從生態系統視角檢視臺灣自閉症家庭研究之發展與轉向：2014-2025年文獻回顧

Evolution of Autism Family Research in Taiwan (2014–2025): A Scoping Review From an Ecological Systems Perspective

本研究採用範疇性文獻回顧（scoping review）方法，依PRISMA-ScR指引，系統性檢索並分析2014-2025年間發表於核心期刊之臺灣自閉症家庭相關研究，共納入19篇文獻。在分析架構上，本研究以生態系統理論作為主要分類軸，輔以PPCT模式與Double ABCX模型作為跨文獻的詮釋視角，透過資料摘錄與主題地圖化分析，描繪研究主題、分析層級與時間脈絡的分布樣貌。研究結果顯示，臺灣自閉症家庭研究呈現三項主要發展趨勢。首先，研究主題由早期以親職壓力與家庭困境為主，逐漸增加對支持條件與家庭回應的關注。其次，部分研究開始將家庭置於教育、醫療與社會服務等跨系統互動脈絡中理解，顯示家庭經驗逐漸被視為多系統互動的結果。第三，研究分析層級由微系統逐步擴展至外系統、巨系統與時間系統，並開始納入制度條件與歷時脈絡對家庭經驗的影響。研究發現臺灣自閉症家庭研究正處於由問題導向邁向支持與情境導向的發展階段。整體而言，臺灣自閉症家庭研究已逐漸由家庭內部問題的描述，擴展至制度與支持脈絡的關注，但在制度作用機制與歷程分析上仍有進一步深化的空間。本研究透過生態系統與PPCT觀點整合既有研究，呈現臺灣自閉症家庭研究的發展樣貌，並提出未來研究可深化制度機制分析與歷程研究之方向，以促進對自閉症家庭經驗更全面的理解。

