自闭症-泛自闭症障碍症候群课件

AUTISMSPECTRUMDISORDER(ASD)

泛自閉症障礙症候群KathyM.Small,M.A.Instructor,SanFranciscoStateUniversityTeacherandAutismSpecialist,WestContraCostaUnifiedSchoolDistrict1AutismSpectrumDisorder

泛自閉症障礙症候群Overview:AutismSpectrumDisorder

LearningCharacteristicsoftheYoungChildwithAutism學習特徵InterventionPracticesforYoungChildrenwithAutism介入EducationalMethodologies教學方法WorkingwithandSupportingFamilies家庭合作與支持2Overview:AutismSpectrumDisorder(ASD)

泛自閉症障礙症候群Whatisautism什麼是自閉症LeoKanner,1943AutismSpectrumDisordersinclude:泛自閉症障礙症候群包括:Autism自閉症PDD-NOS未註明的廣泛性發展障礙Aspergers亞斯柏格症Retts雷特氏症ChildhoodDisintegrativeDisorder兒童期崩解症AutismCoreChallengeareas(CoreDeficits):

自閉症主要問題(主要缺陷):SocialInteraction社會互動Communication溝通RestrictedInterests,Repetitive/StereotypedBehaviors

有限的興趣,重複的行為Diagnostictools診斷工具:DSMIV/ICD-10andmore3DiagnosticCriteriaforASD

(DSM-IV-TR)

診斷標準Social(2ormore)Limitedeyecontact,facialexpressions,gestures,prosody

無法以眼對眼凝視、面部表情、身體姿勢及手勢來協助社會互動Few/nofriends無法建立同儕關係Littlesharingofinterestswithothers無法與他人分享興趣Impairedsocial-emotionalreciprocity缺乏社交或情緒相互作用Communication(1ormore)Delayinlanguage語言發展遲緩Poorconversation與他人談話的能力有明顯障礙Idiosyncraticlanguage(e.g.echolalia)刻板的或重複的使用語句(例如仿說)Repetitive/StereotypedBehaviors(1ormore)Narrowinterests侷限的興趣模式Non-functionalroutines/insistenceonsameness/routines不具功能性的常規或儀式行為Motorstereotypies刻板而重複的身體動作Preoccupationwithpartofobjects持續專注於物體的一部份AutismSpectrumDisorders,Ozonoff,Rogers,Hendren,20034OverviewofASDNeurologicalDisordernotPsychological神經上的失調而非生理上的DevelopmentalDisorder/Syndrome發展性的症狀Currently1:150CenterforDiseaseControl(CDC)目前大約1:150Whyisautismincreasing?為什麼自閉症在增加?Betterdiagnosticpractices:shiftfrommentalretardationtoautismdiagnosis有較完整的診斷:從MR轉變為自閉症診斷標準Increasedrecognitionofmildpresentations對於自閉症認識的增加Changesindiagnosticcriteria診斷標準的改變Otherfactorspossible:toxicexposure,biologicalpredispositionandenvironment,vaccinations其他可能因素:中毒、生理和環境因素、疫苗AutismSpectrumDisorders,Ozonoff,Rogers,Hendren,20035OverviewofASDMoreboysthangirlsdiagnosed男生比女生多Girlsoftenmoreinvolved女生的障礙上較複雜10-15%withASDaverage/aboveIQ

10-15%的智力在平均以上25-35%Borderline/MildMentalRetardation

25-35%位於輕度MR的臨界RemaindermoderatetoprofoundMentalRetardation

其餘的大多是重度MR

HelpingChildrenwithAutismLearn,Siegel20036Imitation

模仿Imitationasinnate直覺的模仿Imitationasfoundationoflearning學習基礎的模仿DifficultyattendingtohumanmodelLackofinterestincopyingothers’actions對於複製他人行為的興趣不足ImitationwithoutImagination:Thescrewdriverandthepencil模仿缺乏想像力:螺絲起子和鉛筆Imitationchallengesthroughtheages:actionontoystostylesoffashionImplicationsforEarlyInterventionEducators早期介入9NeedforRoutines:PredictionandAnticipation

必須按照例行行程:可以預估且預測

Youngchildrenrelyonroutines:skillsincrease,needdecreases依賴例行行程:增加技能、減少需求Routinesfamiliar/notnovel熟悉的例行行程,不是無先例的RoutineusedtoPredictwhat’snext可預測下一個是什麼Predictingfutureeventsimportant;inabilitysustainsroutines可預測未來重要的結果;無法維持例行行程Anticipatingfutureeventssupportsinterest/engagement預測ImplicationsforEarlyInterventionEducators:Pickyourbattles:Doesitinterfereorregulate?早期介入:10Motivation

