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Disorders of Childhood
兒童期疾患
Abnormal Psychology, Tenth Edition
by
Ann M. Kring, Gerald C. Davison, John M. Neale,
& Sheri L. Johnson
Classification and Diagnosis of Childhood
Disorders
兒童期疾患的分類和診斷

Developmental psychopathology 發展的心理病理學
» Studies disorders of childhood within the context of normal child
development 在正常兒童發展的背景脈絡下研究兒童期的疾患

Externalizing disorders 外化性疾患
» Characterized by outward behaviors 以外化性的行為為其特性
– Noncompliance, aggressiveness, overactivity, impulsiveness 不服從,攻擊,
過動,衝動
– More common in boys 在男孩較普遍

Internalizing disorders 內化性疾患
» Characterized by inward behaviors 以向化的行為為其特性
– Depression, anxiety, social withdrawal 憂鬱,焦慮,社會退縮
– More common in girls 在女孩較普遍
Copyright 2005 John Wiley & Sons, NY
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Table 14.1 Chapters Where Disorders are Discussed That
Occur in Both Children and Adults
在兒童和成人身上皆會發生的疾患章節
Copyright 2005 John Wiley & Sons, NY
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Attention Deficit/Hyperactivity Disorder
注意力不足/過動疾患

Excessive levels of activity 過多的活動
» Fidgeting, squirming, running around when inappropriate,
incessant talking 不安,扭動,不恰當的走動,不停的說話

Distractability and difficulty concentrating 分心和有困
難集中
» Makes careless mistakes, can’t follow instructions, forgetful
粗心犯錯,不能聽從指令,健忘

Must be severe and persistent 必須嚴重且持續
» Present for at least 6 months and cause impairments in
functioning 持續至少六個月並產生功能的受損
Copyright 2005 John Wiley & Sons, NY
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Attention Deficit/Hyperactivity Disorder
注意力不足/過動疾患

Three subcategories in DSM-IV-TR
在DSM-IV-TR中可分為三個亞型：
1.
2.
3.
Predominantly inattentive type 主要為不注意型
Predominantly hyperactive-impulsive type 主要為過動-易衝動型
Combined type 複合型
Differential diagnosis 鑑別診斷

»
»
ADHD or Conduct Disorder? 注意力不足過動疾患或品性疾患？
ADHD注意力不足過動疾患
–
»
More off-task behavior, cognitive & achievement deficits 較多無法達成工
作的行為,認知和成就上缺陷
Conduct Disorder 品行疾患
–
More aggressive, act out in most settings, antisocial parents, family
hostility 較多攻擊性, 常出現動作外化行為,反社會性父母,家人敵意
Copyright 2005 John Wiley & Sons, NY
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Attention Deficit/Hyperactivity Disorder
注意力不足/過動疾患
ADHD often comorbid
with anxiety and
depression 通常和焦慮
和憂鬱共病
Prevalence estimates 2
to 7% 盛行率估計約2
到7％
Symptoms persist
beyond childhood 症狀
在兒童期之後仍持續



»
Most still meet criteria in
adolescence 大部分在青
少年期仍符合準則
Copyright 2005 John Wiley & Sons, NY
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Etiology of ADHD
注意力不足過動疾患的病因學

Genetic factors 遺傳因素
» Twin studies 雙生子研究
– Heritability estimates as high as 70 to 80% 遺傳率估計有百分之70到
80高
» Two dopamine genes implicated 二個多巴胺基因受到影響

Neurobiological factors 神經生物因素
» Underresponsive frontal lobes 額葉反應性低
» Reduced cerebral blood flow 大腦血流量減少
» Smaller frontal lobes, caudate nucleus, globus pallidus 額葉,
尾核和蒼白球較小
Copyright 2005 John Wiley & Sons, NY
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Etiology of ADHD
注意力不足過動疾患的病因學

