支持需求量表（SIS）作為智障者支持需求評估工具：文獻探討與案例分析

Supports Intensity Scale (SIS) as an assessment tool meeting support needs for people with an intellectual disability: Literature review and cases analyses

SIS「支持需求量表」（Supports Intensity Scale）2004年出版操作手冊，2005－2006年心路基金會購買使用版權及中文版翻譯完成，2009年國內20位資深工作者獲美國智障及發展協會（American Association on Intellectual and Developmental Disabilities,AAIDD）訓練師資格認證。2009－2011年，有九個服務單位144名智障者接受SIS評量，2012年另有26個單位784名智障者完成該評量。本研究目的在探討SIS發展與運用，及比較智障服務使用者SIS和手冊診斷障礙程度、日常生活功能量表（Activity of Daily Life;ADL）、工具式日常生活功能量表（Instrumental Activity of Daily Life;IADL）評量結果。研究方法：文獻探討方法（圖書館電子資料庫尋找與SIS相關期刊文章）及焦點團體（2012年十月北中南各舉辦一場焦點團體，邀請一個至兩個單位提供一至三名案例，討論智障服務使用者在SIS及其他評量結果比較及服務意涵）。研究結果：SIS強調個人與所處環境互動及來自社會環境障礙，以智障者「支持需要」（support needs）為出發點，非其「問題」、「異常」、「不適應行為」或「失能」、「損傷」；服務規劃及輸送時，強調「支持」密度，促進智障者獨立、社區融入。SIS可做為智障者服務規劃工具外，可為資源配置（resource allocation）依據（如美國州政府以SIS為經費補助及資源分配模式決策依據）。八個案例分析結果發現，ADL有低估使用者需求，IADL和障礙手冊有高估，SIS介於其中；SIS針對有情緒行為或健康需求者會加權支持需求密度；SIS就資源分配是較保守的，第一部分六個支持面向，就服務規劃與輸送有參考價值。結論：針對智障者服務規劃或資源配置，SIS可提供另外一種評估工具。

Supports Intensity Scale (SIS) was developed by the American Association on Intellectual and Developmental Disabilities in 2004; the copyright of the Taiwanese version of SISwas purchased and issued in 2005 and 2006 respectively. This study aims to explore the utilization of the SISin Taiwan and compare the assessment outcome of SISwith three other assessment scales' outcomes, namely, the disability diagnosis in the Disability Certificate of Taiwan, the Activities of Daily Living (ADL)and Instrumental Activities of Daily Living (IADL). Methods: Two research methods were used: (1) a literature review and discussion; and (2) focus groups across Taiwan. Three focus groups were conducted during October of 2012; and eight service users with ID who had been assessed by the SISwere discussed. Results: SIS was designed to be part of the person-centered planning processes that focuses on the individuals' interactions with the environment and their preferences. Results showed that SISis not only a valid and reliable assessment tool for service delivery, but it is also an effective tool for resource allocation. Based on the analyses of eight users, the ADL scale has underestimated their needs while both the diagnosis in the Disability Certificate and the IADL scale have overestimated them. With SIS, resource allocation can be more effective and appropriate. Conclusion: SIScan be another valid alternative of needs assessment for service users with ID in terms of resource allocation and service delivery.