臺北市早期療育服務社區照顧經驗

The Community-Oriented Experience of Early Intervention Services in Taipei City

早期療育服務是近年政府大力推動的政策之一，其介入的目標在於增進兒童發展、提升家庭功能、減少教育投資及減少社會負擔。基此，臺北市政府率先以實驗計畫辦理，更跨局處整合衛生、教育和社福單位，且在家長團體及市議會的大力推動下，從只有少數單位與資源投入的困境，逐漸走出多元化、社區化的本土都會模式。本文係以作者8年來實地的參與、推動臺北市的早療服務經驗，將現況依「宣導與發現」、「篩檢與通報」、「鑑定與轉介」、「療育服務」、「人員培訓」及「行政支援」等六面向逐項分析。作者發現在家長的參與、專業的投入及政府的承擔三方力量同心協力下，臺北市成立了1家通報轉介中心、6個社區資源中心、15家醫療機構22個據點提供發展遲緩兒童評估鑑定與療育服務（其中臺北市立聯合醫院有7個院區及早期療育評估中心），12所身心障礙福利機構、1所早療機構、3家基金會及300多所幼稚園及托兒所提供融合教育機會，使發展遲緩及身心障礙兒童之通報從1年98人激增至95年的2,523人，累計通報25,277人，至少影響家戶人口75,000人，不僅使得遲緩或身心障礙兒童現況得以改善，障礙情形降至最低，家庭也因此得到支持與服務。早期療育的推動需要以「積極」代替「著急」；以「社區照顧」理念，推展以「家庭」為核心的「社區化」早期療育服務。

The purpose of this paper is to emphasize the importance of early intervention. The purpose of early intervention in Taipei City is to help child development, promote parenting skills, and reduce educational and social costs. In order to meet these goals, parenting groups and Taipei City Council have made great efforts to make early intervention work in Taipei City. In April 1995, Taipei City Government started planning and setting up the service network. To date, Taipei City has set up one reporting and referral center, six community resources centers, 22 medical assessment and intervention clinics, 12 child development centers, one early intervention training center, three non-profit foundations and more than 300 inclusion schools, such as kindergartens and day care centers. With parent participation, professional devotion and Taipei City Government's commitment, the number of assisted children has increased from 98 to 2,523/year. By the end of 2006, Taipei had already funded 25,277 children. We estimate Taipei City early intervention services to have affected at least 75,000 persons, including development-delayed and disabled children, their parents, grandparents and siblings. We found that early intervention services help the children to build up self esteem, grow their potential, learn how to socialize, and receive an education, while the most important aim is to help them to reduce their level of disability or to prevent them from getting worse. At the same time, their families get support and a diverse range of services. An integrated early intervention program should include children, families, and multidisciplinary professionals. The system should therefore be more ”family-centered” and ”community-oriented” to provide appropriate services to children and families through a positive and aggressive attitude.