| Summary: | 碩士 === 長庚大學 === 臨床行為科學研究所 === 96 === As one of the pervasive developmental disorders, Asperger’s disorder (AD) is characterized by difficulties in social interaction. Previous studies have suggested that such difficulties in social interaction might be partly due to a deficit in theory of mind(ToM). Many intervention programs, including cognitive behavioral therapy (CBT) programs, have been developed to improve the theory of mind and social skills for children with Asperger’s disorder. There were some empirical supports for the effectiveness of CBT on many childhood disorders, however, more rigorous research is needed to examine the efficacy of CBT on children with Asperger’s disorder in Taiwan. This study intended to examine the immediate and lasting effect of a CBT program, designed to promote social skills and theory of mind, on school-age children with Asperger’s disorder.
Two groups of participants were recruited for this study: the experimental group and the control group. Each group included eight boys with Asperger’s disorder. They were 9 to 11 year-old with average intelligence. The CBT program included 10 weekly group sessions for AD children (90 minutes each) and five psycho-educational meetings for parents to acquire knowledge about AD symptoms , behavior modification, and theory of mind. The control group maintained their regular visit to the out-patient clinic and no CBT program was provided to the children or parents in the control group. A pretest - posttest control group design was used to compare the performance of two groups on various measures at pretest, posttest and followup. Five measures were used: (1) Gilliam Asperger’s Disorder Scale (GADS); (2) Vineland Adaptive Behavior Scales-2nd Edition-interview version (VABS-II)-Socialization subscale; (3) Vineland Adaptive Behavior Scale-Classroom version (VABS)- Socialization subscale; (4) Children’s version of the Reading the Mind in the Eyes Test (Eyes Test); and (5) Theory of Mind Test (ToM Test). Parents and teachers rated the participating children on their AD symptoms (GADS) and socialization behaviors (VABS-II or VABS). All the children were administered the Eyes Test and the ToM Test.
Nonparametric statistical test were used to analysis the data.The results partly support an immediate effect of this CBT program on the experimental group. The pre-post comparison showed significant improvements in parental ratings of the experimental group in AD symptom severity and socialization behaviors. The experimental group also obtained immediate and lasting significant improvement in second-order flase belief, one of the aspect of ToM. A delayed improvement in the emotion recognition ability of the experimental group was found at followup. However, there were no significant difference in teachers’ ratings of the experimental group on AD symptom severity and socialization behaviors, indicating poor generalization effect of this CBT program to school settings.
Findings of this study partially support an immediate effect of this CBT program for Taiwanese children with Asperger’s disorder in clinical settings and at home, but with limited generalization effect in school situations. Future studies are needed to clarify the differential effect of children’s CBT group and psycho-education for parents. In addition, future study or clinical practice should promote teacher’s involvement in intervenetion for AD children or design school-based program to facilitate the generalization effect of training to school settings.
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