學齡前發展遲緩兒童之「參與」及其測量

兒童之「參與」攸關其身心發展，也為早期療育之最終目標。而早期療育所關注之學齡前發展遲緩兒童，其在「參與」日常活動時往往比一般兒童有較多的限制。本文透過文獻回顧，輔以「國際健康功能與身心障礙分類系統－兒童與青少年版」（International Classification of Functioning, Disability and Health-Children & Youth Version，簡稱ICF-CY）及不同學者的觀點，釐清「參與」的定義及其所涵蓋的面向。文中也藉由適用於學齡前幼童「參與」測量工具之回顧，歸納其所涵蓋之「參與」面向。參與之層次涵蓋「在自然情境下的能力」（capability）、在一般或自然情境下所做的「表現」（performance）及心理學觀點之主觀感受。本文所回顧之「參與」測量工具，依據施測方法分為：照顧者填答問卷、訪談問卷及觀察評估。近期發展的工具多數以ICF-CY架構設計，而早期臨床所使用的「參與」評估工具，則要經由研究以了解其與ICF-CY編碼之連結度。由於「參與」與環境之密切相關，在臨床運用「參與」測量工具時，盼能配合相關環境評量以充分掌握兒童自然情境之「參與」功能及其相關的決定因素。此外，藉由「參與」測量，專業人員更易於與家長合作設定目標及擬定策略，以循序漸進使兒童能具有「參與」面向所涵蓋之多樣性、高頻率、融入社會、愉悅、自主、有探索動機之特質，以達成療育之終極目標。

關鍵字

參與； ICF-CY ；測量；評估工具

並列摘要

Children's ”participation” is associated with their physical and psychological development and is also the optimal goal of childhood early intervention. Children with developmental delays usually experience more ”participation” restriction than typically developing children. This review aimed to clarify the definitions and the dimensions under the concept of ”participation” by means of literature review accompanied with the framework of International Classification of Functioning, Disability and Health-Children & Youth Version (ICF-CY) and with varying perspectives from scholars. This review also introduced the assessment tools or measures of ”participation” and mapped their content of measuring to the dimensions of ”participation”. The dimensions of participation were namely ”capability” (can do in natural environment), ”performance” (does do in natural environment), and subjective experience of involvement. The measures of ”participation” can be classified into three forms by the methods of information collected: the caregiver-reported questionnaires, interviews, and observational assessments. Most recently developed measures adopted the ICF-CY framework. The previous measures used to assess the particiption of children in clinical settings should be further studied to understand their linkages to the ICF-CY categories. Due to the close relationship between ”participation” and environmental factors, the clinical use of ”participation” measures would better involve assessments for children's environment to comprehensively capture the functioning of their ”participation” in natural context and the related determinants. In this way, the professionals and children's families can collaborate with each other to facilitate goal setting and strategy development and to guide children with developmental delays toward their optimal goal of early intervention. Ultimately, children are expected to acquire the characteristics of diverse participation, high frequency of participation, increased pleasure, independency, motivation for exploration and integration into social surroundings.

並列關鍵字

Participation ； ICF-CY ； Measures ； Assessment tools

國際替代計量

學齡前發展遲緩兒童之「參與」及其測量

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