Despite an increased interest in autism over the last decades, little research exists about life outcomes of autistic adults. The earliest follow-up studies of autistic individuals suggested that self- understanding and conscious efforts to change could be crucial factors in successfully reaching good life outcomes. However, these initial suggestions have not been further investigated. Therefore, this exploratory qualitative study examined the lives of eight highfunctioning autistic adults aged 25 to 63, from their own perspectives, through in-depth, semistructured interviews, to consider the relation of self-understanding and conscious efforts to change—in this study referred to as intentional personal development—to their life outcomes. All participants demonstrated a level of self-understanding beyond what would be predicted by current theoretical models of autism. Their self-understanding was assessed through participants’ self-definitions, meaning-making of life experiences, and understanding of emotions. In their self-definitions, the participants emphasized their abilities and personality characteristics, rather than their disabilities. For their self-defining memories, as indicators of their meaning making of life experiences, most participants chose positive experiences related to their personal development. Their autobiographical accounts revealed that most participants possess a large iii repertoire of emotion words, supporting an understanding of emotions. When a good life outcome is defined traditionally—as being employed, living independently, and having social relationships—this study, contrary to expectations, did not provide overwhelming evidence for the significant role of intentional personal development in achieving this. However, when a good life outcome is defined in terms of achieving personal excellence, then the study did provide confirmation of intentionality as important to attaining good life outcomes. This study therefore suggests that traditional life outcome measures are inadequate for assessing the life outcomes of autistic individuals because such measures do not take into account the individuals’ own sense of satisfaction with themselves and with their lives.

Despite an increased interest in autism over the last decades, little research exists about life outcomes of autistic adults. The earliest follow-up studies of autistic individuals suggested that self- understanding and conscious efforts to change could be crucial factors in successfully reaching good life outcomes. However, these initial suggestions have not been further investigated. Therefore, this exploratory qualitative study examined the lives of eight highfunctioning autistic adults aged 25 to 63, from their own perspectives, through in-depth, semistructured interviews, to consider the relation of self-understanding and conscious efforts to change—in this study referred to as intentional personal development—to their life outcomes. All participants demonstrated a level of self-understanding beyond what would be predicted by current theoretical models of autism. Their self-understanding was assessed through participants’ self-definitions, meaning-making of life experiences, and understanding of emotions. In their self-definitions, the participants emphasized their abilities and personality characteristics, rather than their disabilities. For their self-defining memories, as indicators of their meaning making of life experiences, most participants chose positive experiences related to their personal development. Their autobiographical accounts revealed that most participants possess a large iii repertoire of emotion words, supporting an understanding of emotions. When a good life outcome is defined traditionally—as being employed, living independently, and having social relationships—this study, contrary to expectations, did not provide overwhelming evidence for the significant role of intentional personal development in achieving this. However, when a good life outcome is defined in terms of achieving personal excellence, then the study did provide confirmation of intentionality as important to attaining good life outcomes. This study therefore suggests that traditional life outcome measures are inadequate for assessing the life outcomes of autistic individuals because such measures do not take into account the individuals’ own sense of satisfaction with themselves and with their lives.

