| 研究生: |
尤姿婷 Yu, Tzu-Ting |
|---|---|
| 論文名稱: |
學齡前自閉症類群障礙症孩童日常社交參與動機:與正常發展孩童之比較 Motivation for real-life social engagement of preschool children with autism spectrum disorder compared to typically developing peers |
| 指導教授: |
陳官琳
Chen, Kuan-Lin |
| 共同指導教授: |
陳昱瑋
Chen, Yu-Wei Ryan |
| 學位類別: |
碩士 Master |
| 系所名稱: |
醫學院 - 職能治療學系 Department of Occupational Therapy |
| 論文出版年: | 2020 |
| 畢業學年度: | 108 |
| 語文別: | 英文 |
| 論文頁數: | 78 |
| 中文關鍵詞: | 社交動機 、自閉症類群障礙症 、自我決定理論 、經驗取樣法 |
| 外文關鍵詞: | motivation for social engagement, autism spectrum disorder, self-determination theory, experience sampling methodology |
| 相關次數: | 點閱:81 下載:0 |
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社交動機 (motivation for social engagement)是自閉症類群障礙症孩童 (autism spectrum disorder, ASD)社交參與重要的影響因子之一,進而影響ASD孩童的家庭互動與學校生活。然而,目前文獻關於ASD孩童是否有社交動機有不同的結論,原因可能有二:(一) ASD孩童在特定情境下才有社交動機,以及(二) 目前社交動機都是在實驗室情境下測量並以二分法區分。因此過去研究無法真實反映ASD孩童的日常生活環境中的社交動機,在特定情境下才有社交動機的ASD孩童也有可能被認為無社交動機。自我決定理論 (self-determination theory, SDT)強調情境對於基本心理需求滿足程度和社交動機的影響,而經驗取樣法 (experience sampling methodology, ESM)可用以蒐集社交動機與自然情境間的動態資料。此外,ASD嚴重程度也可能影響基本心理需求滿足程度,進而影響社交動機。為考量上述二議題,本研究以SDT為理論基礎、採用ESM並考量ASD嚴重程度來探討學齡前ASD孩童的日常情境與社交動機的關係。本研究包含四目的:(一) 比較ASD孩童與正常發展 (typically-developing, TD)孩童的社交動機;(二) 探討ASD嚴重程度是否為社交動機的調節因子;(三) 探討ASD及TD孩童在日常情境中基本心理需求滿足程度是否不同。本研究納入30位3至6歲學齡前ASD孩童與年齡和性別相對應的30位TD孩童以及其照顧者。日常社交參與問卷 (ESM survey of daily social participation, ESM-DSP)用於調查學齡前孩童七天的情境、基本心理需求滿足程度和社交動機,是由探討ASD青少年及成人社交經驗的經驗取樣法問卷翻譯及文化調整而來。魏氏幼兒智力量表第四版語言分測驗 (Verbal Comprehension Index of the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, WPPSI-IV)及自閉症兒童行為檢核表 (Childhood Autism Rating Scale, CARS)將分別評估孩童的語言理解能力及ASD症狀嚴重度。多階層模型 (multilevel modeling)將用來比較ASD及TD孩童的社交動機、分析ASD嚴重程度是否為社交動機的調節因子以及檢驗ASD及TD孩童的日常情境與基本心理需求滿足程度間的關係。本研究結果顯示ASD和TD孩童在參與社交性遊戲/休閒活動時較有內在動機且自主性的滿足程度較高;而他們參與有社交互動的非遊戲/休閒活動(如日常生活活動)時,皆較沒有內在動機且自主性和勝任感的滿足程度較低,然而ASD嚴重程度越高的孩童在參與有社交互動的非遊戲/休閒活動時較有內在動機。總結,本研究凸顯了日常情境是影響社交參與動機的重要因子。照顧者和臨床人員應該給予孩童支持性的環境並鼓勵他們多參與社交性遊戲/休閒活動以增加他們的社交參與。對於ASD嚴重程度較高的孩童,照顧者和臨床人員應藉由社交互動來引導並協助他們參與勝任感較低的活動。
Motivation is an influential factor in social engagement and worthy of research in children with autism spectrum disorder (ASD). However, the current findings on whether children with ASD have motivation for social engagement are controversial. The reason may be that children with ASD have motivation for social engagement only in specific contexts, but such motivation has only been examined in the laboratory and rated dichotomously. Therefore, self-determination theory (SDT) is recommended for looking into the relationships among context, basic psychological needs, and differentiated motivation, and the experience sampling methodology (ESM) is recommended to reflect the motivation for social engagement in the natural environments of preschool children with ASD. In addition, severity of symptoms may influence basic psychological needs, which in turn can affect motivation for social engagement. To overcome the aforementioned issues in the current literature on motivation for social engagement in preschool children with ASD, three objectives were set. The first was to compare the daily motivation for social engagement between preschool children with ASD and their typically-developing (TD) peers. The second was to examine whether the severity of ASD symptoms moderates motivation for social engagement. The third was to compare the relationships between context and satisfaction of basic psychological needs in the two groups. Thirty preschool children with ASD aged 3–6 years and 30 matched peers with TD were recruited, along with their caregivers. The ESM survey of daily social participation (ESM-DSP), which was translated and culturally adapted from the original ESM survey for examining the social experiences of adolescents and adults with ASD, was used to examine the participants’ motivation for social engagement, contexts and basic psychological needs over a period of seven days. The Verbal Comprehension Index (VCI) of the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV) and the Childhood Autism Rating Scale (CARS) were used to measure the verbal comprehension ability and severity of ASD symptoms, respectively. Multilevel modeling was used to compare the social experience of preschool children with ASD with that of their TD peers, analyze whether children’s severity of ASD symptoms is a moderator of motivation for social engagement, and examine the relationships between context and basic psychological needs. The results showed that preschool children, regardless of the diagnosis of ASD, were more likely to be intrinsically motivated and satisfied in autonomy while engaging in social play/leisure activities. Conversely, they were less likely to be intrinsically motivated, autonomous and competent while doing non-play/leisure activities (e.g., activities of daily living) involving social interactions. However, preschool children with ASD who had more ASD symptoms were more likely to be intrinsically motivated in non-play/leisure activities involving social interactions. In conclusion, the findings highlighted the importance of daily social contexts when exploring motivation for social engagement and satisfaction of basic psychological needs during engagement. Caregivers and clinicians should provide a supportive environment and encourage children more frequently to initiate engagement in social play/leisure activities. In addition, caregivers and clinicians should provide guidance and instructions for children with more severe ASD symptoms to engage in daily activities which they perceive difficult and challenging.
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