一位注意力缺陷妥瑞兒之參與觀察個案研究

A Participant-Observational Case Study on a Tourette Syndrome Child with Attention Deficit Disorder

近年來「妥瑞症」（Tourette syndrome）已漸漸在台灣的醫學界受到重視，但是社會大眾甚至老師對「妥瑞症」並不熟悉，尤其是針對妥瑞症兒童在教育場域的相關研究可謂鳳毛麟角。本研究旨在了解一位妥瑞兒在學習適應上所遭遇的問題，及家長和老師在面對妥瑞兒時之反應態度。研究者以十個月的時間，實地參與觀察一位國小三年級注意力缺陷之男性妥瑞兒個案的學習與適應狀況，同時訪問個案家長及安親班老師，進一步解析個案在不同場域裡的處境。研究者發現這位妥瑞個案，因為合併的注意力缺陷症狀使他在情緒管理及行為控制上有較差的表現，他在班上各種干擾性行為讓他與同儕間產生人際疏離。然而，他卻有許多正向的利社會性行為，例如會主動幫助別人。此外，他有優異的數理能力及超強的記憶力。本研究結果希望對妥瑞兒、家長、老師及諮商輔導人員提供具體的建議及幫助。

Tourette syndrome has increasingly gained attention in Taiwan’s medical field， especially within the past few years. However， most individuals， even school teachers， are not familiar with Tourette syndrome (TS). The lack of understanding of this neurological disorder is largely due to the limited number of empirical studies on the subject. The purpose of this study was to understand the every day life experiences of a child with TS. The researcher observed a third- grade TS child who had been diagnosed with Attention Deficit Disorder for ten months. During this time the researcher also interviewed the child’s parents and teachers. The results of this study indicated that a TS child with Attention Deficit Disorder had more emotional and behavior problems than other children. In this study our TS subject had more interfered behaviors and did not have good relationships with other students. But， this study also found that our TS subject had many positive social behaviors， such as helping others. Besides， our TS subject demonstrated outstanding abilities in mathematics and memory. The researcher hopes the findings of this study can provides some suggestions for the TS child， parents， and teachers， as well as the school counselor.