是社區服務，還是以社區為基礎服務？早期療育之文獻分析

Are these Community Services or Community-based Services? Document Analysis in Early Intervention in Taiwan

本文旨在藉由文獻分析，呈現學術研究及實務論述性質的期刊論文中，早期療育領域中，對於社區服務的討論內容，進而思索若欲討論以社區為基礎服務時，有待努力的方向。研究方法為文獻分析法，以社區、療育二個詞彙，搜尋國家圖書館期刊文獻資訊網、華藝中文電子期刊，以Excel為分析工具，針對43篇期刊論文進行分析。研究結果：1.研究者將發表時間分為三個時期（1995-2001、2002-2008、2009-2021年）後發現，2002年內政部兒童局（衛生福利部社會及家庭署）試辦早期療育到宅服務以降，期刊論文篇數增加；有關社區療育服務議題的論文發表於2009-2021年。2.多數研究論及服務介入時，關注的是區域資源配置不足，以及服務必須符合家庭需求；相關單位若要進入社區提供服務時，發掘重要他人和在地資源聯繫是經常使用的策略。3.專業人員評估及提供服務時，必須顧及在地特質及文化，以及家庭在社區中能夠就近得到服務；但是，也有文獻就早療家庭的觀點發現，家長對社區參與或服務的需求不高，可能的原因是，家長大多以養育子女為關切的要項。部分研究提出政府單位的行政作業必須保有彈性，以及培育專業人員對於社區相關議題關注的重要性。研究建議為，若欲發展以社區為基礎的服務，必須兼顧區域文化及特質、家庭需求。

This study aims to demonstrate the discussion on community services in the studies of early intervention services in Taiwan and to illustrate implement strategies for developing community-based services. The research data were collected by document analysis, and 43 articles, published from 1995 to 2017, were found in Airiti Library and NCL Taiwan Periodical Literature. The shift of key themes is proven after applying Excel proving quantify and qualify means. This study discovers three important results. First, since 2002, Child Welfare Bureau, Ministry of the Interior had declared the pilot program of home-based services for developmentally delayed children and their families, the number of articles was increased. Meanwhile, the analysis of articles published in three stages (1995-2001, 2002-2008, 2009-2021), showed that the issues about community intervention services had increased between 2009 and 2021. Second, significant others and community resource connections are key components in the service delivery process, while most studies focused on resource allocation in rural districts and services that meet the needs of children and their families. Third, some articles concerned about regional characteristics and culture and resource accessibility from the viewpoints of professionals. Others mentioned on that the lack of community participation of families due to child caring. Only a few studies pointed out the importance of the flexibility of administrative procedures of central or local governments and the community related training for pre-professionals and professionals. To improve practical works, this study suggested that regional characteristics/culture and family needs could be contribute to the transformation from community services to community-based service.