臺灣博碩士論文加值系統

亞斯伯格症(Asperger’s disorder, AspD)屬於廣泛性發展疾患的一種，患者的主要症狀為社會互動障礙以及侷限、重複且刻板的興趣和行為。AspD兒童大多是在進入學齡期，與同儕互動要求增多後，才容易被察覺其問題。然而若能早期發現並處理其問題，將會有較佳的預後。目前歐美已有多種評估AspD的工具，然而台灣仍缺乏方便使用且具有信效度的評估工具。本研究以台灣北部地區學童為對象，針對Gilliam亞斯伯格症量表中文版(GADS-C)，進行信效度檢驗。
本研究共招募年齡介於7-15歲、智能在正常範圍之AspD男童46名、ADHD男童30名及一般男童30名參與研究，三組參與者的年齡與智商相當。三組兒童均施測：（1）魏氏兒童智力量表第三版；（2）眼神辨識測驗兒童版；（3）心智理論測驗。三組兒童的家長及教師均填寫：（1）Gilliam亞斯伯格症量表；（2）文蘭適應行為量表社會化領域分量表；（3）兒童行為檢核表或教師報告表。
研究結果顯示GADS-C具有適當的信效度。信度方面，家長及教師評量的GADS-C內部一致性分別為.96與.95，家長及教師評量的GADS-C三至六週再測信度分別為.77與.78。效度方面，在建構效度上，GADS-C得分與醫師診斷之點二系列相關達顯著；在同時效度上GADS-C得分與文蘭適應行為量表社會化領域、心智理論測驗層次二呈顯著相關；在區辨效度上，GADS-C的家長評量結果可有效地區辨AspD兒童與ADHD組及一般組，教師評量結果則可有效區辨AspD兒童與一般兒童。比較GADS-C的家長與教師評量結果，發現家長普遍傾向於對孩子的亞斯伯格症症狀給予顯著較高的評分。
本研究顯示，GADS-C具有適當的信效度與區辨力，適合作為初步篩檢AspD與協助診斷的工具。由於研究發現針對同一位兒童家長及教師在GADS-C的評量結果上有顯著的差異，建議未來建立台灣常模時，宜考量評分者因素，分別建立家長常模與教師常模。

As one of the pervasive developmental disorders, Asperger’s disorder (AspD) is characterized by significant impairments of the social interactions as well as restricted and repetitive patterns of behavior and interests. Children with AspD are often not diagnosed until they enter elementary schools when needs for interpersonal interaction increase. Despite the urgent need for early diagnosis and intervention, limited instruments have been developed in Taiwan to assess symptoms of AspD. Since the Gilliam Asperger’s Disorder Scale (GADS) has good reliability and validity, this study intends to translate the GADS into Chinese and evaluate the reliability and validity of the Chinese version of GADS (GADS-C) using samples of Taiwanese boys.
Forty-six boys with AspD, 30 boys with Attention Deficit Hyperactivity Disorder (ADHD), and 30 normally developing boys were recruited to participate in this study. All the participants were between 7 and 15 years-old and had average intelligence. Three groups were matched on both age and IQ. All the children were administered (1) the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), (2) the Children’s Version of the Reading the Mind in the Eyes Test (Eyes Test), and (3) the Theory of Mind Test (ToM Test). All parents and teachers completed behavior ratings for the children using (1) the GADS-C, (2) the Socialization subscale of the Vineland Adaptive Behavior Scale (Vineland-II and VABS), and (3) the Child Behavior Checklist (CBCL) and Teacher Report Form (TRF).
The results revealed that GADS-C has good reliability and validity. The internal consistency coeficients of parental and of teacher’s ratings are .96 and .97 respectively; and the three- to six- week test-retest reliability of parental and teacher’s ratings are .77 and .78 respectively. The point-biserial correlation between the GADS-C scores and clinical diagnosis is statistically significant. The GADS-C is also significantly correlated with the socialization scores of Vineland-II/VABS and the level II of ToM test. Parental ratings could discriminate the children with AspD from those with ADHD or normally developing children. Teacher’s ratings could discriminate the children with AspD from normal counterpart. Compared to teachers, parents tended to report more severe problems in their children.
In conclusion, GADS-C has demonstrated adequate reliability and validity. It is recommended that clinician include GADS-C as a screening test in diagnosing Asperger’s disorder. Since there is a significant difference between parental and teacher’s ratings, it is suggested that separate norms should be established for different informants, i.e., parents and teachers.

