輕度自閉症幼兒智能、氣質和情緒與行為問題之研究

本研究目的是探討輕度自閉症幼兒(簡稱輕度ASD幼兒)之智能、氣質和情緒與行為問題之關係，有助於早期發現自閉症幼兒的問題，進而擬定適性的早期療育計畫，提升他們的適應功能。本研究選取魏氏幼兒智力量表-第四版(中文版)(WPPSI-IV)智力70以上且具口語能力的對象共有輕度ASD幼兒74位為研究對象，依生理年齡分為低年齡組(2歲6個月至3歲11個月)共34位，高年齡組(4歲至6歲)共40位。再依全量表智商(FSIQ)分類，高於等於85分為高組共48位，低於85分為低組共26位。所有研究對象皆接受研究者以WPPSI-IV(中文版)檢測他們的智能，以及其家長填寫高功能自閉症/亞斯伯格症兒童行為檢核表(學前版)、兒童氣質量表（BSQ）、學齡前期兒童行為檢核表(CBCL/1½−5)。研究結果指出: 一、輕度ASD幼兒智能:輕度ASD幼兒智能多在中等範圍，智能表現組型為語文理解表現最佳，工作記憶表現最弱。高低年齡組的全量表的分佈不同，低年齡組全量表在臨界範圍佔比率最多，高年齡組則在中等範圍佔比率最多。高年齡組視覺空間表現相對最佳，工作記憶表現相對最弱，低年齡組則語文理解表現相對最佳，工作記憶表現相對最弱，兩組在語文理解與視覺空間有顯著差異，均是高年齡組優於低年齡組。不同智能組的所有智能指數組間皆有差異，均是高組優於低組。高組語文理解與視覺空間表現最佳，其次是流體推理，工作記憶與處理速度表現弱；低組，各能力表現較接近，流體推理、語文理解、處理速度與視覺空間表現較佳，工作記憶表現較弱。二、輕度ASD幼兒氣質表現:輕度ASD男童與同齡同性別常模比較，較趨近環境、情緒較正向，3歲輕度ASD男童活動量較低、適應佳，5歲輕度ASD男童則還有反應強度較強；不同生理年齡組間氣質沒有顯著差異；高低智能組有3項氣質向度有差異，低組反應強度較低，情緒較負向，堅持度高。三、輕度ASD幼兒情緒與行為問題: 輕度ASD幼兒有較多情緒反應、身體抱怨、退縮、睡眠、注意力、內化問題與整體問題；高年齡組有較多情緒反應；低組有較多退縮問題。四、輕度ASD幼兒智能、氣質和情緒與行為問題之關係: (一) 輕度ASD幼兒的智能指數與情緒反應、睡眠、外化、整體問題呈顯著正相關，且達差異；與退縮呈顯著負相關，但只能以全量表智能預測退縮問題。 (二) 輕度ASD幼兒的氣質對情緒與行為問題具有預測力，規律性對整體問題、睡眠問題具有顯著預測力；趨避性對退縮具有顯著預測力；反應閾值對注意力具有顯著預測力。 (三) 輕度ASD幼兒症狀的嚴重度對情緒與行為問題具有預測力，行為症狀嚴重度對整體問題、身體抱怨、外化問題具有顯著預測力。社會症狀嚴重度可預測退縮問題。 (四) 輕度ASD幼兒的整體症狀、全量表智能、氣質可預測內化問題，但只有整體症狀對可以解釋內化問題13.2%的變異量。以症狀、全量表、氣質可以預測外化問題的所有變異量36.5%，但只有活動量可以解釋外化問題9%的變異量，規律性可以解釋外化問題11.7 % 的變異量。研究限制:由於本研究樣本數少，在推論輕度自閉症幼兒的智能、氣質、情緒與行為問題的關係有限，以及沒有對照組，在了解輕度自閉症幼兒的智能、氣質、情緒與行為問題組間差異亦有限，未來可增加樣本數，對照組、臨床群組，深入了解輕度自閉症幼兒的獨特性與特異性，進而擬定更適性的介入方案。

關鍵字

輕度自閉症幼兒；智能；氣質；情緒與行為問題

並列摘要

The study aims to understand intelligence、temperament and emotional and behavioral problems for preschoolers with mild ASD, to investigate the relationship among intelligence, temperament and emotional and behavioral problems. The subjects were 74 mild ASD children ( age groups : 2 yr. 6 mo. to 3 yr.11mo.N=35, Young group； 4 yr. 0 mo. to 6 yr. 0 mo. N=48, Elderly group in chronological age) without mental retardation(FSIQ≧70, FSIQ groups : FSIQ≧85, High FSIQ group；FSIQ < 85, Low FSIQ group) and their mothers. Measures included: (1)Wechsler Preschool And Primary Scale Of Intellgence -Fourth Edition (WPPSI-IV), (2) Behavior Style Questionnaire (BSQ), (3) Child Behavior Checklist (CBCL), (4) Checklist for High Function Autism/ Asperger’s. All the children were individually evaluated for their intelligence. Parents rated the participating children on their ASD symptoms (Checklist for High Function Autism/ Asperger’s), temperament (BSQ), , and emotional and behavioral problems (CBCL). The main result of this research was as follows: 一、 Mild ASD intellgence: Full Scale Intelligence Quotient (FSIQ) performance was average range , the verbal comprehension index (VCI) performance was the best, and the working memory index (WMI) performance was the weakest among the five factor indices. Mild ASD in WPPSI-Ⅳ had its unique cognitive profile .The different age groups of mild ASD in VCI and VSI index score were with statistical significant difference, Elderly ASD was higher than the Young ASD. The different FSIQ groups of mild ASD in each index score were with statistical significant difference, high FSIQ group of ASD was higher than the low FSIQ group of ASD. 二、 Mild ASD temperament: Mild ASD’s approach/withdraw and quality of mood were lower than normal . The low FSIQ group’s intensity of reaction and persistence were lower than the high FSIQ group. The low FSIQ group’s quality of mood were higher than the high FSIQ group. 三、 Mild ASD emotional and behavioral problems: Mild ASD group significantly higher on total problems, internalizing problem, externalizing problem. Elderly ASD was higher emotional reaction than the Young ASD. The low FSIQ ASD was more withdrawal problem. The high FSIQ ASD was more emotional reaction. 四、 Mild ASD the relationship among intelligence, temperament and emotional and behavioral problems : The behavioral symptomatology could predict the total problems, somatic problems, externalizing problem. The social symptomatology, FSIQ and approach/withdraw could predict the withdrawal problem. The rhythmicity could predict the total problems, sleep problem. The threshold could predict the attentional problem. Because this research only aims at mild ASD, not making comparison with the typical develop child, therefore, it is unable to understand differences between mild ASD and the typical develop child or other clinical barrier groups, it is suggested the future research might aim at some specific groups to distinguish for comparison research.