高功能自閉症學齡兒童的心智理論與口語敘說

Theory of Mind and Narrative Abilities in School-Aged Children with High-Functioning Autism

10.6129/CJP.2012.5403.06

曹峰銘(Feng-Ming Tsao)；蔡佩君(Pei-Chun Tsai)；王加恩(Jia-En Wang)；呂信慧(Hsin-Hui Lu)

心智理論 ； 高功能自閉症 ； 敘說 ； 學齡兒童 ； high-functioning autism ； narrative ； school-aged children ； theory of mind

中華心理學刊

54卷3期（2012 / 09 / 01）

365 - 383

繁體中文

自閉症學齡兒童呈現「心智理論」能力缺陷，而且出現異常的「口語敘說」。但是，低年級高功能自閉症兒童的「心智理論」表現是否與正常發展兒童不同，並伴隨特殊的「口語敘說」風格，以及兩種能力彼此關連等議題則有待檢驗。本研究以系列心智理論及連環圖敘說作業，探索六至八歲高功能自閉症（n = 30）和配對生理年齡、整體智商及語文智商之正常發展兒童（n = 30）的心智理論與敘說表現。「心智理論」作業的結果顯示，兩組兒童心智理論分作業的難度順序類似，均為「不同欲求」、「不同信念」、「訊息知曉」、「初級錯誤信念－非預期內容」、「初級錯誤信念－非預期位置」、「情緒隱藏」及「次級錯誤信念」；另外，高功能自閉症組心智理論各分作業的通過率均低於配對組。「敘說」作業的結果顯示，兩組兒童敘說圖畫故事時的整體結構、細部的語言特徵（即，詞彙總量及詞彙變異性）相似；但是高功能自閉症組的敘說較少以「心理歸因」為主題、正確指涉故事人物意圖的比例偏低、而較常使用「敘說強調技巧」。最後，相關分析顯示，高功能自閉症兒童的心智理論作業總分與敘說的「意圖指涉正確比例」、「語意強調」及「語意不清」等指標有關。逐步回歸分析顯示，「意圖指涉正確比例」和「語意強調」最能解釋心智理論表現的變異量。

The Theory of Mind (ToM) deficit is well-documented in children with high-functioning autism (HFA). Few studies have explored the differences of ToM and narrative performances between children with HFA and typically developing children in the first and second grades. In addition, it is unclear whether ToM and narrative performances in children with HFA are related. To examine these questions, we administered a variety of ToM tasks as well as narrative tasks (with a series of comic strips) to 6- to 8-year-olds with HFA (n = 30) and typically developing children at the same ages (n = 30). Results show that the HFA and matched groups responded similarly to the difficulty rankings of the ToM tasks, with Diverse Desire (DD) being the most difficult, followed by Diverse Belief (DB), Knowledge Access (KA), False Belief-Unexpected Content (FB-UC), False Belief-Unexpected Location (FB-UL), Hidden Emotion (HE) and Secondary False Belief task (SFB). However, the matched group outperformed the HFA group on each ToM task. On narrative tasks, children with HFA performed similarly to the matched group in global narrative structure and specific linguistic features (e.g., total number of words and type-token ratio). However, compared with the matched group, HFA children used fewer psychological attributions, had lower ratio to correctly attribute character's intentions, and had more semantic intensifiers in their narratives. Finally, the ToM scores were significantly correlated with specific narrative features (i.e., ratio to correctly attribute character's intentions, usage of semantic intensifiers and number of ambiguous references). The stepwise regression model shows that ratio to correctly attribute character's intentions and usage of semantic intensifiers accounted for the most variances in HFA children's ToM performances.