目錄
指導教授推薦書……………………………………………………………i
口試委員會審定書…………………………………………………………ii
碩士論文著作授權書………………………………………………………iii
國家圖書館授權書…………………………………………………………iv
致謝…………………………………………………………………………v
中文摘要……………………………………………………………………vii
英文摘要……………………………………………………………………ix
目錄…………………………………………………………………………xi
圖表目錄……………………………………………………………………xiv
第一章 緒論………………………………………………………………1
1.1研究背景………………………………………………………………1
1.2文獻回顧………………………………………………………………1
1.2.1 亞斯伯格症的特徵及盛行率……………………………………1
1.2.2亞斯伯格症評估工具簡介…………………………………………4
1.2.3中文評估量表之現況………………………………………………11
1.2.4評估者因素…………………………………………………………13
1.3研究目的與假設 ………………………………………………………15
第二章 研究方法……………………………………………………………17
2.1研究參與者………………………………………………………………17
2.2研究工具…………………………………………………………………18
2.2.1魏氏兒童智力量表第三版……………………………………………19
2.2.2 Gilliam亞斯伯格症量表…………………………………………19
2.2.3文蘭適應行為量表第二版—調查晤談版……………………………20
2.2.4兒童行為檢核表及教師報告表………………………………………22
2.2.5眼神辨識測驗兒童版…………………………………………………23
2.2.6心智理論測驗 …………………………………………………………24
2.3研究程序…………………………………………………………………25
2.4資料分析…………………………………………………………………26
第三章 研究結果……………………………………………………………27
3.1基本資料與量表得分……………………………………………………27
3.1.1參與者基本資料………………………………………………………27
3.1.2 評分者分析…………………………………………………………28
3.1.3 組別分析……………………………………………………………29
3.1.4年齡分析……………………………………………………………30
3.2信度……………………………………………………………………30
3.2.1 內部一致性 ………………………………………………………30
3.2.2 再測信度……………………………………………………………31
3.3效度……………………………………………………………………32
3.3.1以醫師診斷為效標…………………………………………………32
3.3.2同時效度……………………………………………………………32
3.3.3 區辨分析…………………………………………………………35
第四章 討論…………………………………………………………………36
4.1 Gilliam亞斯伯格症量表中文版的信效度…………………………36
4.2影響GADS-C評量的因素………………………………………………38
4.1.1評分者因素的影響…………………………………………………38
4.1.2 文化因素的影響…………………………………………………39
第五章 結論………………………………………………………………40
5.1研究發現與貢獻………………………………………………………40
5.2研究限制………………………………………………………………40
5.3未來研究方向…………………………………………………………41
參考文獻……………………………………………………………………42

圖表目錄
表1-1 六個行為量表的比較………………………………………………10
表3-1 AspD、ADHD及一般組在年齡及智商之比較………………………28
表3-2 家長及教師評估各組參與者在GADS-C得分之二因子變異數分析摘要表…………………………………………………………………………………28
表3-3 AspD、ADHD及一般組兒童在GADS-C的各量表分數與ADQ平均數及標準差………………………………………………………………………………29
表3-4 GADS-C的內部一致性係數……………………………………………31
表3-5 GADS-C的再測信度……………………………………………………32
表3-6 Gilliam亞斯伯格症量表與其他指標之相關…………………………34
表3-7 GADS-C的臨床切截分數………………………………………………35

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