發展遲緩兒童巡迴輔導服務之前導性研究：以台北市托嬰中心為例

Implementing Early Intervention in Infant and Toddler Daycare Centers: Results from a Pilot Study in Taipei City

林毓雯(Yu-Wen Lin) ； 吳憶芬(Yi-Fen Wu)

《臺灣職能治療研究與實務雜誌》 13卷2期 (2017/12) Pp. 110-119

https://doi.org/10.6534/jtotrp.201712_13(2).0005

摘要

近幾年台北市的托嬰中心持續增加，這類社區型的托育服務對一般家庭來說是可及性漸高的現有資源。本研究的目的在將托嬰中心納入嬰幼兒之發展遲緩兒童之篩檢、介入與轉介之重要一環後，初步成果之呈現，以利後續服務在服務、評估與記錄模式上，有調整並改善的參考資料。本方案所篩出並服務之兒童共有95位，不論是以收案年齡或結案年齡分組，和性別兩組皆沒有在統計上有顯著差異。符合社會局的早療通報轉介中心之通報資格且尚未通報之兒童有18位（75%），總服務的人數中，16位幼童有轉介至相關醫療社福單位之記錄。服務模式的不同（重點巡輔／一般巡輔）則會影響到每位幼童每月接受之服務時數，接受重點巡輔模式下，每位幼兒平均每月的受服務時數為0.9小時（SD = .3），一般巡輔模式下，每位幼兒每月受服務時數則為0.6小時（SD = .2）。以每位個案收案時及結案時之台北市學前兒童發展檢核表第二版之未通過題數為成效指標下，使用曼惠二氏U檢定法分析之結果為p = .017，達顯著上的差異。使用獨立t檢定比較收案月齡在各遲緩領域上作比較，發現三個領域皆有顯著差異，且依差異之大小分別為社會互動（p ＜ .001, t = 3.93）、語言能力（p ＜ .01）、粗大動作（p = .03），以結案月齡和各遲緩領域作比較時，則發現動作領域已不再顯著，語言能力（p ＜ .001）和社會互動（p ＜ .001, t = 4.02）領域則越發顯著。目前台北市托嬰巡迴輔導模式雖未達成熟階段，但持續的執行並記錄將有助於推動發展遲緩兒童於自然情境下之及早療育，通報及轉介服務則有利於所篩出之發展遲緩兒童家長及早獲得有效資源。

關鍵字

托嬰中心 ； 發展遲緩 ； 發展篩檢 ； 巡迴輔導

並列摘要

Infant and toddler daycare centers (ITDC) centers are increasing recent years, therefore community based childcare services are more easily to access for the families. The purpose of this study is to present the preliminary results after one year carrying out developmental screening, intervention and referral in ITDCs, and to give reference to adjust the future service, especially assessment, data recording, and the service model. There were 95 children screened and served in this program, regardless of whether they were grouped at age of recruitment or at age of closure, or were pooled in male and female, there were no significant difference found for the demographic variables. Eighteen (75%) of the children who achieved the standard of being notified to the Early Intervention Management Center for Mentally Challenged Children of Social bureau were not notified. Of the total number of services, 16 children were referred to the relevant medical social welfare units. The difference in service mode (point tour counseling / general tour counseling ) will affect the number of hours of service received by each young child. In the point tour counseling mode. The average number of service hours per month for each child is 0.9 hours (SD = .3). In the general tour counseling mode, the number of service hours per child per month was 0.6 hours (SD = .2). The results of taking the number of failing to pass items of Taipei City Developmental Checklist for Preschoolers 2nd version as indicator. Significant difference was found using the Mannie’s U test, p = .017. Three significant differences were found, using independent t-test, by subject’s classification of recruitment age. Following items range from the most significant to the least significant level, social interaction (p ＜ .001, t = 3.93), communication skills (p ＜ .01), and gross motor (p = .03). As taking closure age to compare with the target abilities, we found gross motor no longer statistically significant. And the communication skills (p ＜ .001) and social interaction (p ＜ .001, t = 4.02) were more significant. Although, the Taipei City Tour counseling model is far from mature so far, continuous implementation and record will help to promote the development of early intervention for children in the natural context. Simultaneously, notification and referral services are conducive to connect the families and effective resources.

並列關鍵字

Infant and toddler daycare center ； Developmental delay ； Developmental screening ； Tour counseling