- 學位論文
電腦化語彙理解分析軟體應用於學齡前亞斯伯格症兒童語言表徵之研究
Applying Computer-Assisted PPVT-R to Mandarin Preschool-Age Children with and without Asperger Syndrome
摘要
摘要 簡介： 本研究主要探討亞斯伯格症候群（Asperger's syndrome, AS）兒童，在語彙理解能力上的表現，是否會因施測模式的不同而在得分表現上有所差異。因AS兒童具有正常語言發展能力，卻因其仍伴隨有泛自閉症疾患（autistic spectrum disorders, ASD）特質，故AS兒童與社會進行人際互動時，仍普遍存在有語言溝通的障礙，且其障礙會持續至成年期。 在臨床上常見初次接受評估的AS兒童因不熟悉環境、且必須單獨面對陌生治療師，而多出現不願開口或哭鬧的情緒問題，而導致評估無法進行或是測驗一直中斷，在評估時得到的分數結果上，也較無法準確得到兒童的實際能力，在給予建議及障礙嚴重程度的判斷上，也較為不準確。 過去研究結果指出：泛自閉症患者在處理圖片-文字的作業比單純文字-文字的作業表現上較佳，顯現出圖片比文字較易讓自閉症患者理解語意，故本篇研究採用AS兒童表現能力較佳的圖片呈現方式，並配合電腦化介面，利用其優勢的視覺空間操作能力及可獨立操控測驗流程的特性，吸引兒童專注於電腦介面並且轉移與人互動的社交困難，進而測得AS兒童的語言理解能力。 材料與方法： 本篇研究以電腦化語彙理解分析軟體，利用web介面，設計可將圖形、聲音整合於MySQL資料庫中存取的軟體，並具有自動計分、自動分析及儲存於資料庫中的功能。藉由讓AS兒童獨立操控電腦進行語彙理解評估，除可轉移兒童對陌生情境的焦慮感，亦能增加其表現。此外，因為不需要口語作答，只需指認四選一的圖片，較可減少因需要使用口語，而影響其表現的狀況，以電腦化配合圖片施測，亦較容易讓AS兒童增加其專注於測驗內容。 研究結果： 本篇研究結果顯示：使用paper based PPVT-R及Computer-Assisted PPVT-R之正常組兒童，在得分表現的比較上，兩者間並未有統計上的顯著差異；而使用paper based PPVT-R及Computer-Assisted PPVT-R方式，分別施測於AS組兒童時，其在得分表現的比較上，兩者達顯著差異，Computer-Assisted PPVT-R之兒童其得分表現較高。在比較電腦化正常組及電腦化AS組兒童在個別得分詞彙類別向度上的表現時，亦發現AS組兒童在「與人有關的術語」及「人身體各部分」類得分較正常組低並達到顯著差異，此與AS組兒童的不善與人交際之自閉症特質有相關。 由實驗結果得知：利用電腦化施測AS兒童，的確可以增加其測驗的得分表現，並與傳統紙本測驗結果相比，達到統計上的顯著差異，藉由電腦為施測工具，提升AS兒童在陌生測驗情境中的表現，而讓其得分更趨於其實際的理解能力表現。 結論： 本研究利用電腦化畢保德圖畫詞彙測驗（Computer-Assisted PPVT-R）作為兒童語彙理解測驗的工具，的確收到受試者較傳統紙本測驗時更正常穩定的施測表現的功效，尤其針對AS兒童，去除環境變動與社交困難的因素後，更能讓其專心於施測內容，此優點並反映於得分顯著優於傳統紙本測驗的表現上，並希冀提醒臨床語言治療師們，在使用紙本測驗進行AS兒童語彙理解測驗的評估時，應考慮是否有來自非其能力的不利因素干擾，而低估其理解能力的可能性，利用不同的施測方式作為評估工具，給予AS兒童更適切的療育建議。
並列摘要
Introduction Asperger’s syndrome (AS) is a developmental disorder classified as one of the pervasive developmental disorders (PDDs). AS falls within a subgroup of PDDs commonly referred to as autism spectrum disorders (ASDs). Children with AS is limited in their linguistic and cognitive abilities and are characterized by significant difficulties with social communication and play as well as being restricted, rigid, and exhibiting repetitive behaviors. The social disability of children with AS is usually extended into adulthood. In clinical settings, initial assessment of AS children often reveals them to be afraid of unfamiliar environment. When they have to speak to the speech language pathologist alone, they are often unable to express anything, and appear anxious when they have to participate in speech evaluation. As a result, the assessments are often inaccurate depictions of the actual speech comprehensive of the children. Past research has shown that children with AS performed better with picture to word versus word to word models. This distinct advantage reveals the fact that people with AS understand semantics better through pictures than words alone. In this study, we use pictures on computers to provide a focal point for kids during the computer-assisted assessment. Using this method, we are able to get more accurate representations of the actual vocabulary comprehension capabilities of AS children. Materials and Methods This study used a Computer-Assisted PPVT-R mediating web interface and uses graphics and sounds integrated into the MySQL database software. This software has the function of automatic scoring, analysis, and data storage. Using the computer interface for the initial assessment has shown to reduce the anxiety of the children, and enhance test performance. AS children only have to point to one of the four pictures on the PPVT-R which reduces the inaccuracy resulting from verbal expression. This Computer-assisted testing mode allows AS children to pay attention to the test content rather than being distracted by the environment. Result The results showed that there were no significant difference between Computer-Assisted PPVT-R score and paper based PPVT-R score for children with normal development. However, there was a significant increase in the Computer-Assisted PPVT-R score versus the paper based PPVT-R score in AS children. As a result, using Computer-Assisted PPVT-R on the AS children can reveal test results that are closer to their actually capabilities and allow for more accurate assessment of research data. Using the Computer-Assisted PPVT-R assessment method, we then administered tests for “social language” and “parts of the human body” for the children with AS. The resulting score for children with AS was found to be significantly lower than children with normal developmental which shows children with AS may be slower in their social development which can be related to their autistic disposition. Conclusion We use a new tool to evaluate the receptive language performance for children by using Computer-Assisted PPVT-R and found the computer based assessment to be a much more accurate tool than the paper based PPVT-R. The AS children was able to maintain more focus on the test and less distracted by the environment. As a result, given the same test content, the study reveals that the Computer-Assisted PPVT-R was able to help the kids achieve higher and more accurate scores of the their actual ability than the paper counterpart. There was still a gap in the test scores between AS children and normal children especially in socially based topics, but the new assessment method at gave a more accurate depiction of actual discrepancy and can be the basis of future learning protocol for kids with AS.