臺灣博碩士論文加值系統

本研究旨在探討使用教練模式教導學齡前語言發展遲緩幼兒的家長學習「切題性輪替」、「擴展」、「時間延宕」與「提示」等四項加強式情境教學策略（EMT）之成效，以及對其幼兒口語表達能力的影響。
研究採用單一受試法跨行為多試探設計，以基隆地區三對親子為研究對象。參與研究的三位男童在華語嬰幼兒溝通發展量表（幼兒版）之「詞彙表達」分測驗的表現皆小於百分等級5，且皆具備仿說單詞的能力，其年齡介於26個月至29個月。三位家長均為全職媽媽，教育程度皆在專科以上。在介入期間，除了每週2次，每次40分鐘以教練模式教導家長四項EMT策略外，家長在家中也會每天使用EMT策略與幼兒互動至少15分鐘。本研究結果如下：
(一)家長在24次至31次的教練模式教導後，可立即習得「切題性輪替」、「擴展」、「時間延宕」、「提示」四項EMT策略，且使用四項EMT策略的行為具維持性成效。
(二)三位幼兒於華語嬰幼兒溝通發展量表（幼兒版）四項分測驗的表現提升至百分等級5~75。從溝通樣本中，可看出三位幼兒的溝通形式由非口語溝通轉為口語溝通，表達性詞彙量大幅增加，平均語句長度也進步至可說出雙詞結合句甚至簡單句。
(三)三位家長皆認為透過教練模式的教學可幫助其瞭解四項EMT策略的使用時機與使用步驟，也認為四項策略在日常生活中非常實用。此外，三位家長也感受到以EMT策略與其幼兒互動後，幼兒的口語表達能力明顯進步。
透過教練模式協助家長學習EMT策略可達到家長增能的目的，且可在一般醫療院限定之療育期間習得此四項EMT策略。因此，本研究可証即使進行療育的場域為醫療院所，亦可適切的提供符合「以家庭為中心」精神之療育服務。

The aims of this study were to investigate the effects of the coaching approach on parents’ learning of four Enhanced Milieu Teaching (EMT) strategies and on their children’s expressive language skills. A single-subject, multiple-baseline, across-behaviors design was used, and three language-delayed child-parent dyads from Keelung area were participated in this study.
The three boys with an age of 26 Month to 29 months participated in the study. They performed less than a percentage of 5 in the Mandarin-Chinese Communicative Development Inventory-Taiwan (MCDI-T); however, all had the ability to imitate some single word. All three parents were full-time mothers, and had college degree. During the intervention, the parents received coaching approach for learning EMT strategies twice a week, and 40 minutes per time. In addition, parents used EMT strategies to interact with their child for at least 15 minutes every day. The results of this study were summarized as follows:
(1) After receiving 24 to 31 lessons, the parents not only learned the four EMT strategies of "matched turns", "expansions", "time delays", and "prompting" immediately, but also maintained using above strategies after intervention.
(2) All three children showed improvement from percentage of 5 to 75 in the MCDI-T. From the communication sample, it can be seen that the communication forms of the three young children are changed from non-verbal communication to oral communication, the expressive vocabulary is greatly increased, and the average sentence length is also improved to say two-words or short phrases.
(3) All three parents believed that the coaching approach can help them understand the timing and use of the four EMT strategies. In addition, the three parents also felt that the child's oral expression ability improved significantly after interacting with the EMT strategy.
Helping parents learn EMT strategies through coaching approach can achieve the goal of parental empowerment, and parents can learn these four EMT strategies within the period of treatment prescribed by general medical institutions. Therefore, this study can prove that even if it is treated in a medical institution, it can provide "family-centered" treatment services.

摘要 I
Abstract III
目次 V
表次 VII
圖次 VIII
第一章 緒論 1
第一節 研究動機 1
第二節 研究目的與待答問題 6
第三節 名詞釋義 8
第二章 文獻探討 11
第一節 早期療育的重要性與成效 11
第二節 加強式情境教學 18
第三節 教練模式在家長訓練的應用 35
第三章 研究方法 47
第一節 研究架構與實驗設計 47
第二節 研究參與者 61
第三節 介入方案 66
第四節 研究工具 70
第五節 研究流程 75
第六節 資料處理與分析 79
第四章 研究結果 85
第一節 家長學習加強式情境教學策略之成效 85
第二節 幼兒口語表達之成效分析 115
第三節 社會性效度 127
第五章 討論 133
第一節 使用教練模式教導家長EMT策略，有助於家長精進使用EMT策略 133
第二節 家長以EMT策略與幼兒互動可提升幼兒的口語表達能力 136
第三節 家長學習EMT策略的表現出現個別差異 139
第四節 在醫院運用教練模式執行間接介入之可行性 142
第六章 結論與建議 145
第一節 結論 145
第二節 研究限制與建議 147
參考文獻 151
附錄 165
附錄一 家長同意書 165
附錄二 幼兒與家長基本資料調查表 166
附錄三 介入者執行教學檢核表 168
附錄四 家長問卷 169
附錄五 家長使用EMT策略與幼童前後測分析與計分說明手冊 173
附錄六 家長問卷專家內容效度評分結果與建議 179
附錄七 教練模式「活動一—教學」之教案範例 184

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