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1 ( ).., , ,.,,,,.,,,,,,,,,,,,.,, Kanner,., DSM - III (1980) (perv a siv e dev elopm ent al disorders ). (Rapin, 1991). (Stone, 1987, 1988), DSM - IV ICD- 10,,.

2 ,., (Rapin, 1991), (heterogeneous). (Siegel et al., 1988; Stone, 1988; Volkmar, Cohen & Paul, 1986).., (Rutter, 1978),.,.. (Lovaas, 1987; Rogers & Lewis, 1989), (Stone et al., 1994).,.,,, (Wakschlag & Leventhal, 1996). 1-2.,.

3 , ( )52. 32, 23 (, ) ,, DSM - III- R (APA, 1987),. 16 8, 5 2, 6 1, 5 1 (autistic disorder ). (atypical autism, pervasive developmental disorder, not otherwise specified ).,,... 2

4 . Schopler and Reichler (1971) Psycho- Educational Profile(PEP ), Chapel Hill,. (1975),..,,,, -,, 7.,,,, 5,,. (passing ), (emerging ), (failing ), 1. (absent ), (mild), (severe),.,, Schopler et al. (1986) (CARS : Childhood Autism Rating Scale)., , (cutoff score) 30., DSM - III- R (APA, 1987) 16,.,. 3. SPSS,

5 Student t- test, Chi- Square test.. 1. < - 1> , , 24-48, (85.5 %), 8 (15.5 %) 5.9:1, 42 (80.8 %), 10 (19.2 %) 4.2:1.. < - 1> (N = 55) (N = 52) N ( % ) N ( % ) 47 (85.5) 8 (14.5) 42 (80.8) 10 (19.2) (36.4) 14 (25.5) 17 (32.7) 12 (23.1) ( 3.6) 8 (15.4) 4.31 * 19 (34.5) 15 (28.8) (61.8) 33 (63.4) (25.5) 7 (12.7) 16 (30.8) 3 ( 5.8) ( )

6 3 ( 5.5) 4 ( 7.7) (21.8) 15 (28.8) (45.5) 22 (42.3) (18.2) 8 (15.4) ( 9.1) 3 ( 5.8) ( 7.3) 3 (5.8) ( 7.3) 9 (17.3) (12.7) 10 (19.2) 0.84 Mean SD Mean SD t- value () () * ** CARS * ** * * p <.05, * * * p <.001, * * * * p <.0001 CARS: Childhood Autism Rating Scale (p <.001). CARS (p <.05).,, % 3.6 % (2 ) (p <.001). 2. < - 2>.,, 1,,,,,, (p <.05)

7 . < - 2> (N = 55) (N = 52) N ( % ) N ( % ) 2 / 7 (12.7) 3 ( 5.5) 4 ( 7.3) 10 (18.2) 14 (25.5) 10 (18.2) 5 ( 9.1) 3 ( 5.5) 4 ( 7.3) 14 (25.5) 16 (30.8) 3 ( 5.8) 4 ( 7.7) 19 (36.5) 14 (26.9) 15 (28.8) 9 (17.3) 6 (11.5) 8 (15.4) 15 (28.8) 5.09 * * * p < < - 3 >., (85.5 %), (81.8 %), (76.4 %). (67.3 %), (55.8 %), (51.9 %). (p <.001), (p <.01), (p <.01), (p <.0001), (p <.001), (p <.01), (p <.001).

8 < - 3> (N = 55) (N = 52) N ( % ) N ( % ) 2 34 (61.8) 7 (12.7) 40 (72.7) 45 (81.8) 37 (67.3) 16 (30.8) 5 ( 9.6) 35 (67.3) 29 (55.8) 27 (51.9) * * * * * 2.59 () 33 (60.0) 42 (76.4) 47 (85.5) 10 (18.2) 7 (12.7) 3 ( 5.3) 22 (42.3) 26 (50.0) 25 (48.8) 8 (15.4) 8 (15.4) 9 (17.3) * * * * * * (49.1) 30 (54.6) 12 (21.8) 10 (18.2) 29 (52.7) 10 (19.2) 16 (30.8) 9 (17.3) 7 (13.5) 7 (13.5) * * * 6.09 * * * * * * * p <.05, * * p <.01, * * * p <.001, * * * * p < (Psycho- Educational Profile) < - 4>., (p <.05), (p <.001).

9 < - 4> PEP (N = 55) (N = 52) Mean SD Mean SD t * * * * * * p <.05, * * * p <.001 PEP : Psycho- Educational Profile.,..,....,,,,.,

10 .,,.,.,., 3,,,,.. (Rutter, 1978), (Rogers & Dillala, 1990). 36.,.,., (stigma) (Rapin, 1991).,.,..,,

11 , 18,., (p <.001).,.,.,..,, % 3.6 % (2 ) (p <.001).,. < - 2> (p <.05). < - 2>

12 .,, 1,,,,,.. Bryson et al. (1988), Finegan and Quarrington (1979). < - 3>., (85.5 %), (81.8 %), (76.4 %). (67.3 %), (55.8 %), (51.9 %).,. 3,.,, 48. Stone (1994)., ,. (5.5 %), (12.7 %), (12.7 %), (18.2 %), (18.2 %)., 5 3,..