Perinatal and prenatal factors 出生前後和產前因素
» Low birth weight 出生體重低
» Maternal tobacco and alcohol use 母親吸菸和酒精使用

Environmental toxins 環境毒素
» Food additives and sugar not related to ADHD 食品添加物和糖與
注意力不足過動疾患沒有相關
» Nicotine from maternal smoking 來自母親吸煙所產生尼古丁
– May damage dopaminergic system in fetus 可能損害胎兒多巴胺內生性系統
Copyright 2005 John Wiley & Sons, NY
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Etiology of ADHD
注意力不足過動疾患的病因學

Psychological Factors 心理因素
» Ineffective parenting, negative interactions 無效能
的親職教育,負向互動
» Probably interact with genetic and neurobiological
factors 可能和遺傳和神經生物因素產生交互影響
» Likely to exacerbate or maintain ADHD behaviors
but not cause them 很可能惡化或維持ADHD的行為
問題但不會造成此疾患
Copyright 2005 John Wiley & Sons, NY
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Treatment of ADHD
注意力不足過動疾患的治療

Stimulant medications 興奮劑藥物治療
» Reduce disruptive behavior 降低破壞性行為
» Improve attention and concentration 改善注意力和專心
–
–
–
–
Ritalin 利他能
Adderall
Concerta
Strattera
» Side effects 副作用
– Loss of appetite 失去食慾
– Sleep problems 睡眠問題
Copyright 2005 John Wiley & Sons, NY
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Treatment of ADHD
注意力不足過動疾患的治療

Psychological treatment 心理治療
» Operant conditioning 操作制約
– Parent training 父母親訓練
– Classroom management and teacher training 課堂管理
和老師的訓練
– Classroom structure 課堂結構




Brief assignments 簡短的作業
Immediate feedback 立即回饋
Task-focused style 聚焦於作業的方式
Breaks for exercise 中間休息以作運動
Copyright 2005 John Wiley & Sons, NY
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Conduct Disorder (CD)
品行疾患

Pattern of engaging in behaviors that violate social
norms, the rights of others, and are often illegal.從事
違反社會規範,侵害他人權利和經常犯法的行為模式
»
»
»
»
»
»
Aggression 攻擊
Cruelty towards other people or animals 虐待他人或動物
Lying 說謊
Stealing 偷竊
Vandalism 暴力行為
Often accompanied by lack of remorse and callousness 通
常伴隨缺乏憐憫和無情
Copyright 2005 John Wiley & Sons, NY
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Oppositional Defiant Disorder (ODD)
對立性反抗疾患

ODD behaviors do not meet criteria for CD but child
displays pattern of defiant behavior 對立性反抗疾患的行為
並不符合品行疾患的準則 但兒童呈現反抗的行為模式
»
»
»
»
»
»

Argumentative 愛爭論的
Loses temper 脾氣不佳
Lack of compliance 缺乏服從性
Deliberately aggravates other 故意激怒他人
Hostile, vindictive, spiteful, or touchy 充滿敵意,懷恨,惡意或暴躁的
Blame others for their problems 將自己的行為問題責怪他人
Most often diagnosed in boys but may be as prevalent in
girls 通常診斷於男孩但女孩也可能很普遍
Copyright 2005 John Wiley & Sons, NY
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Conduct Disorder (CD)
品行疾患

Many times first identified by legal authorities 通常會
先被法庭發現其問題行為
» ‘Juvenile delinquents’ 青少年罪犯



Substance abuse common普遍有物質濫用
Comorbid with anxiety and depression, especially for
girls 與焦慮和憂鬱共病,特別是針對女孩
Prevalence 盛行率
» Boys 男孩
– 4 to 16% 百分比四到十六
» Girls 女孩
– 1.2 to 9% 百分比ㄧ點二到九
Copyright 2005 John Wiley & Sons, NY
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Figure 14.1 Arrest Rates Across Ages for Homicide, Forcible
Rape, Robber, Aggravated Assault, and Auto Theft
殺人、強暴、搶劫、攻擊、偷車者在各年齡層的逮捕率
Copyright 2005 John Wiley & Sons, NY
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Conduct Disorder (CD)
品行疾患
Moffitt (1993) two paths 在1993年Moffitt所提的兩條發展路徑

