| Autism spectrum disorder (ASD) is manifested by persistent deficits in social and communication interaction, deficits in developing, understanding and maintaining relationships, as well as abnormal and fixed interests and repetitive behaviors. According to the intelligence level and the severity level, ASD can be divided into severe and milder. Children with severe ASD (typical autistic) have obvious deficits in language andcommunication, imagination activities and social interaction, and accompanying by serious stereotyped action and lower intelligence level. Children with milder ASD (Asperger's and pervasive developmental disorder-not other specified) usually have odd behavior, and have poor abilities in social and communication, but their general intelligence level usually higher.Although children with "milder"ASD can study in mainstream schools because of their milder symptom at earlier, they have qualitative deficits in social skills and social cognition and often show cognitive abnormalities on social rules, which may further affect their social behaviors. Social rules include moral rules, custom rules and personal rules. Some researchers had explored the cognitive characteristics of moral and conventional rules in children with ASD, and they found that both children with ASD and the typical development could make a distinction between moral and conventional rules. The cognitive difference between the two groups was in the justification because of the judgments were multiple-choice questions which reflected the explicit social cognition, and the justification was the qualitative encoding question which was inclined to reflect the implicit social cognition.Mostly previous studies on the cognitive abnormalities of social rules in children with milder ASD mainly focused on theory of mind, and had explained the cognitive abnormalities of social rules and social behaviors. But the relationship between theory of mind and the cognition of social rules in milder ASD was more complex than we thought. We can't clearly explain the relationship between social cognitive deficits and understanding or participating in the real social rules scene in children with milder ASD by theory of mind. We only know that the theory of mind in children with milder ASD is significantly poorer than that children in typical development. Although there had some researches on the social information processing model (SIP) which explored the implicit social cognitive deficits in children with milder ASD, but these studies didn't involve the specific type of social rules. And the social cognition of children with ASD is more based on their own personal experiences and personal preferences (Grant, etal.,2005), they may be more concerned on personal rules in a certain degree. But, previous studies have neglected to explore the personal rules of children with milder ASD.This study focused on the cognitive ability of social rules in school-aged children with milder ASD, and based on the social domain theory and the theory of social information processing. In research one, the prevalence and its influencing factors of school-aged children with milder ASD was explored. Based on the screening results of research one and the abnormalities of cognition on social rules in children with milder ASD, the cognitive characteristics of social rules was explored in five judgments which included permissibility, severity, justification, universality and authority in research two.In research three, the implicit social cognition mechanism behind the cognitive characteristics of social rules in school-aged children with milder ASD and its relationship with social skills and theory of mind were explored.Subsequently, designing an intervention program according to the results of research three and previous interventions related to SIP, the purpose of which was to improve the social skills and advance the peer relationship and ASD symptoms, also to improve the implicit social cognition of school-aged children with milder ASD.The results were found as follows:(1) The prevalence of ASD was 27.9 (95% CI 14.6-41.1) cases per 10,000 children in general-population sample and 65.9 (95% CI 56.2-75.7) cases per 100 children in high-probability sample. The overall prevalence of ASD was 124.5 (95% CI 96.8-152.1) cases per 10,000 children which was closer to the results of recent studies in developed countries.Male children, father has not a history of mental illness, family monthly income? 1999yuan and the gestation is 34-36 months were related with ASD.(2) School-aged children with milder ASD could distinguished the moral rules, conventional rules and personal rules on permission, universality and authority. They thought more serious to violate conventional rules and personal rules. Children with milder ASD put much more importance on conventional rules in authority.In justification, school-aged children with milder ASD provided less responses in custom and social norms,and more responses in simple repetition. They had different responsive patterns with TD children in justification of avoiding punishment and authority prohibiting, personal choice, practical consequences and abnormal feedback.School-aged children with milder ASD had some degree of theory of mind, but the ability of which only worked in the field of moral rules.(3) In the stages of social information processing theory (SIP), school-aged children with milder ASD had poor coding ability and poor attribution ability in moral rules, they made more responses in attack, non social withdrawal and pro social withdrawal and less responses in active reaction. Milder ASD group had contrary pattern on the active responses in the field of social rules.Milder ASD group got less scores on the response quality and positive consequences of active responseres in active and assertive, more scores on the response quality and positive consequences of attack and withrdrawal responseres in attack, they had cross-domain pattern in the acticve and assertive response and attack responses.(4) The theory of mind of school-aged children with milder ASD were significantly lower, and it's relative with social and emotional skills of teachers' assessment and the peer nomination. The coding, positive consequences of respnses related with the social and emotional competence on teachers' assessment and peer nomination.(5) The curriculum of social cognitive intervention based on SIP model has positive effect to milder ASD. The intervention group's social and emotional ability have been improved significantly,and the symptoms of ASD and peer nomination also improved sinificantly. The effect of intervention could maintained to 6 weeks or 3 months after intervention.There had a limited effect in SIP at 6 weeks after intervention finished. In the assessment of the positive consequences and quality of responses in active and assertive, the intervention effect to milder ASD can be maintained to 3 months later. |
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