共享式注意力多元介入方案療效研究：三名學前中高功能自閉症男童的探究

江淑蓉; 彭雅凌; 姜忠信; 林家慶

doi:10.6172/BSE201207.3702003

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P59 - 84

社会科学 > 教育学

DOI： 10.6172/BSE

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共享式注意力多元介入方案療效研究：三名学前中高功能自闭症男童的探究

The Effectiveness of Multi-Component Joint Attention Intervention in Three Middle-to-high Functioning Boys with Autism

江淑蓉(Shu-Jung Chiang) ；彭雅凌(Ya-Lin Peng) ；姜忠信(Chung-Hsin Chiang) ；林家庆(Chia-Ching Lin)

特殊教育研究学刊； 37 卷 2 期 (2012 / 07 / 01) ， P59 - 84

繁体中文 DOI： 10.6172/BSE201207.3702003

共享式注意力介入；自闭症儿童；家长训練；区别尝试训練；环境教学模式； Joint attention intervention ； autism ； parent training ； discrete trial training ； milieu teaching

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摘要 │ 参考文献 (39) │ 被引用文献 (7) │ 国际计量

摘要〈TOP〉

并列摘要〈TOP〉

Purpose: Joint attention (JA) is one of the core deficits in children with autism, associated with other developmental abilities such as language, play, social ability, and imitation. The current study uses multiple-case design with a combined approach for a JA intervention program including parent training to investigate the effects of JA and its collateral abilities for 3 children with middle-to-high functioning autism. Methods: Three 4- year old boys (CA = 48-52 months, MA = 26-30 months) with middle-to-high functioning autism were diagnosed with DSM-IV-TR (APA, 2000) and ADOS (Lord et al., 2000) by a multidisciplinary team including a psychiatrist, pediatrician, and psychologists. The children and their mothers participated in this individual program, conducted in 24 sessions and followed up 3 and 6 months later. The program included discrete trial training (DTT) and milieu teaching method adapted from Kasari et al. (2006, 2010). Parent training sessions were also simultaneously included in the program. Each child training session was approximately 30 minutes, 3 times per week, for a total of 24 sessions. The DTT and milieu teaching approaches were used on the table time and floor time separately. The JA intervention program for parents was based on the authors' clinical experience and followed the Parent JA Intervention Manual (PJAIM). For the first half of the parent training from session 1 to 12, the interventionist used the PJAIM as a reference to explain to the parent what was going on from a one-way mirror while parents observed their child's training session in the playroom. From sessions 13-24, the parent was invited to the playroom to interact with the child, guided by the interventionist for 15 minutes after the child's training session. The intervention outcomes were collected through standardized tools/tasks, structured and unstructured activities by independent testers, and from parent reports. The threshold for intervention efficacy defined by these gain scores in our measurements equaled or exceeded those values in the interventional group of previous published studies. Findings: The results show that the 3 children improved their JA skills and joint engagement state after the JA intervention program. The children improved from pointing for requesting an object to showing/giving an object to a person, and developed from unengaged or object engagement to supported joint engagement in the postintervention test. Similar improvements are shown in the three-month follow-up test. Parent responsiveness was also highly associated with joint engagement between parents and children. Other collateral effects on relevant abilities including receptive language, symbolic play, and social ability were also noticeable, and were maintained 3-6 months. Conclusions/ implications: The results support that children with autism receiving our JA intervention program improved their JA skills, joint engagement state, and relevant abilities, similar to previous studies; however, the maintenance was shorter. Further studies need to explore the variables that influence the effects maintained, and to include a large sample and a control group to extend to younger children with autism, and to evaluate efficacy while arranging different intensities or frequencies of parent training sessions.

参考文献 ( 39 ) 〈TOP〉

吴进钦、姜忠信、侯育铭(2006)。自闭症儿童的立即模仿与延迟模仿之研究。中华心理卫生学刊，18，1-24。
连结：
姜忠信、彭雅凌、江淑蓉(2010)。个案报告：中低功能自闭症儿童相互注意协调能力的介入。中华心理卫生学刊，23，125-151。
连结：
姜忠信、彭雅凌、江淑蓉(2010)。个案报告：中低功能自闭症儿童相互注意协调能力的介入。中华心理卫生学刊，23，125-151。
连结：
黄钰菁、凤华(2007)。学龄前自闭症儿童相互注意协调能力学习成效初探之研究。特殊教育研究学刊，32，121-142。
连结：
Adamson, L. B.,Bakeman, R.,Deckner, D. F.(2004).The development of symbol-infused joint engagement.Child development,75,1171-1187.

被引用文献 ( 7 ) 〈TOP〉

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