發展遲緩兒童早期療育社會服務品質及其成效之研究

早期療育乃透過社會福利、衛生及教育等專業人員的共同合作，提供發展遲緩兒童及其家庭相關服務，以改善或減輕兒童的遲緩現象，並提升家庭面對發展遲緩兒童問題的解決能力。社會工作者在早期療育服務輸送系統中，對於家庭所需各項資源的提供與支持有其重要的角色與功能。本研究旨在探討發展遲緩兒童早期療育社會服務之品質，瞭解社會工作者的介入對家庭及兒童的服務成效。本研究採問卷調查的方式進行資料蒐集，由研究者編制之問卷為主要內容，以民國九十七年四月以前由台中市通報轉介中心派案至個案管理中心之個案為研究樣本，共寄出615份問卷，有效問卷為205份。經統計分析，研究結果如下： 1.早期療育社會服務品質的重要性及符合程度分別與服務介入對家庭影響的符合程度有正相關存在。但在早期療育社會服務品質與早療服務介入對家庭影響之重要性高於符合程度。 2.社工人員的服務頻率在社會服務品質對家庭的重要性及符合程度、早療服務介入對家庭影響的符合程度有差異存在。 3.發展遲緩兒童的年齡、是否領有身心障礙手冊及父母親的教育程度對於早期療育服務使用情形有差異存在。 4.發展遲緩兒童家庭的每月家庭收入、父親的教育程度對於社會服務品質的重要性及符合程度有差異存在。 5.發展遲緩兒童的性別、家庭每月收入、父親的教育程度對於早期療育服務介入成效有差異存在。 6.早期療育社會服務品質在參與及伙伴/合作關係的重要性，可以有效解釋17.6%的服務介入對家庭影響的符合程度；在彈性、公開性及可近性三個要素的符合程度可以有效解釋69.3%的服務介入對家庭影響的符合程度。基於上述研究結果，本研究提出相關的研究建議：(1)政策層面—重視早期療育個案管理服務的內涵；針對發展遲緩與身心障礙兒童規劃不同層面的服務；建立早期療育社會服務品質監督機制，有助於服務品質之提升。(2)在實務層面--提升社工人員在家庭服務的內涵，以增強家庭權能；增強社工人員社會服務品質之知能，以增進其在服務品質之自我檢視能力；提供早期療育社會服務時，應重視家長支持團體方案之設計。(3)服務使用面--主動積極參與早期療育相關服務；提高主要照顧者自我情緒之關照。(4)在學術層面--積極投入早期療育社會服務品質之研究；建構早期療育社會服務品質量表；重視早期療育社會工作教育。

關鍵字

早期療育；社會服務品質；個案管理；成效

並列摘要

Early intervention services are provided by specialists in social welfare, health care, and education through joint cooperation to help developmentally delayed children as well as their families. These services are intended to improve or alleviate developmental delays in these children and enhance their families’ abilities to cope with problems arising from developmental delays. In the early intervention service transmission system, social workers play an important role in providing and supporting various resources needed by the children’s families. This study aimed to investigate the quality of early intervention services for developmentally delayed children and understand the effectiveness of social workers’ intervention services. Data were collected through a questionnaire developed by the researcher. The subjects were cases referred by Taichung City Government before April 2008 to the early intervention case management center. A total of 615 questionnaires were issued, and 205 valid responses were obtained. Through statistical analysis, the following findings were obtained: 1.The importance and conformance of the quality of early intervention social services are respectively positively correlated with the conformance of service intervention with family needs. However, the importance of the quality of early intervention social services and early intervention for family is higher than their conformance with family needs. 2.The service frequency of social workers affects the importance and conformance of social service quality and conformance of early intervention services with family needs. 3.The age of developmentally delayed children, possession of the Handbook for Physically and Mentally Impaired Persons, and parents’ education background will all affect a family’s use of early intervention services. 4.Family monthly income and father’s education background affect the family’s perception of the importance and conformance of social service quality. 5.The gender of the developmentally delayed children, family monthly income, and father’s education background affect the effectiveness of early intervention services. 6.The importance of participation and partnership/cooperation in early intervention social services could effectively explain 17.6% conformance of service intervention with family needs. The conformance in flexibility, publicity, and accessibility could effectively explain 69.3% conformance of service intervention with family needs. Based on the above findings, the following suggestions were proposed: (1) In the policy aspect—The content of early intervention case management should be emphasized; different aspects of services should be planned for developmentally delayed and physically or mentally impaired children; a service quality supervisory mechanism should be set up to improve the quality of intervention services. (2) In the practical aspect—The content of social workers’ family services should be enhanced to reinforce family power and functions; social workers’ knowledge of social service quality should be improved to develop their ability to examine their service quality; when providing early intervention social services, parental support group plans should be emphasized. (3) In the service use aspect—Users should proactively participate in services related to early intervention; primary caregivers should pay more attention to self-control of emotions. (4) In the academic aspect—Efforts should be made to research the quality of early intervention services, develop a service quality scale for early intervention, and improve the education of early intervention social work.