想法解读内容想法解读TheoryofMind课件

社會福利署臨床心理服務科中央心理輔助服務混合幼兒中心員工訓練工作坊自閉症兒童訓練－想法解讀社會福利署1內容想法解讀TheoryofMind(ToM)的理論基礎自閉症兒童的社交及溝通障礙ToM評估方法ToM訓練方法本地教材介紹內容想法解讀TheoryofMind(ToM)的理論基2想法解讀的理論基礎（ToM)想法解讀的理論基礎（ToM)3ToM理論基礎於70年代學者研究猿猴類動物能否理解想法而提出的理論(Premack&Woodruffm,1978)80年代其他學者將理論應用於兒童的研究上，發現它能解釋很多自閉症狀的成因(Baron-Cohen,Lewslie&Frith,1985)，例如：不會指著一些東西叫人看不能維持互動式的應對很少說出自己的想法及意念不懂辨別較複雜的感受ToM理論基礎於70年代學者研究猿猴類動物能否理解想法而提出4ToM理論基礎定義：推測別人想法的能力（想法泛指信念、AbilitytousethisawarenesstointerpretsocialbehaviorKnowdifferentthingsHavedifferentfeelingsAremotivatedbydifferentthingsEtc.ToM理論基礎定義：推測別人想法的能力（想法泛指信念、Abi5TOMhasamajorinfluenceoncommunication1.HelpdecidewhentocommunicateIsalisteneravailable?What’sthelistenerdoing?What’sthefeelingofthelistener?Wills/hewanttobeinterrupted?TOMhasamajorinfluenceonc62.HelpsshapeselectionofcontentIsitrelevant/importanttothelistener?BackgroundknowledgeSharedknowledege?WhatinformationisneededHowmuchdetail?2.Helpsshapeselectionofco73.HelpsshapeselectionofformListener’sproximity?Listener’svisualperspective?Comprehensionlevel?RelationshipTimeconstraints?3.Helpsshapeselectionoffo8“Effectiveconversationreliesonanunderstandingthatpeopleknowdifferentthingsandthatthesestatesofknowledgecanbeshared.”(Hadwin,Baron-Cohen,Howlin&Hill,1997)“Effectiveconversationrelies9AssumptionsTypicallearnersautomaticallyinterpretsocialbehaviorbyassigningmotivestotheagentsofaction(mind-reading)TOMhelpsustomakesenseoutofseeminglydisconnectedutterancesMind-readingisdonereflexivelyandtheskillsarepartofthebrain’sinnate“cognitvestructure”.AssumptionsTypicallearnersau10TheoryofMind

Baron-Cohen(1995)TOMisdefinedastheability"toattributementalstatetooneselfandtoothersandtointerpretbehaviorintermsofmentalstates...mentalstatesareunobservableentitiesthatweusequitesuccessfullytoexplainandpredictbehavior"Inorderforpeopletohaveatheoryofmindmechanism(ToMM),theymustalsohaveasharedattentionmechanism(SAM),whichhappenswhentwopeoplefocustheirattentiononthesameobject.TheSAMuses"availableinformationabouttheperceptualstateofanotherperson(oranimal)…Itthencomputessharedattentionsbycomparinganotheragent'sperceptualstatewiththeself'scurrentperceptualstate”TheoryofMind

Baron-Cohen(1111.Intentionalitydetector(ID)AperceptualdeviceActivatedwheneverinputidentifiessomethingasanpotentialagentofactionInterpretsmotionasgoal-orientedbehaviorMind-readingCognitiveStructures1.Intentionalitydetector(ID12視線偵察……視線偵察……13Mind-readingCognitiveStructures2.Eyedirectiondetector(EDD)Noticesanotherperson’seyesNoticesdirectionofgaze“Iknowwhatyousee”Mind-readingCognitiveStructu14Mind-readingCognitiveStructures3.SharedAttentionMechanism(SAM)Buildstriadicrepresentation“IknowthatyouseewhatIsee”Mind-readingCognitiveStructu15Mind-readingCognitiveStructures4.TOMMechanism(TOMM)AbilitytoinferfullrangeofmentalstatesPerceptionsFeelingsDesiresIntentionsKnowledgeRetainsinmemoryandupdateinformationMind-readingCognitiveStructu16TheMindreadingMechanismIDMovingstimulusEDSharedJointAttn.Eye-likestimuliSAMFollowgazeRecognizeagentTOMMInferfullrangeofmentalstatesStoreinfo&useaspartofthetheoryTheMindreadingMechanismIDMov17TheoriesaboutTOMandAutismSimonBaronCohen(1995)LearnerswithautismhaveaspecificTOMdeficit(i.e.mindblindness)ImpliesthatThecognitivewiringisabsent-damagedTheabilitymaynotbeteachableTheoriesaboutTOMandAutismS18OtherTheories:

