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題名:共享式注意力多元介入方案療效研究:三名學前中高功能自閉症男童的探究     (52點)
The Effectiveness of Multi-Component Joint Attention Intervention in Three Middle-to-high Functioning Boys with Autism
著者:江淑蓉(Shu-Jung Chiang) ;彭雅凌(Ya-Lin Peng) ;姜忠信(Chung-Hsin Chiang) ;林家慶(Chia-Ching Lin)
關鍵字:共享式注意力介入 ; 自閉症兒童 ; 家長訓練 ; 區別嘗試訓練 ; 環境教學模式 ; joint attention intervention ; autism ; parent training ; discrete trial training ; milieu teaching
摘要: 中文摘要PDF ; 英文摘要PDF

Purpose: Joint attention (JA) is one of the core deficits in children with autism, associated with other developmental abilities such as language, play, social ability, and imitation. The current study uses multiple-case design with a combined approach for a JA intervention program including parent training to investigate the effects of JA and its collateral abilities for 3 children with middle-to-high functioning autism. Methods: Three 4- year old boys (CA=48-52 months, MA=26-30 months) with middle-to-high functioning autism were diagnosed with DSM-IV-TR (APA, 2000) and ADOS (Lord et al., 2000) by a multidisciplinary team including a psychiatrist, pediatrician, and psychologists. The children and their mothers participated in this individual program, conducted in 24 sessions and followed up 3 and 6 months later. The program included discrete trial training (DTT) and milieu teaching method adapted from Kasari et al. (2006, 2010). Parent training sessions were also simultaneously included in the program. Each child training session was approximately 30 minutes, 3 times per week, for a total of 24 sessions. The DTT and milieu teaching approaches were used on the table time and floor time separately. The JA intervention program for parents was based on the authors' clinical experience and followed the Parent JA Intervention Manual (PJAIM). For the first half of the parent training from session 1 to 12, the interventionist used the PJAIM as a reference to explain to the parent what was going on from a one-way mirror while parents observed their child's training session in the playroom. From sessions 13-24, the parent was invited to the playroom to interact with the child, guided by the interventionist for 15 minutes after the child's training session. The intervention outcomes were collected through standardized tools/tasks, structured and unstructured activities by independent testers, and from parent reports. The threshold for intervention efficacy defined by these gain scores in our measurements equaled or exceeded those values in the interventional group of previous published studies. Findings: The results show that the 3 children improved their JA skills and joint engagement state after the JA intervention program. The children improved from pointing for requesting an object to showing/giving an object to a person, and developed from unengaged or object engagement to supported joint engagement in the post-intervention test. Similar improvements are shown in the three-month follow-up test. Parent responsiveness was also highly associated with joint engagement between parents and children. Other collateral effects on relevant abilities including receptive language, symbolic play, and social ability were also noticeable, and were maintained 3-6 months. Conclusions/implications: The results support that children with autism receiving our JA intervention program improved their JA skills, joint engagement state, and relevant abilities, similar to previous studies; however, the maintenance was shorter. Further studies need to explore the variables that influence the effects maintained, and to include a large sample and a control group to extend to younger children with autism, and to evaluate efficacy while arranging different intensities or frequencies of parent training sessions.


特殊教育研究學刊 37卷2期 (2012.7)
循著中介系統的脈絡來探討特教與幼教老師在自然情境中的合作歷程/ 劉凱曾淑賢
社交技巧訓練對高功能自閉症及亞斯柏格症者介入成效之後設分析/ 吳佳蒨鈕文英
共享式注意力多元介入方案療效研究:三名學前中高功能自閉症男童的探究/ 江淑蓉彭雅凌姜忠信林家慶
亞斯柏格症學生在魏氏兒童智力量表-第四版(WISC-IV)的表現/ 吳沛璇張正芬

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