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題名 高功能自閉症類群障礙兒童的執行功能之探究： 與症狀嚴重度、適應行為及行為問題表現之關聯性
Exploration of the Executive Function in Children with High-functioning Autism Spectrum Disorder: Relationship with Symptom Severity, Adaptive Function and Problem Behaviors
作者 林怡安
Lin, Yi An
貢獻者 姜忠信
Chiang, Chung Hsin
林怡安
Lin, Yi An
關鍵詞 高功能自閉症類群障礙症
執行功能
症狀嚴重度
適應行為
內外化行為問題
智能優異
high-functioning autism spectrum disorder
executive function
symptom severity
adaptive functioning
internalized and externalized behavior problems
intellectually gifted
日期 2016
上傳時間 1-七月-2016 15:16:18 (UTC+8)
摘要 研究目的：本研究之目的，是探索高功能自閉症類群障礙（High-functioning Autism Spectrum Disorder, HFASD）兒童的執行功能表現，並以Pellicano（2011）提出的獨特性、解釋力、普遍性等觀點作為架構進行討論。獨特性方面，試圖以冷執行功能（包括認知彈性、工作記憶、反應抑制）與熱執行功能之架構剖繪HFASD兒童的執行功能表現形態；解釋力方面，是探索執行功能表現對自閉症狀嚴重度、適應行為及行為問題的預測力；普遍性方面，呼應自閉症類群障礙的高度異質性，嘗試以執行功能表現解釋研究樣本中具注意力不足／過動症特質和智能優異特質的兒童特性。
方法：以生理年齡界於7至10歲的54名HFASD兒童和27名一般發展組作為研究對象，兩組於生理年齡和智力進行配對控制，分別以七項認知作業和執行功能行為評定量表評估受試者在實驗室和日常生活中的執行功能表現，也評估智力、症狀嚴重度、適應行為、內外化行為問題表現。
結果：與一般發展兒童相較，HFASD組的執行功能呈現反應抑制的缺損最為明顯、認知彈性次之，而工作記憶則表現相對正常的獨特表現形態；且在誘發情緒和動機後，部分HFASD兒童有「避免懲罰」或「避免冒險」之作答傾向，此傾向與較嚴重的侷限重複行為有關。認知作業測得的結果和家長評估兒童的執行功能表現關聯性不大。執行功能中的抑制、轉換能力能預測侷限重複性行為的自閉症狀和內外化行為問題，然HFASD兒童的抑制能力越佳，也反映更多的內化行為困擾。此外，本研究HFASD受試樣本中具高度異質性，智能優異特質者幾乎沒有明顯的認知作業執行功能缺損，以BRIEF評估時，與非智能優異者相較具備較佳的計劃能力；而轉換、抑制及自我監控能力差可預測HFASD兒童中較高的注意力不足／過動症特質。
總結：HFASD兒童具獨特的執行功能表現形態，且HFASD的症狀表現和高度異質性可部分由執行功能所解釋，顯示執行功能缺損作為核心的認知能力假說具參考價值。進一步討論結果對於未來臨床實務中的介入價值。
Purposes: The purpose of the study was to explore the executive function (EF) of the High-functioning Autism Spectrum Disorder (HFASD), and EF was discussed on the basis of uniqueness, explanatory power, universality proposed by Pellicano (2011). For the uniqueness, the study captures the cool EF (including cognitive flexibility, working memory, and response inhibition) and hot EF profile in children with HFASD. For the explanatory power, to examine whether EF can predict ASD symptom severity, adaptive function, and behavior problems. For the universality, concerning the significant heterogeneity within ASD, the study attempts to use EF to identify ADHD trait and intellectually gifted children within HFASD.
Methods: Fifty-four children aged 7–10 years with HFASD and 27 control participants (Non-ASDs) with matched Age, Verbal, Performance, and Full Scale IQ were recruited. EF measurements include performance-based executive function task, as well as the BRIEF (Behavior Rating Inventory of Executive Functions) questionnaire completed by parents for daily life executive performance of their children. IQ, symptom severity, adaptive function, internalized and externalized behavior problems were also measured either by questionnaire or semi-structured assessments.
