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系統性文獻回顧:學齡期自閉症類群障礙兒童的動作障礙及其與社交溝通缺損之相關性

A Systematic Literature Review: Motor Impairments and the Relationship with Social Communication Deficits in School-Aged Children with Autism Spectrum Disorder

摘要


兒童罹患自閉症類群障礙(簡稱自閉症)的核心症狀為社交溝通缺損與侷限、重複的固著行為和興趣。近年來的研究顯示自閉症兒童在嬰幼兒至學齡期的動作發展比同齡正常兒童的發展落後。學齡期的自閉症兒童,其動作功能的障礙可能影響社交活動的參與,使其在動作技能上的學習和發展更為受限。因此,本篇文章對過去學齡期自閉症兒童的動作發展研究進行文獻回顧,並探討其動作障礙與社交溝通缺損之相關性。綜合文獻資料顯示,學齡期自閉症兒童在動作協調、模仿與實物操作、手部精細動作、姿勢控制與平衡、及動作計畫較同齡的正常兒童或注意力不足過動症、發展協調障礙、及語言發展遲緩的兒童差,並且自閉症兒童的動作功能與其社交溝通能力具有重要相關性。過去研究顯示社交溝通缺損越嚴重的自閉症兒童,其球類操控技能、模仿及實務操作能力的表現也越差。其動作障礙的原因可能和感覺調節、神經生理的缺損、及異常的動作學習模式有關。以知覺動作結合理論的觀點做解釋,自閉症兒童的動作障礙會影響兒童和同儕互動的機會,使其社交溝通能力更為低落,並且其社交障礙亦會長期影響兒童動作技巧。本篇的文獻回顧顯示,早期介入自閉症兒童的動作問題,對於改善其社交溝通症狀與動作發展有其重要性,物理治療師亟需對其動作問題進行臨床評估與積極治療,因此本篇文章亦介紹具實證基礎的行為介入方法,以提供對自閉症兒童的動作問題之介入策略。

並列摘要


The core symptoms of children with autism spectrum disorder (ASD) are deficits in social interaction and communication, and restricted, repetitive patterns of behavior, interests, or activities. Nowadays, a number of studies have indicated that, from infancy to school age, children with ASD showed slower motor development than their peers without ASD. For school-aged children with ASD, motor impairments may affect their participation in social activities and subsequently limit motor skill learning and development. Thus, the present study aims to review previous studies on the motor function and development of children with ASD, and to examine the relationship between motor impairments and social communication deficits. Previous studies suggested that children with ASD are less developed in abilities related to motor coordination, imitation and praxis, postural control, and motor planning than children of the same age without ASD, with attention deficit hyperactivity disorder, developmental coordination disorder, or language delay. In addition, previous studies observed a significant correlation between the motor coordination and social communication skills of children with ASD, indicating that, for these children, severe social communication difficulties associated with poor ball skills, imitation and praxis skills. These impairments in motor function may be caused by sensory modulation disorders, neurophysiological impairments, or abnormal motor learning. From the perspective of perception-action coupling, motor impairments prevent children with ASD from interacting with peers, deteriorate social communication skills, and meanwhile affect motor learning experience on a long-term basis. The literature shows that, for these children, early motor intervention is crucial to improving social communication deficits and long-term motor development. Moreover, they must receive comprehensive developmental assessments and intervention from physical therapists to reduce motor development problems. Therefore, a number of evidence-based behavior intervention approaches for children with ASD are introduced in this study to provide a reference for clinical intervention strategies.

並列關鍵字

ASD Motor Social communication School-aged children

被引用紀錄


張芷榕、佘永吉(2020)。功能性動作訓練課程對高中資源班自閉症學生動作精練度之成效特殊教育季刊(155),21-37。https://doi.org/10.6217%2fSEQ.202006_(155).21-38
洪暐珍、鍾儀潔、鳳華(2023)。語言行為與語言行為結合音樂教學對提升泛自閉症兒童互動式語言之成效與差異特殊教育學報(58),85-120。https://doi.org/10.53106%2f207455832023120058003

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