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研究生:林姿伶
研究生(外文):Tzu-Ling Lin
論文名稱:自閉症幼兒非語言溝通能力之研究
論文名稱(外文):Nonverbal Communication Skills in Young Children with Autism
指導教授:譚偉象譚偉象引用關係姜忠信姜忠信引用關係
指導教授(外文):Wai-Cheong Carl TamChung-Hsin Chiang
學位類別:碩士
校院名稱:中原大學
系所名稱:心理學研究所
學門:社會及行為科學學門
學類:心理學類
論文種類:學術論文
論文出版年:2003
畢業學年度:91
語文別:中文
論文頁數:129
中文關鍵詞:自閉症非語言溝通能力
外文關鍵詞:autismnonverbal communication skills
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摘 要

自閉症為一具有溝通及社會性缺陷,並伴隨特殊行為、興趣的廣泛性發展障礙。探討自閉症心理病理學的假說中,相互注意協調能力缺陷假說在80年代逐漸受到重視,其認為自閉症患者在早期非語言溝通能力的發展上,相互注意協調能力為其特定的缺陷,且影響後續語言發展;然而,有研究指出自閉症患者其他非語言溝通能力(如要求能力、社會互動能力)亦有發展遲緩或偏差的情形。本研究希望能夠在結構情境下,使用配對比較法,較系統地瞭解自閉症患者早期非語言溝通能力的發展。

本研究分為研究一與研究二。研究一主要目的在探討平均生理年齡42個月以下的自閉症幼兒與心理年齡配對之發展遲緩、大正常幼兒,以及另一組年齡更小之小正常幼兒在三種不同功能的非語言溝通能力(相互注意協調能力、要求能力、社會互動能力)的差異。研究二主要目的在探討各組幼兒早期非語言溝通能力與後續語言發展之關係。

研究一以早期社會溝通量表(ESCS)選取幼兒三種不同功能之溝通行為,除分析各組幼兒溝通行為次數的差異外,並嘗試分析各組幼兒溝通行為所佔比例的差異;研究受試包括自閉症幼兒23名、發展遲緩幼兒23名、大正常幼兒22名,小正常幼兒22名,共計90名。研究二使用學齡前兒童語言障礙評量表、修訂畢保德圖畫詞彙測驗兩種語言量表,追蹤研究一受試一年後的語文智商、接受性語言及表達性語言能力,以分析早期非語言溝通能力與後續語言發展的相關性;研究受試包括自閉症幼兒8名、發展遲緩幼兒8名、小正常幼兒11名,大正常幼兒12名,共39名。



本研究主要發現如下:
一、 自閉症幼兒非語言溝通能力與其他受試之比較
(1) 溝通行為次數:自閉症幼兒主動、回應相互注意協調能力行為次數顯著少於發展遲緩、正常幼兒;主動要求行為次數顯著少於正常幼兒;主動社會互動行為次數顯著少於發展遲緩幼兒。
(2) 溝通行為比例:自閉症幼兒在所有溝通行為中,相互注意協調能力所佔比例顯著低於發展遲緩、正常幼兒;要求能力所佔比例顯著高於發展遲緩幼兒。社會互動能力所佔比例顯著低於發展遲緩幼兒。
二、早期非語言溝通能力與後續語言發展的關係
(1) 自閉症幼兒回應相互注意協調能力與語文智商呈負相關;發展遲緩幼兒回應要求能力與接受性語言呈正相關;小正常幼兒主動相互注意協調能力與接受性語言呈正相關;大正常幼兒主動社會互動能力與表達性語言呈負相關。

本文最後,筆者進一步依本研究結果討論自閉症相互注意協調能力缺陷假說的後續研究方向,以及本研究的優、缺點,在臨床實務的應用方向。
Abstract

Recent data suggest that disturbance in the development of joint attention skills is a specific characteristic of young autistic children. However, some studies indicated that autistic children also have developmental disturbance in other nonverbal communication skills

This research had two main goals. The first one was using Early Social Communication Scale (ESCS) to examine the nonverbal communication production and comprehension skills of 23 under 42-month-old autistic children by comparing MA-matched developmental-delayed and normal children. The other goal was to examine the relation between early nonverbal communication skills and language skills one year later.

The results indicated: (1) Autistic children had significantly fewer joint attention behaviors than developmental-delayed and normal children. Also, Autistic children had significantly fewer requesting behaviors than normal children, and had significantly fewer social interaction behaviors than developmental-delayed children. (2) Autistic children had significantly lower proportion of joint attention behaviors in all communicational behaviors than developmental-delayed and normal children, and had significantly higher proportion of requesting behaviors in all communication behaviors than developmental-delayed children. (3) 14-month-old normal children had significantly fewer pointing behaviors of joint attention than 19-month-old normal children. (4) There was a significant relation between early nonverbal communication skills and subsequent language skills.

