輔助溝通系統服務提供者在特殊教育實踐現況之調查

Investigating the Implementation of Augmentative and Alternative Communication Service in Special Education by Service Providers

10.3966/207455832020120052001

李淑靜(Shu-Ching Lee)；陳明聰(Ming-Chung Chen)

輔助溝通系統 ； 特殊教育 ； 特殊教育教師 ； 語言治療師 ； 考量因素 ； AAC ； special education ； special education teacher ； speech and language pathologists ； consideration factors

特殊教育學報

52期（2020 / 12 / 01）

1 - 27

繁體中文

輔助溝通系統是特殊教育支持服務項目之一，但是臺灣在國教階段特教學校和集中式特教班裡，輔助溝通系統介入服務的現況為何？國內輔助溝通系統服務主要由特教教師和語言治療師執行，因此，本研究透過問卷調查，探討實務工作者提供服務的情形、實踐經驗及對介入輔助溝通系統時的考量因素之自覺重要程度。本研究共回收610份有效問卷，關於實踐經驗和考量因素的重要性部分只使用其中477位一直有提供或曾經提供過輔助溝通系統服務的資料進行分析。結果發現，在服務提供方面，服務對象以發展性障礙為多；設備以低科技比例最高；使用目的以表達需求和想望比例最高；評估選用工作以語言治療師為主，但訓練則以特教教師為主。在服務實踐經驗部分，評估選用、訓練與成效評估和語言評量等三向度的實踐度均偏低，不過語言治療師有較高的實踐度，一直有提供服務者比曾經提供者在前兩向度上有較高的實踐度，而語言評量向度的實踐度最低。實務工作者對介入輔助溝通系統時的四個考量因素（自覺輔具取得、態度與支持、個案能力、成果因素）自覺重要程度皆高，但自覺成果因素重要性較低。文中也根據研究結果進行討論，並提供未來研究和服務上的建議。

Augmentative and alternative communication (AAC) is one of supportive services that should be provided for students with complex communication needs, required by law. Special education teachers and speech language pathologists (SLPs) are the major AAC services providers in schools. Therefore, this study aimed to investigate the current AAC services situation, implementation experience, and importance of consideration factors for providing AAC services. 610 valid questionnaires were gained from teachers of self-contained class or special education schools and SLPs in special education system. Only the data of 477 who continued to provide AAC services or provided before were used for analysis. The major findings were (a) AAC services provided: the major AAC users were students with developmental disabilities, low tech AAC were used most, the main purposes of using AAC were expressing needs and wants, the procedure of AAC selection was SLPs' major job while special education teachers were in charge of AAC training. (b) implementation of AAC services: the degree of implementation in dimensions of assessment and selection, training and outcome measurement, and language assessment were low. But SLPs demonstrated higher degree, and AAC services providers who provided service continuously had higher degree in the previous two dimensions. (c) importance of consideration factors for AAC services: four factors (device obtaining, attitude and support, capabilities of client, outcome) were regarded as very important.