Rationale & Purpose：In recent decades，the number of individuals with autism spectrum disorder（ASD）has substantially increased in Taiwan，highlighting the pivotal role of families in supporting these individuals across developmental stages. Family members of individuals with ASD typically constitute the primary unit to responsible for caregiving，coordinating educational and medical services，and facilitating daily participation in social contexts. Consequently，understanding family experiences has become a key focus in ASD research. Several studies have explored factors such as parental stress，family adaptation，and caregiving experiences. However，many studies have examined these factors from relatively narrow perspectives，often focusing on individual variables or specific family experiences rather than situating them within broader environmental contexts. Bronfenbrenner’s ecological systems theory provides a useful framework for understanding how family experiences are shaped through interactions across multiple environmental levels，including the microsystem（family interactions），mesosystem（connections among family，school，and service providers），exosystem（institutional structures and social resources），macrosystem（cultural and policy contexts），and chronosystem（historical changes）. The process–person–context–time（PPCT）model highlights the importance of interaction processes and temporal dynamics in shaping developmental experiences. Complementing this perspective，the Double ABCX Model of family stress explains how families interpret stressors，mobilize resources，and adapt to challenges. Although researchers in Taiwan have yielded a high volume of data on the experiences of families caring for relatives with ASD，few studies have systematically synthesized the literature or examined how research themes and analytical perspectives have evolved over time. Major institutional and policy changes have occurred in Taiwan since 2014—for example，implementation of the Convention on the Rights of Persons with Disabilities treaty and reforms in early intervention and special education services. These changes may have influenced both research agendas and the lived experiences of family members of individuals with ASD. In the present study，we conducted a scoping review of Taiwanese ASD family research published between 2014 and 2025. Guided by ecological systems theory，the PPCT model，and the Double ABCX framework，we mapped the thematic distribution and analytical levels of the literature. Specifically，we（1）identified major research themes and trends in Taiwanese ASD family research，（2）examined how relevant studies are distributed across ecological system levels，and（3）explored shifts in research focus，including the shift from stress-oriented perspectives toward support- and context-oriented understandings of family experiences. Methods：This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews framework. A scoping review approach was adopted to map the scope and characteristics of existing research rather than to evaluate intervention effectiveness or methodological bias. This review included studies published between 2014 and 2025，a period selected because it represents a major transition in Taiwan’s ASD-related research and policy context. Diagnostic and Statistical Manual of Mental Disorders，Fifth Edition was published in 2013，and implementation of the Convention on the Rights of Persons with Disabilities treaty began to influence Taiwan’s disability policy framework 2014 onward. A systematic search was conducted across multiple databases，including Airiti Library，EBSCO，PubMed，PsycINFO，and Web of Science. Search terms included“autism，”“autism spectrum disorder，”“ASD，”“family，”“parents，”“caregivers，”and“Taiwan，”combined using Boolean operators. Only peer-reviewed journal articles were included. The initial search identified 1，689 records. When the timeframe was limited to 2014–2025，749 articles remained. Screening by publication type and academic discipline yielded 158 journal articles，among which 54 articles indexed in Taiwan Social Sciences Citation Index core journals were further evaluated. After the removal of duplicates and screening of titles，abstracts，and full texts，19 studies were included in the final analysis. Required data were extracted using a structured charting table that collected information on publication year，research methods，participants，research focus，ecological system level，PPCT dimensions，and thematic categories derived from the Double ABCX framework. Ecological system levels were used as the primary classification axis，and Double ABCX themes，including stress，support，adaptation，and collaboration themes，were coded nonexclusively to capture multiple themes within each study. Comparative analyses were performed across three time periods（2014–2018，2019–2021，and 2022–2025）to identify changes in research focus and analytical perspectives. Results：The results revealed several patterns in the evolution of ASD family research in Taiwan. First，regarding research methods，quantitative studies and intervention-based research were the most common approaches. Quantitative studies frequently examined parental stress，family functioning，and service utilization through survey or cross-sectional designs. Intervention studies focused on early intervention programs，parent training models，and family-centered intervention strategies. Qualitative studies were relatively limited，suggesting that in-depth explorations of family narratives are uncommon. Second，regarding research participants，most studies focused on parents or primary caregivers. Research examining siblings’experiences，children’s perspectives，or broader family dynamics was relatively rare，indicating that whole-family perspectives remain underrepresented. Third，analysis of thematic trends revealed a clear shift in research focus. Studies published between 2014 and 2018 primarily emphasized parental stress and caregiving burdens. Between 2019 and 2021，research began to incorporate themes related to family support systems and collaboration with service providers. In the most recent period（2022–2025），support resources and cross-system collaboration became dominant research topics，and studies focusing primarily on parental stress became less common. Fourth，from an ecological perspective，research attention gradually expanded beyond the microsystem level. Early studies focused mainly on family-level interactions and parental experiences within the household. Over time，research increasingly incorporated analyses of institutional contexts such as education systems，health-care services，and social welfare policies. Recent studies have begun to consider chronosystem factors such as policy reforms and societal events，indicating a growing interest in understanding family experiences within broader temporal and institutional contexts. Conclusions and Implications：This scoping review indicates that ASD family research in Taiwan has undergone a transformation over the past decade. Research themes have shifted from focusing primarily on family stress and caregiving burdens to examining support systems，resource accessibility，and cross-system collaboration. In addition，analytical perspectives have expanded from family-level experiences to broader ecological contexts. Our findings suggest that ASD family research in Taiwan is transitioning from a problem-oriented perspective toward a support- and context-oriented understanding of family experiences. However，many studies still treat institutional structures and policy contexts primarily as background conditions rather than examining how these systems concretely shape family decision-making and long-term adaptation processes. Future research may benefit from adopting multilevel analytical frameworks that examine interactions among families，service systems，and policy environments. Furthermore，studies adopting longitudinal approaches and whole-family perspectives may clarify how families adapt to ASD-related challenges. Insights from such studies may inform more responsive support systems and policies for families caring for individuals with ASD in Taiwan.