近年來，世界衛生組織提倡國際健康功能與身心障礙分類系統，參與的概念開始提升，而其中與人之間的互動更被認為是基本需求，因此，社會參與可當作為個人健康狀態、生活品質的指標之一。透過社會參與有助於孩童發展社會互動、人際關係等，進一步達到自我滿足、價值。自閉症類群障礙症主要發生在兒童發展早期，其症狀之一包含社交互動上的缺陷，使得他們無法順暢的與他人進行溝通，造成其生活品質、健康狀況受到限制。過去研究發現自閉症類群障礙症族群與典型發展者其社會參與相對而言來得低，然而，過去文獻所探討年齡族群較廣泛，且僅探討社會參與次數，並未著重於學齡前孩童，以及更深入探討社會參與各項層面，並透過ICF-CY參考架構完整來了解孩童與社會參與之相關因子。因此本研究目的有以下兩項：(1)比較學齡前自閉症類群障礙症孩童與典型發展孩童於社會參與情況的差異；(2)探討影響學齡前自閉症類群障礙症孩童社會參與的相關因子。研究工具主要由家長進行填寫量表，包含基本資料、社會參與量表、感覺處理能力剖析量2簡短版，而自閉症類群障礙組須填寫「文蘭適應性行為量表」、「1歲半至5歲兒童行為檢核表」，並且由治療師進行施測「兒童自閉症評量量表第二版」、「萊特非語文智力測驗修訂版」，過程約1小時。本研究收案人數為自閉症類群障礙孩童58位、典型發展孩童51位，結果呈現自閉症類群障礙孩童其社會參與的總活動數及差異度顯著低於典型發展孩童；然而，自閉症類群障礙孩童其社會參與的強度與典型發展孩童比較未有顯著性的差異。探討社會參與頻率、平均時間、投入程度，自閉症類群障礙孩童其在非結構性遊戲頻率顯著低於典型發展孩童，而在自閉症類群障礙孩童其在規則性遊戲頻率顯著高於典型發展孩童；針對平均時間，自閉症類群障礙孩童其在參訪展覽活動、技能課程、非結構遊戲顯著低於典型發展孩童；針對投入程度，自閉症類群障礙孩童其大多投入程度顯著低於典型發展孩童，除了在特殊活動、社區親子活動、規則性遊戲之外，其餘活動無顯著上的差異。在參與頻率中，自閉症類群障礙孩童到外面吃飯頻率與其症狀呈現輕度正相關，與認知、日常生活、社會化呈現輕度負相關；在參與非結構遊戲頻率與其症狀呈現輕度負相關，與認知、溝通、日常生活呈現輕度正相關；在參與規則性遊戲頻率與感覺登錄、情緒行為呈現輕度負相關。在參與平均時間中，參與規則性遊戲與認知具有中度正相關。在參與投入程度，參與展覽活動與症狀呈現中度負相關，與認知、溝通、日常生活能力呈現中度正相關；參與非結構遊戲與症狀、感覺逃避呈現中度負相關，與心理記憶、社會化呈現中度正相關。總結來說，良好的社會參與能夠促進孩童發展技能、提升生活品質，孩童心智功能、自閉症嚴重度、情緒行為、感覺處理能力、動作能力、日常生活功能和溝通與部份社會參與活動之相關性，顯示職能治療師未來促進自閉症兒童社會參與的表現可以著重於上述相關因子，並幫助家庭建立生活型態，提供孩童更多從自然情境中學習技巧的機會。

關鍵字:自閉症、社會參與、學齡前孩童、感覺特徵

Children can develop social interaction, interpersonal relationships, achieve self-satisfaction, and self-worth through social participation. The purposes of this study were stated as followed:(1) to compare the differences in social participation between preschool children with ASD and typically developing children; and (2) to examine factors associated with social participation of preschool children with ASD. This study included 58 children with ASD and 51 children with typical development. The Childhood Autism Rating Scale-Second Edition (CARS-2) and Leiter International Performance Scale-Revised (Leiter-R) for preschool children with ASD were administered by a registered occupational therapist. Questionnaires were completed by their parents. This study found that children with ASD had a significantly lower level of overall social participation and participated in a fewer number of activities than typically developing children. However, intensity of social participation of children with ASD were not significantly different from that of typically developing children. Most factors are related to some social participation activities. In the future, occupational therapists can focus on the related factors and work with families to establish a family life style.
Keywords: Autism Spectrum Disorder, Social Participation, Preschool Children, Sensory Processing Ability.

