社交能力 (social competence) 是整合許多技巧以有效地滿足自身與他人在社交情境中需求的能力。自閉症類群障礙症 (autism spectrum disorder, ASD) 孩童被認為具社交能力缺陷，而可能導致社會參與、學業表現、自尊感與心理健康等方面的不良結果。評估社交能力因而顯得重要，好的社交能力評估工具不僅可提供資訊作為規劃社交介入之依據，同時亦能了解社交介入之成效。然而，現今用以評估ASD孩童的社交成效評估工具會面臨一些問題與限制：評估目的非評量社交能力改變、非多面向性社交能力構念、臨床適用性不佳與心理計量特性不足。因此，本研究目的為新發展一社交能力成效評量工具–社交能力觀察評量 (Observational Social Competence Assessment, OSCA) ，並檢驗其心理計量特性。OSCA依據文獻回顧及多面向社交能力理論而建構，將社交能力分為三面向—社交技巧元素 (social skill elements) 、社交交互性 (social reciprocity) 與社交調適 (social adjustment) 來評量，共包含22個項目。初步建構後，歷經專家會議與前導研究而多次修訂，以提升工具的可行性與臨床適用性。OSCA的內容效度由3位兒童發展和ASD專家審核。心理計量特性檢驗階段中，76名3至12歲的ASD孩童和10名年齡與性別配對之一般發展孩童接受社交能力觀察評量、魏氏兒童智力測驗第四版 (Wechsler Intelligence Scale for Children, Fourth Edition) 或魏氏幼兒智力測驗第四版 (Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition) 的口語理解指數 (Verbal Comprehension Index, VCI) ，其照顧者接受兒童自閉症評量量表第二版 (Childhood Autism Rating Scale, Second Edition, CARS-2) 的訪談，並填答社會性反應量表第二版 (Social Responsiveness Scale, Second Edition, SRS-2) 以及文蘭適應行為量表 (Vineland Adaptive Behavior Scales, VABS) 或文蘭適應行為量表第三版 (Vineland Adaptive Behavior Scales, Third Edition, VABS-3) 。為了檢驗反應性，各有6位ASD孩童參加了為期4個月的社交技巧訓練組 (Social Skills Training) 及控制組（一般職能治療），於介入前後皆接受了OSCA的評估。研究結果顯示OSCA具有好的內部一致性 (internal consistency, Cronbach’s alpha = 0.842–0.961) 、再測信度 (test–retest reliability, intraclass correlation coefficient, ICC = 0.917–0.96) 以及施測者間信度 (inter-rater reliability, ICC = 0.905–0.974) 。OSCA與VCI (r = 0.713, p < 0.01) 、CARS-2 ( r = -0.525, p < 0.01) 、SRS-2 (r = -0.256, p < 0.05) 以及合併VABS與VABS-3二版本的社會化領域 (r = 0.491, p < 0.01) 具有好的收斂效度 (convergent validity)；與合併VABS與VABS-3二版本的動作技巧領域 (r = -0.001) 具有好的發散效度 (divergent validity) 。已知組別校度 (known-groups validity) 亦佳，OSCA總分能區分ASD孩童與一般發展孩童 (F = 5.159, p = 0.036) 。OSCA表現出良好的反應性，反應出二組產生變化的社交能力面向（SST組的社交調適面向：ES = 1.6，SRM = 1.72；對照組的社交交互性面向：ES = 0.74，SRM = 1.42）。總結來說，OSCA能同時具備臨床適用性與良好的心理計量特性，以作為ASD孩童社交能力成效評量工具。OSCA將協助臨床從業人員辨識ASD孩童社交能力的優劣勢以作為介入規劃的依據並反映介入療效，亦有助於研究上ASD孩童社交介入的進展與改良。

Social competence is an integrated ability to effectively meet the needs of self and others in social contexts. Children with autism spectrum disorder (ASD) have been found to have social competence deficits leading to poor outcomes. Assessments of social competence are therefore important to provide information for intervention planning and to understand intervention outcomes. However, several issues have been raised regarding the use of current assessments as outcome measures of social competence in children with ASD, including the assessment purpose, construct, clinical applicability, and psychometric properties. Therefore, the purposes of this study were to develop a professional-administrated outcome measure, named the Observational Social Competence Assessment (OSCA), and examine its psychometric properties. The OSCA was constructed based on literature review and a multidimensional theoretical view of social competence. The OSCA measures social competence with 22 items belonging to three dimensions: social skill elements, social reciprocity, and social adjustment. After the initial construction, the OSCA was revised based on expert reviews and a pilot study to improve its feasibility and clinical applicability. The content validity of the OSCA was reviewed by 3 experts on child development and ASD. For psychometric examination, 76 children with ASD and 10 typically-developing (TD) children between 3 and 12 years old matched for age and gender were assessed with OSCA and the Verbal Comprehension Index (VCI) of the Chinese version of the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) or the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV). Their caregivers were interviewed with the Childhood Autism Rating Scale, Second Edition (CARS-2), and completed the Social Responsiveness Scale, Second Edition (SRS-2) and Vineland Adaptive Behavior Scales (VABS) or Vineland Adaptive Behavior Scales, Third Edition (VABS-3). Twelve of the 76 children with ASD, who participated in a Social Skills Training group (SST), and a control group were assessed with the OSCA before and after the 4-month intervention to examine responsiveness. The results showed that the OSCA has good internal consistency (Cronbach’s alpha = 0.842–0.961), test–retest reliability (ICC = 0.917–0.960), and inter-rater reliability (ICC = 0.905–0.974). The OSCA has good convergent validity with the VCI (r = 0.713, p < 0.01), CARS-2 (r = -0.525, p < 0.01), SRS-2 (r = -0.256, p < 0.05), and socialization domain of the combined VABS and VABS-3 standard scores (r = 0.491, p < 0.01). The OSCA has also shown good divergent validity with the motor skills domain of the combined VABS and VABS-3 standard scores (r = -0.001). The known-groups validity of the OSCA has been found to be good, as the total score could discriminate children with ASD and TD children (F = 5.159, p = 0.036). The OSCA shows good responsiveness, highlighting the main changes in dimensions in both groups (social adjustment dimension of the SST group: ES = 1.6, SRM = 1.72; social reciprocity dimension of the control group: ES = 0.74, SRM = 1.42). In conclusion, the good psychometric evidence of the OSCA supports its application as an outcome measure. The OSCA can help clinical practitioners identify strengths and weaknesses in social competence for intervention planning and reflect the effectiveness of interventions. In addition, the OSCA can offer researchers an option when choosing outcome measures of social competence for developing social interventions.

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