自閉症幼兒症狀嚴重度、認知功能與母親心理健康對親子關係之預測因子初探

A Preliminary Study on Predictability of Children’s Symptom Severity and Cognition and Maternal Mental Health in Parent-child Relationships in Preschoolers with Autism Spectrum Disorder

親子關係品質對於自閉症幼兒發展極為重要。根據親子關係雙向模式瞭解到幼兒與母親特質皆會影響親子關係品質，包括幼兒的認知功能、症狀嚴重度與母親的心理健康因子，故本研究比較幼兒的症狀嚴重度、認知功能與母親的心理健康狀態對親子關係中五個層面（滿足感、溝通、參與度、設限與自主性）的重要性。共招募33 位自閉症幼兒之母親，邀請母親填寫「親子關係量表」、「貝克憂鬱量表」與「親職壓力量表短版」，並透過病歷查詢取得幼兒心智功能測驗分數，再由主要治療師填寫「兒童期自閉症量表」。經逐步回歸分析後發現母親的憂鬱情緒能預測親職滿足感、母親對幼兒的設限及自主性；而幼兒的症狀嚴重度能預測親子參與度及溝通品質。研究結果提供臨床工作者設定治療目標之參考，建議在臨床評估時，除了評估幼兒的症狀嚴重度外，更須評估母親的憂鬱情緒，若改善母親憂鬱情緒則更利於建立適合幼兒與母親間溫暖且穩定的親子關係。

The quality of parent-child relationships is important for the development ofpreschoolers in children with autism spectrum disorder (ASD). The severity ofsymptoms and cognitive functions of the child as well as maternal mental health affectthe quality of their relationship. In this study, we explored the predictors for fivedomains in the quality of parent-child relationships, in terms of satisfaction withparenting scale, involvement, communication, limit setting and autonomy, byconsidering the symptom severity and cognitive functions of children and maternalmental health, which includes depression and parenting stress. A total of 33 mothers ofpreschoolers with ASD were recruited in this study, and they were asked to fill out threequestionnaires (Parent-Child Relationship Inventory, Beck Depression Inventory, andParenting Stress Index). We obtained the scores of children’s cognitive tests and severity of symptoms from medical records and therapists respectively. Our findingsshowed that maternal depression was a significant negative predictor in domains ofsatisfaction, limit setting and autonomy in parent-child relationships, while the severityof the child’s symptoms can be used to predict the domain of involvement andcommunication. This study provided a reference for clinicians in setting the treatmentgoals of the children with ASD. It is suggested that assessments of the mothers’depression and clinical intervention are needed. If maternal depression can be cured, itwould lead to more adequate, stable and loving parent-child relationships.