替代性溝通訓練對重度智能障礙兒童溝通能力與異常行為之影響

The Effects of Alternative Communication Training on Communication Abilities and Problem Behaviors of Children with Severe Mental Retardation

重度智能障礙兒童由於嚴重發展遲緩，在認知能力有限、生活經驗缺乏之下，往往呈現溝通能力低下之情形。更甚者，很多重度智能障礙兒童稍具或未具口語能力。在口語能力不足，而又未習得其他替代性溝通方法（如圖卡、照片、動作、實物），往往以異常行為替代溝通表達之功能。基於上述，本研究主要目的在於探討替代性溝通訓練，對無口語能力之重度智能障礙兒童的溝通行為是否有所增進，及其異常行為是否因其接受替代性溝通訓練後有所減少。研究採用單一受試多基準線跨個人實驗研究設計（multiple baseline across individuals design）。研究對象為三名重度智能障礙兒童，三名受試分別接受基線期與處理期之實驗。在處理期，受試先後接受替代性溝通訓練。最後將基線期與處理期所蒐集之資料，以自視法及C統計加以分析，以了解替代性溝通訓練對三名重度智能障礙兒童在溝通能力與異常行為之影響。最後並進行追蹤期之資料分析，以瞭解處理期之效果是否繼續存在。本研究之主要結果如下：1、三名受試經過替代性溝通訓練後，其異常行為出現次數明顯減少，且穩定的保留其進步成果。2、三名受試經過替代性溝通訓練後，其主動溝通之行為次數明顯增加，且穩定的保留其進步成果。

Low cognitive ability and lack of living experiences are problems commonly found among children with severe mental retardation. These children generally exhibit little or no capability of oral communication. Problem behaviors usually develop to satisfy their communicational needs if alternative communication training such as line drawing, photograph, gesture, and tangible object was not provided. This study investigated the effectiveness of alternative communication training on improving the communication capability and hence, decreasing the occurrence of problem behaviors of the children with severe mental retardation.Multiple baseline across individuals research design was used with alternative communication training as independent variable and the numbers of communication behaviors and problem behaviors as dependent variables. Frequency counts on the related behaviors of three research subjects were recorded on baseline, intervention, and follow-up phases.The observed data were then analyzed using visual analysis and time series C statistic. Results of the analysis indicated that the number of problem behaviors was significantly decreased and the number of communication behaviors increased on each of the three research subjects after receiving alternative communication training. A follow-up phase study also indicated that the improvement had been retained.