 與症狀嚴重度、適應行為及行為問題表現之關聯性 / Exploration of the Executive Function in Children with High-functioning Autism Spectrum Disorder: Relationship with Symptom Severity, Adaptive Function and Problem Behaviors林怡安, Lin, Yi An Unknown Date (has links)
研究目的:本研究之目的,是探索高功能自閉症類群障礙(High-functioning Autism Spectrum Disorder, HFASD)兒童的執行功能表現,並以Pellicano(2011)提出的獨特性、解釋力、普遍性等觀點作為架構進行討論。獨特性方面,試圖以冷執行功能(包括認知彈性、工作記憶、反應抑制)與熱執行功能之架構剖繪HFASD兒童的執行功能表現形態;解釋力方面,是探索執行功能表現對自閉症狀嚴重度、適應行為及行為問題的預測力;普遍性方面,呼應自閉症類群障礙的高度異質性,嘗試以執行功能表現解釋研究樣本中具注意力不足/過動症特質和智能優異特質的兒童特性。
方法:以生理年齡界於7至10歲的54名HFASD兒童和27名一般發展組作為研究對象,兩組於生理年齡和智力進行配對控制,分別以七項認知作業和執行功能行為評定量表評估受試者在實驗室和日常生活中的執行功能表現,也評估智力、症狀嚴重度、適應行為、內外化行為問題表現。
結果:與一般發展兒童相較,HFASD組的執行功能呈現反應抑制的缺損最為明顯、認知彈性次之,而工作記憶則表現相對正常的獨特表現形態;且在誘發情緒和動機後,部分HFASD兒童有「避免懲罰」或「避免冒險」之作答傾向,此傾向與較嚴重的侷限重複行為有關。認知作業測得的結果和家長評估兒童的執行功能表現關聯性不大。執行功能中的抑制、轉換能力能預測侷限重複性行為的自閉症狀和內外化行為問題,然HFASD兒童的抑制能力越佳,也反映更多的內化行為困擾。此外,本研究HFASD受試樣本中具高度異質性,智能優異特質者幾乎沒有明顯的認知作業執行功能缺損,以BRIEF評估時,與非智能優異者相較具備較佳的計劃能力;而轉換、抑制及自我監控能力差可預測HFASD兒童中較高的注意力不足/過動症特質。
總結:HFASD兒童具獨特的執行功能表現形態,且HFASD的症狀表現和高度異質性可部分由執行功能所解釋,顯示執行功能缺損作為核心的認知能力假說具參考價值。進一步討論結果對於未來臨床實務中的介入價值。 / Purposes: The purpose of the study was to explore the executive function (EF) of the High-functioning Autism Spectrum Disorder (HFASD), and EF was discussed on the basis of uniqueness, explanatory power, universality proposed by Pellicano (2011). For the uniqueness, the study captures the cool EF (including cognitive flexibility, working memory, and response inhibition) and hot EF profile in children with HFASD. For the explanatory power, to examine whether EF can predict ASD symptom severity, adaptive function, and behavior problems. For the universality, concerning the significant heterogeneity within ASD, the study attempts to use EF to identify ADHD trait and intellectually gifted children within HFASD.
Methods: Fifty-four children aged 7–10 years with HFASD and 27 control participants (Non-ASDs) with matched Age, Verbal, Performance, and Full Scale IQ were recruited. EF measurements include performance-based executive function task, as well as the BRIEF (Behavior Rating Inventory of Executive Functions) questionnaire completed by parents for daily life executive performance of their children. IQ, symptom severity, adaptive function, internalized and externalized behavior problems were also measured either by questionnaire or semi-structured assessments.
Results: Results indicated that compared with Non-ASDs, HFASD shows the most imairment in responses inhibition, then in cognitive shifting. However, the working memory is relativily intact. When the motivation and emotion were induced during the task, an “avoidance punishment” or “avoidance risk” tendancy was observed in some children with HFASD, which is related to more restricted and repetitive symptoms. Performance-based tasks are not highly related with questionnaire-based measurement of EF. Problems with inhibition and shift ability can predict more restricted and repetitive symptoms as well as internalized and externalized behavior problems. However, when children with HFASD show better inhibition ability, they might have more internalized behavior disturbance. Furthermore, we found high heterogeneity within the study sample of HFASD.There is no significant deficits in performance-based EF tasks within intellectually gifted HFASD, and they also have higher performance on the plan scale of BRIEF. Problems with shift, inhibition, and self-monitoring can predict higher ADHD traits in children with HFASD.
Conclusions: Findngs support the uniqness of EF profile in children with HFASD, and the heterogeneity within ASD can be partially explained by EF components. This indicated the importance of EF dysfunction hypothesis in ASD.The theoretical and clinical implications were discussed.
