自閉症類群障礙症孩童與一般發展孩童心智理論能力與表現之比較

A Comparison of Theory of Mind Capacity and Performance in Children with Autism Spectrum Disorder and Typical Development

邱琬庭(Wan-Ting Chiu) ； 李雅珍(Ya-Chen Lee) ； 林健禾(Chien-Ho Lin) ； 江岱蓉(Dai-Rong Jiang) ； 陳承德(Cheng-Te Chen) ； 陳官琳(Kuan-Lin Chen)

《職能治療學會雜誌》 34卷2期 (2016/12) Pp. 198-213

https://doi.org/10.6594/JTOTA.2016.34(2).03

摘要

評估掌握自閉症類群障礙症(autism spectrum disorder, ASD)孩童的心智理論(theory of mind, ToM)是介入其社交困難的關鍵。孩童的ToM評估可分為能力(capacity)與表現(performance)二層面。然而，目前多是以實驗室標準化情境作業評估孩童ToM能力，而非日常生活中實際的ToM表現，其ToM能力的評估結果無法直接類推至表現。此外，國內關於孩童ToM的研究為數不多，更鮮少同時比較ASD孩童與一般發展(typically developing, TD)孩童的ToM表現。因此，臨床人員無法瞭解ASD與TD孩童ToM能力與表現之差異，進而無法提供相對應的介入。故本研究目的為同時比較ASD與TD孩童的ToM能力及表現之差異。共62位以語言理解能力配對之3-7歲的孩童參與此研究，ASD與TD孩童各31名，平均皆具中等程度語言理解能力。本研究分別以心智理論測驗(Theory of Mind Task Battery, ToMTB)與心智理論量表中文版(Chinese version of Theory of Mind Inventory-2, ToMI-2-C)評估孩童之ToM能力與表現。以二因子變異數分析(two-way ANOVA)檢驗ASD與TD組在ToMTB與ToMI-2-C分數是否有顯著差異。結果發現ASD與TD組的ToMTB與ToMI-2-C分數皆達顯著差異(p＜0.000)。此外，由研究結果亦得知，ASD組孩童的ToM能力與表現皆落後TD組一個發展階段，對3-7歲具中等程度語言理解能力的ASD孩童來說，不論是ToM的能力或表現，從基本ToM過渡到進階ToM可能是發展的瓶頸。本研究結果可作為ASD孩童臨床評估（ToM能力與表現）與其治療計畫擬定之實證參考。

關鍵字

自閉症類群障礙症 ； 一般發展孩童 ； 心智理論

並列摘要

Assessments of ToM can be divided into two constructs: capacity and performance, which represent the ToM function in the laboratory and daily context, respectively. However, only few studies examine the ToM capacity and performance simultaneously in children with autism spectrum disorder (ASD) and typically developing (TD) children. Therefore, this study was to examine whether the differences exist in both ToM capacity and performance between children with ASD and TD children to fully capture the ToM of children with ASD. A total of 62 children aged 3 to 7 years, including 31 children with ASD and 31 TD children matched for their verbal ability, participated in this study. The Theory of Mind Task Battery and the Theory of Mind Inventory-2-Chinese version were administered to assess children's ToM capacity and performance, respectively. Two-way analysis of variance was used to examine whether there were significant differences in ToM capacity and performance between children with ASD and TD children. We found that significant differences existed in ToM capacity (F5.61, p = .021) and performance (F23.13, p ＜ .000) between children with ASD and TD children. Additionally, most of children with ASD were in the stage of the basic mental development, while most of TD children were in the stage of advanced mental development. This result suggests that children with ASD are one stage behind TD children in both ToM capacity and performance, although their verbal comprehension was at the same level of TD children. Results highlight the importance to assess ToM capacity and performance in children with ASD.

並列關鍵字

Autism Spectrum Disorder ； Typically Developing Children ； Theory of Mind