高功能自閉症兒童說故事能力與相關影響因素研究

Narrative Story Telling of High-Functioning Children with Autism Spectrum Disorders

本研究主要目的在探討高功能自閉症兒童說故事的內容及語言表現，並探討智力、錯誤信念、情緒理解及語法能力等因素和說故事能力之間的關連性。19 位平均總智商105 左右的自閉症及19 位對照組普通兒童看圖畫書「青蛙你在哪裡」並自編故事。高功能自閉症與對照組兒童主要的顯著差異在故事內容的理解與表達，如：較無法表達人物高層次的內心目標、較少提及人物內在反應、較易省略故事結尾、故事內容較不完整、有較多不相干的內容、較少提及故事中的人與物，而且他們理解故事人物情緒及說明原因的能力也較差，但是兩組兒童在語言能力多項指標上則無顯著差異。自閉症組理解故事人物情緒及說明原因的能力與說故事時的內容完整性、不相干內容、不相干詞彙及名詞詞彙總數等皆有顯著相關，顯示其對故事的理解與其說故事的表現間有相關。與自閉症組說故事能力相關的因素包含：情緒理解、錯誤信念、句法理解及語文智商；與自閉症組理解故事人物情緒有關的因素有情緒理解與句法理解。研究者從故事因果網絡分析的觀點，認為無法理解故事人物的「目標」是其說故事缺陷的關鍵，也能整合本研究所發現的諸多特徵 。以上研究結果支持廣義的心智理論與自閉症兒童說故事能力有相關性，但也顯示句法理解及智力的可能影響。 研究者針對以上結果提出後續研究與實務評量及介入的建議。

The purpose of the study was to investigate the content and linguistic expression of 19 high-functioning children with autism（full IQ average=105） and a matched group of 19 children with normal development. Story generation of the book “Frog, where are you”was used to collect narrative samples, and tests of intelligence, false belief, emotional understanding and syntax comprehension were used to examine the relationship between these factors and story performance. The high-functioning autistic group was found to perform comparatively well on linguistic indices（length of story, MLU, use of complex sentences） and devices used for evaluations. However, there were significant differences found in story content and structure measures. The autistic group was less likely to express higher-level goals of the characters and tended to omit the endings of the story, to not describe the internal responses, to generate incomplete plots and more irrelevant content, and to omit mentioning the characters and the objects depicted in the pictures. The autistic group also provided less accurate answers to questions about characters’ emotional responses. For the autistic group, scores of the comprehension questions correlated significantly with completeness of the plot , with the irrelevant content, with the irrelevant referents used and with the total noun vocabulary used. This result indicated that their comprehension of the story correlated highly with the content and structure of the story they generated. Emotional understanding, false belief, syntax comprehension and verbal IQ correlated significantly with several measures of story telling of the autistic group. The findings are discussed concerning the role of understanding goals and the influence of theory of mind, linguistic ability and IQ to the story performance of the autistic group.