高危險群嬰幼兒之到宅服務策略

Strategies of Home Based Services for High-Risk Infants and Toddlers

黃靄雯(Ai-Wen Hwang) ； 謝中君(Jung-Jiun Shie) ； 鄭素芳(Suh-Fang Jeng)

《物理治療》 30卷6期 (2005/12) Pp. 348-354

摘要

近年來早期療育中有關高危險群嬰幼兒之到宅服務，強調最少限制、自然環境及以家庭為中心等概念，內容著重於提供0-3歲高危險群嬰幼兒居家之訓練活動，藉由親子互動及家庭共同參與的模式來促進兒童各方面的發展，使兒童能在家庭自然情境中學習。在國外，美國於1986年後針對高危險群嬰幼兒之早期療育方案即包括到宅服務項目。在臺灣，內政部兒童局於2002年開始推展到宅服務計畫，並委託各縣市民間單位進行到宅服務。高危險群嬰幼兒之到宅服務的理論基礎乃綜合動態系統理論(Dynamical system theory)、互動模式理論(Transectional model)與知覺動作觀點(Perception-action perspective)，到宅服務之介入策略包括改善嬰幼兒之自我調節能力、在家中提供豐富的探索及互動環境、給予重複學習的機會、利用家中社會性互動環境、配合家中的作息時間等。到宅專業人員經由訓練，進而利用這些介入方式在家中提供家庭及嬰幼兒相關的療育活動。未來之發展可著重於到宅服務流程的完整性、健康及生活品質之結果評估，並期待將來醫療系統能與到宅服務系統相結合，使提供到宅服務者、嬰幼兒及其家庭均能獲得最佳的支持及保障。

關鍵字

到宅服務 ； 高危險群嬰幼兒 ； 早期療育 ； 介入策略

並列摘要

Current home based services designated for early intervention of high-risk infants have emphasized ”least restriction,” ”natural environment” and ”family-centered service.” The services emphasize on providing home program and activities to high-risk infants aged 0 to 3 years and their families. The professionals involved in home based services require special training in program design for infants and young children to learn in home environment. Home based services for high-risk infants were originated in the United States in 1986. In Taiwan, the Children's Bureau has funded several private non-profit organizations to conduct home based intervention programs since 2002. The theoretical framework of home based services has been grounded on the dynamical system theory, transactional model, and perception-action perspective. The intervention strategies consist of improvement of infant's self-regulation, modification of environment for exploration, provision of opportunity for repeated practice, facilitation of development by means of social interaction, and adaptation of routines or schedule. Future efforts need to enhance the integration of medical services and home based intervention, the use of appropriate outcome measures of health and quality of life, and the comprehensiveness of service delivery to optimize the support of home based services to high-risk infants and their families.

並列關鍵字

Home based service ； High-risk infants and toddlers ； Early intervention strategies