Winner(2002)viewsTOMdeficitsonaspectrum,likeASDMB:Mindblindness–completelackofTOMskillsEPT:emergingperspectivetakers–passtasks;don’tgeneralizeIIPT:ImpairmentofInteractivePerspectiveTakingTOM:Normalsocialinferencingskills

AssumesTOMskillsofchildreninthemiddlecanbeenhancedthroughinstructionOtherTheories: Winner(2002)19心智解讀是……明白別人擁有思想、信念、願望、動機及感覺(各樣精神狀態)

重要性:

了解別人的動機有助我們預測別人(包括敵人)的行為心智解讀是……明白別人擁有思想、信念、願望、動機20自閉症兒童的社交及溝通障礙自閉症兒童的社交及溝通障礙21自閉症兒童的特徵語言及溝通社交假想能力固執行為及狹隘的興趣自閉症兒童的特徵22自閉症早期之特徵……目光接觸互聯注意假想遊戲對人的反應模仿力非語言溝通模式語言社交回應(微笑)與友伴的關係自閉症早期之特徵……目光接觸非語言溝通模式23研究結果……約有八成以上的自閉症兒童並未能通過心智解讀的測試研究結果……約有八成以上的自閉症兒童並未能通過24研究結果自閉症兒童發展正常兒童唐氏綜合症兒童Baron-Cohen,Leslie,A.M.,&Frith,U.(1985)研究結果自閉症兒童發展正常唐氏綜合症Baron-Cohen,25自閉症兒童的心智解讀能力一般幼兒自閉症幼兒留意別人的視線來了解別人的目的九至十八個月三至七歲錯誤信念四歲八至十四歲自閉症兒童的心智解讀能力一般幼兒自閉症幼兒留意別人的視線來了26心智解讀是……自閉症兒童因心智解讀能力較弱

不能解讀別人的心智

不能鑑貌辨色

不能預知別人下一步的行動心智解讀是……自閉症兒童因心智解讀能力較弱27心智解讀是……

以為自己看到的(視線)，別人也能看到不能投入假想遊戲

不能分辨想像與真實的世界

不能理解說話中比喻及諷刺的真正意思心智解讀是……

以為自己看到的(視線)，別人也28ToM評估方法ToM評估方法29SixteenFrequentlyUsedMeasuresTestsofmental-physicaldistinctionBrainfunctionstestsTheappearance-realitydistinctionFirst-orderfalse-belieftasksSeeleadstoknowingtasksTestsofrecognizingmental-statewordsSpontaneoususeofmentalstatewordsTestsoftheproductionofspontaneouspretendplaySixteenFrequentlyUsedMeasur30SixteenFrequentlyUsedMeasuresTestsofunderstandingmorecomplexcausesofemotionTestsofinferringthought/intentfromgazedirectionTestsofbeingabletomonitorone’sownintentionsTestsofdeceptionTestsofunderstandingmetaphor,sarcasm&ironyTestsofpragmaticsMeasuresofcorrelationwithreal-lifesocialskillsSecondorderfalse-belief(FB)testsSixteenFrequentlyUsedMeasur31ToM訓練方法ToM訓練方法32InterventionResearchASDlearnerscanbetaughttopassFBtasksManydon’tgeneralizeknowledgeinvivoSomegeneralisedirectexperienceFBtasktotraditionaltask(picture-based)SomestudiesfoundnodifferentinteractionfollowingtrainingonFBtaskButtrainingtookplaceovershorttimeMaybeASDlearnersneedmoreintensepracticeMaybetheyneedtobetaughtgeneralizationInterventionResearchASDlearn33InterventionResearchOnestudyfoundcorrelationbetweenVinelandscoresandTOMskillsVinelandwasadaptedtoincludemoreQsaboutperspectivetakingCorrelationsvariedbystrengthofTOM(higherforASDwhocouldpassFBtasks,lowerforthosejustlearnedtopassthem)Someteachingstrategieslookedmorepromisingthanothers(e.g.teaching“thoughtsarelikepicturesinyourhead”)IfASDhaveproblemwithoverselection,TeachthemwhattoattendtoTeachthemwhattoignoreInterventionResearchOnestudy34InterventionResearchCognitivesciencehasbeenhelpfulinShowingthatASDdopoorlyonFBtasksShowingthatFBtaskscanbelearnedIdentifyingsomeprostheticsthatcanbeusedtoteachitCognitivesciencehasnotshownHowtoidentifyoverselectioninvivoHowtoteachASDtolookforrelevantcuresHowtoteachtoASDtomakeinferencesfromcuesInterventionResearchCognitive35心智解讀的基礎心智解讀學習程度≥24個月語言表達及理解程度≥24個月