Abstract This research explored, within the framework of relevance theory, how normally developing 3- to 9-year-old children and two age groups (age 7–9 and age 10–12) of children with Asperger syndrome or high-functioning autism (AS/HFA) and their 7- to 9-year-old control group used context when answering questions and giving explanations for their correct answers. The children were asked questions targeting the pragmatic processes of reference assignments, enrichments, routines, implicatures and feelings. They were also asked to explain their correct answers to routine, implicature and feeling questions to elicit understanding about their awareness of how they had derived the answers from the context. In normally developing children the largest increase in correct answers occurred between the ages of 3 and 4 in all question types except feeling questions, where rapid development continued until age 5. After that development progressed more gradually until the age of 8 when the children performed near the ceiling level in all of these question types. Giving explanations for correct answers developed gradually between the ages of 3 and 9, indicating that becoming aware of the information used in inferencing has a longer developmental timeframe. Children's incorrect answers and explanations showed that, as children develop, their answering strategies become more sophisticated as they increasingly utilise context in different ways. Children with AS/HFA were able to answer all the question types. However, compared to the control group, the younger AS/HFA group did less well when answering contextually demanding questions, and the performance of the older AS/HFA group fell in between the younger AS/HFA group and the control group. Both AS/HFA groups had difficulties when giving explanations for their correct answers, showing difficulty in articulating explicitly how they had used context in arriving at the correct answer. Incorrect answers and explanations indicated that, usually, all the children tried to utilise contextual information, although the attempt failed somehow. For children with AS/HFA it was more typical to continue with their answer after first giving a correct answer or explanation, which then led to an irrelevant answer, suggesting that these children had difficulties with stopping processing at the relevant point. / Tiivistelmä Tutkimuksessa tarkasteltiin, kuinka normaalisti kehittyneet 3–9-vuotiaat lapset ja kaksi ikäryhmää lapsia (7–9-vuotiaat ja 10–12-vuotiaat), joilla on Aspergerin oireyhtymä tai hyvätasoinen autismi (AS/HFA) ja heidän 7–9-vuotiaista koostuva kontrolliryhmänsä, käyttivät kontekstia vastatessaan kysymyksiin ja perustellessaan oikeita vastauksiaan. Tutkimus tehtiin relevanssiteorian viitekehyksessä. Lapsilta kysyttiin pragmaattista prosessointia vaativia kysymyksiä, jotka arvioivat viittausten, epätäydellisten lauseiden, rutiinien, implikatuurien ja tunnetilojen ymmärtämistä. Lisäksi heidän tuli perustella oikeat vastaukset rutiini-, implikatuuri- ja tunnekysymyksiin, jotta nähtiin, olivatko lapset tietoisia, kuinka he olivat johtaneet vastauksensa kontekstista. Normaalisti kehittyneillä lapsilla oikeiden vastausten määrä lisääntyi nopeasti 3. ja 4. ikävuoden välillä kaikissa kysymystyypeissä. Tunnekysymyksiin vastaamisessa tämä nopean kehityksen kausi jatkui 5. ikävuoteen saakka. Tämän jälkeen kehitys jatkui hitaampana 8 vuoden ikään saakka, jolloin lapset suoriutuivat lähes kaikista kysymyksistä kaikissa eri kysymystyypeissä. Perustelujen antaminen oikeisiin vastauksiin kehittyi asteittain 3. ja 9. ikävuoden välillä, mikä kertoi, että vastauksessa käytetyn informaation tiedostamisen kehittyminen tapahtui pitemmällä aikavälillä. Lasten virheelliset vastaukset ja perustelut osoittivat, että iän lisääntyessä lasten vastausstrategiat muuttuivat kehittyneemmiksi ja he hyödynsivät kontekstia monin eri tavoin. Lapset, joilla oli AS/HFA, osasivat vastata kaikkiin esitettyihin kysymystyyppeihin. Kuitenkin nuorempi AS/HFA-ryhmä suoriutui kontrolliryhmää heikommin ja vanhemman AS/HFA-ryhmän suoriutuminen sijoittui nuoremman ikäryhmän ja kontrolliryhmän suoriutumisen puoliväliin. Molemmilla AS/HFA-ryhmillä esiintyi vaikeuksia oikeiden vastausten perustelussa, mikä kertoi vaikeudesta ilmaista, kuinka he olivat käyttäneet kontekstia oikeaan vastaukseen pääsemiseksi. Virheelliset vastaukset ja perustelut osoittivat, että yleensä kaikki lapset pyrkivät kontekstin hyödyntämiseen vaikka epäonnistuivatkin siinä. Lapsille, joilla oli AS/HFA, oli tyypillisempää jatkaa vastaamista vielä oikean vastauksen tai perustelun antamisen jälkeen, mikä lopulta johti aiheesta syrjähtämiseen. Tämä kertoi vaikeudesta lopettaa prosessointi relevantissa kohdassa.