Results: Results indicated that compared with Non-ASDs, HFASD shows the most imairment in responses inhibition, then in cognitive shifting. However, the working memory is relativily intact. When the motivation and emotion were induced during the task, an “avoidance punishment” or “avoidance risk” tendancy was observed in some children with HFASD, which is related to more restricted and repetitive symptoms. Performance-based tasks are not highly related with questionnaire-based measurement of EF. Problems with inhibition and shift ability can predict more restricted and repetitive symptoms as well as internalized and externalized behavior problems. However, when children with HFASD show better inhibition ability, they might have more internalized behavior disturbance. Furthermore, we found high heterogeneity within the study sample of HFASD.There is no significant deficits in performance-based EF tasks within intellectually gifted HFASD, and they also have higher performance on the plan scale of BRIEF. Problems with shift, inhibition, and self-monitoring can predict higher ADHD traits in children with HFASD.
Conclusions: Findngs support the uniqness of EF profile in children with HFASD, and the heterogeneity within ASD can be partially explained by EF components. This indicated the importance of EF dysfunction hypothesis in ASD.The theoretical and clinical implications were discussed.
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描述 碩士
國立政治大學
心理學系
101752013
資料來源 http://thesis.lib.nccu.edu.tw/record/#G1017520131
資料類型 thesis
dc.contributor.advisor 姜忠信zh_TW
dc.contributor.advisor Chiang, Chung Hsinen_US
dc.contributor.author (作者) 林怡安zh_TW
dc.contributor.author (作者) Lin, Yi Anen_US
dc.creator (作者) 林怡安zh_TW
dc.creator (作者) Lin, Yi Anen_US
dc.date (日期) 2016en_US
dc.date.accessioned 1-七月-2016 15:16:18 (UTC+8)-
dc.date.available 1-七月-2016 15:16:18 (UTC+8)-
dc.date.issued (上傳時間) 1-七月-2016 15:16:18 (UTC+8)-
dc.identifier (其他 識別碼) G1017520131en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/98621-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 心理學系zh_TW
dc.description (描述) 101752013zh_TW
dc.description.abstract (摘要) 研究目的：本研究之目的，是探索高功能自閉症類群障礙（High-functioning Autism Spectrum Disorder, HFASD）兒童的執行功能表現，並以Pellicano（2011）提出的獨特性、解釋力、普遍性等觀點作為架構進行討論。獨特性方面，試圖以冷執行功能（包括認知彈性、工作記憶、反應抑制）與熱執行功能之架構剖繪HFASD兒童的執行功能表現形態；解釋力方面，是探索執行功能表現對自閉症狀嚴重度、適應行為及行為問題的預測力；普遍性方面，呼應自閉症類群障礙的高度異質性，嘗試以執行功能表現解釋研究樣本中具注意力不足／過動症特質和智能優異特質的兒童特性。
方法：以生理年齡界於7至10歲的54名HFASD兒童和27名一般發展組作為研究對象，兩組於生理年齡和智力進行配對控制，分別以七項認知作業和執行功能行為評定量表評估受試者在實驗室和日常生活中的執行功能表現，也評估智力、症狀嚴重度、適應行為、內外化行為問題表現。
結果：與一般發展兒童相較，HFASD組的執行功能呈現反應抑制的缺損最為明顯、認知彈性次之，而工作記憶則表現相對正常的獨特表現形態；且在誘發情緒和動機後，部分HFASD兒童有「避免懲罰」或「避免冒險」之作答傾向，此傾向與較嚴重的侷限重複行為有關。認知作業測得的結果和家長評估兒童的執行功能表現關聯性不大。執行功能中的抑制、轉換能力能預測侷限重複性行為的自閉症狀和內外化行為問題，然HFASD兒童的抑制能力越佳，也反映更多的內化行為困擾。此外，本研究HFASD受試樣本中具高度異質性，智能優異特質者幾乎沒有明顯的認知作業執行功能缺損，以BRIEF評估時，與非智能優異者相較具備較佳的計劃能力；而轉換、抑制及自我監控能力差可預測HFASD兒童中較高的注意力不足／過動症特質。
總結：HFASD兒童具獨特的執行功能表現形態，且HFASD的症狀表現和高度異質性可部分由執行功能所解釋，顯示執行功能缺損作為核心的認知能力假說具參考價值。進一步討論結果對於未來臨床實務中的介入價值。		zh_TW
dc.description.abstract (摘要) Purposes: The purpose of the study was to explore the executive function (EF) of the High-functioning Autism Spectrum Disorder (HFASD), and EF was discussed on the basis of uniqueness, explanatory power, universality proposed by Pellicano (2011). For the uniqueness, the study captures the cool EF (including cognitive flexibility, working memory, and response inhibition) and hot EF profile in children with HFASD. For the explanatory power, to examine whether EF can predict ASD symptom severity, adaptive function, and behavior problems. For the universality, concerning the significant heterogeneity within ASD, the study attempts to use EF to identify ADHD trait and intellectually gifted children within HFASD.