13 < - 4>.,, (p <.05), (p <.001). PEP. (1992). CARS , ,,.,.,..,.,.. V.,,.,,

14 .,.,.,,,,.,,,,,,,,,,,.,,.

15 (1985).... (1992).., 3, American Psychiatric Association (1980). D iagnostic and S tatistical M anual of M ental D isorders (DSM - III) (3rd Ed.). Washington, DC: American Psychiatric Association. American Psychiatric Association (1987). D iagnostic and S tatistical M anual of M ental D isorders (DSM - III -R ) (3rd Ed.). Washington, DC: American Psychiatric Association. American Psychiatric Association (1994). D iagnostic and S tatistical M anual of M ental D isorders (DSM - I V) (4th Ed.). Washington, DC: American Psychiatric Association. Beyson, S. E., Smith, I. M. & Eastwood, D. (1988). Obstetrical suboptimality in autistic children. J ournal of the A m erican A cademy of Child Psy chiatry, 27, Finegan, J. A. & Quarrington, B. (1979). Pre-, peri-, and neonatal factors and infantile autism. Journal of Child Psychology and Psychiatry, 20, Kanner, L. (1943). Autistic disturbances of affective contact. The N ervous Child, 2, Lovaas, O. I. (1987). Behavior treatment and normal educational and intellectual functioning in young autistic children. J ournal of Consulting and Clinical Psychology, 55, 3-9. Rapin, I., Mattis, S. & Rowan, A. J. (1977). Verbal auditory agnosia in children. D evelop m ental Medicine and Child N eurology, 19, Rapin, I. (1991). Autistic children: Diagnosis and clinical features. P ediatrics, 87 (suppl.), Rogers, S. J. & Lewis, H. (1989). An effective day treatment model for young children with pervasive developmental disorders. Journal of the A m erican A cademy of Child Psychiatry, 28, Rogers, S. J. & Dillala, D. L. (1990). Age of symptom onset in young children with pervasive developmental disorders. Journal of the A m erican A cademy of Child Psychiatry, 29, Rutter, M. (1978). Diagnosis and definition of childhood autism. Journal of A utism and D evelop m ental D isorders, 8, Schopler, E. & Reichler, R. J. (1971). Individualiz ed A ssessm ent and Treatm ent for A utistic and D evelopmentally D isabled Children. Vol. 1, Psychoeducational Prof ile. Baltimore: University Park Press. Schopler, E, Reichler, R. J. & Renner, B. R. (1986). The Childhood A utism Rating Scale ( CA R S) for

16 D iagnostic Screening and Classif ication of A utism. New York, NY: Irvington. Siegel, B., Pliner, C., Eschler, J. & Elliott, G. R. (1988). How children with autism are diagnosed. J ournal of D evelopm ental B ehavior P ediatry, 9, Stone, W. L. (1987). Cross- disciplinary perspectives on autism. Journal of P ediatry and Psychology, 12, Stone, W. L. & Rosenbaum, J. L. (1988). A comparison of teacher and parents views of autism. J ournal of A utism and D evelopm ental D isorders, 18, Stone, W. L., Hoffman, E. L., Lewis, S. E. & Ousley, O. Y. (1994). Early recognition of autism. A rchives of P ediatric and A dolescent M edicine, 148, Volkmar, F. R., Cohen, D. J. & Paul, R. (1986). An evaluation of DSM- III criteria for infantile autism. Jouranl of the A m erican A cademy Child Psychiatry, 25, Wakschlag, L. S. & Leventhal, B. L. (1996). Consultation with young autistic children and their families. Journal of the A m erican A cademy Child Psychiatry, 35, World Health Organization (1992). International S tatistical Classif ication of D isease and R elated H ealth P roblems (10th Eds.). World Health Organization.

17 AB ST RACT F act or s Relatin g t o E ar ly Recognition of Autism M in N am, M.D.*1(Division of Child and Adolescent Mental Health, Kohnodai Hospital, National Institute of Mental Health, Japan) T he diagnosis of autism or early- onset pervasive developmental disorder in very young children is difficult for both families and clinicians. This study is to facilitate early recognition of autism by identifying sociodemographic characteristics and family environment, prenatal and perinatal factors on mothers, and behavior characteristics that are most apparent at young ages. Social interaction, communication, restricted activities and interests were evaluated using standard diagnostic criteria for autism. Results suggested that the areas of lack awareness of others, social play, nonverbal communication, imaginative play, stereotyped body movements, parts of objects and range of interests are more prominent than young child with mental retardation. Also, birth order, age on recognition, score of childhood autism rating scale, maternal age, birth weight and part of Psycho-Educational Profile appear to detect different aspects of characteristics in this sample. In this study, a few symptom variables may represent on conversation skill, speech production and content. This result suggests that different criteria of autistic symptoms are recommend on recognition of autism in early age. * psy543@nownuri.net

歯6권2호.PDF

歯6권2호.PDF : / / * ** ( *, **). : / /., 2 0 0 1, 6, 2, 4 9 3-5 04.... / / 3, 4 1 8 32.. / / 17.6 %.,,.. (articulation and phonological disorders) ( :,, )..,., (, 2000).. 498 (acquisition or establishment), (stabilization),

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歯남민4.PDF