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| Title: | 自閉症類群障礙症之症狀嚴重度、認知能力、適應功能及生活品質：從幼兒到青年
Symptom Severity, Cognitive and Adaptive Functions, and the Quality of Life in Autism Spectrum Disorder: from Early Childhood to Youth |
| Authors: | 劉怡君
Liu, Yi-Chun |
| Contributors: | 姜忠信
Chiang, Chung-Hsin
劉怡君
Liu, Yi-Chun |
| Keywords: | 自閉症類群障礙
自閉症發展軌跡
認知功能
適應行為
生活品質
整體社會功能
Autism spectrum disorder
Developmental trajectory
Cognitive function
Adaptive behavior
Quality of life
Social functioning |
| Date: | 2022 |
| Issue Date: | 2023-07-06 16:59:11 (UTC+8) |
| Abstract: | 研究背景及目的：過去西方國家的縱貫研究研究發現，自閉症類群障礙症診斷穩定，症狀嚴重度、智商和適應行為變化，並不一致，亞洲國家的研究非常有限。本次納入過去三個時間點（時間點一：2.5歲、時間點二：4歲、時間點三：8.5歲），持續追蹤時間點四（18歲）的青年，來瞭解台灣南部自閉症患者從幼兒到青年期間的診斷穩定度、症狀嚴重度、認知功能和適應行為發展變化，並了解過去時間點中哪些指標對青年生活品質及整體社會功能有預測性。研究方法：本研究納入台灣嘉義地區16-19歲（時間點四）之22名ASD與18名非ASD（Non-ASD）共40位受試者，22名ASD與15名Non-ASD有完整四個時間點資料，兩組在四個時間點皆接受評估症狀嚴重度，使用自閉症診斷觀察量表和家長診斷會談，評估認知功能使用魏氏兒童/成人智力量表第四版，時間點二至四接受評估適應行為，使用文蘭適應行為量表第二版晤談版，時間點四（青年期）接受評估生活品質和整體社會功能，使用世衛組織生活品質問卷及自閉症生活品質問卷。統計方法為獨立樣本t檢定、斯皮爾曼相關、二因子重複測量、線性迴歸。研究結果：（一）ASD和Non-ASD個案從幼兒至青年診斷穩定度高；ASD在幼兒至學齡期（時間點三）症狀漸嚴重，學齡期後未有顯著變化，而Non-ASD症狀嚴重度則是幼兒至青年皆未有顯著變化。（二）學齡期前，ASD及Non-ASD之認知功能和適應行為皆隨時間增加而進步，學齡期至青年時，ASD認知功能進步，適應行為的溝通領域退步，Non-ASD認知功能退步，適應行為的日常生活技巧進步。（三）ASD和Non-ASD青年生活品質分數未有差異，ASD相較其家長填答結果，感受社交關係滿意度較高，80%ASD青年整體社會功能表現為中等以下程度。（四）學齡期後症狀嚴重度低、整體適應行為佳，整體社會功能越好；幼兒期、學齡期智商高和青年期適應行為佳，社交關係或身心障礙生活品質越好；青年期情緒行為問題越少，生活品質越好。結論：本研究發現ASD和Non-ASD在幼兒至青年發展變化中，學齡期可能為重要時間點，學齡期至青年，ASD和Non-ASD個案在症狀嚴重度、認知功能、適應行為皆有不同變化，但診斷大致穩定不變。學齡前智商、學齡後症狀嚴重度及適應行為可能為影響青年ASD和Non-ASD整體社會功能和生活品質的重要因子。
Background and Purpose: Previous studies showed that the diagnosis of Autism Spectrum Disorder (ASD) is stable, but the changes in symptom severity, cognitive function, and adaptive behavior are inconsistent. The purpose of the study was to examine the diagnostic stability, autism symptom severity, cognitive functions, and adaptive behaviors from toddler to adolescence, and which predictors make important contributions to the quality of life and social functioning of adolescents.
Methods: The study followed the previous data in the past 3 time points (time 1: 2.5 years old, time 2: 4 years old, time 3: 8.5 years old) in Chiayi, Taiwan, including 40 youth with 22 ASD and 18 Non-ASD at time 4 (16-19 years old), 37 of them have full time point data (22 ASD and 15 Non-ASD). The study assessed Autism symptom severity and Cognitive function by ADOS/ADI-R and WAIS/WISC at all times; adaptive behaviors by VABS-II at times 2 to 4; quality of life by WHOQOL or ASQoL, and social functioning at time 4. Statistical methods included two-sample t-test, spearman correlation, repeated measures, and linear regression.
Results: The results showed that the diagnostic stability of ASD and Non-ASD was high from toddlerhood to adolescence. Autism symptom severity increased from toddlerhood to school age, but remained relatively stable thereafter. Non-ASD symptom severity did not change significantly over time. Cognitive function and adaptive behaviors followed similar patterns in both groups before school age. In ASD, cognitive function improved after school age, while communication skills decreased in youth compared to school age. Non-ASD individuals showed improved cognitive function and daily living skills after school age. There was no significant difference in the quality of life between ASD and Non-ASD youth, but ASD individuals reported higher satisfaction in social relationships compared to parent proxy reports. Approximately three-quarters of youth were graded ‘fail or good’ in social function by their parents. Better social functioning was associated with lower symptom severity after school age and improved adaptive behaviors. Higher IQ before school age and better adaptive behaviors or fewer emotional and behavioral problems in youth were associated with better quality of life.
Conclusion: This study found that school age (time 3) may be a critical period for understanding the trajectories of symptom severity, cognitive function, and adaptive behavior in individuals with ASD and Non-ASD. While the diagnosis remained stable, there were distinct developmental patterns observed in these domains. IQ, adaptive behaviors and symptom severity were significant predictors of the quality of life and social functioning of youth. |
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| Description: | 碩士
國立政治大學
心理學系
109752004 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0109752004 |
| Data Type: | thesis |
| Appears in Collections: | [心理學系] 學位論文
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