國小選擇性緘默症兒童之支援服務個案研究

A Case Study of Supporting Services for a Student with Selective Mutism in an Elementary School

10.6457/BSER.200706.0047

陳志平(Chih-Ping Chen)；張媛媛(Yuan-Yuan Chang)；賴霖歆(Ling-Shin Lai)；張瓊文(Chiung-Wen Chang)

選擇性緘默症 ； 支援服務 ； 個案研究 ； Selective Mutism ； Supporting Services ； Case Study

特殊教育與復健學報

17期（2007 / 06 / 01）

47 - 71

繁體中文

本研究旨在探討一位國小選擇性緘默症兒童之支援服務的現況與需求，並針對研究結果提出建議。研究進行十個多月，其間透過錄影、觀察、訪談以及文件分析等蒐集資料，經過三角交叉檢證獲得以下結果：（1）還原個案真實樣貌：個案雖是選擇性緘默症，但並非極端不說話，且其某些學習能力也未停滯，相關人員嘗試從不同的情境去體察個案的優弱勢及創造舒緩焦慮情緒的校園情境，並以資源班為中心，試著設計結合自我示範、遊戲、電腦教學和藥物治療為主的多元處遇方案。（2）家庭衝突與支援服務需求：個案的家庭雖存在許多優勢，但家庭衝突及缺乏適當的教養觀念阻礙了個案的發展，因此過程中除提醒相關人員摒除偏見，並建議家人避免使用負向語言教育個案，以及協助個案培養各種能力和為家人剖析藥物治療的利弊得失。（3）學校系統的支援服務：在校長的影響下，校園充滿對特殊兒童支持的氣氛，並在行政、教學和同儕方面依照個案的障礙及焦慮特質提供整合性的服務。不過資源班教師要能有效的整合資源以及訓練協助的同儕，避免不恰當的態度反而成為個案的最大焦慮來源。（4）融合教育的再設計：融合並非「混合」，因此在各種條件限制下，融合教育的最佳方案(maximum)未必存在現實社會，資源班教師應主動調整家庭、教學和行政方面的支援服務，為個案重新設計融合教育的最適(optimum)方案。

In this study, the case is a student with selective mutism in elementary school. It employed observations, interviews, and document analysis to explore the conditions and demands for supporting services for ten months. Following are the major conclusions throughout triangulation.1. A clear look at the original conditions of the case: It doesn't mean the case can't speak and learn even though she always keeps silence in school. If only school related professionals can highly regard her strengths and weaknesses in different contexts and help her to avoid the anxiety situations, she can do many things. Also, resource teachers play an important role in designing multidisciplinary plan including self modeling, play therapy, computer-assisted instruction, and medication.2. Conflict origins from family and demands of family support services: Although the case's family has the advantage of a better economy, conflict comes from family and lacks of proper educational concepts of her parents are disadvantages. Without bias, school related professionals have to provide related services and medical assistances to meet her special needs, and to suggest her family to stop teasing her weaknesses.3. The needs of school support service: The case could receive related services because of wide support from school principle, and according to the case's abilities the resource teachers have to collaborate with school personnel to provide the case assistances including planning, studying, using resources, and avoiding peer stress throughout properly training of peer assistances.4. Adaptations and redesigns of inclusion: A mix of students isn't an inclusion. Even though the maximum inclusive program may not exist in real world, the optimum is available. Resource teachers need to create suitable inclusive environments throughout adaptations including providing support services from family, teachers, and administrations.