1. 陳冠杏、張正芬(2005)。國小低年級高功能自閉症學生口語敘事能力之研究。特殊教育與復健學報，13，209-235。
   連結：
2. 鄒啟蓉、張鑑如、張顯達(2009)。高功能自閉症兒童個人生活經驗敘述研究。特殊教育研究學刊，34(2)，73-99。
   連結：
3. 鄒啟蓉、張顯達(2007)。高功能自閉症兒童說故事能力與相關影響因素研究。特殊教育研究學刊，32(3)，87-109。
   連結：
4. 陳榮華、陳心怡（ 2 0 0 7 ） ： 《魏氏兒童智力量表第四版（ 中文版） 指導手冊》。台北： 中國行為科學社。[Chen, R.-H., & Chen, H.-Y. (2007). Administration and scoring manual of Wechsler intelligence scale for children -- Fourth edition（Chinese Version）. Taipei: Chinese Behavioral Science Corporation.]。
5. Linacre, J. M. (2007). A user's guide to WINSTEPS MINISTEP: Rasch-Model computer programes. Chicago: Winsteps.com..
6. American Psychiatric Association(2000).Diagnostic and statistical manual of mental disorders.Washington, DC:Author.
7. Bamberg, M.,Reilly, J.(1996).Emotion, narrative, and affect: How children discover the relationship between what to say and how to say it.Hillsdale, NJ:Lawrence Erlbaum Associates.
8. Baron-Cohen, S.(1989).The autistic child's theory of mind: A case of specific developmental delay.Journal of Child Psychology and Psychiatry,30,285-298.
9. Baron-Cohen, S.(2009).Autism: The empathizingsystemizing (E-S) theory.Annals of the New York Academy of Science,1156,68-80.
10. Baron-Cohen, S.(2000).Theory of mind and autism: A review.International Review of Research in Mental Retardation,23,169-184.
11. Baron-Cohen, S.(Ed.),Tager-Flusberg, H.(Ed.),Cohen, D. J.(Ed.)(1994).Understanding other minds: Perspectives from autism.New York:Oxford University Press.
12. Baron-Cohen, S.,Leslie, A. M.,Frith, U.(1985).Does the autistic child have a "theory of mind?".Cognition,21,37-46.
13. Baron-Cohen, S.,Leslie, A. M.,Frith, U.(1986).Mechanical, behavioural and intentional understanding of picture stories in autistic children.British Journal of Developmental Psychology,4,113-125.
14. Capps, L.,Losh, M.,Thurber, C.(2000)."The frog ate the bug and made his mouth sad:" Narrative competence in children with autism.Journal of Abnormal Child Psychology,28,193-204.
15. Carroll, J. B.(1964).Language and thought.Englewood Cliffs, NJ:Prentice-Hall.
16. Colle, L.,Baron-Cohen, S.,Wheelwright, S.,van der Lely, H. K. J.(2008).Narrative discourse in adults with high-functioning autism or Asperger syndrome.Journal of Autism and Developmental Disorders,38,28-40.
17. Ehlers, S.,Gillberg, C.,Wing, L.(1999).A screening questionnaire for Asperger syndrome and other highfunctioning autism spectrum disorders in school age children.Journal of Autism and Developmental Disorders,29,129-141.
18. García-Pérez, R. M.,Hobson, R. P.,Lee, A.(2008).Narrative role-taking in autism.Journal of Autism and Developmental Disorders,38,156-168.
19. Happé, F. G. E.(1995).The role of age and verbal ability in the theory of mind task performance of subjects with autism.Child Development,66,843-855.
20. Labov, W.(1972).Language in the inner city: Studies in the black English vernacular.Philadelphia, PA:University of Pennsylvania Press.
21. Lind, S. E.,Bowler, D. M.(2009).Language and theory of mind in autism spectrum disorder: The relationship between complement syntax and false belief task performance.Journal of Autism and Developmental Disorders,39,929-937.
22. Liu, D.,Wellman, H. M.,Tardif, T.,Sabbagh, M. A.(2008).Theory of mind development in Chinese children: A meta-analysis of false-belief understanding across cultures and languages.Developmental Psychology,44,523-531.
23. Losh, M.,Capps, L.(2003).Narrative ability in high-functioning children with autism or Asperger's syndrome.Journal of Autism and Developmental Disorders,33,239-251.
24. Loveland, K. A.,McEvoy, R. E.,Tunali, B.,Kelley, M. L.(1990).Narrative story telling in autism and Down's syndrome.British Journal of Developmental Psychology,8,9-23.
25. MacWhinney, B.(2000).The CHILDES project : Tools for analyzing talk - Volume II: The database.Mahwah, NJ:Lawrence Erlbaum Associates.
26. Nelson, N. W.(1998).Childhood language disorders in context: Infancy through adolescence.Austin, TX:Pro-Ed.
27. Paynter, J.,Peterson, C.(2010).Language and ToM development in autism versus Asperger syndrome: Contrasting influences of syntactic versus lexical/semantic maturity.Research in Autism Spectrum Disorders,4,377-385.
28. Perner, J.,Wimmer, H.(1985)."John thinks that Mary thinks that ...:" Attribution of second-order beliefs by 5-to 10-year-old children.Journal of Experimental Child Psychology,39,437-471.
29. Peterson, C. C.,Wellman, H. M.,Liu, D.(2005).Steps in theory-of-mind development for children with deafness or autism.Child Development,76,502-517.
30. Premack, D.,Woodruff, G.(1978).Does the chimpanzee have a theory of mind?.Behavioral and Brain Science,1,515-526.
31. Tager-Flusberg, H.(1995)."Once upon a ribbit:" Stories narrated by autistic children.British Journal of Developmental Psychology,13,45-59.
32. Tager-Flusberg, H.(2007).Evaluating the theory-ofmind hypothesis of autism.Current Directions in Psychological Sciecne,16,311-315.
33. Tager-Flusberg, H.,Sullivan, K.(1995).Attributing mental states to story characters: A comparison of narratives produced by autistic and mentally retarded individuals.Applied Psycholinguistics,16,241-256.
34. Tager-Flusberg, H.,Sullivan, K.(1994).A second look at second-order belief attribution in autism.Journal of Autism and Developmental Disorders,24,577-586.
35. Tsai, M. L.,Tsao, F. M.,Liu, H. M.,Wang, P. L.(2009).Young children's reading of serial pictures: A tool to assess language development.the 2009 Society for Research in Child Development Biennial Meeting,Denver, CO:
36. Volden, J.,Lord, C.(1991).Neologisms and idiosyncratic language in autistic speakers.Journal of Autism and Developmental Disorders,21,109-130.
37. Volkmar, F. R.,State, M.,Klin, A.(2009).Autism and autism spectrum disorders: Diagnostic issues for the coming decade.Journal of Child Psychology and Psychiatry,50,108-115.
38. Wellman, H. M.,Liu, D.(2004).Scaling of theory-ofmind tasks.Child Development,75,523-541.
39. Williams, D.(2010).Theory of own mind in autism: Evidence of a specific deficit in self-awareness?.Autism,14,474-494.
40. Wimmer, H.,Perner, J.(1983).Beliefs about beliefs: Representation and constraining function of wrong beliefs in young children's understanding of deception.Cognition,13,103-128.
41. 陳質采(2007)。Taipei, Taiwan，國立陽明大學公共衛生研究所=National Yang-Ming University。
42. 錢才瑋、王文中、陳承德、張文信、林宏榮、劉歐(2006)。Rasch分析在醫療界之應用。台南=Tainan:聞道=Catholic Window Press。
43. 錡寶香(2003)。國小低閱讀能力學童與一般閱讀能力學童的敘事能力：篇章凝聚之分析。特殊教育研究學刊，24，63-84。
44. 錡寶香(2001)。國小低閱讀成就學生的口語述說能力： 語言層面的分析。特殊教育學報，15，129-175。