學習程度≥48個月語言表達及理解程度≥42個月

心智解讀的基礎心智解讀學習程度≥24個月學習程度≥436掌握心智解讀的能力有何用?懂得鑑貌辨色增加假想能力提升EQ明白說話背後的意思改善社交關係懂得美麗的謊言發展自省的能力提升溝通能力掌握心智解讀的能力有何用?懂得鑑貌辨色增加假想能力提升EQ明37心思材料特性食客口味烹調方法選材及份量食客反應心思材料食客烹調選材及食客38心智解讀材料特性心智解讀是什麼？心智解讀材料心智解讀是什麼？39心智解讀食客口味適合嗎？透過評估了解兒童的心智解讀發展至那一個階段心智解讀食客適合嗎？40心智解讀選材及份量按評估結果釐定訓練目標選擇訓練重點/比重/先後次序心智解讀選材及按評估結果41心智解讀烹調方法形式(個別、小組)小組組合(全部自閉症兒童/混合發展遲緩兒童)家長參與心智解讀烹調形式(個別、小組)42心智解讀食客反應檢討兒童學習進度/掌握能力心智解讀食客檢討兒童學習進度/掌握能力43心智解讀─教導時需注意的事項訂立明確的訓練目標2.分拆成細項來教導，可能需較長的時間來掌握3.在自然環境下教導，增強類化4.選取兒童喜愛的事物作教材，增強學習動機心智解讀─教導時需注意的事項訂立明確的訓練目標44心智解讀─教導時需注意的事項……5.配合不同的媒介及方法媒介：遊戲、圖片、電腦方法：手偶故事、角色扮演、漫畫故事、卡通片6.給予清晰及有系統的指示7.配合視覺策略8.「金句」帶出每項活動背後的原則及總結活動重點心智解讀─教導時需注意的事項……5.配合不同的媒介及方法459.捉緊每一刻10.其他人作示範，從別人身上學習