Methods: Fifty-four children aged 7–10 years with HFASD and 27 control participants (Non-ASDs) with matched Age, Verbal, Performance, and Full Scale IQ were recruited. EF measurements include performance-based executive function task, as well as the BRIEF (Behavior Rating Inventory of Executive Functions) questionnaire completed by parents for daily life executive performance of their children. IQ, symptom severity, adaptive function, internalized and externalized behavior problems were also measured either by questionnaire or semi-structured assessments.
Results: Results indicated that compared with Non-ASDs, HFASD shows the most imairment in responses inhibition, then in cognitive shifting. However, the working memory is relativily intact. When the motivation and emotion were induced during the task, an “avoidance punishment” or “avoidance risk” tendancy was observed in some children with HFASD, which is related to more restricted and repetitive symptoms. Performance-based tasks are not highly related with questionnaire-based measurement of EF. Problems with inhibition and shift ability can predict more restricted and repetitive symptoms as well as internalized and externalized behavior problems. However, when children with HFASD show better inhibition ability, they might have more internalized behavior disturbance. Furthermore, we found high heterogeneity within the study sample of HFASD.There is no significant deficits in performance-based EF tasks within intellectually gifted HFASD, and they also have higher performance on the plan scale of BRIEF. Problems with shift, inhibition, and self-monitoring can predict higher ADHD traits in children with HFASD.
Conclusions: Findngs support the uniqness of EF profile in children with HFASD, and the heterogeneity within ASD can be partially explained by EF components. This indicated the importance of EF dysfunction hypothesis in ASD.The theoretical and clinical implications were discussed.		en_US
dc.description.tableofcontents 第一章 緒論 1
第一節 研究動機 1
第二節 名詞釋義 3
第二章 文獻探討 5
第一節 自閉症類群障礙症的介紹 5
壹、 自閉症類群障礙症之歷史沿革與臨床診斷準則 5
貳、 現行診斷議題與契機 7
第二節 自閉症類群障礙兒童執行功能之研究 11
壹、 執行功能的意涵與概念架構 11
貳、 自閉症類群障礙患者執行功能的表現型態 12
參、 執行功能與自閉症狀表現之關聯性研究 35
第三節 智能優異的自閉症類群障礙兒童 45
第四節 研究架構與假設 47
第三章 研究設計 49
第一節 研究對象 49
第二節 研究工具 49
第四章 研究結果 61
第五章 討論 89
第一節 研究樣本特質概述 89
第二節 HFASD之執行功能表現的獨特性 90
第三節 HFASD之執行功能表現的解釋力 98
第四節 以執行功能表現描述ASD的異質性 101
第五節 結論與建議 106
參考文獻 111		zh_TW
dc.format.extent 3152677 bytes-
dc.format.mimetype application/pdf-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G1017520131en_US
dc.subject (關鍵詞) 高功能自閉症類群障礙症zh_TW
dc.subject (關鍵詞) 執行功能zh_TW
dc.subject (關鍵詞) 症狀嚴重度zh_TW
dc.subject (關鍵詞) 適應行為zh_TW
dc.subject (關鍵詞) 內外化行為問題zh_TW
dc.subject (關鍵詞) 智能優異zh_TW
dc.subject (關鍵詞) high-functioning autism spectrum disorderen_US
dc.subject (關鍵詞) executive functionen_US
dc.subject (關鍵詞) symptom severityen_US
dc.subject (關鍵詞) adaptive functioningen_US
dc.subject (關鍵詞) internalized and externalized behavior problemsen_US
dc.subject (關鍵詞) intellectually gifteden_US
dc.title (題名) 高功能自閉症類群障礙兒童的執行功能之探究： 與症狀嚴重度、適應行為及行為問題表現之關聯性zh_TW
dc.title (題名) Exploration of the Executive Function in Children with High-functioning Autism Spectrum Disorder: Relationship with Symptom Severity, Adaptive Function and Problem Behaviorsen_US
dc.type (資料類型) thesisen_US
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