替代性溝通訓練對低功能自閉症兒童溝通能力與異常行為之影響

The Effects of Alternative Communication Training on Communication Abilities and Problem Behaviors of Low Functioning Children with Autism

低功能自閉症兒童由於嚴重發展遲緩，受限於其認知能力的嚴重缺陷、學習特質、生活經驗缺乏之下，往往呈現溝通能力低下之情形。更甚者，很多低功能自閉症兒童稍具或未具口語能力。在口語能力不足，而又未習得其他替代性溝通方法（如圖卡、照片、動作、實物），往往以異常行為替代溝通表達之功能。基於上述，本研究主要目的在於探討替代性溝通訓練，對無口語能力之低功能自閉症兒童的溝通行為是否有所增進，其異常行為是否因其接受替代性溝通訓練後有所減少，及教師主動滿足低功能自閉症兒童的需求行為是否有所減少。研究採用單一受試多基準線跨個人實驗研究設計（multiple baseline across individuals design）。研究對象為三名低功能自閉症兒童，三名受試分別接受基線期與處理期之實驗。在處理期，個案先後接受替代性溝通訓練。最後將基線期與處理期所蒐集之資料，以目視法及C統計加以分析，以了解替代性溝通訓練對三名低功能自閉症兒童在溝通能力、異常行為之影響、教師滿足受試需求行為的影響。最後並進行追蹤期之資料分析，以瞭解處理期之效果是否繼續存在。本研究之主要結果如下：1、三名受試經過替代性溝通訓練後，其異常行為出現次數顯著減少，且穩定的保留其進步成果。2、三名受試經過替代性溝通訓練後，其主動溝通之行為次數顯著增加，且穩定的保留其進步成果。3、三名受試經過替代性溝通訓練後，教師主動滿足受試需求的行為次數顯著減少，且穩定的保留其進步成果。

Low cognitive ability, lack of living experiences, and special learning characteristics are problems commonly found among low functioning children with autism. These children generally exhibit little or no capability of oral communication. Problem behaviors are usually developed to satisfy their communicative needs if alternative communication training such as line drawing, photograph, gesture, and tangible object is not provided. This study investigated the effectiveness of alternative communication training on improving the communication capability and hence, decreasing the occurrence of problem behaviors of the low functioning children with autism, and decreasing the occurrence of teacher's behaviors on satisfying the needs of subjects.Multiple baseline across individuals research design was used with alternative communication training as independent variable, and the numbers of communication behaviors and problem behaviors of three subjects, as well as the numbers of teacher's behaviors on satisfying the needs of subjects as dependent variables. Frequency counts on the related behaviors of three research subjects were recorded on baseline, intervention, and follow-up phases.The observed data were then analyzed using visual analysis and time series C statistic. Finally the results of the study were as following:1. The numbers of communication behavior of subjects significantly increased after receiving alternative communication training, and the training effects remained through the follow-up phase.2. The numbers of problem behavior of subjects significantly decreased after receiving alternative communication training and the training effects remained through the follow-up phase.3. The numbers of teacher's behavior on satisfying subjects' needs significantly decreased after subjects receiving alternative communication training, and the training effects remained through the follow-up phase.