自閉症類群障礙幼兒共享式注意力和語言能力、心智能力、適應功能及自閉症症狀的關係

The Relationships among Joint Attention, Language Abilities, Mental Abilities, Adaptive Functioning, and Autistic Symptoms in Young Children with Autism Spectrum Disorder

研究目的：本研究探究自閉症類群障礙（autism spectrum disorder, ASD）幼兒共享式注意力（joint attention, JA）在語言能力、心智能力、適應功能及自閉症症狀的角色。研究方法：132名ASD幼兒，平均生理年齡約30個月，修訂「臺灣版兩歲期自閉症篩檢工具」，評估主動性共享式注意力（initiating joint attention, IJA）與回應性共享式注意力（responding joint attention, RJA）；「穆林發展量表」評估語言能力與心智能力；「適應行為評量系統第二版」評估適應功能；「自閉症診斷觀察量表」評估自閉症症狀。研究結果：除IJA和社會知能無顯著相關外，JA和語言能力、心智能力、適應功能，及自閉症症狀皆出現顯著相關。RJA對語言能力、心智能力、適應功能及自閉症症狀的貢獻達顯著；但是，IJA只對語言能力、心智能力與自閉症症狀貢獻達顯著。研究結論：RJA在語言能力、心智能力、適應功能，及自閉症症狀的貢獻達顯著，顯示跟隨他人注意力的焦點，在ASD幼兒早期心智與社會能力發展扮演重要角色。IJA在語言能力、心智能力與自閉症症狀的貢獻達顯著，特別是自閉症症狀，顯示主動引發他人注意與分享情緒，是ASD幼兒人際互動能力發展的重要因子。本研究結果提供ASD幼兒早期介入參考。

Purpose: This study explores the role of joint attention (JA) in language abilities, mental abilities, adaptive functioning, and autistic symptoms in young children with autism spectrum disorder (ASD). Methods: Participants included 132 young children with ASD with a mean chronological age of about 30 months. We modified the Screening Tool for Autism in Two-Year-Olds, Taiwan version (T-STAT) to measure both initiating joint attention (IJA) and responding joint attention (RJA). We used the Mullen Scales of Early Learning (MSEL) to measure language and mental abilities. We used the Adaptive Behavior Assessment System-II (ABAS-II) to measure adaptive functioning. In addition, we used the Autism Diagnostic Observation Schedule (ADOS) to measure autistic symptoms. Results: With the exception of IJA and social adaptive functioning from the ABAS-II, the analysis identified significant relationships between JA and language abilities, mental abilities, adaptive functioning, and autistic symptoms. In addition, RJA contributed significantly to language abilities, mental abilities, adaptive functioning, and autistic symptoms. However, IJA contributed significantly only to language ability, mental abilities, and autistic symptoms. Conclusion: The results revealed that RJA is a robust contributor to language abilities, mental abilities, adaptive functioning, and autistic symptoms in young children with ASD. The ability to follow others is very important and can be helpful for the development of mental and social abilities in young children with ASD. IJA was a significant contributor to language abilities, mental abilities, and especially autistic symptoms. These results suggest that directing other’s attention and sharing affect is important for the development of social abilities in young children with ASD. The results of this study provide implication for early intervention in young children with ASD.