學齡前自閉症類兒童的適應行為型態與認知功能及症狀嚴重度之關連

Relating Cognitive Competence and Diagnostic Severity to Adaptive Behavior Profiles in Preschool Children with Autism Spectrum Disorders

朱慶琳(Ching-Lin Chu) ； 黃宜珊(Yi-Shan Huang) ； 姜忠信(Chung-Hsin Chiang) ； 吳進欽(Chin-Chin Wu) ； 侯育銘(Yuh-Ming Hou)

《中華心理學刊》 54卷3期 (2012/09) Pp. 349-364

https://doi.org/10.6129/CJP.2012.5403.05

摘要

Purposes: The present study examined the profile of adaptive functioning in preschool children with autism spectrum disorders (ASDs) and its relationship to cognitive competence and severity of autistic symptoms. Methods: Adaptive behavior skills were assessed using the Vineland Adaptive Behavior Scales-Second Edition (VABS-II). Participants were 81 ASD children with chronological age (CA) between 26 and 61 months. In the first analysis, 32 ASD children with CA between 42 and 52 months, 30 children with developmental delay (DD) (CA: 42-52 months), and 31 typical-developing children (TD) (CA: 27-49 months). They were closely matched for mental age, nonverbal mental age, and verbal mental age. The second analysis involved a total of 81 ASD children. They were divided into high functional autistic spectrum disorders (HFASD) and low functional autistic spectrum disorders (LFASD) by developmental quotient. Results: The VABS-II analysis revealed a 'motor ＞ communication = daily living skills ＞ socialization' profile as indexed by standard score and age equivalence. This was counter to the profile 'daily living skills ＞ communication ＞ socialization' presumed to be shown in autism. Overall, children with ASD lagged behind the two non-ASD groups. In the second analysis, partial correlation analysis controlling cognitive status showed that none of VABS-II domains were correlated to diagnostic features as reported by the Autism Diagnostic Observation Schedule (ADOS) in either HFASD or LFASD. Conclusions: The present findings suggest that there is no 'autism-specific profile' in preschoolers with ASD. Children with ASD exhibited a weakness in socialization domain even their cognitive competency was controlled.

關鍵字

自閉症類 ； 症狀程度 ； 發展遲緩 ； 輪廓 ； 適應行為

並列摘要

Purposes: The present study examined the profile of adaptive functioning in preschool children with autism spectrum disorders (ASDs) and its relationship to cognitive competence and severity of autistic symptoms. Methods: Adaptive behavior skills were assessed using the Vineland Adaptive Behavior Scales-Second Edition (VABS-II). Participants were 81 ASD children with chronological age (CA) between 26 and 61 months. In the first analysis, 32 ASD children with CA between 42 and 52 months, 30 children with developmental delay (DD) (CA: 42-52 months), and 31 typical-developing children (TD) (CA: 27-49 months). They were closely matched for mental age, nonverbal mental age, and verbal mental age. The second analysis involved a total of 81 ASD children. They were divided into high functional autistic spectrum disorders (HFASD) and low functional autistic spectrum disorders (LFASD) by developmental quotient. Results: The VABS-II analysis revealed a 'motor ＞ communication = daily living skills ＞ socialization' profile as indexed by standard score and age equivalence. This was counter to the profile 'daily living skills ＞ communication ＞ socialization' presumed to be shown in autism. Overall, children with ASD lagged behind the two non-ASD groups. In the second analysis, partial correlation analysis controlling cognitive status showed that none of VABS-II domains were correlated to diagnostic features as reported by the Autism Diagnostic Observation Schedule (ADOS) in either HFASD or LFASD. Conclusions: The present findings suggest that there is no 'autism-specific profile' in preschoolers with ASD. Children with ASD exhibited a weakness in socialization domain even their cognitive competency was controlled.

並列關鍵字

adaptive behavior ； autism spectrum disorders ； developmental delay ； profile ； symptom severity

參考文獻

(Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (1999). Autism diagnostic observation schedule (ADOS). Los Angeles, CA: Western Psychological Services.).

American Psychiatric Association(2000).Diagnostic and statistical manual of mental disorders.Washington, DC:Author.

Bölte, S.,Poustka, F.(2002).The relation between general cognitive level and adaptive behavior domains in individuals with autism with and without comorbid mental retardation.Child Psychiatry & Human Development.33,165-172.

Burack, J. A.,Volkmar, F. R.(1992).Development of low‐ and high‐functioning autistic children.Journal of Child Psychology and Psychiatry.33,607-616.

Carter, A. S.,Volkmar, F. R.,Sparrow, S. S.,Wang, J.-J.,Lord, C.,Dawson, G.(1998).The Vineland Adaptive Behavior Scales: Supplementary norms for individuals with autism.Journal of Autism and Developmental Disorders.28,287-302.