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自闭症儿童为什么会这么做

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发表于 2016-5-4 17:33:16 | 显示全部楼层 |阅读模式
                  





Why Do Kids with Autism DoThat?



为什么自闭症孩子会这么做?

When my kids were young,my son Justin was quite curious about the many odd mannerisms his sister withautism demonstrated. We welcomed his questions as well as those from hiscurious neighborhood friends who we were determined to include in our friendlyand oh-so-unconventional home. I did my parental best to offer up ideas as towhy she does what she does, and thankfully they didn’t question me or ask tosee the evidence behind my hypotheses. We asked a panel of providers to give ustheir best answers as to why our kids do what they do. Shelley O’Donnell is anOccupational Therapist specializing in children with autism at Seattle TherapyServices. Jim Mancini is a Speech Language Pathologist and Emily Rastall is aClinical Psychologist, both at Seattle Children’s Autism Center.

我儿子Justin小时候对患自闭症的姐姐的一些奇怪行为很好奇。我们欢迎他和他住在附近的朋友们提问。我尽力向他们解释她为什么要这么做,他们也没有继续追问或索求我支持假设的证据。我们邀请了一些嘉宾来解答这些问题。Shelley O’Donnell在西雅图治疗中心做职能治疗师,专注于自闭症儿童的治疗。Jim Mancini是一位语言病理学家,Emily Rastall是临床心理咨询师,两人都在西雅图儿童自闭症中心工作。



Here’s what they had tosay:

以下是他们的回答:



Why do many kids withautism . . . Avoid eye contact



为什么自闭症儿童没有眼神交流?






Jim: Different reasons,I think. There is a difference between kids who actively avoid eye contact andkids who haven’t learned how to use eye contact during communication. Foractive avoiders, I think there is a sensory component where it is unpleasantfor them to make direct eye to eye contact.

Jim:我认为有许多原因导致这种情况。主动回避眼神交流的孩子和不会进行眼神交流的孩子是有区别的。对于主动回避的孩子来说,我觉得直接的眼神交流会带给他们感官上的不愉快。



Emily: One of the coredeficits for individuals with autism is difficulty coordinating verbal andnon-verbal means of communication. For example, while speaking to someone, achild may forget to make eye contact (which makes it difficult to know to whomthe verbalization is directed). In addition, individuals with autism do notfind communicative meaning in others’ eyes like the rest of us. Thus, they arenot drawn to others’ eyes as information sources.

Emily:自闭症患者的主要缺陷之一就是综合语言和非语言的交流方式。例如,自闭症孩子在和人说话的时候可能会忘记进行眼神交流,这就让人很难知道孩子到底在对谁说话。另外,自闭症患者也不能像我们一样从别人的注视中找到意义。因此,他们不把别人的目光视作信息来源。



Shelley: Because ofdifficulty attaching meaning to the facial cues of caregivers and peers whichrelates to the child’s social-communication skills.

Shelly:自闭症孩子不作眼神交流是由于他们很难从照顾者和同龄人的面部提示中找到意义,这与他们的社交和交流技能有关。



Why do many kids withautism . . . Cover their eyes/face /ears with their hands




为什么自闭症孩子会用手蒙住自己的眼镜/脸/耳朵



Shelley: This couldrelate to many things, such as the child covering their face as a way to blockout too much sensory stimuli, to self-regulate, or to express feelingscared/anxious. Many children with autism have auditory sensitivities tospecific sounds, such as a fire engine, baby crying, or toilet flushing.Covering their ears is one way to lessen the auditory input.

Shelly:这可能与很多因素有关,比如孩子用手蒙住脸来避免过多的感官刺激,控制自己或表达紧张、害怕的感受。许多自闭症孩子对特定的声音十分敏感,例如引擎声,孩子的哭声或冲厕所的声音。用手蒙住耳朵是减少听觉输入的方式。



Emily: Children withautism are often hyper-sensitive to auditory stimuli. Thus, sounds that aretolerable to us may be very loud and uncomfortable for them.

Emily:自闭症孩子通常对听觉刺激过度敏感。因此,我们觉得可以忍受的声音对他们来说可能太大声以至于令他们感到不适。



Jim: Covering ears canoften become a learned behavior and may be linked to anxiety as a child becomesfearful of potential unpleasant noises.