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從眼動證據探索高功能自閉症類群障礙兒童的生物性運動知覺歷程 / An Eye-Tracking Study on Biological Motion Perception in Children with High-Functioning Autism Spectrum Disorder林宛柔, Lin, Wan-Jou Unknown Date (has links)
研究目的:本研究旨在探究高功能自閉症類群障礙(High-Functioning Autism Spectrum Disorder, HFASD)兒童基本的運動知覺、動物生物性運動知覺、與人類生物性運動知覺之偏好注視表現與注意力時間歷程,逐步澄清HFASD兒童的生物性運動知覺表現與社會缺損的關聯性。此外,針對自閉症類群障礙的異質性,進一步探討HFASD兒童具智能優異特質者之生物性運動知覺表現。
研究方法:本研究共招募50名7至10歲之HFASD兒童與25名配對生理年齡與智力之TD兒童。本研究採偏好注視作業,以光點呈現三種運動刺激對比的視覺配對情境:(1)基本運動知覺:物體運動配對散亂運動;(2)動物生物性運動知覺:動物運動配對物體運動;(3)人類生物性運動知覺:人類運動配對動物運動。透過眼動追蹤技術測量受試兒童觀看各運動刺激之凝視時間比例與時間歷程之凝視可能性。研究亦涵蓋智力、症狀嚴重度、及適應行為評估。
研究結果:基本運動知覺方面,TD兒童與HFASD 兒童皆對散亂運動具偏好反應。生物性運動知覺方面,整體來說,TD與HFASD兒童皆較偏好動物與人類運動。時間歷程分析顯示,HFASD與TD兒童在相同的時間窗格對動物與人類運動產生偏好興趣。此外,在動物生物性運動知覺中,於時間歷程早期階段,HFASD兒童偏好動物運動之程度低於TD兒童,且偏好動物運動的程度與社會溝通缺損具相關性,於晚期階段,兩組偏好動物運動的程度無顯著差異。在人類生物性運動知覺中,於時間歷程早期階段,HFASD兒童偏好人類運動的程度與TD兒童相當,隨時間遞增,TD兒童維持對人類運動的偏好興趣,然而,HFASD兒童對人類運動的偏好興趣則逐步遞減,至晚期階段,HFASD兒童偏好人類運動的程度顯著低於TD兒童,且與自閉症狀具相關性。考量本研究HFASD兒童樣本之異質性,結果指出智能優異的HFASD兒童對動物生物性運動的偏好程度與TD兒童相當,但在人類生物性運動知覺中,智能優異組與非智能優異組皆隨時間遞增對人類運動的偏好興趣則逐步遞減。
總結:研究結果指出,HFASD兒童對生物性運動的偏好興趣及產生偏好的速度與TD兒童無明顯差異。但HFASD兒童對人類生物性運動偏好興趣的持續度較TD兒童低落,且不因認知優勢具補償作用。整體而言,顯示HFASD兒童的生物性運動知覺表現型態在反映其社會缺損上具有參考價值。本研究也進一步探討臨床應用、研究限制與未來的研究方向。 / Purposes: This study investigated the preferential attention and attentional processing on the basic motion perception, animal biological motion perception, and human biological motion perception in children with High-Functioning Autism Spectrum Disorder (HFASD). It aimed to explore the processing of biological motion perception in children with HFASD and the association to social deficit. Moreover, concerning the heterogeneity within ASD, the study examined the biological motion perception in intellectually gifted children within HFASD.
Method: Fifty children aged 7 to 10 years with HFASD and twenty-five children with typically development(TD)matched on age and IQ were recruited. The current study utilized preferential looking paradigm and motion point-light displays, demonstrating three visual comparison: (1) basic motion perception: object motion paired with scrambled motion; (2) animal biological motion perception: animal motion paired with object motion; (3) human biological motion: human motion paired with animal motion. Eye-tracking techniques were applied to measure proportion of dwell time and time course of fixation probability on each motion stimuli. Cognitive function, symptom severity, and adaptive function were also measured.
Result: In basic motion perception, children with TD and HFASD preferentially attend toward scrambled motion. In biological motion perception, generally, children with TD and HFASD preferentially attend toward animal motion and human motion. Time-course analysis revealed that children with TD and HFASD attended toward animal motion and human motion at the same time window. Moreover, in animal biological motion perception, children with HFASD showed lower preferential interest in animal motion than children with TD at the early stage of time course, and there were no significnant difference between groups at the late stage of time course. The results also found that the level of preference for animal motion was associated with the severity of social communication. In human biological motion perception, children with TD and HFASD showed similar level of preferential interest in human motion at the early stage of time course; afterthat, children with TD matained preferential interest in human motion across time, but children with HFASD reduced preferential interest in human motion across time. At the late stage of time course, children with HFASD showed significantly lower level preferential interest in human motion than children with TD, and it was associated to symptom severity. Concerning the heterogeneity within the study sample of HFASD, results indicated that there was no difference on the level of preferential interest in animal motion between intellectually gifted HFASD (IG-HFASD) and TD group; however, in human biological motion perception, IG-HFASD and nonIG-HFASD group reduced preferential interest in human motion across time course compared to TD group.
Conclusion: Findings suggested that children with HFASD exhibit the equivalent preferential interest and speed of attending to biological motion as did TD children. However, children with HFASD reduced referential interest in human biological motion across time course compared to TD children, and not influenced by the intellectually gifted advantage with compensation. The results implicated that biological motion perception may play an important role to understanding the social deficit in children with ASD. Theoretical and clinical implications of the study were discussed.
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