1.
2.
Life-course-persistent 生命過程中持續出現
Adolescence-limited 僅在青少年期出現
Not all aggressive or conduct-disordered boys continue
aggressive behavior into adulthood 不是所有具攻擊性或品行
疾患的男孩會持續攻擊行為到成年期

»
Predictive factors 預測因子
–
–
–
–
–
–
Low verbal IQ 低語文智商
Parent with antisocial personality disorder 父母有反社會人格疾患的問題
Temperament 天生氣質
Dysfunctional parent-child interactions 父母與孩子間不良的互動
Poverty 貧窮
Low social support 低社會支持
Copyright 2005 John Wiley & Sons, NY
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Figure 14.2 Etiology of Conduct Disorder
品行疾患的病因學

Insert Figure 14.2
品行疾患的病因學
社會
心理
品行疾患
神經生物
Copyright 2005 John Wiley & Sons, NY
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Etiology of Conduct Disorder (CD)
品行疾患的病因學

Genetic factors 遺傳因素
»
»
»
Heritability likely plays a part 遺傳可能扮演一部分因素
Twin study data show mixed results 雙生子研究資料呈現不一
致的結果
Adoption studies focused on criminal behavior, not conduct
disorder 領養研究著重在犯罪行為，而非品行疾患的行為問題
–

Evidence for genetic influence 相關證據支持遺傳影響
Genetics and environment interact (Caspi et al., 2002)
遺傳和環境的交互影響
»
Abuse as a child PLUS low MAOA activity most likely to
develop CD 虐待孩子加上低單胺氧化酶活性很可能發展品行
疾患
Copyright 2005 John Wiley & Sons, NY
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Etiology of Conduct Disorder (CD)
品行疾患的病因學
Neurobiological factors 神經生物因素

»
»
»
Poor verbal skills 語文技巧不佳
Difficulty with executive functioning 執行功能的困難
Low IQ 低智商
Psychological factors 心理因素

»
»
»
»
»
Deficient moral development, especially lack of remorse 有缺陷的道德發
展,特別是缺乏同情
Modeling and reinforcement of aggressive behavior 攻擊行為的模仿和增
強
Harsh and inconsistent parenting 嚴格和不ㄧ致的教養方式
Lack of parental monitoring 缺乏父母的監控
Cognitive bias (Kenneth Dodge) 認知偏誤
–
Neutral acts by others perceived as hostile 將他人的中性舉動知覺成有敵意的
Copyright 2005 John Wiley & Sons, NY
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Figure 14.3 Dodge’s Cognitive Theory of Aggression
Dodge的攻擊認知理論
Insert
figure 14.3
將模糊舉動解讀成
有敵意
對他人產生更進ㄧ步攻擊
對他人產生攻擊
他人進行報復
Copyright 2005 John Wiley & Sons, NY
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Etiology of Conduct Disorder (CD)
品行疾患的病因學

Peer influence 同儕影響
» Acceptance or rejection by peers 被同儕接受或拒絕
» Affiliation with deviant peers 與有偏差行為的同儕接
近

Sociocultural factors 社會文化因素
» Poverty 貧窮
» Urban environment 都市的環境
Copyright 2005 John Wiley & Sons, NY
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Treatment of Conduct Disorder
品行疾患的治療

Family interventions 家人的介入
» Parental management training (PMT; Gerald
Patterson) 父母親管理訓練
– Teach parents to reward prosocial behavior 教導父母獎
賞利社會行為

