ICF模式應用於輔助溝通系統評估之探討：以複雜性溝通需求者為例

針對複雜溝通障礙需求者（Subjects with Complex Communication Needs, CCN）輔助溝通系統（Augmentative and Alternative Communication, AAC）的評估，採用「國際健康功能與身心障礙分類系統模式」（International Classification of Functioning, Disability and Health, ICF）介入能提供更多元的面向。ICF模式整合醫療和社會層面，強調AAC使用者與環境間的互動情形，並且著重增加AAC使用者在不同環境中的活動參與程度。跟傳統治療的處理模式相比較，傳統的治療模式通常只聚焦在單一成果上，例如：增加發聲、能正確地認識符號的數量，未考量AAC使用者在環境中的功能性表現，ICF模式能更廣泛地評估個體的健康功能，提供更「全人」的觀點。AAC介入的目的是幫助溝通需求者能透過AAC表達自己、增加社會互動、增進學習成效、提高自我價值，並進一步幫助複雜溝通需求者，在最短時間內將其所要表達的內容正確的傳達給溝通伙伴。然而，要對CCN需求者提供最佳的AAC策略，採用AAC團隊進行評估是必要的。AAC團隊的成員基本上包含有CCN需求者本人、其家庭成員或照顧者及各相關專業人員，團隊成員也會隨著CCN需求者的轉變而有所調整。本文將敘述ICF模式和AAC的起源，由文獻資料討論兩者間的關連性，介紹如何使用ICF模式介入AAC團隊評估之中，本文針對一位CCN需求者做為研究對象，討論採用此介入模式會遭遇到的困難與限制。整體而言，ICF為國際性共通語言，是一個以健康功能為出發的理論架構模式，採用ICF模式做為AAC評估與介入是目前國際發展之趨勢，期待國內未來能有更多相關的研究投入。

關鍵字

國際健康功能與身心障礙分類系統；輔助溝通系統；複雜性溝通需求者

並列摘要

The ICF model integratsthe medical and social aspects; it emphasisethe relationship between the human and environment. For speech language pathologists, we engages AAC users must be actively participated multiple environments. The ICF model would enlarge usage of AAC evaluation and treatment. Compared with the traditional model, the ICF model could benefit widely range of health issues and provide the holistic view of personal functions. The intervention of AAC is aim to help the communication disorder patients to express themselves, to increase social interaction, to improve the learning effects, to promote self-esteem and to communicate with close relatives in short time and correct contents. However, the team work was best option in evaluation of AAC for CCN. The team members would be included patient, patient's family or care-giver and transdiscipline practitioners. The team members would be revised by CCN progressing process. The aim of the article would introduce the ICF model and commence of AAC, to discuss the relationship between ICF and AAC from articles review and to introduce how to fulfill the evaluation of AAC via ICF model. We used a subject with CCN to assess AAC. Finally, we discussed the aspects of difficulty and limitation we encountered from evaluation processing. Overall, the ICF were the common language of medical practitioners internationally and the theoretical reference model of health functional issues. The ICF model is international trend of development in AAC assessment. We wish there are more researches in this new field in Taiwan.