以互動式繪畫分析自閉症類群障礙症孩童的交互行為

Reciprocity is the to-and-fro interactive pattern between two individuals. Reciprocity impairment is one of the core features in children with autism spectrum disorders (ASD). However, the current reciprocity measures for children with ASD have two major drawbacks: (1) the caregiver questionnaires or interviews are not objective; (2) the measures of objective observation may underestimate reciprocity of children with ASD due to their limited verbal ability. To better explore reciprocity in children with ASD, the Interactive Drawing Test (IDT), which requires no verbal exchange, was used in this study to examine correlations between reciprocity in the IDT and play contexts; and delineate the reciprocity features of children with ASD. The IDT and the Reciprocal Social Behaviors Observation (RSBO) were respectively used to measure the reciprocity in drawing and playing contexts. A total of 52 children with ASD aged 6 to 12 years having moderate verbal comprehension ability on average were recruited. The results of Pearson correlation coefficients showed that children with ASD who had higher percentages of collaborative drawing performed more turn-taking of reciprocity (r=.369, p=.007) and elements of social behaviors (r=.393, p=.004). The reciprocity features of children with ASD could be classified into five types─collaborative, moderate, restrictive, guided, and low motivation─according to their collaborative motivation, collaborative skills, and personal styles exhibited in the IDT. This study provides clinicians a way of using interactive drawing to measure reciprocity in children with ASD for identifying the reciprocity type and planning corresponding interventions to improve social interaction in children with ASD.