1、社會福利署社會福利署臨床心理服務科臨床心理服務科中央心理輔助服務中央心理輔助服務混合幼兒中心員工訓練工作坊混合幼兒中心員工訓練工作坊自閉症兒童訓練自閉症兒童訓練 想法解讀想法解讀內容內容想法解讀想法解讀Theory of Mind (ToM)的理論基礎的理論基礎自閉症兒童的社交及溝通障礙自閉症兒童的社交及溝通障礙ToM評估方法評估方法ToM訓練方法訓練方法本地教材介紹本地教材介紹想法解讀的理論基礎想法解讀的理論基礎（ToM)ToM理論基礎理論基礎於於70年代學者研究猿猴類動物能否理解想年代學者研究猿猴類動物能否理解想法而提出的理論法而提出的理論 (Premack & Woodruffm, 19
2、78)80年代其他學者將理論應用於兒童的研究年代其他學者將理論應用於兒童的研究上，發現它能解釋很多自閉症狀的成因上，發現它能解釋很多自閉症狀的成因(Baron-Cohen, Lewslie & Frith, 1985)，例如：，例如：不會指著一些東西叫人看不會指著一些東西叫人看不能維持互動式的應對不能維持互動式的應對很少說出自己的想法及意念很少說出自己的想法及意念不懂辨別較複雜的感受不懂辨別較複雜的感受ToM理論基礎理論基礎定義：推測別人想法的能力（想法泛指信念、定義：推測別人想法的能力（想法泛指信念、Ability to use this awareness to interpret soc
3、ial behaviorKnow different thingsHave different feelingsAre motivated by different thingsEtc.TOM has a major influence on communication1. Help decide when to communicateIs a listener available?Whats the listener doing?Whats the feeling of the listener?Will s/he want to be interrupted? 2. Helps shape
4、 selection of contentIs it relevant/ important to the listener?Background knowledgeShared knowledege?What information is neededHow much detail?3. Helps shape selection of formListeners proximity?Listeners visual perspective?Comprehension level?RelationshipTime constraints?“Effective conversation rel
5、ies on an understanding that people know different things and that these states of knowledge can be shared.”(Hadwin, Baron-Cohen, Howlin & Hill, 1997)AssumptionsTypical learners automatically interpret social behavior by assigning motives to the agents of action (mind-reading)TOM helps us to make se
6、nse out of seemingly disconnected utterancesMind-reading is done reflexively and the skills are part of the brains innate “cognitve structure”.Theory of Mind Baron-Cohen (1995) TOM is defined as the ability to attribute mental state to oneself and to others and to interpret behavior in terms of ment
7、al states. mental states are unobservable entities that we use quite successfully to explain and predict behavior In order for people to have a theory of mind mechanism (ToMM), they must also have a shared attention mechanism (SAM), which happens when two people focus their attention on the same obj
8、ect. The SAM uses available information about the perceptual state of another person (or animal) It then computes shared attentions by comparing another agents perceptual state with the selfs current perceptual state” 1. Intentionality detector (ID)A perceptual deviceActivated whenever input identif
9、ies something as an potential agent of actionInterprets motion as goal-oriented behaviorMind-reading Cognitive Structures視線偵察Mind-reading Cognitive Structures2. Eye direction detector (EDD)Notices another persons eyesNotices direction of gaze“I know what you see”Mind-reading Cognitive Structures3. S
10、hared Attention Mechanism (SAM)Builds triadic representation“I know that you see what I see”Mind-reading Cognitive Structures4. TOM Mechanism (TOMM)Ability to infer full range of mental statesPerceptionsFeelingsDesiresIntentionsKnowledgeRetains in memor y and update informationThe Mindreading Mechan
11、ismIDMoving stimulusEDShared Joint Attn.Eye-like stimuliSAMFollow gazeRecognize agentTOMMInfer full range of mental statesStore info & use as part of the theoryTheories about TOM and AutismSimon Baron Cohen (1995)Learners with autism have a specific TOM deficit (i.e. mindblindness) Implies thatThe c
12、ognitive wiring is absent-damagedThe ability may not be teachableOther Theories:Winner (2002) views TOM deficits on a spectrum, like ASDMB : Mindblindness complete lack of TOM skillsEPT : emerging perspective takers pass tasks; dont generalizeIIPT : Impairment of Interactive Perspective TakingTOM :