(A.Bandura,1986)11.從經驗中學習12.即時教導，重覆學習13.輕鬆氣氛、時常獎勵心智解讀─教導時需注意的事項……9.捉緊每一刻心智解讀─教導時需注意的事項……4614.螺旋式學習、進展式學習15.個別化學習心智解讀─教導時需注意的事項……14.螺旋式學習、進展式學習心智解讀─教導時需注意的事項47其他訓練活動破冰遊戲身體語言語氣背後的意思調節情緒其他訓練活動破冰遊戲48如何應用？A.中心課堂：社交、玩技、唱遊、語言溝通、圖工堂、體能活動……環境：情緒角、分組學習、吊飾……日常流程：食飯時間、點名時間……如何應用？A.中心49如何應用？……B.家居把握日常生活的每一刻安排親子時段(玩玩具、一起製作食物、重溫生活照片)一起觀看卡通片撰寫情緒日記備註：1.訓練重點2.家人參與/中介人3.學習氣氛如何應用？……B.家居備註：1.訓練重點50本地教材介紹本地教材介紹51想法解读内容想法解读TheoryofMind课件52社會福利署臨床心理服務科中央心理輔助服務混合幼兒中心員工訓練工作坊自閉症兒童訓練－想法解讀社會福利署53內容想法解讀TheoryofMind(ToM)的理論基礎自閉症兒童的社交及溝通障礙ToM評估方法ToM訓練方法本地教材介紹內容想法解讀TheoryofMind(ToM)的理論基54想法解讀的理論基礎（ToM)想法解讀的理論基礎（ToM)55ToM理論基礎於70年代學者研究猿猴類動物能否理解想法而提出的理論(Premack&Woodruffm,1978)80年代其他學者將理論應用於兒童的研究上，發現它能解釋很多自閉症狀的成因(Baron-Cohen,Lewslie&Frith,1985)，例如：不會指著一些東西叫人看不能維持互動式的應對很少說出自己的想法及意念不懂辨別較複雜的感受ToM理論基礎於70年代學者研究猿猴類動物能否理解想法而提出56ToM理論基礎定義：推測別人想法的能力（想法泛指信念、AbilitytousethisawarenesstointerpretsocialbehaviorKnowdifferentthingsHavedifferentfeelingsAremotivatedbydifferentthingsEtc.ToM理論基礎定義：推測別人想法的能力（想法泛指信念、Abi57TOMhasamajorinfluenceoncommunication1.HelpdecidewhentocommunicateIsalisteneravailable?What’sthelistenerdoing?What’sthefeelingofthelistener?Wills/hewanttobeinterrupted?TOMhasamajorinfluenceonc582.HelpsshapeselectionofcontentIsitrelevant/importanttothelistener?BackgroundknowledgeSharedknowledege?WhatinformationisneededHowmuchdetail?2.Helpsshapeselectionofco593.HelpsshapeselectionofformListener’sproximity?Listener’svisualperspective?Comprehensionlevel?RelationshipTimeconstraints?3.Helpsshapeselectionoffo60“Effectiveconversationreliesonanunderstandingthatpeopleknowdifferentthingsandthatthesestatesofknowledgecanbeshared.”(Hadwin,Baron-Cohen,Howlin&Hill,1997)“Effectiveconversationrelies61AssumptionsTypicallearnersautomaticallyinterpretsocialbehaviorbyassigningmotivestotheagentsofaction(mind-reading)TOMhelpsustomakesenseoutofseeminglydisconnectedutterancesMind-readingisdonereflexivelyandtheskillsarepartofthebrain’sinnate“cognitvestructure”.AssumptionsTypicallearnersau62TheoryofMind

Baron-Cohen(1995)TOMisdefinedastheability"toattributementalstatetooneselfandtoothersandtointerpretbehaviorintermsofmentalstates...mentalstatesareunobservableentitiesthatweusequitesuccessfullytoexplainandpredictbehavior"Inorderforpeopletohaveatheoryofmindmechanism(ToMM),theymustalsohaveasharedattentionmechanism(SAM),whichhappenswhentwopeoplefocustheirattentiononthesameobject.TheSAMuses"availableinformationabouttheperceptualstateofanotherperson(oranimal)…Itthencomputessharedattentionsbycomparinganotheragent'sperceptualstatewiththeself'scurrentperceptualstate”TheoryofMind

Baron-Cohen(1631.Intentionalitydetector(ID)AperceptualdeviceActivatedwheneverinputidentifiessomethingasanpotentialagentofactionInterpretsmotionasgoal-orientedbehaviorMind-readingCognitiveStructures1.Intentionalitydetector(ID64視線偵察……視線偵察……65Mind-readingCognitiveStructures2.Eyedirectiondetector(EDD)Noticesanotherperson’seyesNoticesdirectionofgaze“Iknowwhatyousee”Mind-readingCognitiveStructu66Mind-readingCognitiveStructures3.SharedAttentionMechanism(SAM)Buildstriadicrepresentation“IknowthatyouseewhatIsee”Mind-readingCognitiveStructu67Mind-readingCognitiveStructures4.TOMMechanism(TOMM)AbilitytoinferfullrangeofmentalstatesPerceptionsFeelingsDesiresIntentionsKnowledgeRetainsinmemoryandupdateinformationMind-readingCognitiveStructu68TheMindreadingMechanismIDMovingstimulusEDSharedJointAttn.Eye-likestimuliSAMFollowgazeRecognizeagentTOMMInferfullrangeofmentalstatesStoreinfo&useaspartofthetheoryTheMindreadingMechanismIDMov69TheoriesaboutTOMandAutismSimonBaronCohen(1995)LearnerswithautismhaveaspecificTOMdeficit(i.e.mindblindness)ImpliesthatThecognitivewiringisabsent-damagedTheabilitymaynotbeteachableTheoriesaboutTOMandAutismS70OtherTheories:

