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研究生:張芳慈
研究生(外文):Chang, Fang-Tsyr
論文名稱:職能治療數字概念活動對國小智能障礙學生金錢使用的學習成效
論文名稱(外文):The effect of occupational therapy on numeric concept and money usage for elementary school students with intellectual disabilities
指導教授:陳淑瑜陳淑瑜引用關係
指導教授(外文):Chen, Shu-Yu
口試日期:2017-09-11
學位類別:博士
校院名稱:臺北市立大學
系所名稱:教育學系
學門:教育學門
學類:綜合教育學類
論文種類:學術論文
論文出版年:2017
畢業學年度:106
語文別:中文
論文頁數:539
中文關鍵詞:數字概念活動智能障礙金錢使用職能治療
外文關鍵詞:numeric concept activitiesintellectual disabilitiesmoney usageoccupational therapy
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  隨著「正常化」 (normalization) 的理念和「反機構化」 (deinstitutionalization) 安置的原則,以及受到回歸主流之特教思想的衝擊,身心障礙學生回歸到一般社區家庭生活已成為特殊教育一項重要的目標。因此,有關身心障礙學生在社區中獨立生活的適應也成為特殊教育不可忽視的課題。身心障礙學生如何在社區中獨立生活,如何在社會接納下參與社會活動,履行社會角色,更是職能治療所關注的焦點。在社會中是否有良好的生活適應,獨立生活功能是個關鍵因素。本研究旨在以數字能力來探究智能障礙學生在日常生活中金錢使用的能力,瞭解數字概念知能如何影響到金錢的使用,進而分析障礙程度不同的智能障礙學生在日常金錢使用所能達到的功能性程度,以期智能障礙兒童日常生活中有最大的獨立性。
  本研究採以量化為主之單一受試實驗設計 (single subject experimental design)中的跨行為多探試設計 (multiple probes across behaviors design) 與質性的個案觀察,了解個案的學習歷程,以及金錢使用和數字概念能力的關係。研究對象為六位智能障礙學生,其中四位為輕度智能障礙、一位為中度智能障礙、一位為重度智能障礙。自變項是職能治療數字訓練活動,依變項為受試者金錢使用的能力表現。訓練活動內容包含「認識錢幣」、「錢幣的組合與等值換算」、「錢幣數量總值」、「模擬情境錢幣使用」四個單元,以及「真實錢幣使用」的類化單元。訓練活動在輕度智能障礙者為36節,在中及重度智能障礙者為37節,每節40分鐘。實驗處理包含基線期、處理期、維持期、和類化期四階段。本研究將所蒐集的資料以單一受試研究實驗設計之視覺分析及C統計進行分析和考驗,並輔以受試者學習行為觀察之質性資料分析,與教師和家長回饋之社會效度分析。

本研究之量化資料及質性分析結論綜合摘要如下:
一、職能治療數字訓練活動能增進國小智能障礙學生金錢使用能力之單元立即成效及累積成效。
二、職能治療數字訓練活動對提升國小智能障礙學生金錢使用技能具有維持效果。
三、職能治療數字訓練活動對提升國小智能障礙學生金錢使用技能具有類化效果。
四、根據教師及家長回饋的意見,皆肯定職能治療數字訓練活動對提升國小智能障礙學生金錢使用技能之學習成效,顯示本研究獲得教師及家長的社會效度支持。
五、輕度智能障礙者可自行執行單一步驟、商品數量少、總價少的簡單商品交易,對於多種類多數量的複雜商品交易則顯困難。
六、中度智能障礙者能在協助下計算100元以內之幣值組合總數、10元以內硬幣等值兌換、計算20元以內商品的總價、以及可購買50元以內數量少、種類少、總價小 (通常是1個或兩個) 的商品。
七、重度智能障礙者能在協助下計算20元以內之幣值組合總數、10元以內硬幣等值兌換、計算20元以內商品的總價、以及可購買20元以內數量少、種類少、總價小 (通常是1個或兩個) 的商品。
八、數字的加減乘除靈活運算與數學文字理解能力的不足是影響輕度受試者金錢使用能力最大的因素;而,導致中度及重度受試者無法獨自使用金錢的原因則是在於基本數字概念能力的欠缺。
  根據上述的研究結果發現,本研究乃分別就教師教學、家長日常輔導、及未來相關研究提出具體建議。
  It has become an important issue that disabled student go back to live in community based on the tendency of normalization, deinstitutionalization, mainstream, and inclusive education. So, the status of the independent living adaptation of disabled students should be prepared. It is also the main concern that disabled students’ participation in social activities and implementation on acceptable social roles in the field of occupational therapy. However, a satisfactory life adaptation depends on good independent living skills. The purposes of this study were to examine the abilities of money usage influenced by numeric concept abilities for elementary school students with intellectual disabilities in daily living, to find out how numeric concepts influence the use of money, and to analyze the different functional levels on using money among different impairments on intellectual disabilities. The final goal was to help the students can live with maximal independence in daily living.
  The single subject experimental design with multiple probes across behaviors design was utilized in this study. The case observation was also used to understand students’ learning processing and the relationship between the numeric concepts and use of money. The subjects of this study were six elementary school students, including four students with mild mental retardation, one student with moderate mental retardation, and one student with severe mental retardation. The independent variable was the number training activities of occupational therapy, and the dependent variable was the performance of use of money of the subjects in unit immediate effects, cumulative effects, maintainable effects, and generalized effects.