Cognitive therapy 認知治療
» Anger-control training 憤怒控制訓練
Copyright 2005 John Wiley & Sons, NY
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Figure 14.4 Multisystemic Treatment of CD
品行疾患的多系統化治療

Insert Figure 14.4
Copyright 2005 John Wiley & Sons, NY
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Depression in Children and Adolescents
兒童和青少年的憂鬱

Symptoms common to
children, adolescents, and
adults 兒童,青少年和成人的
共同症狀
» Depressed mood 憂鬱心情
» Inability to experience pleasure
無法經驗愉快
» Fatigue 疲累
» Problems concentrating 難以集
中注意力
» Suicidal ideation 自殺意念

Symptoms specific to
children & adolescents 兒童
和青少年的特定症狀
» Higher rates of suicide
attempts and guilt 較高比例的
自殺嘗試和罪惡感
» Lower rates of 較低比例的
– Early morning awakening 早晨
易醒
– Early morning depression 早
晨憂鬱
– Loss of appetite 缺乏食慾
– Weight loss 體重減少
Copyright 2005 John Wiley & Sons, NY
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Depression in Children and Adolescents
兒童和青少年的憂鬱
Depression recurrent 憂鬱持續再發
 Prevalence 盛行率

» 1% of preschoolers 學齡前兒童為百分之ㄧ
» 2 – 3% of school age children 學齡兒童為百分之二
到三
» Adolescents 青少年
– Girls 女孩


7 – 13% 百分之七到十三
2x that of boys 比男孩高於兩倍
Copyright 2005 John Wiley & Sons, NY
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Etiology of Depression in Children and Adolescents
兒童和青少年憂鬱的病因學


Genetic factors 遺傳因素
Family and relationship factors 家庭和人際關係因素
» A parent who is depressed 父母有ㄧ方是憂鬱的
» Cold and hostile family interactions 冷漠和敵意的家庭互動
» Poor social skills 社交技巧不佳
– Impaired relationships with peers and siblings 和同儕和兄弟姐妹有
不良的關係
» Parental criticism 父母的批評
Copyright 2005 John Wiley & Sons, NY
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Treatment of Depression in Children and Adolescents
兒童和青少年憂鬱的治療


Much less research on childhood depression 對於兒童憂鬱較少
研究
Medications 藥物治療
» SSRIs more effective than tricyclics 選擇性血清素抑制劑較三環抗鬱劑來得
有效
– Concerns about increased risk of suicide attempts 自殺嘗試的風險增加
» CBT plus Prozac more effective than either alone 認知行為治療加上百憂
解比起單獨使用任何一種方式更為有效
– Prozac alone more effective than CBT alone 單獨使用百憂解比單獨使用認知行
為治療更為有效



Interpersonal psychotherapy (IPT) 人際關係心理治療
CBT in school setting 學校環境的認知行為治療
Treatment of depressed parent 憂鬱父母的治療
Copyright 2005 John Wiley & Sons, NY
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Anxiety in Children and Adolescents
兒童和青少年的焦慮


Fears and worries common in childhood 在兒童期害怕
和憂慮很普遍
Anxiety disorder 焦慮疾患
» More severe and persistent worry 更為嚴重和持續性的憂慮
» Must interfere with functioning 必須妨害日常生活功能

Most childhood fears disappear but adults with anxiety
disorders report feeling anxious as children 大部分兒
童時期害怕會逐漸消失 但有焦慮疾患的成人報告當還
是小孩時就有焦慮的感覺
» “I’ve always been this way” 我ㄧ直都是這個樣子
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School Phobia
懼學症

Two types 二種類型
1. Separation anxiety 分離焦慮
» Worry about parental safety when separated 當分離時
擔心父母安全
2. Fear of school 對上學害怕
» Begins later in childhood 在兒童期較晚時開始
» More severe and pervasive avoidance 更為嚴重和廣泛
性的逃避
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Social Phobia
懼學症


