| Summary: | 博士 === 國立臺灣大學 === 職能治療研究所 === 106 === Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core symptoms in social interaction and communication, and repetitive/restricted interests and behaviors. Adaptive behavior is the extent to which a person can be independent in real-life situations, including communication, socialization, daily living, and motor skills. Regarding the associated factors, few studies had investigated sensory processing dysfunction and emotional and behavioral problems as associated factors of adaptive behavior in children with ASD. Sensory processing dysfunction may limit children’s engagement in daily tasks. Emotional and behavioral problems may increase the difficulties in interacting with others and in learning the skills of adaptive behavior. In previous studies examining the associated factors of adaptive behavior, three main limitations were noted. First, the relationships between associated factors and each of the four domains of adaptive behavior remain inconsistent. Second, despite a multitude of studies examining children’s characteristics such as age, gender, cognitive functioning, and symptom severity of ASD as potential associated factors of adaptive behavior in children with ASD, few studies have investigated the relationships of these factors to adaptive behavior jointly. Third, no study has yet investigated the relationships of interaction between children’s characteristics (e.g., sensory processing dysfunction and emotional and behavioral problems) and adaptive behavior in children with ASD.
Purposes: The purpose of the study was twofold: (1) to identify the associated factors for each of the four domains of adaptive behavior considering age, gender, cognitive functioning, symptom severity of ASD, sensory processing dysfunction, and emotional and behavioral problems simultaneously, and (2) to investigate the relationships of interaction between children’s characteristics (e.g., sensory processing and emotional and behavioral problems) and adaptive behavior in children with ASD.
Method: Two hundred and two participants diagnosed with ASD aged 3 to 10 years old were recruited. Multiple linear regressions were used to examine children’s age, gender, cognitive functioning, ASD symptom severity, sensory processing dysfunction, and emotional and behavioral problems as potential associated factors for the four domains of adaptive behavior. Structural equation modeling was applied to examine hypothesized relationships among children’s characteristics and adaptive behavior.
Results: Multiple linear regression models revealed that significant associated factors of the communication domain of adaptive behavior were symptom severity and auditory filtering, and those of the daily living skills domain were tactile sensitivity and auditory filtering. Symptom severity, withdrawn problems, and attention problems were significantly related to the socialization domain. For the motor skill domain, significant associated factors included symptom severity, age, and under-responsive/seeking sensation. Structural equation modeling revealed direct links between symptom severity, sensory processing dysfunction, and emotional problems on overall adaptive behavior. In addition to direct links, sensory processing was also indirectly related to adaptive behavior through emotional problems.
Conclusion: This study examined the relationships among adaptive behavior, sensory processing dysfunction and emotional and behavioral problems in children with ASD. This study concluded that children with less sensory processing dysfunction had less emotional problems, and had better adaptive functioning. The results of the study could serve as a guide for practitioners to set effective treatment goals and design appropriate interventions.
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