謝雅琳(2009)：自閉症孩童母親的日常職能活動經驗與主觀安適感。臺灣大學職能治療研究所學位論文, 1-89.
王南凱、吳岱穎、鄒國蘇、黃宜靜、郭冠良、吳逸帆、陳建志(2013)：淺談自閉症類群障礙。北市醫學雜誌，10(3)，173-181。
衛生福利部(2017)：身心障礙人數按類別及等級分。
http://dep.mohw.gov.tw/DOS/cp-1756-3512-113.html
吳武典、張正芬、盧台華、邱紹春（2004）：文蘭適應行為量表中文編譯版指導手冊台北：心理。
高鵬家、陳渝苓(2011)：遊戲與兒童發展之關係論述-理論與實際。大專體育，113，15-21
黃靄雯、劉淑雯、廖華芳(2013)：學齡前發展遲緩兒童之 [參與] 及其測量。物理治療，38(1)，16-28.
Achenbach, T. M. (2013). Achenbach System of Empirically Based Assessment (ASEBA). The Encyclopedia of Clinical Psychology.
American Occupational Therapy Association. (2014). Occupational therapy practice framework: Domain and process (3rd ed.). American Journal of Occupational Therapy, 68(Suppl. 1), S1-S48.
Bar‐Haim, Y., & Bart, O. (2006). Motor function and social participation in kindergarten children. Social Development, 15(2), 296-310.
Baio, J., Wiggins, L., Christensen, D. L., Maenner, M. J., Daniels, J., Warren, Z., ... & Durkin, M. S. (2018). Prevalence of autism spectrum disorder among children aged 8 years—Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2014. MMWR Surveillance Summaries, 67(6), 1.
Case-Smith, J. & O’Brien, J.C. (2015). Occupational therapy for children and adolescents
(7th ed.). St. Louis: Mosby.
Caster, T. R. (1984). The young child’s play and social and emotional development. In T. D. Yawkey & A. D. Pellegrini (Eds.) Children’s play and play therapy (pp. 17-29). Lancaster, PA: Techonomic Publishing.
Chamberlain, B., Kasari, C., & Rotheram-Fuller, E. (2007). Involvement or isolation? The social networks of children with autism in regular classrooms. Journal of Autism and Developmental Disorders, 37(2), 230-242.
Christensen, D. L., Bilder, D. A., Zahorodny, W., Pettygrove, S., Durkin, M. S., Fitzgerald, R. T., ... & Yeargin-Allsopp, M. (2016). Prevalence and characteristics of autism spectrum disorder among 4-year-old children in the autism and developmental disabilities monitoring network. Journal of Developmental & Behavioral Pediatrics, 37(1), 1-8.
DeGrace, B. W. (2004). The everyday occupation of families with children with autism. American Journal of Occupational Therapy, 58(5), 543-550
Dunn, W. (2014). Sensory Profile 2: User's Manual. Bloomington, MN: Pearson
Dunst, C. J., Hamby, D., Trivette, C. M., Raab, M., & Bruder, M. B. (2002). Young children's participation in everyday family and community activity. Psychological Reports, 91(3), 875-897.
Fabes, R. A., Martin, C. L., Hanish, L. D., Anders, M. C., & Madden-Derdich, D. A. (2003). Early school competence: The roles of sex-segregated play and effortful control. Developmental psychology, 39(5), 848
Farley, M. A., McMahon, W. M., Fombonne, E., Jenson, W. R., Miller, J., Gardner, M., . . . Ritvo, R. A. (2009). Twenty‐year outcome for individuals with autism and average or near‐average cognitive abilities. Autism Research, 2(2), 109-118.
Gan, S.-M., Tung, L.-C., Yeh, C.-H., Chang, H.-Y., & Wang, C.-H. (2014). The ICF-CY-based structural equation model of factors associated with participation in children with autism. Developmental Neurorehabilitation, 17(1), 24-33.
Germani, T., Zwaigenbaum, L., Magill-Evans, J., Hodgetts, S., & Ball, G. (2016). Stakeholders' perspectives on social participation in preschool children with Autism Spectrum Disorder. Developmental Neurorehabilitation, 1-8. doi:10.1080/17518423.2016.1214188
Geisthardt, C. L., Brotherson, M. J., & Cook, C. C. (2002). Friendships of children with disabilities in the home environment. Education and Training in Mental Retardation and Developmental Disabilities, 235-252.