Jim:蒙住耳朵通常是后天习得的行为,当孩子对令人不悦的噪音感到恐惧时,可能与紧张有关。



Why do many kids withautism . . . Startle easily



为什么自闭症孩子容易受到惊吓



Shelley: The child mayhave difficulty anticipating everyday events, and filtering irrelevant socialand environmental stimuli. When children startle easily, the result isfrequently a “fight or flight” response.

Shelly:孩子可能在预测日常活动、过滤无关的社会和环境刺激时有困难。当孩子受到惊吓时,通常表现出“挣扎或逃离”的反应。



Emily: It may besensitivity to their environments. A sound that we could tolerate may bestartling to someone who is more sensitive to auditory input than others.

Emily:这可能是由于他们对环境的敏感性。我们认为可以忍受的声音可能会吓到一个对声音十分敏感的人。



Why do many kids withautism . . .Echo/repeat words/phrases



为什么自闭症孩子会重复词语或短语






Emily: One of theprimary communication deficits in autism is the tendency to echo or repeatwords or phrases that are heard in one’s environment. Because the brain’s“language center” has difficulty coming up with language on its own, it copieswhat it hears from the world around it and uses it in place of original wordsand sentences of its own. It’s sort of like a Rolodex of phrases that theperson pulls from at any given time in the day.

Emily:自闭症患者最主要的交流障碍之一就是模仿或重复在环境中听到的声音的倾向。因为他们的大脑语言中心很难自己想出语言,于是大脑就模仿从周围听到的声音来替代自己的语言。这有点像一个人在任何时间从一堆短语中抽取词汇。



Jim: Repeating words, orecholalia, is a common learning style for children with autism. Children with autismoften learn language in chunks rather than creatively word by word. Inaddition, repeating words and phrases often serves a communicative purpose suchas saying “yes” or helping with processing of information.

Jim:重复词语,或言语模仿症(Echolalia:不自觉地重复他人的语言)在自闭症儿童中是一种常见的学习风格。自闭症儿童学习语言通常是一段一段地,而不是一个词一个词地。另外,重复词语和短语通常能帮助达成交流的目的,例如表示肯定或帮助处理信息。



Shelley: Echolalia mayrelate to the child with autism having difficulty using more complex andspontaneous language. Echolalia can be a developmental phase and working alongsidea SLP is very helpful to identify intervention strategies. As children developmore language, they may repeat phrases (e.g., from a movie) as a socialinitiation, or may learn to ask the same questions during conversation whichhelps make the interaction more predictable.

Shelly:言语模仿症(也许与自闭症儿童不能使用较为复杂的自发语言有关。言语模仿症可能是一个发育阶段,语言病理学家在确认干预策略方面很有帮助。随着孩子语言能力的进步,他们会重复说一些词语(例如,来自电影的一些台词)作为社交行为的开始,或是在沟通交流中询问同样的问题,这样有助于让交流变得更有预见性。



Why do many kids withautism . . .Not talk at all



为什么许多自闭症儿童他们根本不说话



Jim: Talking orexpressive language development requires understanding and use of symbols.Words, after all, are simply symbols for things, actions, and concepts.Sometimes children with autism lack or have significant delays in that ability.Children with difficulty with symbolic representation often have difficultywith understanding of language and use of other communication systems (e.g.sign language, Picture Exchange Communication System). Sometimes, childrendemonstrate the ability to understand language but have difficulty puttingsounds together to form words. This can be a result of a motor speech disordersuch as apraxia of speech.

Jim:言谈或者表达性的语言发展需要具有对一些象征符号的理解运用的能力。语言中的词汇,毕竟都是一些事物、动作和概念的符号。有时候,自闭症儿童缺乏这种能力,或者在这种能力方面的发育十分滞后。在符号化表达方面有障碍的儿童,往往也有语言理解和运用其它交流系统(例如,手语、图片交流系统)的障碍。有时候,儿童展示出对语言的理解能力,但是很难通过发音组合成词汇。这就是运动性言语障碍——例如言语失用症,导致的结果。



Shelley: It’s difficultto know why some children with autism do not talk or express themselvesverbally. If possible, accessing alternative methods of communication, such asusing gestures, pictures, typing, or a voice-output device is an important partof their social development.

Shelly:我们很难弄清楚为什么有些自闭症儿童不说话,或者不会用语言表达。如有可能,利用沟通交流的替代方法,例如使用手势、图片、打字或是语音输出设备,是启发他们社交能力的重要组成部分。



Why do many kids withautism . . .Walk on their toes



为何许多自闭症儿童踮着脚尖走路

Shelley: Toe-walking?This is a good question. Toe-walking may be a learned habit (many toddlers walkon their toes), or may relate to motor coordination challenges, a tightAchilles tendon, or a sensory processing difference. Toe-walking is also seenwith other neurological or developmental disorders, such as cerebral palsy.

