閱讀障礙篩選流程的檢驗─篩選或教師轉介之比較

A Study of the Identification Process for Students with Reading Disabilities: Screening versus Teacher Referral

及早發現及早介入是目前閱讀障礙研究和實務的趨勢，測驗篩選或教師轉介是發現閱讀障礙學生的第一關，本研究依據柯華葳等所擬定的閱讀障礙學生診斷六階段的流程，探討篩選或轉介不同發現閱讀障礙的來源之正確性和可行性。本研究以北、南、東三區各一所國小、國中之小二、小四和七年級為實驗對象，共1126 位學生參加，依據診斷流程最後獲得95 位閱讀障礙學生。本研究依據不同階段所得之疑似閱障學生和最後確定的閱障學生為對象比較兩種發現閱障來源，結果發現篩選所佔比率比較大，約九成的閱障學生可以被篩選出來，在第一階段的疑似閱障學生也以篩選的正確率較高，以最後確認閱障的學生，所得敏感度，也是篩選高於教師轉介。篩選或教師轉介在性別或閱障的亞型比率未見顯著差異，但在年級、區域和閱讀能力卻見二者間的差異。教師轉介比較被學校肯定，但過低的發現率、教師個人偏好或區域對教師培訓制度的程度都會影響轉介的比率和正確性，雖然本研究的教師轉介並未見明顯偏見，但研究發現在小四、七年級階段，篩選工作仍是發現閱障學生的最佳來源，但在小二，篩選功能不若高年級，建議低年級的第一關篩選和教師轉介並用。最後對於閱障的診斷工作和未來研究提出其他的建議。

Early identification of high-risk reading-disabled children is obviously important. Teacher referral and screening by means of tests are the two major ways of detecting students who are likely to have reading disabilities. Ko's team proposed the six-stage process to identify the RD students with the assessment they conducted in the same project: (1) screening by reading competence, (2) excluding other factors, (3) detecting high-risk RD students, (4) excluding by IQ, (5) identifying the subtypes of RD, (6) diagnosing the cognitive profile. Most schools take teacher referral in the first stage instead of the screening by the tests. Therefore, this study investigated the effectiveness of the two approaches in the first stage of the six-stage process of identifying RD students proposed by Ko (2006), There are 1126 students participating in this study; they were selected from three primary schools and three junior high schools in three different counties of Taiwan. When screened with group reading tests, close to 90% of these students were found to have RDs; however, the method of teacher referral identified only 88% of the students as having RDs, meaning the latter method was lightly less sensitive. It was also found that there are few differences (with regard to reading ability) between screened RD students and the RD students referred by teachers. Schools tend to prefer teacher referral, yet the fact that this method appears to be less sensitive than screening is a crucial issue, especially in southern and eastern Taiwan, where a higher proportion of RD students fail to be detected by teachers. Teacher referral is subject to the subjective prejudices or preferences of teachers. Yet while screening is highly recommended as the first step in this identification process, taking teachers' referrals into account with younger students is also recommended. Other recommendations are made regarding the practice of identifying RD students and possible areas for further research.