學齡前自閉症類群障礙症兒童氣質、父母共親職與母親親職壓力

根據Abidin（1990）所建構之親職壓力模式，親子系統中的壓力來源，主要來自於兩大因素：父母因素（parent characteristics）與兒童因素（child characteristics），本研究認為在考量影響親職壓力之相關因素時，須額外納入家庭系統之觀點，才能更加廣泛地描繪父母於教養過程中所感受到的親職壓力之樣貌。親職壓力的來源除了父母、子女本身的個人因素外，父母教養間的合作與親子關係品質亦非常重要，因此，本研究將與夫妻雙方對彼此教養態度及信念有關之「共親職」，作為親職壓力之父母因素來源，進一步探討其與親職壓力間的關係。除了父母因素的影響外，兒童因素對於親職壓力亦具有相當程度之影響力，本研究認為氣質是重要的兒童因素來源，尤其當育有難養氣質的自閉症類群障礙症（autism spectrum disorder, 以下簡稱ASD）兒童時，相較於其他特殊兒童與一般兒童，ASD兒童之父母在養育過程更容易經驗到較為沉重的親職壓力（Hayes & Watson, 2013）。綜整而言，本研究在家庭系統觀點之脈絡下，探究兒童氣質（兒童因素）、母親所覺察到的共親職（父母因素），以及母親自身所感受到之親職壓力三者變項間的關聯。本研究採橫斷式研究設計，共招募106位學齡前ASD兒童（3歲0個月至7歲11個月）及其母親參與研究。母親共填答：親職壓力量表簡式版（Parenting Stress Index: Short Form, PSI/SF）、兒童行為量表（Children’s Behavior Questionnaire, CBQ）、共親職關係量表（Coparenting Relationship Scale, CRS）、自閉症類群障礙症檢核表（Checklist for Autism Spectrum Disorder-Chinese Version, CASD-C）以蒐集母親所知覺到之親職壓力分數、學齡前ASD兒童的氣質和母親覺察到的共親職、以及學齡前ASD兒童症狀嚴重度等資料。此外，研究者以魏氏幼兒智力量表第四版（WPPSI-IV）個別蒐集學齡前ASD兒童之全量表智商分數（FSIQ）。研究發現如下：一、學齡前ASD兒童氣質之「負向情感」可正向預測「親子失功能互動指標」、「困難兒童指標」及「母親親職壓力總分」，而「主動控制」可負向預測「親子失功能互動指標」、「困難兒童指標」及「母親親職壓力總分」；二、「支持性共親職」可負向預測「父母困擾指標」，「抵制性共親職」可正向預測「父母困擾指標」、「困難兒童指標」及「母親親職壓力總分」；三、「支持性共親職」可調節學齡前ASD兒童氣質之「騰動性／外向性」與「親子失功能互動指標」間的關係，而「抵制性共親職」可調節學齡前ASD兒童氣質之「負向情感」與「親子失功能互動指標」、「母親親職壓力總分」，以及學齡前ASD兒童氣質之「騰動性／外向性」與「親子失功能互動指標」間的關係；四、「抵制性共親職」在學齡前ASD兒童氣質之「負向情感」與「母親親職壓力總分」之關係中，具部分中介效果。本研究結果可提供臨床實務工作者以及育有學齡前ASD兒童之父母，更加瞭解並意識到父母共親職對於學齡前ASD兒童氣質親職壓力之預測，進而思考共親職可作為兒童氣質與親職壓力間的中介或調節角色，以凸顯在兒童療育的過程中，父母雙方合作之重要性。

關鍵字

自閉症類群障礙症；共親職；氣質；親職壓力；學齡前兒童

並列摘要

Abidin (1990) made a parenting stress model which included the range of variables and central components of parenting. Parenting stress model attempts to address the stress from the parent-child system, and divides into two major factors: the parent characteristics and the child characteristics. This study attempts to take into consideration on family systems perspective to explore the factors which affect parenting stress, and could be more comprehensive for describing parenting stress. The parenting stress should be consider not only from the personal factors of parents or children, but from the parent-parent and the parent-child relationships. For further exploring the dynamic relationship between it and parenting stress, coparenting could be a complex construct that shares characteristics with other areas of the family systems and defined as how mothers and fathers coordinate their parenting efforts and support/undermine each other in their roles as parents. Besides, temperament is considered the important child components of parenting stress. Due to the difficult temperament of autism spectrum disorder (ASD), parents of children with ASD are at risk for higher stress levels than parents of children with other developmental disabilities and typical development (Hayes & Watson, 2013). In conclusion, the study will investigate the relationship among the ASD preschoolers’ temperament, coparenting and maternal parenting stress in the context of the family systems perspective. This study conducted a cross-sectional design. 106 ASD children (aged from 3yr 0mo to 7yr 11mo) and their mother participated in this research. Several questionnaires were filled out by mothers as follows: Parenting Stress Index: Short Form (PSI/SF) for obtaining maternal parenting stress types index, Children’s Behavior Questionnaire (CBQ) for obtaining the temperament of preschool children with ASD, Coparenting Relationship Scale (CRS) for obtaining supportive and undermining coparenting index, Checklist for Autism Spectrum Disorder-Chinese Version (CASD-C) for obtaining the severity of ASD symptoms. In addition, Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV) were conducted individually to collect the Full Scale IQ (FSIQ) score of each ASD preschooler. Results are as follows: First, ASD preschoolers’ negative affect temperament positively predicted Parent-Child Dysfunctional Interaction, Difficult Child, and Total Scores of Maternal Parenting Stress, while ASD preschoolers’ effortful control temperament negatively predicted Parent-Child Dysfunctional Interaction, Difficult Child, and Total Scores of Maternal Parenting Stress. Second, Supportive Coparenting negatively predicted Parental Distress, while Undermining Coparenting positively predicted Parental Distress and Difficult Child. Third, Supportive Coparenting was a significant moderator between the ASD preschoolers’ surgency/extraversion temperament and Parent-Child Dysfunctional Interaction, while Undermining Coparenting could be the moderator between ASD preschoolers’ temperament (negative affect, surgency/extraversion) and several index of maternal parenting stress (Parent-Child Dysfunctional Interaction, Total Scores of Maternal Parenting Stress). Fourth, Undermining Coparenting was found as a significant partial mediator between the ASD preschoolers’ negative affect temperament and Total Scores of Maternal Parenting Stress. Our research finding could provide some suggest for the clinical practitioners and parents, that ASD’s temperament and coparenting predict maternal parenting stress. Furthermore, coparenting would be the mediator or moderator between the temperament of ASD preschoolers and maternal parenting stress. It will also implies that adjusting parent-parent relationship, which will lead to decrease the level of stress in parenting behavior.