13、Normal social inferencing skillsAssumes TOM skills of children in the middle can be enhanced through instruction心智解讀是 明白別人擁有思想思想、 信念信念、 願願 望望、動機動機及感覺感覺 (各樣精神狀態) 重要性: 了解別人的動機有助我們預了解別人的動機有助我們預 測別人測別人(包括敵人包括敵人)的行為的行為自閉症兒童的社交自閉症兒童的社交及溝通障礙及溝通障礙自閉症兒童的特徵自閉症兒童的特徵1.語言及溝通2.社交3.假想能力 4.固執行為及狹隘的興趣自閉症早期之特徵n目光接觸n互
14、聯注意n假想遊戲n對人的反應n模仿力n 非語言溝通模式n 語言n 社交回應(微笑)n 與友伴的關係研究結果 約有八成八成以上的自閉症兒童並未能通過 心智解讀的測試研究結果發展正常發展正常兒童兒童唐氏綜合症唐氏綜合症兒童兒童Baron-Cohen, Leslie, A. M., & Frith, U. (1985)自閉症兒童的心智解讀能力能力一般幼兒一般幼兒自閉症幼兒自閉症幼兒留意別人的視留意別人的視線來了解別人線來了解別人的目的的目的九至十八個月三至七歲錯誤信念錯誤信念四歲八至十四歲心智解讀是自閉症兒童因心智解讀能力較弱 不能解讀別人的心智不能解讀別人的心智 不能鑑貌辨色不能鑑貌辨色 不能預知
15、別人下一步的行動不能預知別人下一步的行動心智解讀是 以為自己看到的以為自己看到的( (視線視線) )，別人也能看到，別人也能看到 不能投入不能投入假想假想遊戲遊戲 不能分辨不能分辨想像與真實想像與真實的世界的世界 不能理解說話中不能理解說話中比喻及諷刺比喻及諷刺的真正意思的真正意思ToM評估方法評估方法Sixteen Frequently Used MeasuresTests of mental-physical distinctionBrain functions testsThe appearance-reality distinctionFirst-order false-belief
16、tasksSee leads to knowing tasksTests of recognizing mental-state wordsSpontaneous use of mental state wordsTests of the production of spontaneous pretend playSixteen Frequently Used MeasuresTests of understanding more complex causes of emotionTests of inferring thought/intent from gaze directionTest
17、s of being able to monitor ones own intentionsTests of deceptionTests of understanding metaphor, sarcasm & ironyTests of pragmaticsMeasures of correlation with real-life social skillsSecond order false-belief (FB) testsToM訓練方法訓練方法Intervention ResearchASD learners can be taught to pass FB tasksMany d
18、ont generalize knowledge in vivoSome generalise direct experience FB task to traditional task ( picture-based)Some studies found no different interaction following training on FB taskBut training took place over short timeMaybe ASD learners need more intense practiceMaybe they need to be taught gene
19、ralizationIntervention ResearchOne study found correlation between Vineland scores and TOM skillsVineland was adapted to include more Qs about perspective takingCorrelations varied by strength of TOM (higher for ASD who could pass FB tasks, lower for those just learned to pass them)Some teaching str
20、ategies looked more promising than others (e.g. teaching “thoughts are like pictures in your head”)If ASD have problem with overselection, Teach them what to attend to Teach them what to ignoreIntervention ResearchCognitive science has been helpful in Showing that ASD do poorly on FB tasksShowing th
21、at FB tasks can be learnedIdentifying some prosthetics that can be used to teach itCognitive science has not shown How to identify overselection in vivoHow to teach ASD to look for relevant curesHow to teach to ASD to make inferences from cues心智解讀的基礎心智解讀的基礎心智解讀心智解讀學習程度 24個月語言表達及理解程度 24個月 學習程度 48個月語言
22、表達及理解程度 42個月 掌握心智解讀的能力有何用?懂得懂得鑑貌辨色鑑貌辨色增加增加假想假想能力能力提升提升EQ明白明白說話背後說話背後的意思的意思改善改善社交社交關係關係懂得懂得美麗的謊言美麗的謊言發展發展自省自省的能力的能力提升提升溝通溝通能力能力心思心智解讀心智解讀心智解讀心智解讀心智解讀心智解讀心智解讀教導時需注意的事項教導時需注意的事項1. 訂立明確的訓練目標2. 分拆成細項來教導，可能需較長的時間來掌握3. 在自然環境下教導，增強類化4. 選取兒童喜愛的事物作教材，增強學習動機心智解讀心智解讀教導時需注意的事項教導時需注意的事項 5. 配合不同的媒介及方法媒介：遊戲、圖片、電腦方法
23、：手偶故事、角色扮演、漫畫故事、卡通片6. 給予清晰及有系統的指示7. 配合視覺策略8. 金句帶出每項活動背後的原則及總結 活動重點9. 捉緊每一刻10. 其他人作示範，從別人身上學習 (A. Bandura, 1986)11. 從經驗中學習12. 即時教導，重覆學習13. 輕鬆氣氛、時常獎勵心智解讀心智解讀教導時需注意的事項教導時需注意的事項 14. 螺旋式學習、進展式學習15. 個別化學習心智解讀心智解讀教導時需注意的事項教導時需注意的事項 其他訓練活動n破冰遊戲n身體語言n語氣背後的意思n調節情緒如何應用？A. 中心中心 課堂：社交、玩技、唱遊、語言溝通、圖工堂、體能活動環境：情緒角、分組學習、吊飾日常流程：食飯時間、點名時間如何應用？B. 家居家居把握日常生活的每一刻安排親子時段 (玩玩具、一起製作食物、重溫生活照片)一起觀看卡通片撰寫情緒日記備註：1. 訓練重點 2. 家人參與/ 中介人 3. 學習氣氛本地教材介紹本地教材介紹