  Four units were designed for training, including “recognizing coins and bills”, “exchanging coins and bills”, “counting coins and bills”, and “using coins and bills in simulative shopping scenario”. The “using actual coins and bills” was applied for generalization unit. The period of training program was lasted for consecutive 36 sessions for subjects with mild mental retardation and 37 sessions for subjects with moderate and severe mental retardation. There were 40 minutes in each session. The data analysis included for baseline, intervention, maintenance, and generalization. The data were analyzed by visual analysis and C statistic. The data of case observation was also collected for qualitative analysis and the feedback from questionnaires completed by teachers and parents was summarized for social validity.
  Quantitative and qualitative findings for this study were concluded as follows:
1.The occupational therapy activity focused on number training could enhance the immediate effects and cumulative effects of money use by six elementary school students with intellectual disabilities.
2. There were good maintainable effects when six elementary school mental retardation students learned the skills of using money by means of the number training activity in occupational therapy.
3.The ability of money use could be generalized in six elementary school students with intellectual disabilities even the occupational therapy training programs were removed.

4.The teachers and parents of the subjects were undoubtedly satisfied with the results and with positive attitudes. This indicated that the research had a high social validity support.
5.The mild mental retardation students had the abilities to buy few items with low price independently, but had difficulty to purchase many items at a time. They might miss some items and have wrong calculation to total price.
6.The moderate mental retardation student has already learned to sum the coins within 100 dollars, to exchange the coins within 10 dollars, calculate to total price within 20 dollars, and pay the money of 1 or 2 items within 50 dollars under the supervision.
7.The severe mental retardation student has already learned to sum the coins within 20 dollars, to exchange the coins within 10 dollars, calculate to total price within 20 dollars, and pay the money of 1 or 2 items within 20 dollars under the supervision.
8.The abilities of mathematical calculation on addition, subtraction, multiplication, division and word problem solving abilities were the main factors that influence the use of money in mile mental retardation students, while the lacking in numeric concepts resulted in poor abilities of the use of money in moderate and severe mental retardation students.
  According to the results mentioned above, some recommendations for teachers’ teaching, parents’ counseling in daily living, and future researches were proposed.
第一章 緒論  1
第一節 研究背景與動機  1
第二節 研究目的  11
第三節 待答問題  11
第四節 名詞解釋  12
第二章 文獻探討  15
第一節 智能障礙的定義與智能障礙者的學習特徵   15
第二節 職能治療與特殊教育   29
第三節 智能障礙者的日常生活之基本技能  42
第四節 兒童的數字概念  53
第五節 智能障礙者金錢使用能力的相關研究  83
第三章 研究方法  109
第一節 研究設計  109
第二節 研究流程  116
第三節 研究參與者  121
第四節 研究工具  130
第五節 職能治療活動設計  136
第六節 信度和效度  147
第七節 資料處理與分析  150
第四章 結果與討論  157
第一節 六位受試者金錢使用學習成效之分析  157
第二節 六位受試者在金錢使用能力上的學習歷程  306
第三節 障礙程度不同之智能障礙學生在金錢使用能力
上之功能性程度表現與數字概念知能的關係  388
第四節 綜合討論  398
第五章 結論與建議  429
第一節 結論   429
第二節 研究限制  437
第三節 建議  439
参考文獻  449
附錄
附錄一-1 智能障礙者人數總計與百分比   509
附錄一-2 智能障礙者人數與百分比統計 (以年齡分)  510
附錄一-3 智能障礙者人數與百分比統計 (以障礙程度分) 511
附錄一-4 智能障礙者總人數統計 (以年齡及障礙程度分)  512
附錄一-5 身心障礙者總人數統計 (以年齡及障礙程度分) 513
附錄一-6各教育階段身心障礙特殊教育學生人數總計及智能障礙學生之比例   514
附錄二-1 生活適應能力檢核手冊數學領域量與
實測單元中「錢幣」檢核項目  515
附錄二-2 中重度智障者功能性教學綱要實用學科副領域
「使用金錢」學習目標摘錄   516
附錄二-3.1 國民教育階段智能障礙類課程綱要實用數學
領域「金錢與消費」學習目標   517
附錄二-3.2 國民教育階段智能障礙類課程綱要【學習目標檢核手冊】實用數學領域「金錢與消費」項目學習目標   518
附錄二-4 九年一貫課程在認知功能嚴重缺損學生之應用
手冊「金錢與消費」學習目標    519
附錄三-1 數學基礎能力檢核表   520
附錄三-2 金錢使用能力評量單 — 單元一  523
附錄三-3 金錢使用能力評量單 — 單元二  524
附錄三-4 金錢使用能力評量單 — 單元三  525
附錄三-5 金錢使用能力評量單 — 單元四  526
附錄三-6 金錢使用能力單元學習評量單一 — 單元一   527
附錄三-7 金錢使用能力單元學習評量單二 — 單元二   528
附錄三-8 金錢使用能力單元學習評量單三 — 單元三   529
附錄三-9 金錢使用能力單元學習評量單四 — 單元四   530
附錄三-10 金錢使用能力評量單 — 單元五  531
附錄三-11 金錢使用觀察記錄單  532
附錄四-1 受試者甲各階段評量成績表  533
附錄四-2 受試者乙各階段評量成績表  534
附錄四-3 受試者丙各階段評量成績表  535
附錄四-4 受試者丁各階段評量成績表  536
附錄四-5 輕度受試者 (受試者甲至受試者丁) 各階段評量平均成績表  537
附錄四-6 受試者戊各階段評量成績表  538
附錄四-7 受試者己各階段評量成績表   539
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