Extreme shyness and withdrawal 極端害羞和退縮
May exhibit selective mutism 可能呈現選擇性緘默症的症狀
» Refusal to speak in unfamiliar social setting 不願意在不熟悉的社會情境
中說話

Prevalence 盛行率
» 1% of children and adolescents 兒童和青少年為百分之ㄧ

Etiology 病因學
» Overestimation of threat 對威脅的高估
» Underestimation of coping ability 對自我應付能力的低估
» Poor social skills 社交技巧不佳
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PTSD
創傷後壓力症候群
Exposure to trauma 暴露於創傷

»
»
»
Chronic physical or sexual abuse 長期身體或性虐待
Community violence 社區暴力
Natural disasters 自然災害
Symptom categories 症狀種類

»
»
»
Flashbacks, nightmares, intrusive thoughts 經驗瞬間再現,惡夢,侵入性
思考
Avoidance 逃避
Hyperarousal and vigilance 過度容易被激發和警覺
Etiology 病因學

»
»
»
Preexisting anxiety 原先即存在焦慮
Family stress and coping styles 家庭壓力和應對方式
Parental response to trauma 父母親對創傷的反應
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Treatment of Anxiety Disorders in Childhood and
Adolescence
在兒童期和青少年期焦慮疾患的治療

Exposure to feared object 暴露於所害怕的物體
» Reward approach behavior 獎賞接近的行為


Modeling 示範
CBT Kendall’s Coping Cat program
»
»
»
»
»
»
Cognitive restructuring 認知重組
Psychoeducation 心理教育
Modeling and exposure 示範和暴露
Skills training 技巧訓練
Relapse prevention 再發預防
Include family in treatment 治療包括家人
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Learning Disability
學習障礙

Evidence of inadequate development in a specific area
of academic, language, speech or motor skills 在學業、
語言、說話或運動技能領域有不適當發展的證據
» e.g., arithmetic or reading 例如：數學或閱讀學習障礙


Not due to mental retardation, autism, physical disorder
or lack of educational opportunity 不是由於智能遲緩,生理
疾病或缺乏教育機會所造成
Individual usually average or above average intelligence
個體通常有平均或高於平均的智力
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Learning Disability
學習障礙

DSM-IV-TR categories 在DSM-IV-TR中的類別
» Learning disorders 學習疾患
» Communication disorders 溝通疾患
» Motor skills disorder 運動技能疾患
Often identified and treated in school 通常在學
校中被辨認和治療
 Reading disorders more common in boys 在男
孩閱讀疾患更為普遍

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Learning Disorders
學習障礙

Reading disorder (dyslexia) 閱讀疾患(失讀症)
» Problems with word recognition and reading comprehension
對於字的辨認和閱讀理解有問題

Disorder of written expression 文字表達疾患
» Problems writing including spelling, grammar, and
punctuation errors 文字寫作問題包括：拼字,文法和標點符號
的錯誤

Mathematics disorder 數學疾患
» Problems counting, remembering arithmetic facts, and
alignment of numbers in columns 在算術,記住數學事實和欄
位數字的排列上有問題
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Communication Disorders
溝通疾患

Expressive Language disorder 語言表達疾患
» Difficulty expressing self in verbal speech 有困難以口語表達自己
» Speaks in short phrases 說簡短的片語
» Forgets word meanings 忘記字義

Phonological disorder 音韻疾患
» Vocabulary adequate but difficulty articulating speech sounds 有足夠字彙但有困
難清晰的發音
» Complete recovery common with speech therapy 經由語言治療普遍可以完全恢復

Stuttering 口吃
»
»
»
»
»
Frequent repetitions or prolongations of sounds 經常語音重複或拖長
Long pauses between words 在字的中間有較長的暫停
Repeating words 重複字詞
Body twitching and blinking 身體痙孿和眨眼
80% recover by age 16 在年齡十六歲時，有八成會恢復
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Motor Skills Disorder
運動技能疾患

