自閉症兒童之感覺處理功能——先驅研究

Sensory Processing in Children with Autism--A Pilot Study

自閉症孩童常有對感覺刺激的反應不足或過度反應之感覺處理功能上的障礙。若治療師對自閉症孩童的感覺處理功能有進一步的瞭解，方能針對其需求的感覺刺激設計適當的治療活動，以促進孩童的發展。本研究之目的即探討自閉症孩童與正常發展孩童之感覺處理功能之差異，及自閉症孩童之感覺處理功能障礙之症狀軸向。實驗組41名自閉症孩童年齡為2.8歲至11.8歲。對照組的726名正常孩童年齡為2.3歲至13.0歲。由熟悉孩童的家長填寫「感覺史量表」。以描述性統計分析自閉症孩童與正常孩童在「感覺史量表」各題目上勾選”總是”或”經常”之頻率，以瞭解兩組發生感覺調節障礙行為之林率。以MANOVA來查驗自閉症孩童與正常孩童在各題目上的表現之差異。以因素分析檢驗「感覺史量表」之因素組成以瞭解自閉症孩童之感覺處理功能障礙軸向。結果顯示行為發生頻率最高為71.4%，僅有一題達到此頻率：視覺13－避免與人視線接觸。自閉症兒童與正常兒童的感覺處理功能障礙行為之發生頻率有顯著差異者有628題（P<0.01）。因素分析結果產生7個因素：情緒反應，注意力缺失/過動，低肌肉張力/重力不安感，觸覺防禦，觸覺敏感度低，精細動作/視知覺，感覺登錄不良，共解釋45.4%的變異量。自閉症孩童之感覺處理功能障礙行為發生比例比正常孩童為高，且其感覺處理功能障礙症狀軸向與有感覺調節功能障礙孩童的行為模式相似。

The disturbances of sensory modulation characterized by under-and overreactivity to sensory stimu|i are often reported in persons with autism and related developmental disabilities. From the sensory processing perspective, the bizarre response to sensory events may possibly be due to the child's inability to generate responses that are appropriately graded in relation to incoming sensory stimuli. If the therapists are knowledgeable about the child's sensory processing functioning and identify the child's sensory needs, they could plan intervention effectively and promote the child's new developmental skills. The purposes of this study are to investigate the differences of sensory processing function between children with autism and children with typical development and the symptom dimensions of sensory processing disorders. Parents of 41 children with autism aged 2.8 to 11.8 years (mean = 6.22 years, SD 2.53 years) and of 726 children without autism aged 2.3 to 13.O (mean = 5.0 years, SD = 1.46 years) completed the Chinese version Sensory Profile. Parents used a five-point Likert scale to report the percentage of time their children engaged in each behavior. A descriptive analysis of the data set identified the distribution of responses on each item. MANOVA on the frequency of each item identified possible differences between children with autism and without autism. Factor analysis on the 100 items of the Chinese version Sensory Profile identified relationships among these items. Results showed that no items on the Chinese version Sensory Profile met the criterion we established for a behavior to be considered common in children with autism (i.e., if 80% or more of the parents reported that their child displayed the behavior always or frequently, the criterion was met). The highest frequency of occurrence was 7l.4%, and this only occurred with one item: Visual-- 13: Avoids eye contact.’ On the basis of the t-test results, children with autism performed differently than the children without autism (p < 0.01) on 68 out of 100 items. Results of factor analysis revealed 7 factors: Factor I: emotional reaction, Factor II: attention deficit, Factor III: low tone/gravitational insecurity. Factor IV: tactile defensiveness, Factor V: poor tactile registration, Factor VI: fine motor/visual perception, Factor VII: poor sensory registration, These factors explained 45.4% of variance. The prevalence of sensory processing dysfunction of children with autism was much higher than that of children without autism. The symptom dimensions of sensory processing dysfunction in children with autism were similar to that of children with sensory modulation disorders.