主要照護者實施回應式互動對自閉症孩童溝通行為影響之研究

The Inf luence of Caregivers' Responsive Interaction on Autistic Children's Communicative Behavior

本研究的目的在於探討教導主要照護者回應式親子互動訓練課程是否有效地改變親子互動行為以及是否改變自閉症幼兒溝通行為。研究樣本為四位居住在桃園及台北地區0－4歲自閉症兒童及其主要照護者。研究步驟包含前後測使用學齡前兒童行為發展量表與溝通象徵行為量表蒐集自閉症幼兒溝通行為表現前後測之間主要照護者接受14週的＂More Than Words＂(Sussman， 1999)介入課程，該課程的主旨在教導主要照護者使用回應式互動以增進孩童的溝通能力，而從前測至介入至後測期間皆蒐集親子互動行為。資料分析將以單一受試法呈現親子互動行為的改變情形；而自閉症幼兒溝通行為的改變情形則將呈現樣本在學齡前兒童行為發展量表與溝通及象徵行為量表的前後測表現差異。研究結果發現教導父母回應式親子互動訓練課程改變其中一位主要照護者實施更多孩童主導的回應式互動；而另一位家長在介入前即已實施孩童主導的回應式互動。此外，當主要照護者實施以孩童主導的回應式互動，則其自閉症孩童的溝通行為頻率也有所增加。

This study examined the effectiveness of teaching ca regivers to use responsive interaction strategies on the communicative functioning of children with autism. The sample for this study consisted of 4 preschoolers diagnosed with autism and their caregivers. The research procedures included pretest and posttest using the measurements of Chinese Child Development Inventory (CCDI) and Communication and Symbolic Behavior Sca le (CSBS) to collect t he per for ma nce of child ren's com mun ication functioning. On the other hand， caregivers received weekly intervention curriculum for 14 sessions. These sessions focused on encouraging caregivers to use responsive interaction with children. A single subject design was used to examine the change of caregivers' interaction and comparisons of pre- and posttests on 2 standardized measurements were used to examine the children's change of communicative functioning. The results indicated that 1 of 4 caregivers initiated more responsive interactions during intervention; an other caregiver already used responsive interactions before intervention. In addition， increases in caregivers' responsiveness were associated with improvements in children's communicative behavior.