艾斯柏格症學前兒童的矯治

Treatment of A Preschooler with Asperger’s Syndrome

艾斯柏格症是一種廣泛發展障礙症，其特徵為社會功能障礙及某些刻板、狹隘的興趣或行為，但沒有明顯語言和認知發展遲緩。國內對艾斯柏格症的診斷和治療雖有譯作，但有關艾斯柏格症的治療文獻只有一例語言治療報告。本文報告一位診斷為艾斯柏格症的歲個月女童，主要問題為在幼稚園少與小朋友互動，對老師的指令不太理會，自己說話、玩耍。案童和案母接受為期八個月共次的行為治療，治療目標以結構案童學習環境、強化案童社會技巧，並訓練案母成為協同治療者為主。本文介紹治療的技巧與改變過程，探討治療歷程中遇到的困難及改變的機制，並對臨床和研究應用加以討論。

Asperger’s syndrome is a pervasive developmental disorder characterized by the presence of social impairment, and restricted, repetitive and stereotyped patterns of behavior or interests, but no clinically significant general delay in language or cognitive development. There is only one report addressing the treatment of communication problems in a 3.5 yearold boy with Asperger’s syndrome in Taiwan. We present the treatment of a preschool girl with Asperger’s syndrome. Her presenting problems included impaired social interaction with peers, not following teacher’s instructions, and preoccupation with self talking and playing alone. The total of 23 therapy sessions with the girl and her mother were conducted in 8 months. The goals of therapy were to structure the environment, to develop the skills to follow instructions and to facilitate appropriate interaction, and to train the mother to be the co-therapist. The treatment procedure and the process of behavior change are presented and discussed. The implications in clinical practice and research are also given.