Les cliniciens soulèvent de plus en plus souvent la question de liens entre Troubles Autistiques et Haut Potentiel Intellectuel (HPI), en raison de signes cliniques parfois communs, en particulier avec le Syndrome d'Asperger (SA). Dans cette étude, nous avons comparé le profil clinique, cognitif, socio-émotionnel et moteur de 5 groupes (N = 75 ; 7 à 15 ans) : Autisme de Haut Niveau (AHN) ; SA ; HPI avec profil homogène à la WISC-IV (HPI HO) ; HPI avec profil hétérogène à la WISC-IV (HPI HE) et Contrôle. Les résultats montrent que le groupe HPI HO présente moins de spécificités cliniques, et obtient des performances globalement au-dessus de la norme et supérieures aux autres groupes, notamment en Mémoire de Travail et raisonnement fluide. Le groupe HPI HE se caractérise par des performances verbales significativement supérieures aux autres groupes. Il obtient un score déficitaire au « Quotient Autisme » (AQ), à l'échelle d'évaluation de la pragmatique du langage (CCC) et présente de légers troubles moteurs (coordination, contrôle postural, latéralité mal affirmée). Les groupes SA et AHN obtiennent les scores les plus déficitaires au AQ, à la CCC, en cognition sociale et présentent divers troubles moteurs. Les comparaisons de paires de groupes montrent que : le groupe HPI HO présentent de meilleurs compétences mnésiques et motrices que le groupe HPI HE, les deux groupes se distinguent significativement sur 38,9% de variables hors normes. Le groupe HPI HE présente de meilleures performances en cognition sociale que le groupe SA et les deux groupes se distinguent significativement sur 35,1 % de variables hors normes. Le groupe SA présente de meilleures performances verbales que le groupe AHN et les deux groupes se distinguent significativement sur 28,3 % de variables hors norme. Le sous-groupe HPI HE obtenant des scores très déficitaires au AQ (HPI HE AQ+) se distingue significativement du sous-groupe SA de haut niveau verbal sur seulement 4,8 % de variables hors norme. Ce sous-groupe HPI HE AQ+ présente un tableau clinique et un profil neuro-développemental proche du groupe SA mais ne présente pas de déficit en cognition sociale. Il existe un socle de caractéristiques communes entre ces différents groupes mais aussi des spécificités qui leur sont propres, renvoyant à des trajectoires développementales atypiques, peut-être portées par une étiologie commune. / The issue of the links between Autistic Disorders and High Intellectual Potential (HIP) is an increasing focus among clinicians on account of certain shared symptoms, in particular with Asperger's syndrome (AS). The present study compared clinical, cognitive, socio-emotional and motor profiles across five groups (n = 75, age 7-15 years): High-Functioning Autism (HFA), AS, HIP with a homogenous WISIV profile (HIP HO), HIP with a heterogeneous WISC-IV profile (HIP HE), and a control group. The results showed that the HIP HO group presented fewer clinical specificities, and achieved performances that were overall above the norms and higher than in the other groups, in particular for working memory and fluid reasoning. The HIP HE group was characterised by better verbal performances than the other groups. HIP HE scores were below the norms on the Autism Quotient (AQ), and on the Children's Communication Checklist (CCC), and this group presented minor motor disorders (coordination, postural control, poorly determined laterality). The AS and HFA groups obtained the lowest scores on the AQ and the CCC, and in social cognition, and presented various motor impairments. The paired comparisons of groups showed that the HIP HO group presented better memory performances than the HIP HE group, and the two groups were significantly different for 38.9% of the variables falling outside the norms. The HIP HE group presented better performances in social cognition than the AS group, and the two groups were significantly different for 35.1% of the variables outside the norms. The AS group presented better verbal performances than the HFA group, and these groups differed significantly for 28.3% of the variables outside the norms. The HIP HE subgroup that obtained very low scores on the AQ (HIP HE AQ+) was significantly distinct from the AS subgroup with high-verbal skills for just 4.8% of the variables outside the norms. The HIP HE AQ+ subgroup exhibited a clinical presentation and a neuro-developmental profile that was close to the AS group, but presented no deficit in social cognition. There is a common core of features across these different groups, but there are also features specific to each, suggesting atypical developmental trajectories, possibly with a common aetiology.