Thus, the results of this research suggest that young autistic children not only have a deficit in joint attention but also in social interaction. The results also suggest that there are some kinds of relations between early nonverbal communication skills and subsequent language skills, but those relations need more research to clarify. The implications of these findings for further research on autism are discussed.
目 錄

第一章 緒論……………………………………………………...…1
第一節 研究動機…...……………………………………….....1
第二節 自閉症之症狀表現…………………………………....2
第三節 自閉症兒童的非語言溝通能力………………………4
第四節 名詞解釋………………………………………………6
第二章 文獻探討………………………………………………….11
第一節 非語言溝通能力的理論背景………………………..11
第二節 正常兒童非語言溝通能力發展……………………..15
第三節 自閉症兒童非語言溝通能力發展…………………..23
第四節 非語言溝通能力與語言發展的關係………………..32
第五節 研究目的與假設……………………………………..37
第三章 研究一方法……………………………………………….40
第一節 研究樣本……………………………………………..40
第二節 早期社會溝通量表(ESCS)實驗設計…………….43
第三節 資料處理與分析……………………………………..47
第四章 研究一結果……………………………………………….54
第一節 初步分析……………………………………………..54
第二節 行為次數分析………………………………………..57
第三節 行為比例分析………………………………………..68
第五章 研究一討論……………………………………………….78
第一節 四組受試在非語言溝通能力上的差異……………..78
第二節 各組受試的非語言溝通能力發展…………………..88

第六章 研究二方法……………………………………………….98
第一節 研究樣本……………………………………………..98
第二節 研究工具……………………………………………199
第三節 實施程序…………………………………………....100
第四節 資料處理與分析……………………………………101
第七章 研究二結果……………………………………………...102
第一節 四組受試語言能力的比較…………………………105
第二節 四組受試非語言溝通能力與後續語言之相關……105
第八章 研究二討論……………………………………………...107
第九章 綜合討論………………………………………………...109
第一節 研究結論……………………………………………109
第二節 再論自閉症相互注意協調能力缺陷假說…………110
第三節 未來研究及應用方向……………………………....112

參考文獻……………………………………………………………..115
附錄一 ESCS作業的活動設計…………………………………...124

表 目 錄

表3-1 完成ESCS作業受試之生理年齡、發展年齡及智能之比較……………...42
表4-1 各組受試IQ與ESCS各行為之相關列表………………………………… 54
表4-2 四組受試在ESCS作業上實施時間的比較…………………………………55
表4-3 四組受試在ESCS作業中總行為次數之比較………………………………56
表4-4 四組受試在ESCS作業中主動、回應行為次數之比較……………………56
表4-5 四組受試在ESCS作業中主動、回應行為比例之比較……………………57
表4-6 四組受試在ESCS中三類非語言溝通行為之比較…………………………58
表4-7 四組受試在ESCS中三類非語言溝通行為區分主動、回應之行為次數
比較…………………………………………………………………….……...61
表4-8 四組受試不同功能類別之高低層次行為的比較…………………….……...63
表4-9 四組受試在不同類別的個別行為比較……………………………….……...67
表4-10 四組受試在ESCS中三類非語言溝通行為所佔行為比例之比較………….69
表4-11 四組受試在ESCS中三類之主動非語言溝通行為比較…………………….71
表4-12 四組受試在高低層次主動非語言溝通能力行為比例之比較……….……...72
表4-13 四組受試不同功能的個別行為在總主動行為中所佔行為比例之比較……75
表4-14 四組受試在主動相互注意協調能力中伴隨正向情緒所佔比例的比較……76
表4-15 四組受試對他人要求的回應率之比較………………………………………76
表4-16 維持輪流活動中超過6次的人數分佈………………………………………77
表6-1 完成語言測驗受試之生理年齡、心理年齡的比較…………………………99
表7-1 四組受試語言能力之比較……………………………………………….….103
表7-2 A組各項語言能力之相關矩陣……………………………………………..104
表7-3 D組各項語言能力之相關矩陣……………………………………………..104
表7-4 N1組各項語言能力之相關矩陣……………………………………………104
表7-5 N2組各項語言能力之相關矩陣……………………………………………104
表7-6 A組受試主動、回應非語言溝通能力與後續語言之相關………………..105
表7-7 D組受試主動、回應非語言溝通能力與後續語言之相關………………..106
表7-8 N1組受試主動、回應非語言溝通能力與後續語言之相關……………….106
表7-9 N2組受試主動、回應非語言溝通能力與後續語言之相關……………….106

圖 目 錄


圖一 ESCS可觀察之行為…………………………………………………..10
圖二 ESCS作業材料示意圖………………………………………………..45
圖三 實驗室配置圖…………………………………………………………46
圖四 行為次數A<N2, D的項目………………………………………….83
圖五 行為次數A, D<N2的項目………………………………………….83
圖六 行為次數A, N2<D的項目………………………………………….84
圖七 行為次數A<N1, D的項目………………………………………….84
圖八 行為次數A, D<N1的項目………………………………………….85
圖九 行為次數N1<N2的項目……………………………………………85
圖十 行為比例或回應率AA<N2, D的項目……………………………..86
圖十一 行為比例A, N2<D的項目……………………………………….86
圖十二 行為比例D<A的項目……………………………………………87
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