自閉症學生堅持同一性、感覺處理能力、無法忍受不確定性與焦慮之探究

Abstract

本研究探討輕度自閉症學生之堅持同一性、感覺處理能力、無法忍受不確定性與焦慮之關係，有助於進而擬定適切的介入計畫，提升適應能力。本研究選取臺灣北部地區經過該縣市鑑定輔導會鑑定列冊之自閉症學生，其魏氏兒童智力量表全量表智商85以上且語文理解指數85以上，共45位為研究參與者，其中國小組25位，國中組20位。所有研究參與者皆填寫三份自陳量表：青少年/成人感覺處理能力剖析量表、無法忍受不確定性量表以及台灣版多向度兒童青少年焦慮量表。研究參與者的家長填寫重複行為量表，取其中三個分量表代表堅持同一性，再根據所得資料進行描述統計、獨立樣本T考驗、變異數相關分析及迴歸分析。研究結果指出: (1) 自閉症學生有高達41名 (91.1%) 有堅持同一性的困難；有28名 (62%) 至少有一項以上感覺處理能力顯著困難；無法忍受不確定量表兩個分量表高分組的比率分別為34名 (75.5%)與31名 (68.9%)，預期性焦慮比率略高於抑制性焦慮；「社交焦慮」相較其他分量表為自閉症學生主要焦慮來源。 (2) 國中組在堅持同一性量表的「固定行為」分量表、感覺處理能力的「感覺敏感」、「感覺逃避」分量表、焦慮中的「社交焦慮」分量表均顯著高於與國小組，顯示國中生有更高的困難。(3)「感覺敏感」、「焦慮」、「社交焦慮」與其他量表及分量表均呈現顯著關聯性。 (4) 「堅持同一性」在自閉症學生之「感覺敏感」與「焦慮」的路徑模型中，具有部分中介的效果。同樣的，「無法忍受不確定性」在自閉症學生之「感覺敏感」與「焦慮」的路徑模型中，也具有部分中介的效果。除此之外，「感覺敏感」在自閉症學生之「堅持同一性」與「社交焦慮」的路徑模型中，具有完全中介的效果。同樣的，「感覺敏感」在自閉症學生之「無法忍受不確定性」與「社交焦慮」的路徑模型中，具有完全中介的效果。因此，社交焦慮或許是自閉症學生主要焦慮來源，而透過降低感覺敏感、提高堅持同一性與無法忍受不確定性等多元途徑可能可以減輕焦慮。最後，本研究對研究結果進行討論，並對後續研究提出建議。The study aimed to investigate the relationship and interaction trend between four characteristics of students with mild autism: the insistence on sameness, sensory processing ability, intolerance of uncertainty, and anxiety. The results were considered for planning social skill interventions. Participants were forty-five (N=45) children with ASD (age from 10-15, FSIQ of WISC IV or V>=85, VCI >=85) from the northern part of Taiwan who were diagnosed by multi-disciplinary teams. All participants completed three self-report scales: Adolescent/ Adult Sensory Profile, Intolerance of Uncertainty Scale, and Multidimensional Anxiety Scale for children -Taiwan Version. The insistence on sameness was measured by three subscales of the Repetitive Behavior Scale-Revised (RBS-R) filled out by the children’s parents. The data was analyzed by descriptive analysis, Independent Sample Test, ANOVA, and Regression Analysis. The results indicated that: (1) Up to 41 students with autism (91.1%) experience difficulties in the insistence on sameness; 28 students (62%) have significant challenges in at least one sensory processing ability; the ratio of that intolerance of uncertainty in the high-scoring groups of both subscales is 34 students (75.5%) and 31 students (68.9%) respectively, with anticipatory anxiety slightly surpassing inhibitory anxiety;"social anxiety" stands out as the primary source of anxiety among students with autism. (2) There is a significant correlation between the "rigid behaviors" subscale of the persistence of sameness in the middle school group and the elementary school group; there are no significant differences between the middle school and elementary school groups in sensory processing ability, intolerance of uncertainty, and anxiety. (3) "Sensory sensitivity," "anxiety," and "social anxiety" are significantly correlated with other scales and subscales. (4) The"insistence on sameness" and "intolerance of uncertainty" serve as mediating variables in the pathway model of "anxiety," both with partial mediating effects. Furthermore, "sensory sensitivity" acts as a mediating variable between "anxiety" and "social anxiety," caused by either "persistence of sameness" or "intolerance of uncertainty," with complete mediating effects. In the context of the pathway models, "social anxiety" may be the primary source of anxiety for students with autism. They may alleviate anxiety by reducing sensory sensitivity, enhancing the insistence on sameness, and increasing the tolerance of uncertainty. Finally, this study discusses the research findings and offers suggestions for future studies.