臺灣博碩士論文加值系統

廣泛性發展疾患意指在多種領域方面有廣泛而嚴重的發展障礙，其中以自閉症疾患與亞斯伯格症為常見的兩種疾患，此兩種疾患在臨床上的症狀有許多相似之處，例如均在社會互動方面有質的障礙，且都表現出侷限、重複及刻板的行為與興趣等，由於高功能自閉症與亞斯伯格症較容易產生混淆及診斷上的困難，因此許多研究嘗試將兩者進行比較，欲釐清兩者的關係。
然而根據現有文獻的研究結果，高功能自閉症與亞斯伯格症的異同與否直到目前仍尚無清楚的定論，且研究的結果常因對於亞斯伯格症受試的篩選標準不一致、診斷工具尚不夠成熟或樣本之間未有足夠良好的配對等問題，以致於在進行結果的推論時有所限制，而研究結果的信效度亦受到質疑。
本研究修正過去相關研究對於樣本的篩選標準及配對內容，以國內學者修訂的標準化心智理論測驗為四十五名學齡兒童（包括高功能自閉症、亞斯伯格症以及一般正常組各十五名）進行施測，探討三者在心智理論能力上的差異，並嘗試為亞斯伯格症的診斷及後續處遇的建立提供依據。
研究結果顯示，高功能自閉症組在心智理論測驗的表現上明顯較控制組差(p< .001)，但亞斯伯格症組則與控制組無異，且亦顯著優於高功能自閉症組(p< .001)，符合本研究之預期。研究結果除了指出亞斯伯格症患者可表現出與一般正常組相符的心智理論能力外，也代表關於亞斯伯格症與高功能自閉症異同的研究有其持續進行的價值與必要。

Introduction: Asperger’s Syndrome (AS) and High-Functioning Autism (HFA) are two kinds of Pervasive Developmental Disorders (PDD) that are often seen in the clinical setting. They usually perform similar deficits on social interaction situation, behavior or communication, and are often difficult to be discriminated. Some researches have tried to find out the differences between AS and HFA by comparing their performance on Theory of Mind (ToM) tasks. However, the results are still inconsistent regarding whether they are the same or different kinds of syndromes. The past researches tend to overlook the matching between AS and HFA in selecting study subjects. Hence the purpose of the present study is to examine the difference of performance on ToM test between AS, HFA and normal school-age children in the Taipei area after matching their verbal IQ and careful selection of the clinical group by formal diagnosis criteria.

Methods: The subjects in the present study were recruited from the communities, hospitals, and elementary schools in the great Taipei area. Fifteen HFA children (14 boys and one girl, mean age=7.47), fifteen AS children (15 boys, mean age= 8.13) and fifteen normal school-age children (14 boys and one girl, mean age=7.47) were involved in the study. Prior to administrating the ToM test, parents of the subjects were invited to complete the Childhood Autism Screening Questionnaire. The subjects of the two clinical groups all met the criteria of autism or Asperger’s syndrome in DSM-IV. All the subjects were given the Chinese version of the Wechsler Intelligence Scale for Children Third Edition (WISC-III) and a Theory of Mind test.


Result: The results of the present study revealed that school-age children with HFA had significant lower ToM scores than children with AS and normal children, and there is no significant difference in ToM scores between the AS group and normal group.

Conclusion: As the results of the past researches showed, school-age children with HFA in the Taipei area obtained significantly lower scores in most of theory of mind test, including precursors of theory of mind, first manifestations of a real theory of mind, and advanced theory of mind. However, the children of AS group did not show significant differences from normal children. The results indicated that HFA children had deficits on theory of mind abilities but children with AS can develop the theory of mind abilities normally. The present findings may imply that high-functioning autism and Asperger’s syndrome are two different kinds of diagnoses although they are relatively similar. More researches are needed in clarifying the differences in quality between AS and HFA.

摘要 i
第一章 緒論
第一節 研究動機 1
第二節 研究目的 3
第三節 名詞解釋 5
第四節 研究假設 8
第二章 文獻回顧
第一節 自閉症 9
一、 自閉症研究之緣起 9
二、 鑑定標準與特徵 9
三、 鑑定工具 12
四、 高功能自閉症 15
第二節 亞斯伯格症 17
一、 亞斯伯格症研究之緣起 17
二、 鑑定標準與特徵 18
第三節 心智理論 21
一、 心智理論研究之緣起 21
二、 心智理論的意義與研究方向 25
三、 心智理論能力的發展 27
四、 心智理論的評估 30
五、 自閉症與亞斯伯格症的心智理論33
第三章 研究方法
第一節 研究設計 41
第二節 研究對象 42
一、 高功能自閉症組 42
二、 亞斯伯格症組 42
三、 正常對照組 43
第三節 研究工具 44
第四節 資料處理 49
第五節 研究程序 50
第四章 研究結果
第一節 研究樣本之基本描述 51
第二節 心智理論測驗之得分與比較 55
第五章 討論
第一節 研究假設之驗證 62
第二節 測驗過程中的發現 65
第三節 研究限制 67
第四節 總結與建議 69
參考文獻
中文資料 72
西文資料 74
附錄
附錄一、 心智理論測驗之題目與計分說明 78
附錄二、 心智理論測驗施測說明 94
附錄三、 研究說明與家長同意書 96
附錄四、 亞斯伯格症受試者之對話資料整理 98

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