Shelly:垫着脚尖走路?这个问题很好。孩子用脚尖走路,也许是一个后天养成的行为习惯(许多刚学会走路的孩子就用脚尖走路),或是与运动协调能力相关,脚跟腱过紧或是感觉处理的差异。踮着脚走路同样被视为脑神经失调或脑神经功能发育障碍的症状,常见如脑瘫。



Emily: Children withautism often present with stereotyped motor movements, one of which may bewalking on their tip-toes. Others hypothesize that walking on toes reducesoverstimulation in the feet that can occur as a result of walking on the entirefoot.

Emily:自闭症儿童往往呈现出一些刻板的行为动作,其中的一种表现就是踮着脚尖走路。有人提出一种假设,踮着脚尖走路能降低自闭症儿童全脚掌着地走路时所引起的过度刺激感。



Why do many kids withautism . . . Flap their hands?



为什么很多自闭症孩子常摆动手?






Shelley: Children withautism tend to have repetitive motor behaviors such as waving or flapping theirhands. This arm and hand motion may be accompanied with other motor mannerisms,such as jumping or head turning.

自闭症孩子倾向于表现出重复性的动作行为,比如说招手或摆手。他们的手臂和手部动作可以跟其他运动行为一起出现,比如说跳跃或转头。



Jim: Repetitive motormannerisms, such as flapping hands (but also tensing parts of their body,jumping or “dancing”) are often linked to strong emotions (such as excitementor frustration). We see similar behavior in babies who eventually “grow out” ofthe behavior.

像摆手这种重复性的动作(也包括跳跃,或“跳舞”一类让部分身体紧张起来的动作),常常跟强烈的感情(比如兴奋或沮丧)有关联。我们也能在婴儿身上看到类似的行为。不过这类行为会在婴儿成长过程中逐渐消失。



Emily: These may also beself-soothing behaviors and/or attempts at regulating when what is perceived asoverwhelming upset/excitement/boredom/anxiety is present.

这些行为可能是出于自我安慰,和/或是为了应对让孩子感到过度生气/兴奋/无聊/焦虑的事物。



Why do many kids withautism . . . Like to spin and jump?



为什么自闭症孩子喜欢转圈和跳跃?



Shelley: Spinning andjumping are also examples of repetitive motor behaviors. When a child isspinning or jumping he/she is activating the vestibular system. The child mayseek vestibular stimulation as a means to elicit “feel good” sensations and/oralso to positively affect his/her arousal.

转圈和跳跃也是重复运动行为的例子。当一个孩子在转圈或跳跃时,他/她正在触发前庭系统。这个孩子可能通过触发前庭系统来获得舒服的感官感受,并且/或者获得正面刺激。



Emily: Yes, in otherwords, many children with autism seek sensory information or experiences fromthe environment (due to feeling under-stimulated). They may also use spinningand jumping as a way of regulating themselves (i.e.: when they are stressed,anxious, or overwhelmed). Spinning and jumping can help one feel regulated and “grounded.”

是的,换种方式来说,(因为常处于弱刺激情况下)很多自闭症孩子会从环境中寻找感官信息或体验。当他们感到紧张、焦虑、或不知所措时,他们可能也会用转圈和跳跃来控制自己。转圈和跳跃可以使一个人感到控制和安定。



Why do many kids withautism . . . Have difficulty sitting still?



为什么很多自闭症孩子很难静坐?


Shelley: The child mayhave sensory-motor challenges, or may have difficulty with attending behaviors.

自闭症的孩子可能有感觉和运动上的困难,或者在管理行为上有困难。



Emily: It is notuncommon for individuals with autism to present with hyperactivity and“fidgety” behavior. This is related to an executive functioning deficit thatleads to difficulty regulating and planning behaviors and resisting impulses.

