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研究生:丁于珊
研究生(外文):Ding, Yu-Shan
論文名稱:以ImPACT課程應用家長三級介入模式提升臺灣自閉症幼兒家長之社會性溝通研究
論文名稱(外文):Applying Three Tier Model of Parent Education with ImPACT Curriculum to Improve Social Communication of Taiwanese Parents with Young Children with Autism Spectrum Disorder
指導教授:王慧婷王慧婷引用關係
指導教授(外文):Wang, Hui-Ting
學位類別:碩士
校院名稱:國立臺灣師範大學
系所名稱:特殊教育學系
學門:教育學門
學類:特殊教育學類
論文出版年:2020
畢業學年度:109
語文別:中文
論文頁數:118
中文關鍵詞:自閉症幼兒家長三級介入家長社會性溝通技巧單一受試變更情境設計ImPACT
外文關鍵詞:parent-implemented three tier interventionparental social communication skills
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本研究旨在探討應用ImPACT家長三級介入模式對自閉症幼兒家長社會性溝通技巧的成效。以單一受試變更情境為研究設計,以初級自學、次級家長團體和第三級一對一教練形式,探究所有參與家長均能學會社會性溝通技巧之外,檢視三級模式是否能達到減少需要次級、第三級介入的家長人數。並且,在資源與需求適配的情形下,試圖解決家長介入的困境。全數10位參與家長,全程參與共9位。家長介入反應比率定義為親子居家互動影片5分鐘,以30秒部分時距紀錄四項技巧的平均90%以上,據此標準初級達介入反應通過3位,通過率30%;次級達介入反應5位,通過率50%;第三級達介入反應1位,通過率10%。尚有1位因疫情考量退出。研究結果顯示初級家長滿意時間彈性的自學方式;次級家長團體時間配合家長在周末進行課程,同時提供托育服務;第三級配合家長家庭作息時間,以及提供個別化回饋。透過三級不同密集度和個別化程度設計,各級通過家長均滿意此種學習方式,能解決文獻所述家長介入瓶頸。由本研究結果觀之,基於不同家庭有不同學習需求和條件,家長介入的確需要不同個別化和彈性程度設計,以滿足前述學習需求,依據研究結果提出建議及展望,以供未來家長介入研究及教學參考。
Parent-implemented intervention is one of the evidence-based practices for students with autism spectrum disorders(ASD). Reflecting from the literature on stepped care and response to intervention models, a three-tier intervention model was applied to parent education with the curriculum ImPACT A single-subject changing conditions design was used to examine the implication of a three- tier intervention model in a diverse group of families (n=10) participating in a parent training program. The three tiers consisted of (a) Tier 1: self-administered learning, (b) Tier 2: group training , and (c) Tier3: one-on-one individualized coaching. Following each phase, parental skills during parent-child interactions at home were observed with parent-child interaction video clips which determine parents’ response to the intervention(s) by the average of 30 seconds partial-interval recording of four skills. Parents who met specified response-to-intervention criteria discontinued treatment and attach one-month follow up, while those that did not meet criteria continued to the next tier. Of the nine participants (90%) who completed treatment, all responded to intervention. Results suggest that the Tier 1 intervention was effective for three (30%) parent-child dyads.
Five dyads (50%) responded to Tier 2 intervention and one dyad (11%) required Tier 3 intervention to meet response-to-intervention criteria. One dyad dropped out because of the concern of COVID-19. Discussion focuses on the application of a tiered model of intervention to increase efficiency by minimizing the need for more costly time-intensive interventions for parents who may not require them and also discussed the utilization of western program in Taiwan. According to the results, three-tier parent training model can content the different needs of learning of diverse families. More studies are needed in the future.
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 5
第三節 名詞解釋 7

第二章 文獻探討 9
第一節 自閉症家長介入的歷史與系統性文獻回顧 9
第二節 家長介入與家長三級介入模式 13
第三節 ImPACT與家長三級介入適配性 21
第四節 家長促進自閉症幼兒社會性溝通介入技巧 25

第三章 研究設計與實施程序 29
第一節 研究對象和場域 29
第二節 研究倫理 31
第三節 ImPACT課程 33
第四節 家長社會性溝通測量 35
第五節 研究設計與流程 39
第六節 資料分析 43
第七節 信效度 45
第八節 前導研究 47

第四章 研究結果 49
第一節 家長三級介入模式各級達介入反應之家長樣態 49
第二節 家長流失率與研究信效度 73
第三節 研究問題綜合討論 75
第五章 討論與研究建議 87

參考文獻 93

附錄
附錄一、家庭背景資料…101
附錄二、家長介入真確性檢核表(跟隨兒童引導)…103
附錄三、家長介入真確性檢核表(模仿兒童)…105
附錄四、家長介入真確性檢核表(誇張化)…107
附錄五、家長介入真確性檢核表(示範與擴展語言)…109
附錄六、ImPACT家長滿意度調查表(自學)…111
附錄七、ImPACT家長滿意度調查表(團體)…113
附錄八、ImPACT家長滿意度調查表(一對一個別)…115
附錄九、幼兒社會性溝通能力檢核表…117




中文文獻
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Aldred, C., Green, J., & Adams, C. (2004). A new social communication intervention for children with autism: pilot randomised controlled treatment study suggesting effectiveness. Journal of Child Psychology and Psychiatry, 45(8), 1420-1430.
Baggett, K. M., Davis, B., Feil, E. G., Sheeber, L. L., Landry, S. H., Carta, J. J., & Leve, C. (2010). Technologies for expanding the reach of evidence-based interventions: Preliminary results for promoting social-emotional development in early childhood. Topics in Early Childhood Special Education, 29(4), 226-238.
Brookman-Frazee, L., & Koegel, R. (2004). Using parent/clinician partnerships in parent education programs for children with autism. Journal of Positive Behavior Interventions, 6(4), 195-213.
Carter, A. S., Messinger, D. S., Stone, W. L., Celimli, S., Nahmias, A. S., & Yoder, P. (2011). A randomized controlled trial of Hanen’s ‘More Than Words’ in toddlers with early autism symptoms. Journal of Child Psychology and Psychiatry, 52(7), 741-752.
Casenhiser, D. M., Shanker, S. G., & Stieben, J. (2013). Learning through interaction in children with autism: preliminary data from asocial-communication-based intervention. Autism, 17(2), 220-241.
Cidav, Z., Marcus, S. C., & Mandell, D. S. (2012). Implications of childhood autism for parental employment and earnings. Pediatrics, 129(4), 617-623.
Delano, M. E. (2007). Video modeling interventions for individuals with autism. Remedial and Special education, 28(1), 33-42.
Drew, A., Baird, G., Baron-Cohen, S., Cox, A., Slonims, V., Wheelwright, S., Swettenham, J., Berry, B., & Charman, T. (2002). A pilot randomised control trial of a parent training intervention for pre-school children with autism. European child & adolescent psychiatry, 11(6), 266-272.
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