1. 吳雅萍,王華沛,陳明聰(2014)。特殊教育學校國高中生輔助溝通系統使用類型與現況之調查研究。特教季刊，130，11-20。
   連結：
2. 李淑靜,陳明聰(2020)。標準化語言評量工具在輔助溝通系統介入過程中之調查研究。特殊教育與輔助科技學報，11，1-20。
   連結：
3. 陳明聰,吳雅萍,陳思涵(2017)。輔助溝通系統介入成果評量架構之探究。特殊教育季刊，144，1-10。
   連結：
4. 黃宜屏,吳雅萍,陳佩伶,陳明聰(2016)。輔助溝通介入對發展性障礙者表達性溝通成效探討：近六年臺灣研究系統性分析結果。特教論壇，21，20-39。
   連結：
5. 羅翌菁,王淑娟,葉秀鈺(2015)。國小特教班學生溝通輔具需求與現況之調查研究。臺灣聽力語言學會雜誌，34，53-86。
   連結：
6. American Speech-Language-Hearing Association (2020). Augmentative and alternative communication. Retrieved from https://www.asha.org/practiceportal/professional-issues/augmentative-and-alternative-communication/#collapse_1
7. Beukelman, D. R.,Mirenda, P.(2013).Augmentative and alternative communication: Supporting children and adults with complex communication needs.Baltimore, MD:Paul H. Brookes.
8. Higginbotham, D. J.,Shane, H.,Russell, S.,Caves, K.(2007).Access to AAC: Present, past, and future.Augmentative and Alternative Communication,23(3),243-257.
9. King, M. R.,Binger, C.,Kent-Walsh, J.(2015).Using dynamic assessment to evaluate the expressive syntax of children who use augmentative and alternative communication.Augmentative and Alternative Communication,31(1),1-14.
10. Kovacs, T.,Hill, K.(2015).A Tutorial on reliability testing in AAC language sample transcription and analysis.Augmentative and Alternative Communication,31(2),59-69.
11. Light, J. C.(1989).Toward a definition of communicative competence for individuals using augmentative and alternative communication systems.Augmentative and Alternative Communication,5(4),137-144.
12. Light, J.,McNaughton, D.(2014).Communicative competence for individuals who require augmentative and alternative communication: A new definition for a new era of communication?.Augmentative and Alternative Communication,30(1),1-18.
13. Lund, S. K.,Light, J.(2006).Long-term outcomes for individuals who use augmentative and alternative communication: Part I - what is a "good" outcome?.Augmentative and Alternative Communication,22(4),284-299.
14. Millar, D. C.,Light, J. C.,Schlosser, R. W.(2006).The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review.Journal of Speech, Language, and Hearing Research,49,248-264.
15. Norburn, K.,Morgan, S.,Levin, A.,Harding, C.(2016).A survey of augmentative and alternative communication used in an inner city special school.British Journal of Special Education,43(3),289-306.
16. Romski, M.,Sevcik, R. A.(2005).Augmentative communication and early intervention: Myths and realities.Infants & Young Children,18(3),174-185.
17. Rowland, C.,Fried-Oken, M.,Steiner, S. M.,Lollar, D.,Phelps, R.,Simeonsson, R. J.,Granlund, M.(2012).Developing the ICF-CY for AAC Profile and Code Set for Children Who Rely on AAC.Augmentative and Alternative Communication,28(1),21-32.
18. Schlosser, R. W.,Koul, R. K.(2015).Speech output technologies in interventions for individuals with autism spectrum disorders: A scoping review.Augmentative and Alternative Communication,31(4),285-309.
19. Smith, M. M.(2015).Language development of individuals who require aided communication: Reflections on state of the science and future research directions.Augmentative and Alternative Communication,31(3),215-233.
20. Solomon-Rice, P.,Soto, G.(2014).Facilitating vocabulary in toddlers using AAC: A preliminary study comparing focused stimulation and augmented input.Communication Disorders Quarterly,35,204-215.
21. Sutherland, D. E.,Gillon, G. G.,Yoder, D. E.(2005).AAC use and service provision: A survey of New Zealand speech-language therapists.Augmentative and Alternative Communication,21(4),295-307.
22. Tsai, M. J.(2019).Augmentative and alternative communication service by speech-language pathologists in Taiwan.Communication Disorders Quarterly,40(3),176-191.
23. Wu, Y. P.,Chen, M. C.,Wang, H. P.(2011).Evaluating AAC treatment research: Lessons learned from a systematic review in Taiwan.5th International Convention on Rehabilitation Engineering & Assistive Technology,Bangkok, Thailand:
24. 何素華（編）(2016).智能障礙.臺北市:華騰文化.
25. 吳亭芳,陳明聰,王曉嵐(2006)。輔助性科技服務模式之探討。特殊教育季刊，103，32-40。
26. 周台傑（編）(2019).特殊教育行政.臺北市:華騰文化.
27. 孫迺祤（編）,廖福特（編）(2017).身心障礙者權利公約.臺北市:臺灣新世紀文教基金會.
28. 教育部(2019b)。十二年國民基本教育身心障礙相關之特殊需求領域課程綱要。取自 https://sencir.spc.ntnu.edu.tw/_other/GoWeb/include/index.php?Page=6&news13=7592367155d3033c23fd38
29. 教育部(2019a)。中華民國 108 年特殊教育統計年報。臺北市：教育部。
30. 教育部(2015)。中華民國 104 年特殊教育統計年報。臺北市：教育部。
31. 陳明聰,吳亭芳(2005)。談以學生學習為中心的輔助科技服務。雲嘉特教，1，41-53。
32. 黃怡碧（編）(2020).CRPD 話重點：認識「身心障礙者權利公約」的關鍵15 講.臺北市:人權公約施行監督聯盟.
33. 黃郁雁(2010)。臺北市，國立臺北護理學院聽語障礙科學研究所語言組。
34. 蔡佩妏,張函儒,陳佳倫(2016)。國中特教教師對 AAC 態度與所遇困難之調查──以苗栗縣集中式特教班學校為例。特殊教育與輔助科技半年刊，14，42-49。
35. 鍾麗珍,黃國祐,黃淑琦(2011)。父母和語言治療師對自閉症孩童使用溝通輔具的認知與態度。中山醫學雜誌，22(1)，9-22。