自闭症患者表现出过度活跃和“不安”的行为并不是一件罕见的事。这是执行性机能短缺导致的在管理、计划行为和拒绝冲动上的困难。



Why do many kids withautism . . .Fixate on certain things (such as little things – tiny photo on abig page of a book or wheel of a big toy car)

为什么很多自闭症小孩会盯着某些东西(比如小事物-书页上很小的一幅图片或是大玩具车的一个轮子。)



Shelley: When we thinkabout it developmentally, children look at objects that are visually pleasing –such as rotating objects (fans, wheels, pinwheels). Fixating on certain thingscould also relate to visual processing, such as seeing the components ofobjects rather than the “whole” object, or perhaps the child has difficultyexpanding play with toys and engages in repetitive play.

Shelley:如果我们从发育的角度来看,孩子们会愿意看着视觉上给他们快乐的东西——比如旋转的东西(风扇,轮子,风车)。盯着某些东西也与视觉过程有联系,比如看到一个东西的不同部分而不是它的整体,或者孩子在玩不同玩具时有困难,从而重复同样的玩耍活动。



Emily: Individuals withautism tend to have brains that think about things over and over. They mayfixate on things that they find enjoyable or may get “stuck” trying to finish atask or game. A brain affected by autism tends to be more rigid and “black andwhite”. So it is hard to be flexible with a number of interests and ways ofthinking about things.

Emily:患有自闭症的人比较容易喜欢对一件事情反复思考。他们会盯着那些令他们快乐的事情,或者是那些他们遇到困难但是想要去完成的游戏。被自闭症影响的大脑容易变得比较刻板以及“黑白分明”。所以他们很难有不同的兴趣和思考方法。



Why do many kids withautism . . .Not seem to need much sleep




为什么许多自闭症孩子看起来不需要很多的睡眠?



Shelley: I wish I knew(and so do a lot of parents)!



Shelly: 我也想知道这个问题的答案(很多家长也这样想)!



Jim and Emily didn’thazard a guess on the sleep issue.

Jim和Emily没有对这个问题做出一个猜测。



Lynn (whose child hasbeen up since 3:30 this morning): Rats! This is the one question I most wantedan answer to!

Lynn(他的孩子今早3:30就醒来了):这是我最想得到答案的一个问题!



Why do many kids withautism . . .Stare into space



为什么许多自闭症孩子凝视着半空出神?


Shelley: Some childrendon’t realize they are staring – but may be “tuning out” what is overwhelmingthem or daydreaming about preferred interests. If the behavior is concerning,parents should consult with their pediatrician.

Shelly:一些孩子并不会意识到他们正在凝视——他们可能因为什么而感到不知所措,或在做关于喜欢的事情的白日梦。如果家长对这些行为感到担忧,应该带孩子去看儿科医生。



Emily: Individuals withautism are often very detail-oriented. Thus, they may notice details in theenvironment that we do not, and may get fixated on those details (thus,blocking all else out of their attention span and appearing to be “spacedout”).

Emily:自闭症小孩往往都很在意细节。因此,他们可能会看到很多平时我们都不会在意的细节,然后盯着那些细节(因此,注意不到任何其他人,看起来在出神。)



Why do many kids withautism . . .Have trouble with transitions



为什么很多自闭症孩子很难接受转变。



Emily: This relates tothe way a brain affected by autism works – being less flexible than otherbrains. When it is fixated on something that it finds enjoyable, it has a hardtime “flexing” to allow for new tasks or information to come in. It needs timeand many reminders to switch to a new topic.

Emily:这和他们被自闭症影响的大脑有关——不够灵活。当他们盯着一些他们觉得开心的事物时,他们很难再去接受新的任务或是信息。转变话题需要很长时间以及提醒。



We’d like to thank ourproviders for taking a stab at answering some of the more perplexing questionsabout why kids with autism do some of the things they do. This may help thoseof us who love someone with autism to describe and explain our kids’ behaviorand allow others to understand them better.

我们很感谢嘉宾尝试回答为什么自闭症孩子做某些事情的问题。这将帮助自闭症孩子的亲人和朋友描述和解释他们的行为,从而让其他人更好地理解自闭症孩子。






对本文的特别申明: 文中红色部分为广告,没有进行翻译。由于我们的医学专业知识和翻译水平有限,译文可能会有瑕疵,欢迎大家提出宝贵的意见和建议,以便帮助豆苗计划翻译小组更好地开展工作。

豆苗计划翻译小组

翻译:小太阳  Greta  梦缘  祚同

复核:MONOのcaicai    刘玘   Rexx  

时间:2015.12.31





发表于 2016-5-24 15:39:58 | 显示全部楼层
       学到了很多
发表于 2017-2-8 08:45:14 来自手机 | 显示全部楼层
理解很重要。
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