高功能自閉症學齡孩童的情緒語調辨識：以瞳孔反應為指標

Abstract

社交能力缺損為自閉症個案的主要診斷標準之一，而情緒語調辨識能力為社交能力中的一環。不同的自閉症心理病理理論中，主要由「心智理論缺陷」來解釋社交能力的限制，而執行功能亦與心智理論相關，因此本研究同時評估受試者心智理論及執行功能的表現，以了解影響情緒語調辨識的因素。此外，本研究以瞳孔大小作為辨識情緒語調的指標，以更仔細地了解自閉症學齡孩童辨識情緒語調的訊息處理時間歷程。本研究招募9 至13 歲的高功能自閉症學齡兒童(樣本數=52)及一般兒童(樣本數=42)兒童，結果顯示自閉症組情緒語調辨識正確率與一般組相近，但和情緒辨識有關的瞳孔變化則與一般組相異。比起開心情緒語調，自閉症組辨識傷心與生氣語調的瞳孔大小變化的最大值及平均變化量較大，一般發展組未有此差異。進一步以主成分分析法檢視和情緒訊息處理有關的因素，顯示自閉症組辨認傷心與生氣語調時，比開心語調耗費更多的專注力。而情緒語調、心智理論及執行功能作業結果顯示，在自閉症組中，情緒語調辨識能力與心智理論相關；心智理論與執行功能作業中的工作記憶、空間記憶、心理彈性與持續性專注力相關。一般發展組中，情緒語調辨識與持續性專注力相關；心智理論則與衝動控制、工作記憶、空間記憶與持續性專注力相關。整體而言，行為指標的結果顯示自閉症兒童辨識情緒語調的表現和一般組相當；但是瞳孔反應則顯示，自閉症組使用更多認知資源來辨識情緒語調。另外，自閉症兒童的心智理論缺陷和執行功能密切相關。

Social communication deficit is one of the diagnostic criteria for autism spectrum disorder (ASD), and the ability to accurate judge emotions from speech prosody is essential to effective social interactions. Due to variability of social communication impairments in ASD group, it is still an open issue that children with ASD experienced any difficulties in perceiving emotional prosody. This study assessed the emotion prosody perception through both behavioral measures and pupillometry in 9-13 year-old children with high-functioning autism (HFA, n = 52) and typicallydeveloping children (TD, n = 42). Furthermore, this study examined whether the theory of mind and executive function would account for emotional prosody perception deficits in HFA children. Results of emotional prosody identification task showed that HFA performed similar to TD group in recognizing emotional prosody, but their pupil responses to emotional prosody were different. Compared with happy prosody, HFA group exhibited larger dilation than listening to sad and angry prosody. In contrast, TD group exhibited similar pupil sizes when listening to variety of emotional prosody. Moreover, results of principal component analysis (PCA) on pupil size changes implicated that HFA group allocated more cognitive resources to recognize sad and angry prosody than happy prosody. Results of the pupillometry suggested that HFA children, but not TD group, allocated more cognitive resources to recognize emotional prosody. For HFA group, the emotional prosody identification was correlated with theory of mind (ToM), and ToM was correlated with subcomponents of executive function (EF), i.e., working memory, cognitive flexibility and sustained attention. In conclusion, results of this study indicated that pupillometry would be a sensitive measure to assess emotional prosody perception in HFA schoolaged children, and revealed the associations among emotional prosody perception, ToM and EF.