2016-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/646443摘要：曰常生活參與在學前孩童發展上扮演重要的角色，對於發展障礙孩童 來說尤其重要，因為參與的情境能提供學習技巧、發展遊戲、及各種表現 的能力、建立友誼及感到滿足之機會。「參與」也是發展遲緩兒童早期療 育的終極目標。然而很少研究探討學前ASD孩童之參與，且探討學前ASD 孩童參與之研究有幾項限制：（1)使用ICF-CY為基礎的量表，題項主要敘 述活動性質，無法呈現孩童生活環境下所參與活動，結果無法讓臨床工作 人員了解ASD兒童是在哪些曰常活動有困難。（2)探討影響因子時，未能同 時考量孩童因素、家庭因素，或環境因素，（3)有的研究使用的樣本混合 學前與學齡ASD孩童，或混合其他發展障礙，影響研究結果類化到學前ASD 孩童。基於以上限制，迄今吾人對學前ASD孩童之日常生活參與情形暨其 影響因子，仍無法有完整明確的了解。所以本研究目的有二，（1)將採用「學前活動卡片組」探討3-6歲ASD孩 童之日常生活參與，以呈現兒童在其生活環境下（在家裡、學校、社區） 所參與活動之情況及限制，以期對3-6歲ASD孩童之參與有完整的了解，(2)探討日常生活活動參與之預測因子，將同時納入孩童因素，家庭因 素，與環境因素之因子。研究對象將為220名轉介自綜合醫院復健部、兒童心智科門診、復健科 診所、小學附設幼稚園特教班、幼兒園之3至6歲學前ASD孩童。評估工具 將包含評估孩童因素（包括ASD的自閉症嚴重度，適應行為、社會技巧、 行為問題、社會性溝通技巧、感覺處理功能等），家庭因素（家庭資源 (父母的教育程度，家庭收入、學習資源可用性）親職壓力、家庭環境評 量、家庭主動參與休閒活動等），與環境因素（服務及支持系統、接受早 期療育狀況（包含療育種類與每週時數）、兒童之教育安置、社區設施 等）之標準化評估工具和基本資料問卷。將以描述性統計分析孩童及家長 之人口統計學資料，學前活動卡片組中文版之活動參與的表現情形、以及 所有預測因子(孩童因素、家庭因素、環境因素)之相關測驗分數分佈。(2)以多元迴歸分析探討活動參與表現與所有預測因子(孩童因素、家庭 因素、環境因素)之關係。研究結果將有助於專業人員瞭解學前ASD孩童在日常生活之參與情況及 限制，以及瞭解孩童因素、家庭因素及環境因素中，哪些因子影響孩童的 參與，尤其是其中可改變的相關因子將成為未來學前ASD兒童早期治療或 教育計晝的主要介入目標。此外與環境因素有關的因子，不僅有助於專 業人員協助孩童之家庭尋求最大的支持與資源，進而使孩童的功能與參與 達到最佳的表現，亦可作為政府擬定政策或投注資源以有效支持ASD兒童社區參與之考。<br> Abstract: Daily life participation plays an important role in child development, particularly in preschool stage. By participating in daily life activities, children learn, gain sensory-motor and cognitive experiences, and develop their intellectual abilities and social competence. Being able to participate in daily life activities thus becomes the ultimate goal of early intervention.However, few studies have examined the participation of preschool children with autism spectrum disorder (ASD). Moreover, among those studies, there are several limitations: (1) the items in the ICF-CY based assessment describe the skills/abilities tapped rather than the activities occurring in daily life, such that clinicians cannot have a clear idea about what activities the child encounters difficulties with. (2) When examining the potential predictors of activity participation, factors from dimensions of child, family, and environment were not taken into account jointly. (3) Participants of some studies were a mixture of preschool and school-aged children, as well as a mixture of both ASD and other developmental disabilities. Results of their studies are not applicable to preschool children with ASD. Thus, activity participation and its predictors of preschool children with ASD remain unknown.The purpose of the study is twofold:⑴ The Preschool Activity Card Sort will be used to investigate activity participation in preschool children with ASD, in order to obtain a complete profile of activity participation in home, school and community. (2) Various factors from dimensions of child, family, and environment will be taken into account jointly when examining the potential predictors of activity participation.There will be 220 preschool children with ASD, aged from 3 to 6 years, recruited from the rehabilitation departments of general hospitals, child psychiatry departments, rehabilitation clinics, special classrooms of kindergartens in elementary schools and preschools. Child factors (Severity of autistic syndrome, social communication skill, social interaction, adaptive behaviors, behavioral problems, sensory processing dysfunction), family factors (parent education, family income, availability of learning materials, parenting stress, family environment, active participation in leisure activities), and environmental factors (service and support system, early intervention services, educational placement, community resources) along with child and parentdemographic data will be collected using standardized assessment tools and basic information questionnaire. Descriptive analysis will be conducted to characterize the basic properties of the observed variables. In multivariate analysis, multiple linear regression models will be constructed to identify the predictors of the activity participation of preschool children with ASD.Results of this study could inform caregivers and clinicians of activity participation and its limitations in preschool children with ASD. Further, knowledge of the predictors of activity participation could guide clinicians’ early intervention planning and teachers’ educational plan. In particular, knowledge of the predictors in the environment domain could serve as a guide for police making to improve community resources.活動參與自閉症 類群障礙學齡前兒童activityparticipationautism spectrum disorderpreschoolers