國小選擇性緘默症兒童之支援服務個案研究

A Case Study of Supporting Services for a Student with Selective Mutism in an Elementary School

本研究旨在探討一位國小選擇性緘默症兒童之支援服務的現況與需求，並針對研究結果提出建議。研究進行十個多月，其間透過錄影、觀察、訪談以及文件分析等蒐集資料，經過三角交叉檢證獲得以下結果：1.還原個案真實樣貌：個案雖是選擇性緘默症，但並非極端不說話，且其某些學習能力也未停滯，相關人員嘗試從不同的情境去體察個案的優弱勢及創造舒緩焦慮情緒的校園情境，並以資源班為中心，試著設計結合自我示範、遊戲、電腦教學和藥物治療為主的多元處遇方案。2.家庭衝突與支援服務需求：個案的家庭雖存在許多優勢，但家庭衝突及缺乏適當的教養觀念阻礙了個案的發展，因此過程中除提醒相關人員摒除偏見，並建議家人避免使用負向語言教育個案，以及協助個案培養各種能力和為家人剖析藥物治療的利弊得失。3.學校系統的支援服務：在校長的影響下，校園充滿對特殊兒童支持的氣氛，並在行政、教學和同儕方面依照個案的障礙及焦慮特質提供整合性的服務。不過資源班教師要能有效的整合資源以及訓練協助的同儕，避免不恰當的態度反而成為個案的最大焦慮來源。4.融合教育的再設計：融合並非「混合」，因此在各種條件限制下，融合教育的最佳方案(maximum)未必存在現實社會，資源班教師應主動調整家庭、教學和行政方面的支援服務，為個案重新設計融合教育的最適(optimum)方案。

In this study， the case is a student with selective mutism in elementary school. It employed observations， interviews， and document analysis to explore the conditions and demands for supporting services for ten months. Following are the major conclusions throughout triangulation. 1.A clear look at the original conditions of the case: It doesn't mean the case can't speak and learn even though she always keeps silence in school. If only school related professionals can highly regard her strengths and weaknesses in different contexts and help her to avoid the anxiety situations， she can do many things. Also， resource teachers play an important role in designing multidisciplinary plan including self modeling， play therapy， computer-assisted instruction， and medication. 2.Conf lict origins from family and demands of family support services: Although the case's family has the advantage of a better economy， conflict comes from family and lacks of proper educational concepts of her parents are disadvantages. Without bias， school related professionals have to provide related services and medical assistances to meet her special needs， and to suggest her family to stop teasing her weaknesses. 3.The needs of school support service: The case could receive related services because of wide support from school principle， and according to the case's abilities the resource teachers have to collaborate with school personnel to provide the case assistances including planning， studying， using resources， and avoiding peer stress throughout properly training of peer assistances. 4.Adaptations and redesigns of inclusion: A mix of students isn't an inclusion. Even though the maximum inclusive program may not exist in real world， the optimum is available. Resource teachers need to create suitable inclusive environments throughout adaptations including providing support services from family， teachers， and administrations.