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| Title: | 丹佛早療模式對自閉症類群障礙症幼兒的社會溝通能力之療效研究
The Effectiveness of Early Start Denver Model on the Social Communication Abilities for Young Children with Autism Spectrum Disorder |
| Authors: | 曹芷庭
Tsao, Chih-Ting |
| Contributors: | 姜忠信
曹芷庭
Tsao, Chih-Ting |
| Keywords: | 自閉症類群障礙症
丹佛早療模式
共享式注意力
假扮遊戲
模仿
Autism spectrum disorder
Early Start Denver Model
Joint attention
Pretend play
Imitation |
| Date: | 2020 |
| Issue Date: | 2020-07-01 13:49:15 (UTC+8) |
| Abstract: | 研究目的：發展心理病理的論點之一，是認為自閉症類群障礙症（autism spectrum disorder, ASD）患者有心智理論能力的發展缺陷。丹佛早療模式（Early Start Denver Model, ESDM）是一個兼具實徵研究及理論基礎的綜合性ASD幼兒早療模式，過去研究顯示其對ASD幼兒的整體認知能力及症狀行為具有療效。本研究以心智理論能力的先備能力為基礎，評估ESDM對於共享式注意力（joint attention, JA）、模仿及遊戲能力等早期社會溝通缺損，以及各領域症狀嚴重度之療效。
研究方法：本研究以前、後測個案控制研究設計，共招募介入組及對照組各21位參與者（平均生理月齡分別為33.23/35.25個月），介入組參與者接受24週的ESDM個別介入，對照組則接受一般醫療院所、坊間早療及幼兒園等介入。兩組參與者分別介入前（時間點一）、介入後（時間點二），以及介入結束半年後（時間點三）等三個時間點，接受JA、遊戲及模仿能力的實驗室作業測量，及以自閉症觀察診斷量表（Autism Diagnostic Observation Schedule）評估症狀嚴重度。
研究結果：相較介入前的表現，介入組參與者遊戲能力在時間點三進步較對照組大。此外，本研究以發展商數55區分高、低功能參與者，發現介入組低功能參與者介入後的假扮遊戲進步明顯較大，時間點三之手部模仿，即時的主動共享式注意力及遊戲能力進展幅度亦優於對照組。
結論：整體而言，ESDM對於ASD幼兒的遊戲能力有明顯助益，且更能提升低功能參與者的社會溝通能力。未來研究建議選擇隨機控制設計，選擇適切的測量指標，蒐集具代表性的樣本，以進一步澄清ESDM對ASD患者早期社會溝通能力的療效。
Objectives: Individauls with autism spectrum disorder (ASD) are characterized with Theory of Mind (ToM) deficit, one of theoretical perspectives in developmental psychopathology. Early Start Denver Model (ESDM) is an evidence- and theory-based comprehensive early intervention for young children with ASD. The positive effect of ESDM on cognition and symptoms has been demonstrated in recent studies. This study evaluated the effectiveness of ESDM on the precursors of ToM: joint attention, play and imitation, as well as symptom severity.
Methods: A pre-post test case control study was conducted. Twenty-one children with ASD were recruited as the intervention group (N = 21, mean age = 33.23 months), receiving one-on-one ESDM intervention for 24 weeks. While the comparison group (N = 21, mean age = 35.25 months) received community-intervention. The joint attention, play and imitation abilities and symptom severity were assessed per-intervention (T1), post-intervention (T2) and 6 months after intervention (T3).
Results: Compared to the comparison group, the intervention group showed greater improvement in play ability from T1 to T3. Furthermore, low-functioning children (development quotient < 55) with ASD in the intervention group showed significant improvement in pretend play on T2, as well as in hand motion imitation, initiation of joint attention and pretend play on T3 compared to low-functioning children with ASD in the comparison group.
Conclusions: The findings suggested ESDM have positive effects on precursors of ToM for young children with ASD, especially for low-functioning participants. Suggestions for future study are mentioned, including recruiting larger sample size, adjusting the measurement and conducting a randomized control study. |
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| Description: | 碩士
國立政治大學
心理學系
105752005 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0105752005 |
| Data Type: | thesis |
| DOI: | 10.6814/NCCU202000631 |
| Appears in Collections: | [心理學系] 學位論文
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| 200501.pdf | | 3046Kb | Adobe PDF2 | 48 | View/Open |
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