1. 柯懿真、盧台華(2005)。資源教師與普通班教師實施合作教學之行動研究－以一個國小二年級班級為例。特殊教育研究學刊，29，95-112。
   連結：
2. Congressional Research Service
3. Brownell, M. Y.,Adams, A.,Sindela r, P.,Waldron, N.,Vanhover, S.(2006).Learning from collaboration: The role of teacher qualities.Exceptional Children,72(2),169-182.
4. Cai, J.(2005).Speechless: Giving a voice to childhood selective mutism.Harvard Science Review.
5. Causton-Theoharis, J. N.,Malmgren, K. W.(2005).Increasing interactions between students with severe disabilities and their peers via paraprofessional training.Exceptional Children,71(4),431-444.
6. Cline, T.,Baldwin, S.(2004).Selective Mutism in Childhood.London:Whurr.
7. Dettmer, P.,Thurston, L. P.,Dyck, N.(2005).Consultation, collaboration, and teamwork for students with special needs.Boston:Allyn & Bacon.
8. DiPaola, M. F.,Tschannen-Moran, M.,Walther-Thomas, C.(2004).School principals and special education: Creating the context for academic success.Focus on Exceptional Children,37(1),1-12.
9. Giddan, J.,Ross, G.,Sechler, L.,Becher, B.(1997).Selective mutism in elementary school: Multidisciplinary interventions.Language, Speech, and Hearing Services in the Schools,28(2),127-133.
10. Johnson, L. J.,Pugach, M. C.,Hawkins, A.(2004).School-family collaboration: A partnership.Focus on Exceptional Children,36(5),1-15.
11. Kervatt, G.(1999).The silence within: A teacher/parent guide to helping selectively mute and shy children.Oak Ridge, New Jersey::Gail Kervatt.
12. Krysanski, V. L.(2003).A brief review of selective mutism literature.The Journal of Psychology,137(1),29-39.
13. McMillan, J. H.,Schumacher, S.(2006).Research in education: Evidence-based inquiry.Boston:Allyn & Bacon.
14. Merriam, S.(1988).Qualitative research and case study applications in education.San Francisco:Jossey-Bass.
15. Schumaker, J. B.,Deshler, D. D.,Bulgren, J. A.,Davis, B.,Lenz, B. K.,Grossen, B.(2002).Access of adolescents with disabilities to general education curriculum: Myth or reality.Focus on Exceptional Children,35(3),1-15.
16. Sum mers, J. A.,Hoffman, L.,Marquis, J.,Turnbull, A.,Poston, D.,Lord Nelson, L.(2005).Measuring the quality of family-professional partnerships in special education services.Exceptional Children,72(1),65-81.
17. Yin, R. K.(2003).Case study research: Design and methods.Thousand Oaks, CA:Sage.
18. 孔繁鐘編譯(2002)。DSM-IV精神疾病的診斷與統計。台北:合記。
19. 王淑娟(2002)。兒童選擇性緘默症問題分析與探討－三個實例研究。臺中師院學報，16，383-398。
20. 丘彥南、宋維村(1997)。行政院國科會專題研究計畫成果報告行政院國科會專題研究計畫成果報告,未出版
21. 宋維村(1995)。行政院國科會專題研究計畫成果報告行政院國科會專題研究計畫成果報告,未出版
22. 宋維村、丘彥南(1993)。行政院國科會專題研究計畫成果報告行政院國科會專題研究計畫成果報告,未出版
23. 李旭原、國立台灣師範大學特教系編(2003)。畏懼在心口難開－認識選擇性緘默症。2004年手語暨溝通障礙研討會論文集，台北:
24. 林佩璇、中正大學教育研究所主編(2000)。質的研究法。高雄:麗文。
25. 林秋榮、葉瓊華、國立彰化師範大學教育學院編(2005)。原住民地區國小多重障礙學生支援服務之個案研究。轉型與發展－創造師範教育新風貌學術研討會論文集，彰化:
26. 邱上真、王文科主持人(2003)。從特殊教育課程設計理念的演變談如何幫助特殊需求學生在普通班課程中進行有效學習？。課程與教學。2003特殊教育學術研討會
27. 黃士欽(2005)。國立新竹師範學院國民教育研究所輔導教學碩士論文（未出版）。
28. 黃金源、國立台中師範學院特殊教育中心編印(2002)。特殊教育論文集。台中:國立台中師範學院特殊教育中心。
29. 蔡宜青(2000)。國立臺北市立師範學院視覺藝術研究所碩士論文（未出版）。
30. 盧台華、王文科主持人(2003)。由全方位課程設計談普通教育課程在特殊教育上的應用。課程與教學。2003特殊教育學術研討會
31. 顏倩霞(2005)。談安置於普通班身心障礙學生之支援服務。特教園丁，20(4)，17-23。

1. 陳彥宇(2016)。融合教育趨勢下的特殊教育服務與學校行政支援─以高屏地區三所不同安置型態學校為例。特教論壇，21，82-96。
2. 謝倍珊、陳儀娉、李依娟、王慧禎(2016)。繪本輔導方案提升選擇性緘默兒童社會技巧之行動研究。特殊教育學報，43，01-28。