Also known as developmental coordination
disorder 也被稱為是發展性運動協調疾患
» Marked impairment in motor coordination 動作協調
上有明顯的受損
– e.g., difficulty tying shoes, writing, catching a ball
例如：有困難綁鞋帶、寫作和接住球
Copyright 2005 John Wiley & Sons, NY
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Etiology of Learning Disabilities: Dyslexia
學習障礙的病因學：失讀症

Perceptual deficits 知覺缺陷
» Mirror image or reversal of letters 鏡像或字母的顛倒
» Little support for this hypothesis 對於此假設獲得較少支持

Genetic factors 遺傳因素
» Evidence from family and twin studies 來自家庭和雙生子研究的相關證據

Problems in language processing 在語言處理上有問題
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Speech perception 語音知覺
Difficulty recognizing rhyme and alliteration 有困難辨認韻律和頭韻
Problems naming familiar objects rapidly 有困難快速的說出熟悉物體的名字
Delays learning syntactic rules 學習句法規則的延遲
Deficient phonological awareness 語音覺察有缺陷
– Inadequate left temporo-parietal-occipital functioning 不良的左顳-頂-枕葉功能
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Treatment of Learning Disabilities
學習障礙的治療
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Reading and writing disorders 閱讀和書寫文字疾患
» Multisensory instruction in listening, speaking, and writing
skills 聽,說,和寫的技巧的多重感官教導
» Readiness skills in younger children as preparation for
learning to read 幼小小孩準備就緒技巧作為學習閱讀的準
備
» Phonics instruction 語音的教導
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Communication disorders 溝通疾患
» Fast ForWord
– Involves computer games and audiotapes that slow speech
sounds 包括電腦遊戲和語音較慢的錄音帶
Copyright 2005 John Wiley & Sons, NY
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Mental Retardation
智能不足
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Significantly below average intellectual functioning智
力功能顯著低於平均
» IQ less than 70 智商少於七十
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Deficits in adaptive functioning 適應功能的缺陷
» Self-care, communication, home living, decision making,
etc. 自我照顧,溝通,家居生活,做決定等等
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Onset before age 18 在十八歲前初發
Most professionals focus on strengths of individual to
assess ability to function 多數專家會強調個案的優勢
以評估其功能
Copyright 2005 John Wiley & Sons, NY
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Table 14.3 Sample Items from Vineland Adaptive
Behavior Scales
來自Vineland適應行為量表的例題
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Table 14.4 DSM-IV-TR Categories of Mental
Retardation
智能不足在DSM-IV-TR的分類
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Table 14.5 AAMR Definition of
Mental Retardation
美國智能不足學會對智能不足的定義
Copyright 2005 John Wiley & Sons, NY
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Etiology of Mental Retardation: Neurological Factors
智能不足的病因學：神經學因素