1. 陳香如、張鑑如(2014)。一般發展幼兒及輕度泛自閉症幼兒心智理論與母親心智言談。特殊教育研究學刊，39(3)，1-27。
2. 李穎安(2021)。自閉症與注意力缺陷過動症兒童之口語敘事表現。特殊教育季刊，158，37-48。
3. 薩文蕙,童寶娟(2019).STORYBOOK NARRATIVES IN MANDARIN-SPEAKING PRE-ADOLESCENTS WITH AND WITHOUT AUTISM SPECTRUM DISORDER: INTERNAL STATE LANGUAGE AND THEORY OF MIND ABILITIES.Taiwan Journal of Linguistics,17(2),67-89.
4. 楊書沛、楊欣諭、林慧麗、李霈璿(2015)。漢語母語自閉障礙患童與青少年的主謂賓語句型理解與心智理論縱貫研究。教育心理學報，46(3)，401-423。
5. 張正芬、林迺超(2015)。輕症自閉症兒童故事重述能力之研究。特殊教育研究學刊，40(2)，61-90。
6. (2023)。語言行為與語言行為結合音樂教學對提升泛自閉症兒童互動式語言之成效與差異。特殊教育學報，58，85-120。
7. (2024)。口罩遮蔽對不同臉孔表情判斷之影響：與自閉症特質及同理心的關聯性。臨床心理學刊，18(1)，18-34。