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This study aims to explore the application of picture book instruction to enhance the text and graphic narrative ability of elementary school children with medium mental disability. By implementation of picture book instruction, this study generalized and analyzed the performance of text and graphic narrative of children with medium mental disability. Research purposes are shown below: 1. to explore the instructional design and practice of application of the text and graphic narrative ability of elementary school children with medium mental disability. 2. to probe into the learning performance in the text and graphic narrative ability of elementary school children with medium mental disability by picture book instruction of story structure. By action research, this study treated one fifth grade elementary school student with medium mental disability in the special education class taught by the researcher as the subject to implement an eight-week instruction. In the first seven weeks, the instruction was provided three times a week, and in the last week, it was once a week. Practice time of each picture book instruction was 40 minutes. The whole course included 22 times of teaching activity. By the implementation of teaching design, the researcher observed and recorded the student's learning, and used the journal of afterthoughts and observers' discussion to generalize and analyze the findings of this study. Based on the findings, the conclusions are as follows: 1. Teaching design to apply picture book instruction to enhance the text and graphic narrative ability of elementary school children with medium mental disability should consider the students' competence and learning process and be student-centered. 2. The teaching strategy of picture book instruction is effective in enhancing the text and graphic narrative ability of elementary school children with medium mental disability.
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