Down’s syndrome 唐氏症
» Chromosomal trisomy 染色體21有三條 (trisomy 21)
» 47 instead of 46 chromosomes 有47個染色體而非23對
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Fragile X syndrome 脆性X症候群
» Mutation in the fMRI gene on the X chromosome 在X染色體產生I基因的突變
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Recessive-gene disease 隱性基因疾病
» Phenylketonuria (PKU) 苯酮尿症
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Maternal infectious disease, especially during 1st trimester 母親得到傳染性
疾病,特別是在懷孕期的前三個月間
» HIV, rubella, syphilis 愛滋病毒, 德國麻疹,梅毒
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Encephalitis 腦膜炎
Malnutrition營養不良
Brain injuries from falls or auto accidents 跌倒或車禍所導致的大腦受傷
Lead or mercury poisoning 鉛或汞中毒
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Treatment of Mental Retardation
智能不足的治療
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Residential treatment 住宿治療
» Small to medium sized community residences 小到中等大小的社區住處
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Behavioral treatments 行為治療
» Language, social, and motor skills training 語言,社會和動作技巧訓練
» Method of successive approximation to teach basic self-care skills in
severely retarded 用逐步漸近的方法來教導重度智能障礙的自我照顧技巧
– e.g., holding a spoon, toileting 例如：握住湯匙,如廁
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Cognitive treatments 認知治療
» Problem-solving strategies 問題解決策略
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Computer assisted instruction 電腦輔助教學
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Pervasive Developmental Disorders
廣泛性發展疾患
Autistic Disorder 自閉性疾患
 Rett’s Disorder Rett氏疾患
 Childhood disintegrative disorder 兒童期崩解
性疾患
 Asperger’s disorder 亞斯伯格症
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Autistic Disorder
自閉性疾患
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Kanner’s (1943) autistic aloneness 在1943年Kanner首度提出自閉一詞
Impairments in social interactions 社會互動的受損
» Deficient use of nonverbal behaviors 使用非語言行為的障礙
» Poorly developed peer relationships 不良發展的同儕關係
» Lack of social or emotional reciprocity 缺乏社交性或情緒上的相互反應
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Impairments in communication 溝通上的受損
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Lack of spoken language 缺乏口說語言
Difficulty initiating or sustaining conversation 有困難引發或維持對話
Repetitious or idiosyncratic language 重覆或使用特異的語言
Echolalia 語言模仿
Pronoun reversal 代名詞反轉
Repetitious or stereotyped behaviors 重覆或刻板化行為
» Abnormal preoccupation with objects 對物體異常的專注
» Ritualized behaviors 儀式化行為
– Body rocking, hand flapping 身體搖擺,拍手
» Stereotyped mannerisms 刻板化的重覆行為
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Autistic Disorder
自閉性疾患
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Prognosis 預後
» Children with higher IQs who can speak before
age 6 have best outcomes 有較高的智商 在6歲之前
可以說話的孩子 預後較佳
– Many can function fairly independently in adulthood 許多
個案在成人期之後大多可以有獨立生活的功能
Copyright 2005 John Wiley & Sons, NY
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Etiology of Autistic Disorder
自閉性疾患的病因學

Bettleheim’s psychoanalytic theory (1967)
Bettleheim的精神分析理論
» Rejecting and unresponsive parents 拒絕和不反應的父母
» Child withdraws into his own world 孩子退縮至他(她)自己
世界
» Theory unsupported by empirical data 此理論並沒有被實
證資料所支持
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Genetic factors 遺傳因素
» Twin studies 雙生子研究
– 60 to 91% concordance rates 有六十到九十一的共患率
Copyright 2005 John Wiley & Sons, NY
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Etiology of Autistic Disorder
自閉性疾患的病因學
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Neurobiological factors 神經生物因素
» Brain size 腦部大小
– Although normal size at birth, brains of autistic adults
and children are larger than normal. 雖然在出生時有正常
的腦部大小,但自閉成人和小孩的大腦較一般人來得大
– Pruning of neurons may not be occurring 神經元的修剪
可能沒有發生
» Cerebellum abnormalities 小腦異常
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Treatment of Autistic Disorder
自閉兒童的治療
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Intensive operant conditioning (Lovaas, 1987) 密集的操作制約治療
Parent training and education 父母親的訓練和教育
Pivotal response treatment (Koegel et al., 2003) 關鍵反應治療
» Focus on increasing child’s motivation and responsiveness rather than
discrete behaviors 強調要增加孩子的動機和反應性 而不是只著重個別的行為
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Medication most common used 常使用的藥物治療
» Haloperidol (Haldol)
– Antipsychotic 抗精神藥物
– Reduces aggression and stereotyped motor behavior 降低攻擊和刻板動作的行為
– Does not improve language and interpersonal relationships 無法改善語言和人際
關係
– Not all children respond 不是所有小孩都會有反應
– Potentially serious side effects 潛在嚴重的副作用
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