| Abstract: | 敘事表達可反映出敘事者對社會人際知識、對情緒的瞭解，及其對語言的理解、組織與 表達方式。因此，有關敘事能力的研究，可提供我們關於敘事者語言及認知歷程多方面的豐 富訊息。由於社交溝通缺陷是自閉症的核心障礙之一，專家認為敘事能力的評估有助我們瞭 解患者此項障礙。 綜觀國內外有關自閉症患者敘事能力的研究，雖研究方法、樣本特徵不盡相同，但多認 同患者與正常對照組在基本語言能力上差異不大。另一方面，多項分析均指出：自閉症患者 之敘事較少運用心智語彙、鮮少提供人物行為的因果解釋、指涉能力不足、乃至其未顧及聽 者需求。這些觀察，在在與敘事者的心智理論能力有關。 心智理論係指個體意識到他人亦有情感、需求、信念以及對事物的詮釋方式，當個體具 備如是體認，不僅可表述自身，並得以理解與推敲他人的心智狀態，進而解釋或預測他人的 行為，俾使個體得以在社會團體中存活。此種推測他人心智狀態的能力，不僅是人們賴以存 活的要件，亦是敘事中不可或缺的工夫。Tager-Flusberg 與Sullivan（1995）認為心智理論能 力對敘事表達頗為重要：因為成熟的敘事必須提及故事人物的行為動機，而成功的敘事者不 僅應具備穿梭故事人物不同角度的能力，尚須符合言談溝通的條件，體認到聽眾的需求。 多年來，Baron-Cohen 及其團隊經由各種研究取向，深入而有系統地探討自閉症障礙與 心智理論能力間之關係。他們認為自閉症患者對他人心理意圖的理解缺陷，與患者心智理論 的發展遲緩有關，並先後提出amygdala theory of autism、male brain、以及「同理－系統化理 論」等概念，試圖周延地解釋自閉症障礙。這些論述的核心精神旨在探討自閉症患者心智理 論能力的缺陷，與其社會認知及語言表達能力間之關係。 本世紀以來國內外自閉症的出現率迅速攀升，對自閉症之障礙與成因的研究，實有臨床 與理論的迫切需要。主流論述認為心智理論能力的不足是自閉症患者的主要障礙之一，而國 際學界認為敘事表達是觀察患者此項能力的重要窗口，但以漢語自閉症兒童為對象，聚焦於 敘事表達中心智理論能力表現的深入研究尚未有之。鑑於此，並為進一步檢視國外研究及臨 床觀察心得，本研究擬藉由跨領域合作的方式，深入剖析漢語高功能自閉症兒童敘事中心智 理論能力之表現。 本研究以Frog, where are you?為題材，針對敘事中心智理論能力的展現分別由微觀與巨 觀的角度，做質量並重的分析。我們以自閉症兒童為實驗組，以正常發展兒童為對照組；兩 組兒童就生理年齡、性別、語言理解、語言表達、智商等基本能力指標配對，以比較兩組兒 童在敘事中相關能力表現的異同，並釐清導致差異的可能因素。我們先自微觀分析的角度出 發，藉由兩個層面解析敘事者心智推演能力在敘事表達中之呈現。就故事人物的心智狀態描 述的層面而言：除編碼量化心智語彙出現的種類及分布，並進一步分析其出現的語境，以檢 視其是否建構為因果脈絡的一環；此外，我們聚焦於故事中的「麋鹿場景」，觀察自閉症兒童 如何在敘事表達中處理「錯誤表徵」及「外表－真實關係」等心智理論的核心概念。另一層 面，我們依循Colle 等人（2008）的作法，試圖由敘事中指涉策略的運用，推論敘事者對聽 者需求的關切程度，及其對交談合作原則的掌握。而自巨觀分析的角度，本研究藉由改編的 「漢語敘事評定量表」評估自閉症兒童整體敘事能力的表現。透過微觀與巨觀分析，我們探 討敘事者對心智語彙、錯誤表徵、指涉策略的處理，及其與整體敘事能力、情緒理解能力、 乃至各基本能力指標間的關係，以期對漢語高功能自閉症兒童的敘事能力有進一步認識，從 而提供臨床介入實務之參考。藉此，不僅可為國內自閉症兒童在這個研究場域留下珍貴語料， 亦利於將研究結果作跨語文的對應比較，進而檢驗心智理論缺陷說，在解釋自閉症兒童敘事 表達上之適切性。
Given its potential to illuminate not only linguistic capacities, but also cognitive and social knowledge, researchers increasingly analyze narrative ability as a means of exploring language ability of typical children and of measuring pragmatic language abilities of children with autism spectrum disorders (ASDs). As reported, no significant differences in general narrative abilities are found between children with ASDs and normal controls. A substantial amount of studies, however, indicate that autistic children are less likely to use references to frames of mind （FOM） in their narrative production. They tend to merely label emotions for the characters and show little regard for the causes of characters’ internal states. Moreover, autistic children appear to have difficulty in using anaphoric referential expressions, which embodies the failure in adapting their speech to the listeners. These performances presumably link to autistic children’s weakness in the theory of mind (ToM). ToM involves the realization that just as I have feelings, desires and beliefs, so do other people. With this capacity, one can comprehend the mind in relation to human behavior, and thus establish connections between mental states and related behaviors. As indicated by Tager-Flusberg and Sullivan (1995), the ToM ability is essential to narrative production. With this ability, a successful narrator can elaborate the psychological motivations or internal states of the characters in a story so as to account for their behaviors. And a successful narrator needs such ability to consider the needs and perspectives of the listeners so as to meet the requirements for communication. A variety of accounts have been proposed to explain pragmatic impairments of children with ASDs. The ToM deficit account is among the most influential endeavors. Baron-Cohen and his colleagues claim that children with ASDs have delays in the development of ToM. In recent decades, research of various approaches has provided much evidence for the ToM deficit in autistic population. Most of the research believes that the ToM deficit is responsible for the communication impairment in subjects with ASDs. Given the fact that the prevalence of ASDs has increased significantly in recent years, internationally as well as nationally, and that the impairment in pragmatic aspects, including communicative intention, narrative production, and social discourse, is considered one of the defining characteristics of this population, the studies of their difficulties with narrative production may have theoretical and therapeutic implications. In light of this, the present study aims to examine the relationship between the ToM ability and narrative production in high-functioning children with ASDs. We elicit subjects’ narrative production based on the picture book, Frog, where are you. The subjects are matched on Full-scale IQ, chronological age, and the abilities for both language comprehension and production. The present work attempts to uncover, with regard to the ToM ability, similarities and differences between normally-developing children and children with ASDs. To this end, we address the research questions in terms of micro- and macro-analyses. Regarding the microanalyses, we quantify how ToM manifests in children’s narratives by calculating the frequencies of FOM expressions, by sorting the interpretations for misrepresentations in the ‘deer episode’, and by categorizing narrators’ use of anaphoric referential expressions. For the macroanalysis, we assess subjects’ general narrative ability by using the Narrative Assessment Profile. We also examine the interrelatedness between variables such as intelligence quotient, general language ability, the ToM ability, emotion understanding, measures of FOM references, and the employment of referential strategies. In addition, we discuss the validity of the ToM-deficit theory in accounting for narrative ability of Mandarin-speaking children with ASDs. Related explanations in cognitive psychology will also be considered in our discussion. The outcome of the study, thus, may advance our understanding of narrative ability of children with ASDs, provide empirical evidence for examining the validity of related theories in this field, and, more significantly, have implications for therapeutic practices. |
