高功能自閉症類群障礙兒童的適應行為表現與智力和症狀嚴重度之關係探究

Adaptive Behavior Profiles and Their Association with Cognitive Ability and Symptom Severity in Children with High-Functioning Autism Spectrum Disorder

研究目的：本研究目的為探討不同智力程度的高功能自閉症類群障礙（High-Functioning Autism Spectrum Disorder, HFASD）學齡兒童的適應行為表現，並探討其與智力和症狀嚴重度二者之關聯性。研究方法：研究對象為68名生理年齡介於7－12歲的HFASD兒童，依據其智力高低區分為資優HFASD組（intellectual gifted HFASD，簡稱IG_HFASD，33名）和一般HFASD組（Non-intellectual gifted HFASD，簡稱Non-IG_HFASD，35名），並使用中文版文蘭適應行為量表第二版來比較兩組兒童在適應行為表現的差異。除了智力，本研究亦以問卷、訪談和評估者觀察形式測量症狀嚴重度來檢視與各組的適應行為表現之相關性。研究結果：IG_HFASD組在溝通領域的適應行為表現比Non-IG_HFASD組好，在其他領域則沒有差異。在不分組下進行相關分析發現智力與HFASD兒童的溝通領域適應行為有顯著正相關，症狀嚴重度則與社會化領域適應行為存在負相關。分組後顯示IG_HFASD組的症狀嚴重度與日常生活技能和社會化領域適應行為可達至中度負相關，但智力未與任何適應行為之間存在相關；Non-IG_HFASD組則是非語文智力與社會化領域適應行為有明顯的正相關。研究結論：智力仍與HFASD學童的適應行為有所關聯，尤其在溝通領域較為明顯。症狀嚴重度則相對與其日常生活技能和社會化領域較有關聯。但智力和症狀嚴重度與一般智力和資優HFASD學童的適應行為之關聯程度並不一致。

Purpose: This study explores the profiles of adaptive behaviors in school-going children with high-functioning autism spectrum disorder (HFASD) and their relationship with intelligence quotient (IQ) and the severity of ASD symptoms. Methods: Sixty-eight seven- to 12-year-old children with HFASD were divided into intellectually gifted (IG_ HFASD) and non-intellectually gifted (Non-IG_HFASD) groups based on their IQ. The groups’ adaptive behaviors were compared by the Vineland Adaptive Behavior Scales-Second Edition. The correlations between these behaviors and IQ as well as the severity of ASD symptoms were also examined in each group. Results: The IG_HFASD group performed significantly better than the Non-IG_HFASD group in the Communication domain. There were no differences between the groups in other domains of behavior. According to the observation assessment, the Non-IG_HFASD group had more repetitive/stereotypical behaviors than the IG_HFASD group. Among all the children, there was a positive correlation between IQ and the Communication domain, and a negative one between severity and Socialization domains. Examining the correlations in each group revealed that the IG_HFASD group had a moderately negative one between severity and the Daily Living as well as Socialization domains; no significant correlations were found between their IQ and any adaptive behaviors. In contrast, in the Non-IG_HFASD group, non-verbal intelligence was mainly associated with the Socialization domain.Conclusion: IQ is mainly associated with the Communication domain of adaptive behaviors in children with HFASD. The severity of ASD symptoms plays an important role in the Socialization domain and other subdomains. Notably, the two groups show distinct levels of correlations between adaptive behaviors and IQ as well as severity.