A qualitative case study research design is used to investigate the results of a neuropsychological test battery, collated and used with four individual cases. A literature study consisting of research with respect to AS as well as neuropsychological assessments provides the theoretical framework from which existing theory is tested and expanded on. The cases are analysed individually and then by cross case analysis to ascertain any patterns of strength and weaknesses which could result in a "typical" profile of a learner with AS. Findings conclude confusions with respect to diagnostic criteria for AS and a distinction of DSM-IV-TR criteria is used. The neuropsychological test battery includes questionnaires (personal history, Gilliam Asperger's disorder scale, Conners' parent and teacher questionnaire, Dunn's sensory profile) interviews (parents, teachers), observations (classroom and playground) and formal testing (intelligence, motor functions, academic achievement, theory of mind and executive functions). Findings from the literature show similarities between AS children and children with non verbal learning disabilities. Evidence of AS differing from individuals with high functioning autism is conclusive in all previous research using theory of mind tests. Evidence from the literature shows many children had been given another diagnosis, typically ADHD, before being given the diagnosis of AS. Additional disorders such as anxiety and depression were also given. AS children had consistent difficulties with social interaction. A typical neuropsychological profile of AS is not identified, but rather a "personality type" that is dominated by anxiety and individual "quirks" of personality which affects responses to the formal test battery - thereby influencing the scores obtained. Two of the cases presented with an academic profile similar to that of a non verbal learning disability and one presented with similarities with a semantic pragmatic disorder. The thesis concludes with a proposed differentiating model of behavioural, communication and learning disorders in which AS is defined in terms of that originally described by Hans Asperger himself, and specifically treated within the education environment. / Educational Studies / D.Ed. (Psychology of Education)

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.

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.

A qualitative case study research design is used to investigate the results of a neuropsychological test battery, collated and used with four individual cases. A literature study consisting of research with respect to AS as well as neuropsychological assessments provides the theoretical framework from which existing theory is tested and expanded on. The cases are analysed individually and then by cross case analysis to ascertain any patterns of strength and weaknesses which could result in a "typical" profile of a learner with AS. Findings conclude confusions with respect to diagnostic criteria for AS and a distinction of DSM-IV-TR criteria is used. The neuropsychological test battery includes questionnaires (personal history, Gilliam Asperger's disorder scale, Conners' parent and teacher questionnaire, Dunn's sensory profile) interviews (parents, teachers), observations (classroom and playground) and formal testing (intelligence, motor functions, academic achievement, theory of mind and executive functions). Findings from the literature show similarities between AS children and children with non verbal learning disabilities. Evidence of AS differing from individuals with high functioning autism is conclusive in all previous research using theory of mind tests. Evidence from the literature shows many children had been given another diagnosis, typically ADHD, before being given the diagnosis of AS. Additional disorders such as anxiety and depression were also given. AS children had consistent difficulties with social interaction. A typical neuropsychological profile of AS is not identified, but rather a "personality type" that is dominated by anxiety and individual "quirks" of personality which affects responses to the formal test battery - thereby influencing the scores obtained. Two of the cases presented with an academic profile similar to that of a non verbal learning disability and one presented with similarities with a semantic pragmatic disorder. The thesis concludes with a proposed differentiating model of behavioural, communication and learning disorders in which AS is defined in terms of that originally described by Hans Asperger himself, and specifically treated within the education environment. / Educational Studies / D.Ed. (Psychology of Education)