自閉児の発達的変容の類型化の試み ―NAUDSによる臨床像の検討を通して―

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  • ジヘイジ ノ ハッタツテキ ヘンヨウ ノ ルイケイカ ノ ココロミ NAUDS
  • On The Classification of the Developmental Change of Autistic Children

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The purpose of this study was to classify the developmental change of preschool and school aged autistic children through the application of NAUDS(Nagoya University of Autistic Child's Developmental Scale). The NAUDS consisted of 13 items, each one was to evaluate one aspect of some autistic characteristics ; Language (L_1, L_2), Activity level (A_1.A_2), Emotion (E_1,E_2), Empathy (Em), Human relation (Ad_1, Ad_2, C), Eye contact (Ey), Perseveration of sameness (P.S) and Stereotyped behaviour (St). Each item of NAUDS consisted of 5 rating steps according to the level of improvement of autistic characteristics. 1. Factor analysis of NAUDS : NAUDS was administered to 41 autistic children and 28 mentally retarded children treated with play therapy at a clinic (Reseach center of Remedial Education, Aichi University of Education) and 55 autistic children in a prefectual special school for mentally retarded. The NAUDS data were analysed by the principal factor method and the results were rotated by the varimax method.The factors obtained for autistic children were quite different from that of mentally retarded. The 1st factor loaded on E_1, E_2, Em and Ey items was named E factor and the 2nd factor loaded on L_1, L_2, Ad_1, Ad_2, and C items was named L factor. The remaining 4 items (A_1, A_2, P.S, St) were accounted for A factor (FIG. 1). On the other hand, for the mentally retarded children 11 out of 13 items (other than A_1, P.S) were highly correlated to each other and only one factor was extracted (FIG. 2). 2. Examination oftheimprovementofautistic characteristics and the correspondence of developmental change among 13 items : 18 autistic children having been treated with play therapy for 3 or more years were evaluated by NAUDS every year. In the process of developmental change the high correspondence found were among E_2, Em, Ad_1, Ad_2, and C but the correspondence among A_1, P.S, C and St were rather low (FIG. 3, 4). 3. Index for the improvement of autistic characteristics and the classification of the developmental change : From the results of the previous 2 sections, we proposed E-score and L-score as the appropriate index for the improvement of autistic characteristics. E and L scores were obtained as the average rating score for the items containing 1st or 2nd factor respectively. 23 autistic children treated with play therapy once a week at this research center 3 or more years, were evaluated every year. At the beginning of this study, their mean age was 6.3 years. Longitudinal change of autistic characteristics was analysed from the viewpoint of the locus of E and L scores and four types were identified. D1 Type E score level 1-2 L score level 1 (FIG. 5) D2 Type E score level 2 L score level 2 (FIG. 6) D3 Type E score level 3 L score level 3 (FIG. 7) D4 Type E score level 4 L score level 4 (FIG. 8) In addition to the four types discribed above we set up another type(D5) including intelligent autistic children. D5 Type E Score level low L Score level high (Fig. 9)

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