Winner(2002)viewsTOMdeficitsonaspectrum,likeASDMB:Mindblindness–completelackofTOMskillsEPT:emergingperspectivetakers–passtasks;don’tgeneralizeIIPT:ImpairmentofInteractivePerspectiveTakingTOM:Normalsocialinferencingskills

AssumesTOMskillsofchildreninthemiddlecanbeenhancedthroughinstructionOtherTheories: Winner(2002)71心智解讀是……明白別人擁有思想、信念、願望、動機及感覺(各樣精神狀態)

重要性:

了解別人的動機有助我們預測別人(包括敵人)的行為心智解讀是……明白別人擁有思想、信念、願望、動機72自閉症兒童的社交及溝通障礙自閉症兒童的社交及溝通障礙73自閉症兒童的特徵語言及溝通社交假想能力固執行為及狹隘的興趣自閉症兒童的特徵74自閉症早期之特徵……目光接觸互聯注意假想遊戲對人的反應模仿力非語言溝通模式語言社交回應(微笑)與友伴的關係自閉症早期之特徵……目光接觸非語言溝通模式75研究結果……約有八成以上的自閉症兒童並未能通過心智解讀的測試研究結果……約有八成以上的自閉症兒童並未能通過76研究結果自閉症兒童發展正常兒童唐氏綜合症兒童Baron-Cohen,Leslie,A.M.,&Frith,U.(1985)研究結果自閉症兒童發展正常唐氏綜合症Baron-Cohen,77自閉症兒童的心智解讀能力一般幼兒自閉症幼兒留意別人的視線來了解別人的目的九至十八個月三至七歲錯誤信念四歲八至十四歲自閉症兒童的心智解讀能力一般幼兒自閉症幼兒留意別人的視線來了78心智解讀是……自閉症兒童因心智解讀能力較弱

不能解讀別人的心智

不能鑑貌辨色

不能預知別人下一步的行動心智解讀是……自閉症兒童因心智解讀能力較弱79心智解讀是……

以為自己看到的(視線)，別人也能看到不能投入假想遊戲

不能分辨想像與真實的世界

不能理解說話中比喻及諷刺的真正意思心智解讀是……

以為自己看到的(視線)，別人也80ToM評估方法ToM評估方法81SixteenFrequentlyUsedMeasuresTestsofmental-physicaldistinctionBrainfunctionstestsTheappearance-realitydistinctionFirst-orderfalse-belieftasksSeeleadstoknowingtasksTestsofrecognizingmental-statewordsSpontaneoususeofmentalstatewordsTestsoftheproductionofspontaneouspretendplaySixteenFrequentlyUsedMeasur82SixteenFrequentlyUsedMeasuresTestsofunderstandingmorecomplexcausesofemotionTestsofinferringthought/intentfromgazedirectionTestsofbeingabletomonitorone’sownintentionsTestsofdeceptionTestsofunderstandingmetaphor,sarcasm&ironyTestsofpragmaticsMeasuresofcorrelationwithreal-lifesocialskillsSecondorderfalse-belief(FB)testsSixteenFrequentlyUsedMeasur83ToM訓練方法ToM訓練方法84InterventionResearchASDlearnerscanbetaughttopassFBtasksManydon’tgeneralizeknowledgeinvivoSomegeneralisedirectexperienceFBtasktotraditionaltask(picture-based)SomestudiesfoundnodifferentinteractionfollowingtrainingonFBtaskButtrainingtookplaceovershorttimeMaybeASDlearnersneedmoreintensepracticeMaybetheyneedtobetaughtgeneralizationInterventionResearchASDlearn85InterventionResearchOnestudyfoundcorrelationbetweenVinelandscoresandTOMskillsVinelandwasadaptedtoincludemoreQsaboutperspectivetakingCorrelationsvariedbystrengthofTOM(higherforASDwhocouldpassFBtasks,lowerforthosejustlearnedtopassthem)Someteachingstrategieslookedmorepromisingthanothers(e.g.teaching“thoughtsarelikepicturesinyourhead”)IfASDhaveproblemwithoverselection,TeachthemwhattoattendtoTeachthemwhattoignoreInterventionResearchOnestudy86InterventionResearchCognitivesciencehasbeenhelpfulinShowingthatASDdopoorlyonFBtasksShowingthatFB