作息本位模式及在臺灣推廣簡介

Introduction to Routines-Based Model and Its Implementation in Taiwan

廖華芳(Hua-Fang Liao) ； 黃靄雯(Ai-Wen Hwang) ； 孫世恒(Shih-Heng Sun) ； 蘇慧菁(Hui-Ching Su) ； 楊美華(Mei-Hua Yang) ； 潘懿玲(Yi-Ling Pan) ； 陳順隆(Shun-Lung Chen) ； R. A. McWilliam

《物理治療》 47卷3期 (2022/09) Pp. 196-216

https://doi.org/10.6215/FJPT.202209_47(3).0004

摘要

作息本位模式（routines-based model, RBM）是具實證的以家庭為中心早期介入／療育（簡稱早療）服務實務做法，也是疫情下創新遠距早療方法之一。在創始者McWilliam博士支持下，臺灣於2014年開始推廣RBM至今，有些成果，但系統性運用執行科學仍不足。本文介紹RBM，著重作息本位晤談升級版（routines-based interview plus, RBI+），說明臺灣推動RBM的歷史和挑戰，以及新冠肺炎疫情下採用RBM的策略和原則。RBM認為早療是主要照顧者經服務提供者的支持在生活作息中安排或調整環境以提升兒童學習的機會和經驗。RBM成分包括RBI+、服務團隊模式、協力諮詢和成果評量。RBI+是服務初期的需求評估及服務計畫擬定，包括生態圖、作息本位晤談、兒童參與本位目標、家庭目標以及目標作息對照表。RBM的服務團隊模式為主責服務提供者模式或整合性服務提供者模式，由一位早療人員於臨床、課堂或家庭場域中協力諮詢主要照顧者以提升兒童於作息中的投入、獨立和社會關係。建議臺灣推動RBM必須由政策／系統、服務單位和個人三個層次著手。

關鍵字

諮詢 ； 早期療育 ； 執行科學 ； 專業─家庭關係 ； 遠距介入

並列摘要

The routines-based model (RBM) is an empirical family-centered early childhood intervention (ECI) practice and also an innovative tele-intervention in ECI services during the pandemic. With the support of the RBM founder Dr. McWilliam, Taiwan started the RBM implementation in 2014 and had some outcomes, but the application of implementation science is still insufficient. This article introduces the concepts of the RBM and its components, with particular emphasis on the content and steps of the routines-based interview plus (RBI+), describing the history and challenges of promoting RBM in Taiwan, as well as the strategies and principles for adopting the RBM under the COVID-19 outbreak. The principle of the RBM is that in ECI services the primary caregiver provides children with learning opportunities and experiences through daily life arrangement and environmental modification in natural settings with the support of service providers. The RBM components consist of the RBI+, service team model, collaborative consultation, and outcome evaluation. The RBI+ practices are strategies for needs assessment and individualized program planning including an ecological map of family, the routines-based interview, participation-based child goals and family goals, and a goal-routines matrix. The service delivery models of the RBM are the primary service provider model and the comprehensive service provider model. One early interventionist provides collaborative consultation to the primary caregiver of each child with developmental delay/disability to enhance the child's engagement, independence and social relationships in daily life. We recommend that implementation of the RBM in Taiwan could be carried out at three levels: the policy/system, the service unit and the individual.

並列關鍵字

Consultation ； Early intervention ； Implementation science ； Professional-family relations ； Tele-intervention