高功能泛自閉症學童執行功能與侷限重複症狀之初探

Executive Function and Restricted, Repetitive Symptoms in School-Age Children with High-Function Autistic Spectrum Disorders

李竹芳(Chu-Fang Lee)

指導教授 ： 洪福建 ； 陳質采

中原大學/理學院/心理學系/碩士(2009年)

https://doi.org/10.6840/cycu200900071

摘要

研究背景與目的. 近年來，關於高功能泛自閉症執行功能理論之研究受到許多學者關注，雖過去國內外相關研究結果，未一致指出高功能泛自閉症執行功能上特定缺損能力，然多數皆證實泛自閉症執行功能特殊剖繪，且研究結果發現其執行功能缺損與泛自閉症侷限重複之核心症狀之間具關聯性。國內已有研究者對於泛自閉症執行功能之計畫能力與認知彈性能力，進行檢驗與了解；然對於執行功能其他能力與侷限重複症狀之間相關研究相對較少。故本研究為瞭解國內高功能泛自閉症學童之執行功能與侷限重複症狀之表現與相關，以冀提供臨床診斷之協助。

研究方法. 本研究包含12位高功能泛自閉症1至6年級小學學童，及34位正常發展之學童孩童，使用重複行為量表分析其侷限重複之症狀；於控制年齡與智力水準後，比較其五項執行功能領域表現（計畫能力、認知彈性能力、抑制能力、工作記憶能力、產生能力），分析高功能泛自閉症之執行功能相對優弱勢能力。接續，分析執行功能各領域與侷限重複之相關性；最後嘗試以執行功能表現，區辨與預測高功能泛自閉症組與控制組，以及預測其侷限重複行為表現。

研究結果. 本研究結果支持高功能泛自閉症執行功能剖繪。於計畫能力、認知彈性、抑制能力、及非語文產生能力方面，泛自閉症個案均顯著低於正常發展學童之表現；而於工作記憶與語文產生能力表現，兩組未達顯著差異。於執行功能與泛自閉症症狀行為之間關連性，結果發現多數執行功能與侷限重複症狀行為間具顯著相關，且以同一性行為量表相關最高。於執行功能之區辨力與預測性上，亦有正向的結果。

結論. 研究初步證實高功能泛自閉症執行功能理論，以及執行功能作業表現可區辨高功能泛自閉症與正常發展學童，並可預測侷限重複行為症狀。本研究在最後亦提出研究可能的限制，以及未來的研究方向。

關鍵字

侷限重複症狀 ； 工作記憶能力 ； 產生能力 ； 抑制能力 ； 認知彈性能力 ； 執行功能 ； 高功能泛自閉症 ； 計畫能力

並列摘要

Background and purpose. Recently, more and more researchers pay attention on the executive function theory of high-function autistic spectrum disorders（ASD）. Over the past few decades of literatures have no consensus on specifically executive dysfunction of high-function ASD, but most researchers have suggested that ASD has profile of executive function, and studies show relationship between executive dysfunction and restricted, repetitive symptoms of ASD. Several internal researchers have studied the planning and the cognitive flexibility of ASD for examination and comprehension, but there are fewer evidences for other domains of executive function and restricted, repetitive symptoms. Therefore, the main purpose of this study is to verify the relationship between restricted, repetitive behaviors and executive profile of high-function ASD on internal children ,and it may supply evidence to clinical diagnosis.

Method. This study is contributed by 12 children with high-function ASD, and 34 children with non-autism. Firstly, the Repetitive Behavior Scale-Revised is used to estimate the restricted, repetitive symptoms, and then, performances of five functions (planning, cognitive flexibility, inhibition, working memory, generativity) are compared to verify advantages and disadvantages on executive function of high-function ASD after controlling age and intelligence. In this way, the relationship between executive function and restricted, repetitive symptoms in any other domains can be analyzed. Finally, according to the performance of executive function, it can verifies and predicts the symptomatic organization of high-function ASD and the controlling organization, and it can forecast the performance of restricted, repetitive behaviors.

Results. The study results suggest the executive function profile of high-function ASD. Under planning, cognitive flexibility, inhibition, working memory, and generativity, the performances on high-function ASD are significantly lower than normal children. However, the performances of working memory and language generativity are no significant different. The results of the relation between most of executive function domain tasks and restricted, repetitive symptoms show a significant relationship, especially in Sameness Behavior Subscale. Under classification and prediction of executive function, those also show positive results.

Discussion. The study suggests executive function theory of high-function ASD. The executive function work can distinguish high-function ASD from normal children and it implies that restricted, repetitive symptoms could be predicted by the executive function. In the end, this report also proposes a possible restriction and future works.

並列關鍵字

executive function ； High-Function Autistic Spectrum Disorders ； planning ； cognitive flexibility ； inhibition ； restricted repetitive symptoms ； generativity ； working memory

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