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    题名: 自閉症類群障礙兒童症狀嚴重度發展軌跡類型之探討
    Patterns of Developmental Trajectories of Symptom Severity in Children with Autism Spectrum Disorder
    作者: 林楷潔
    Lin, Kai-Chieh
    贡献者: 姜忠信
    Chiang, Chung-Hsin
    林楷潔
    Lin, Kai-Chieh
    关键词: 自閉症類群障礙症
    自閉症症狀發展軌跡類型
    認知功能
    適應行為
    城鄉差距
    autism spectrum disorder
    autistic symptom developmental trajectory
    cognitive function
    adaptive function
    urbanicity
    日期: 2019
    上传时间: 2019-08-07 16:34:12 (UTC+8)
    摘要: 自閉症類群障礙症（Autism Spectrum Disorder, ASD）被視為具高度異質性的發展障礙症，區辨出ASD症狀發展軌跡的類型被視為是理解ASD異質性的重要觀點。本研究追蹤六年74名來自於台灣都會地區台北市（n = 37）與鄉村地區嘉義縣市（n = 37）的ASD兒童，在兒童平均生理年齡為3歲、5歲、9歲三個時間點時測量其ASD症狀嚴重度，透過階層式群集分析搭配二因子混合設計變異數分析，區辨出橫跨學步兒期至學齡期的ASD症狀發展軌跡類型，並進一步使用多項式邏輯斯迴歸分析，探索環境背景、兒童早期特徵等對於發展軌跡類型的預測力，及用單因子變異數分析，檢視各發展軌跡類型的環境、認知功能特徵及行為問題、適應行為、親職壓力等預後表現之組間差異。研究結果區辨出「高嚴重度組」（24.32％）、「改善組」（12.16％）、「持續中嚴重度組」（21.62％）及「惡化組」（41.89％）四種ASD症狀發展軌跡；各發展軌跡類型在父母教育程度、早期認知功能、認知功能進步幅度，及國小階段的認知功能、適應行為上皆具有各自獨特的樣貌；本研究亦發現，收案地區能夠有效地預測發展軌跡組別，僅有居住在都會地區台北市的ASD兒童屬於改善組。研究結果反映出居住環境、醫療資源可行性及疾病敏感度等在ASD病程發展的重要角色。
    Autism spectrum disorder (ASD) is widely known to be a highly heterogeneous neurodevelopmental disorder. Focusing on the developmental trajectories of autism severity is one of promising ways to understand the heterogeneity of ASD and may lead to a better understanding of prognosis (Baker, Smith, Greenberg, Selzer, & Taylor, 2011). However, seldom longitudinal studies have been conducted in the East, and also none of them addressed the topic of urbanicity. In this study, 74 ASD participants recruited from Taiwan metropolitan area Taipei city (n=37) and rural area Chiayi county (n=37) were assessed at three time points from toddlerhood to school age (mean age: T1 = 36.29 months, T2 = 58.78 months, T3 = 109.68 months) across 6 years. The hierarchical cluster analysis collocated with two-way mixed designed ANOVA were used to identify the subgroups of three time points on ADOS Total CSS. Similar to finding of Western sample, Taiwan ASD children can be divided into four subgroups including “high severity” (24.32%), “improving” (12.16%), “persistent moderate severity” (21.62%) and “worsening” (41.89%). Each subgroup has its own characteristics of demography, cognitive functions and adaptive functions. Living area is the strongest predictor to subgroups, which imply the importance of urbanicity, such as unitization of medical sources, opportunity of be detected in places outside home, on ASD developmental psychopathology.
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    描述: 碩士
    國立政治大學
    心理學系
    102752014
    資料來源: http://thesis.lib.nccu.edu.tw/record/#G1027520141
    数据类型: thesis
    DOI: 10.6814/NCCU201900328
    显示于类别:[心理學系] 學位論文

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