自閉症類疾患兒童模仿表現與相關因素

The Performances and Correlates of Imitation in Children with Autism Spectrum Disorders

本研究有兩個主要目的，第一、探究生理年齡四歲以下的自閉症類疾患兒童在不同類型模仿作業的表現；第二、探究自閉症類疾患兒童在不同類型模仿作業表現的相關因素。受試者共有92名，包括：自閉症類疾患兒童49名，發展遲緩兒童22名和一般發展嬰幼兒21名。模仿作業分為四種類型，包括：有意義物體操作模仿、無意義物體操作模仿、有意義手勢動作模仿與無意義手勢動作模仿。此外，使用自閉症診斷觀察量表評估自閉症症狀。研究結果發現：（一）自閉症類疾患兒童全部模仿作業與模仿總分，顯著的比發展遲緩組兒童差；自閉症類疾患兒童在物體操作模仿的表現，顯著的比一般發展嬰幼兒差，但是手勢模仿作業表現，則沒有顯著差異。依發展商數區分為高、低功能自閉症類疾患組，高功能自閉症類疾患兒童，有意義物體模仿沒有出現障礙，但是低功能自閉症類疾患兒童在所有模仿作業都出現障礙。（二）自閉症類疾患兒童不同類型模仿作業表現與整體心理年齡、語言年齡、非語言心理年齡、語言理解、語言表達、反應性共享式注意力及自閉症症狀顯著相關。此外，模仿作業表現和發展能力、語言能力、反應性共享式注意力與自閉症症狀顯著相關，支持模仿在社會與發展能力的重要性，提供早療訓練方向的思考。

The present study had two purposes. First, we wanted to explore the imitation performance in children under 4 years of age with autism spectrum disorders (ASD). Second, we planned to explore the abilities related to different imitation tasks in children with ASD. The participants were 92 children, including 49 children with ASD (chronological age: 25 to 50 months, mental age: 10.5 to 47.25 months), 22 children with developmental delay (chronological age: 25 to 47 months, mental age: 18.25 to 38.5 months), and 21 infants with typical development (chronological age: 18 to 30 months, mental age: 19.5 to 33.75 months). Four tasks were used for evaluating imitation abilities, including meaningful action on objects, nonmeaningful action on objects, meaningful manual movement and nonmeaningful manual movement. In addition, the Autism Diagnostic Observation Schedule (ADOS) (Lord, Rutter, DiLavore & Risi, 1999) was used to assess autistic symptoms of children with ASD. The results of the current study revealed that the children with ASD showed significant impairment compared to the children with developmental delay on all imitation tasks. However, compared to toddlers with typical development, children with ASD performed with significant impairment on both meaningful action on objects and nonmeaningful action on objects but not on meaningful manual movement and nonmeaningful manual movement. Based on the developmental quotient, children with ASD were divided into high-functioning and lowfunctioning groups. The current study also revealed that high-functioning children with ASD performed without significant impairment on meaningful action on objects, but low-functioning children with ASD showed significant impairment on all imitation tasks. All of the imitation abilities were significantly related to different developmental and social abilities, including mental age, verbal mental age, nonverbal mental age, receptive language, expressive language, responding joint attention, and autistic symptoms. However, the relations between the imitative abilities and developmental abilities, language, responding joint attention and autistic symptoms supported that imitative abilities play an important role in the development of social and cognitive skills, and provide a direction for an early intervention program for children with ASD.