一位發展遲緩兒童的到宅服務 早期療育跨專業團隊合作歷程初探

Implementing a Transdisciplinary Team for a Developmentally Delayed Child Who Received a Home Visiting Program

本研究以一個一歲十個月的發展遲缓兒童為例，探討到宅服務 對兒童發展的轉變，並且探討跨專業圑隊到宅服務的合作歷程。本 研究之中的專業圑隊是指由特殊教育教師、物理治療師、職能治療 師以及社工師所組成的圑隊，運用課程性評量工具、到宅服務影音 資料和相關記錄表單來瞭解發展遲缓兒童的發展轉變，另外，本研 究以焦點圑體訪談和到宅服務會議來記錄跨專業合作歷程。 本研究目的之一在探討到宅服務對兒童發展的轉變，研究發現 ，經過八個月的到宅服務，發展遲缓兒童在動作領域的轉變最大， 尤其坐姿、轉位、站立、行走的轉變最大；另外，發展遲缓兒童認 知領域和生活自理能力亦有些微成長，他開始對週遭環境產生興趣 ，也能持續參與成人啓始的活動；生活自理方面，他開始自行拿杯 子、用吸管喝水，也開始拿湯匙自行餵食；此外，到宅服務人員建 議並且示範親子互動遊戲，增進親子互動和兒童的遊戲技能。本研 究另一個研究目的在於瞭解跨專業圑隊到宅服務的合作歷程，結果 發現跨專業圑隊歷經四個合作階段，包含專業合作的模式建立、跨 專業圑隊到宅服務的思考與運作、家庭及圑隊成員的轉變歷程，以 及跨專業團隊介入的收獲及困境。值得一提的是，到宅服務的圑隊 成員角色多元，扮演著家庭的夥伴、示範者、問題解決者和資源連 結者。

There were two purposes for this study. Firstly， the study examined the progress of a developmentally delayed child who received a home visiting program. Secondly， the study investigated how the transdisciplinary team implementing and cooperating on behalf of the child and his family. The subject of this study was a child aged 22 months， who had delays in the areas of motor， self-help skills， cognition， speech and communication. Moreover， members of the transdisciplinary team included two special education teachers， two physical therapists， two occupational therapists， and a social worker. A multiple method of data collection was used， including videotaping， focus group interviews and documentation. The findings showed that the child made great progress in the fine motor and gross motor areas. The child had minor differences in cognition abilities and self-help skills. In addition， the team collaboration had a process accordingly: forming a transdisciplinary collaboration model， implementing a home visiting program， establishing partnership between family and team members， and reconstructing ideas of collaboration and encountering difficulties as well.