輕症自閉症兒童口語敘事能力之研究

Abstract

本研究主要目的在探討國小不同年級的輕症自閉症兒童與一般兒童口語敘事能力的差異情形及重要相關因素。為進行此研究，研究者首先透過魏氏兒童智力量表控制語文智商後，立意取樣了一般兒童及輕症自閉症兒童各47名，合計94名參與本研究，且分別收集了兩組兒童的故事重述、個人經驗敘述共773則故事及評估其心智理論能力。語料資料以CHILDES進行編碼和轉檔，並對兩組兒童的敘事長度、敘事要素及敘事結構及相關重要因素進行比較分析。本研究主要發現如下： 一、敘事長度方面，兩組兒童表現相當，且低、中、高年級各年級間兩組兒童均無顯著差異。 二、敘事要素方面，故事重述方面，輕症自閉症兒童述說背景、結果、引發事件、嘗試、內在反應的表現均顯著低於一般兒童，回應則沒有顯著差異。個人經驗敘述方面，輕症自閉症兒童在主題維持、順序性、訊息量、背景、評價、指涉等六個敘事要素指標的表現均較一般兒童低落，僅有連接詞兩組之間並未有顯著差異。 三、敘事結構方面，故事重述方面，輕症自閉症兒童出現描述式序列類型的故事較一般兒童多；一般兒童則較輕症自閉症兒童出現較多的完整情節類型的故事。個人經驗敘述方面，輕症自閉症兒童流水帳式敘事和無結尾敘事類型的比例較一般兒童多，而一般兒童則是典型敘事類型的比例顯著多於輕症自閉症兒童。 四、輕症自閉症兒童口語敘事長度和心智理論能力有顯著相關，敘事內容則和心智理論能力、生理年齡有顯著相關。

綜合本研究結果與討論，提出下列結論： （一）輕症自閉症兒童並非所有的敘事要素均較一般兒童低落，約可分為四種情形，1.部份敘事要素的使用，無論哪一個年齡層輕症自閉症兒童與一般兒童表現均相當的，如故事重述的回應和個人經驗敘述的連接詞；2.部份敘事要素雖然低年級時輕症自閉症兒童表現較一般兒童低落，但隨著年齡的增加，兩組兒童的述說能力逐漸相當，如故事重述的背景、引發事件、結果等要素和個人經驗敘述的主題維持、順序性等要素；3.部份敘事要素隨著年齡的增加，一般兒童變得更加成熟，但輕症自閉症兒童的發展卻依然停滯，所以產生了差異情形，如故事重述的內在反應和個人經驗敘述的指涉；4.有些敘事要素是輕症自閉症兒童無論哪一個年齡階段，其表現均較一般兒童低落，如個人經驗敘述的訊息量、背景及評價。 （二）輕症自閉症兒童的敘事結構類型未如一般兒童一樣，隨著年齡的發展，增加比較完整故事結構的比例或減少不完整故事結構的比例，顯示其敘事結構類型的發展較一般兒童有遲緩現象。 （三）輕症自閉症兒童心智理論能力越好，其述說的敘事長度越長。此外，無論是故事重述或個人經驗敘述，他們的故事內容亦會隨著年級的增加而更成熟，並非完全停滯不前。 （四）輕症自閉症兒童的故事重述或個人經驗敘述均有敘事長度和敘事內容顯著相關情形，代表敘事長度越長的故事，其敘事內容品質也較佳。。The study investigated the oral narrative ability and related factors in elementary school-age children with mild Autistic Spectrum Disorder (ASD). Forty-seven children with mild ASD and 47 typically- developing pairs matched with the Verbal Comprehension Index (VCI) and the same grades were recruited. Informed consent forms were collected from all parents of children participants. The data includes 773 story-retelling and personal experience narratives. The data is analyzed by the Child Language Data Exchange System (CHILDES). The results were as followings: 1.There was no significant difference in the narrative length between the ASD and control groups across the low, middle and high grade levels. 2.For the narrative elements, the quantities of setting, consequence, initiating event, attempt, and internal response of the mild ASD in the story-retelling narratives were significantly lower than that of their typically-developing peers. No difference was found for the reaction measure. As for the personal experience narratives, the quantities of topic maintenance, event sequencing, informativeness, setting, evaluation, and referencing were significantly lower in the ASD children, but no difference was found in the conjunction measures between the two groups. 3.For the narrative structures, based on the story-telling data, the quantity of descriptive sequences of the mild ASD were higher than that of the peers, whereas the quantity of complete episodes of the typically-developing children were higher than that of children with mild ASD. Based on the personal experience data, the proportion of chronology narrative and end-at-the-high-point narrative were higher in the ASD group, but the proportion of classic narratives were higher in the control group. 4.The narrative length of the mild ASD was significantly correlated with their theory of mind ability, and the narrative contents were significantly related to the theory of mind and chronological age.

Based on the results, four conclusions are drawn in this study: 1.Children with mild ASD are not inferior to children with same verbal intelligence level in all aspects of narrative elements. There are four possible patterns of the development for narrative elements between the two groups: (1) children with mild ASD show equivalent performance for the elements to their age peers consistently across the grade levels; (2) children with mild ASD start poorer for the elements in the low grade level but catch up afterwards; (3) children with ASD does not improve with age for the elements and the difference between the two groups become more obvious in higher grade levels because control children become more sophisticated, and (4) children with mild ASD show consistently poorer performance for the elements to their age peers across the grade levels. 2.The development of narrative structure in children with mild ASD is delayed comparing to the control group. They have higher proportion of incomplete episodes, and the proportion of complete episodes does not increase with age as in the control group. 3.For the ASD group, children with higher theory of mild ability have longer narrative length. Their performances in story contents become more mature in both the story-retelling and personal experience narratives 4.For the mild ASD, the relationship between the narrative length and contents are significant correlated in both the story-retelling and personal experience narratives. The quality of narratives is better as the narrative length increases.