Khetani, M., Graham, J. E., & Alvord, C. (2013). Community participation patterns among preschool-aged children who have received Part C early intervention services. Child Care Health Development, 39(4), 490-499. doi:10.1111/cch.12045
King, G., McDougall, J., DeWit, D., Petrenchik, T., Hurley, P., & Law, M. (2009). Predictors of change over time in the activity participation of children and youth with physical disabilities. Children's Health Care, 38(4), 321-351.
Koster, M., Pijl, S. J., Nakken, H., & Van Houten, E. (2010). Social participation of students with special needs in regular primary education in the Netherlands. International Journal of Disability, Development and Education, 57(1), 59-75.
Lai, D.-C., Tseng, Y.-C., Hou, Y.-M., & Guo, H.-R. (2012). Gender and geographic differences in the prevalence of autism spectrum disorders in children: Analysis of data from the national disability registry of Taiwan. Research in Developmental Disabilities, 33(3), 909-915.
Larson, E. A. (2000). The orchestration of occupation: The dance of mothers. American Journal of Occupational Therapy, 54(3), 269-280.
Law, M., King, G., Petrenchik, T., Kertoy, M., & Anaby, D. (2012). The assessment of preschool children's participation: Internal consistency and construct validity. Physical & Occupational Therapy in Pediatrics, 32(3), 272-287.
Law, M. (2002). Participation in the occupations of everyday life. American Journal of Occupational Therapy, 56(6), 640-649.
Levasseur, M., Richard, L., Gauvin, L., & Raymond, É. (2010). Inventory and analysis of definitions of social participation found in the aging literature: Proposed taxonomy of social activities. Social Science & Medicine, 71(12), 2141-2149.
LaVesser, P., & Berg, C. (2011). Participation patterns in preschool children with an autism spectrum disorder. OTJR: Occupation, Participation and Health, 31(1), 33-39.
Liptak, G. S., Kennedy, J. A., & Dosa, N. P. (2011). Social participation in a nationally representative sample of older youth and young adults with autism. Journal of Developmental & Behavioral Pediatrics, 32(4), 277-283.
Little, L. M., Ausderau, K., Sideris, J., & Baranek, G. T. (2015). Activity participation and sensory features among children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 45(9), 2981.
Liss, M., Saulnier, C., Fein, D., & Kinsbourne, M. (2006). Sensory and attention abnormalities in autistic spectrum disorders. Autism, 10(2), 155-172.
Nina, K., & Sigrid, Ø. (2015). A comparative ICF-CY–based analysis and cultural piloting of the assessment of preschool children's participation (APCP). Physical & Occupational Therapy in Pediatrics, 35(1), 54-72.
Orsmond, G. I., Krauss, M., & Seltzer, M. (2004). Peer relationships and social and recreational activities among adolescents and adults with autism. Journal of Autism and Developmental Disorders, 34(3), 245-256.
Orsmond, G. I., Shattuck, P. T., Cooper, B. P., Sterzing, P. R., & Anderson, K. A. (2013). Social participation among young adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 43(11), 2710-2719.
Pan, C.-Y., Tsai, C.-L., & Chu, C.-H. (2009). Fundamental movement skills in children diagnosed with autism spectrum disorders and attention deficit hyperactivity disorder. Journal of Autism and Developmental Disorders, 39(12), 1694-1705.
Piškur, B. (2013). Social participation: Redesign of education, research, and practice in occupational therapy. Scandinavian Journal of Occupational Therapy, 20(1), 2-8.
Roid, G. H., & Miller, L. J. (2011). Leiter international performance scale-revised (Leiter-R). Madrid: Psymtec.
Schopler, E., Bourgondien, M. E. V., Wellman, G. T., & Love, S. R. (2010). Childhood Autism Rating Scale, Second Edition. Los Angeles, CA: Western Psychological Services.
Solish, A., Perry, A., & Minnes, P. (2010). Participation of children with and without disabilities in social, recreational and leisure activities. Journal of Applied Research in Intellectual Disabilities, 23(3), 226-236.
Sun, X., Allison, C., Matthews, F. E., Sharp, S. J., Auyeung, B., Baron-Cohen, S., & Brayne, C. (2013). Prevalence of autism in mainland China, Hong Kong and Taiwan: A systematic review and meta-analysis. Molecular Autism, 4(1), 7.
Taheri, A., Perry, A., & Minnes, P. (2016). Examining the social participation of children and adolescents with intellectual disabilities and autism spectrum disorder in relation to peers. Journal of Intellectual Disability Research, 60(5), 435-443. doi:10.1111/jir.12289