學齡前自閉症幼兒輔助溝通方式偏好選擇及請求技能學習探討

目前使用輔助溝通（augmentative and alternative communication, 簡稱AAC）的現況中，存在三分之一的AAC使用者學習了輔助溝通系統後，在即使仍需要AAC系統的情況下也會放棄繼續使用AAC系統（American Speech-Language-Hearing Association ，簡稱ASHA，2018）。並且在低口語自閉症的輔助溝通介入上，也未能做到讓其能夠隨時隨地、隨心所欲地進行溝通交流。在研究中往往忽視了使用者本身的選擇偏好。本研究旨在探討有溝通障礙的學齡前自閉症幼兒在偏好選擇系統的歷程，及在偏好選擇AAC進行系統介入後，能否習得並維持請求技能。本研究採取單一受試之多基線跨受試者設計，選取三位符合本研究條件的學齡前自閉症幼兒，採用其本身選擇之輔助溝通系統進行介入，透過量化數據的蒐集及質性觀察與訪談，分析得到結論如下一、學齡前低口語自閉症幼兒能進行AAC系統偏好選擇；二、學齡前低口語自閉症幼兒能以其所偏好之AAC系統習得請求技能；三、學齡前低口語自閉症幼兒使用AAC系統後口語次數有提升；以上自變項與依變項之間有功能關係的建立。本研究另外發現：四、研究對象以其所偏好之AAC系統習得請求技能有類化效果；五、研究對象AAC系統的偏好選擇歷程中，選擇之AAC系統沒有改變；六、研究對象間各種AAC系統習得效能的差異不大，但達標前圖片兌換溝通系統（picture exchange communication system，簡稱 PECS）所需介入總次數少於語音產生裝置（Speech-generating devices ，簡稱SGD）；七、研究對象偏好選擇之AAC系統與文獻提及選擇AAC系統可能的決定因素之間具有適配性。

關鍵字

溝通；溝通系統；輔助溝通；輔助溝通系統；學齡前自閉症

並列摘要

In the current literature of using augmentative and alternative communication (AAC), after one-third of AAC users have learned the communication system, they will discontinue to use the AAC system even if they still need AAC system (American Speech-Language-Hearing Association[ASHA], 2018). Moreover, in the autism intervention of AAC enabling individuals with autism to communicate to the extent of anytime and anywhere at will was rarely mentioned and user's choice of AAC system preference was often ignored. The purpose of this study was to explore the progressof preschool children with autism with communication disorder in their personal selection of AAC system, and whether they can acquire and generalize request skills after choosing AAC system and receiving intervention. The study adopted a single case multiple-baseline-across-participant design.Three preschool children with autism who met the inclusion criteria participated. Through the collection of quantitative data, qualitative observation and interview of the selected AAC system intervention, the conclusions were as followed: I. Preschool children with autism of limited verbal skills were able to select their preferred AAC system. II. Preschool children with autism of limited verbal skills learned to use their preferred AAC system to make requests. III. The frequency of verbal utterances of preschool children with autism of limited verbal skills had increased after the AAC system intervention. Functional relationships were established above between the independent variable and dependent variables. This study also revealed the following findings. IV. Three participants with autism of limited verbal skills maintianed using their preferred AAC system to make request. V. Three participants with autism of limited verbal skills did not change their selectionof AAC system preference. VI. Among the three participants with autism with limited verbal skills, discrepancy did not exsit in their acquisition efficiency of using different AAC systems. However, it took less trials to reach learning criteria by using picture exchange communication system than that of speech generated device communication system. VII. The possible determinants mentioned in the AAC system selection literature matched personal selection of AAC system among the three participants with autism with limited verbal skills in this study.