泛自閉症障礙症候群（Autism Spectrum Disorders, ASD）是職能治療臨床上常治療的個案，由於ASD兒童症狀表現的複雜性與多變異性，治療師在臨床上評估時常遇到許多困難。職能治療目前常用的評估工具雖然能評估到職能表現與表現要素，但沒有一個評估工具能全面性的評估到ASD兒童的三個特質：社會互動上有質的障礙、溝通上有質的障礙及重複刻板的行為與興趣，治療師必須同時選用數種不同特性的評估工具來評估同一位個案，造成時間上的浪費。而沒有使用標準化評估工具，也會造成社會補助及教育上資格認定的困難、專業間溝通的困難、量測個案進步情形的困難。本研究欲了解台灣地區職能治療部門常對ASD兒童使用之標準化評估工具種類、目的與評估時所遭遇之問題。我們採用自行設計的問卷，以調查國內19家職能治療單位對ASD兒童使用標準化評估工具之狀況。結果發現各單位間使用之評估工具種類及數量差異大。大部分單位著重評估個案之表現要素層面（超過八成），評估個案整體職能表現較少（約占一成多）。各單位中，各種評估工具使用之目的，依次為療效評量（34%）、區辨（31%）、篩選（22%）與預測（13%）。評估困難方面，治療師覺得評估很重要，但平均每個案約需花費一小時評估，且高達8成以上的單位認為目前常使用的評估工具無法正確反應ASD兒童的能力及特殊行為，尤其在ASD兒童的不良適應行為（包括獨特性，固著性，情緒穩定性），注意力狀況，社交技巧，日常生活功能，遊戲能力，特殊感覺調節問題，解決困難能力，學習方面的優勢與劣勢，推心能力（theory of mind）等9個面向，以上這些現象嚴重影響治療效能，如訂定治療計畫、療育目標及監測進步等。我們強烈建議職能治療部門使用適用於ASD兒童特質的標準化評估工具來評估，以幫助職能治療師更有效率的訂定治療計畫及監測孩童的進步。

Children with Autism Spectrum Disorders (ASD) are common in clinical practices in occupational therapy. Due to the complexity, variability and the weakness in verbal comprehension and command following in children with ASD, evaluating their functioning is difficult. The purpose of this study was to investigate the use of assessment tools for children with ASD, and to identify the difficulties in assessing children with ASD at occupational therapy departments in Taiwan medical centers. Questionnaires were sent to 19 occupational therapy (OT) departments. Assessment tools used in 19 OT departments were varied. Most of these assessment tools were designed to measure children s performance components (84%) and few were designed to measure their occupational performances. The rates of purposes of using assessment tools were evaluation (34%), discrimination (31%), screening (22%) and prediction (13%). However, more than 80% of OT departments recognized the assessment tools used in clinical practices now were difficult to measure the functioning of the children with ASD, especially in nine dimensions: maladaptive behavior (peculiarity, stereotyped behaviors, emotional problems), attention, social interaction, daily living functioning , play skills, sensory modulation problems, problem solving abilities, learning abilities and theory of mind. We suggest that using standardized assessment tools designed specifically for children with ASD could help therapists set up treatment plans and monitor children s development more effectively.