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自闭症儿童的表达性沟通:具有挑战性的行为的运用。

Expressive communication of children with autism: the use of challenging behaviour.

作者信息

Chiang Hsu-Min

机构信息

Australian Centre for Educational Studies, Macquarie University, Sydney, Australia.

出版信息

J Intellect Disabil Res. 2008 Nov;52(11):966-72. doi: 10.1111/j.1365-2788.2008.01042.x. Epub 2008 Jan 18.

Abstract

BACKGROUND

There is a lack of empirical research investigating challenging behaviour in children with autism with severe speech impairments in naturalistic settings. The aim of the present study was to investigate challenging behaviour among Australian and Taiwanese children with autism who are non-verbal or have limited speech (i.e. less than five functional words) in school settings and to address the following questions: (1) What are the communicative characteristics (e.g. communicative functions, partners, activities and partner's responses) of challenging behaviour? (2) Do sample characteristics (e.g. age, severity of autism, adaptive behaviour level, the use of graphic symbols, the use of non-symbolic acts, the use of speech) associate with the amount of challenging behaviour? (3) Do cultural differences exist in communicative variables of challenging behaviour?

METHOD

Naturalistic observations were used to investigate challenging behaviour in children with autism. A total of 32 (17 Australian and 15 Taiwanese) children with autism who were non-verbal or had limited speech participated in the current study and each participant was videotaped for 2 h during his/her everyday school routines.

RESULTS

Sixteen out of 32 children had challenging behaviour. Challenging behaviour was used for requesting and rejecting communicative functions. A paired-samples t-test revealed that no significant differences existed in the frequency of occurrence between request and reject. Challenging behaviour was directed to adults and peers. A paired-samples t-test revealed that challenging behaviour was directed to adults significantly more frequently than to peers. Communicative partners showed different responses (e.g. deny, no response, delivered, removed, acknowledge) to challenging behaviour. A repeated-measures analysis of variance (ANOVA) revealed a main effect for partner response. Deny was the most common response. Challenging behaviour occurred across a variety of classroom activities (e.g. academic activities, morning circle, morning tea, lunch, free time). A repeated-measures ANOVA revealed a main effect for activity. Challenging behaviour occurred most often during academic activities. A set of correlation analyses indicated a significant correlation existed between the use of graphic symbols and the amount of challenging behaviour. A series of Mann-Whitney U-tests revealed significant differences between Australian and Taiwanese children on the amount of challenging behaviour, communicative functions and partners. A Chi-squared test revealed that there were significantly more Australian children with autism who displayed challenging behaviour than Taiwanese children.

CONCLUSIONS

The current study shows that a high proportion of children with autism with severe speech impairments used challenging behaviour as a form of expressive communication in their school environments. The findings from the present study may have implications for practitioners who work with children with autism.

摘要

背景

缺乏在自然环境中对严重言语障碍的自闭症儿童的挑战性行为进行实证研究。本研究的目的是调查澳大利亚和台湾地区在学校环境中无语言或言语有限(即功能性词汇少于5个)的自闭症儿童的挑战性行为,并回答以下问题:(1)挑战性行为的沟通特征(如沟通功能、伙伴、活动及伙伴反应)是什么?(2)样本特征(如年龄、自闭症严重程度、适应性行为水平、图形符号使用情况、非符号行为使用情况、言语使用情况)与挑战性行为的数量是否相关?(3)挑战性行为的沟通变量中是否存在文化差异?

方法

采用自然观察法调查自闭症儿童的挑战性行为。共有32名(17名澳大利亚儿童和15名台湾儿童)无语言或言语有限的自闭症儿童参与了本研究,每位参与者在其日常学校活动期间被录像2小时。

结果

32名儿童中有16名存在挑战性行为。挑战性行为用于请求和拒绝的沟通功能。配对样本t检验显示,请求和拒绝的发生频率之间无显著差异。挑战性行为针对成人和同伴。配对样本t检验显示,挑战性行为针对成人的频率显著高于针对同伴的频率。沟通伙伴对挑战性行为表现出不同的反应(如拒绝、无反应、给予、拿走、认可)。重复测量方差分析显示伙伴反应存在主效应。拒绝是最常见的反应。挑战性行为发生在各种课堂活动中(如学术活动、晨圈、早茶、午餐、自由活动时间)。重复测量方差分析显示活动存在主效应。挑战性行为最常发生在学术活动期间。一系列相关分析表明,图形符号的使用与挑战性行为的数量之间存在显著相关性。一系列曼-惠特尼U检验显示,澳大利亚和台湾儿童在挑战性行为的数量、沟通功能和伙伴方面存在显著差异。卡方检验显示,表现出挑战性行为的澳大利亚自闭症儿童明显多于台湾儿童。

结论

本研究表明,在学校环境中,高比例的严重言语障碍自闭症儿童将挑战性行为作为一种表达性沟通方式。本研究结果可能对从事自闭症儿童工作的从业者具有启示意义。

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