動機Motivationisimportantforalllearning,butcrucialandnecessaryforstudentswithASD動機對於ASD來說是重要且必須的Motivationincreasesinterestintaskwhichincreasespossibilityforlearning動機增加學習的可能性MotivationhighlyindividualizedinstudentswithASD

Motivationcanameliorateremotenessandsupportengagement動機可以改善和支持承諾Useidiosyncraticinterestsasmotivatorsforlearning在學習時使用特別的興趣當刺激物11Motivation,MeansandInvestmentDevelopclassroomexperiencesthatareMotivating發展學校經驗就是動機DevelopaMeans

bywhichmotivatingexperiencescanoccurby:Structuredactivities結構化的活動Highlymotivatingmaterials高度動機的材料Relevantcurriculum相關的課程AppropriateLearningSupports(e.g.visual,physical)適當的學習支持（例如視覺、生理）CreatealearningenvironmentwhereInvestmentcandevelopby建立一個學習環境可以投資在:Repetitionofhighlymotivatingactivities反覆高動機的活動Normalizinghighlymotivatingactivitiesforexpandedlearningopportunitiesandsocialreinforcementfromothers將高動機的活動平常化來增加學習機會和社會增強Supportgeneralizationofstudent’sinvestmentatschoolandhome支持學生類化在學校和家裡

KathySmall2006

ImplicationsforEarlyInterventionEducators早期介入12Context-Specific/DependentLearnerTypicallearnersanalyze,organizeandstoreinformationandlinktoinfinitevarietyofrelatedexperiences

獨特的學習分析、組織訊息來連結相關的經驗Perceptualassociationsresultinsingularassociation:linkingobjectwithouting:strawbagtomarket,necklacetograndma’s獨特的知覺聯想：連結事物：超市的草帽、外婆的項鍊Generalization:Notunderstandingwashingplatesassameproceduresforglasses

類化：沒辦法瞭解洗盤子的玻璃的步驟是一樣的Learningtiedtoacontext/experience:Theboywhowenttothesnow

學習經驗：男孩去雪地KathleenQuill2000

Oddassociations/contextsofacquiringinformationthatimpactlearning:Eddie’striptoIKEA;Danny’scolorpreferences學習知識使用奇特的聯想；艾迪去IKEA旅行；丹尼喜歡的顏色Waterattherestaurant:SeanBarrows

餐廳裡的水：SeanBarrows There’saBoyInHere,Barrows199213VisualLearnerStrong,evenprecociousvisualabilities強烈，甚至強烈的視覺行為Visualinformationstaticandconcrete靜止且固定的視覺訊息Visualinformationcircumventscorechallenges(e.g.socialinteraction,communication,narrowinterestsandbehavior)主要問題（例如：社會互動、溝通、貧乏的興趣和行為）Visualinformationhighlymotivating高動機視覺訊息

KathleenQuill200014TheoryofMind(ToM):MindblindnessLimited/delayedabilitytointerpretotherpeople’smentalstates,feelings,desires,beliefs,perspectives聯想/延遲行為去瞭解他人的心理感受、要求、行為、期望Blindtothementalthoughtsandintentionsofothers

無法瞭解其他人的想法和意圖Johnwalksintothebedroom,walkedaround,andwalkedout:MentalisticexplanationsrequireTheoryofMind約翰走進臥室，繞了一圈，又走出來：心智理論說明

Mindblindness,AnEssayonAutismandTheoryofMind,SimonBaron-Cohen,1995Theboyandthechocolatecandybar:ToM

男孩和巧克力糖果ScienceMagazine,Volume300,May2003Havetounderstandboy’sintentionsandbeliefs,inspiteofaccuracy,topredict必須瞭解男孩的意圖和行為，正確的惡意、預測15LiteralThinker

缺乏想像力的思考者LiteralThinking:Martinandreadinghismind思考缺乏想像力：瞭解馬丁的想法MaxandtheDoctor/OldLadyWhoSwallowedtheFly醫生和女士吞下蒼蠅LiteralMeaning:15yearoldboywithautism:

What’sthemeaningof“don’tcryoverspilledmilk”:“Ifyouspillmilkyoushouldn’tcryoveritbutyoushouldpickuparag,youshouldmopitupandthencleantheragandthengohavesomemoremi