兒童語言治療介入策略: Responsivity Education/Prelinguistic Milieu Teaching

Responsivity Education/Prelinguistic Milieu Teaching

是一種針對尚未發展口語的兒童介入的策略方式

以下說明RE/PMT策略的適用對象,理論基礎及執行的原則

˙RE/PMT 

(1)Responsivity Education:

  教導家長:對於孩子非口語溝通的意圖可以如何適切的回應。

(2)Prelinguistic Milieu Teaching:

  教導兒童:增加兒童非口語的溝通意圖行為之頻率和複雜度，為下一個語言學習的階段做準備。

˙使用對象: 

 適用生理年齡9~15個月 或是 兒童尚未成為prelinguistic communicators (12~18個月的能力)

  -該策略的介入目標在增加gestures and vocalization的頻率

˙評估工具: Communication and Symbolic Behavior Scales (~24nomth)     

  http://www.brookespublishing.com/store/books/wetherby-csbsdp/checklist.htm#checklist

˙RE/PMT理論基礎:

 Transactional model of communication development:

 -認為孩子和環境雙向互動會促進早期社會和溝通發展。

 -正向的互動經驗(質和量)有助於情緒/社會/溝通發展

  -父母要能適時的提供適切的回應

˙如何執行RE/PMT的介入:

Practical requirements

1.為ㄧ對ㄧ介入

2.家長使用Hanen program或訓練成PMT  

Key component

1.arranging the environment(營造讓孩子有溝通動機的環境)

2.following the child’s attention lead(跟著孩子所注意的事物)

3.social routine building(建立社會互動常規)

˙Prompt  (Induced Communication intention) (誘發溝通意圖)

 -Time delay: turn-taking routine

 -nonverbal prompt :holding out an upturned palm(移動有興趣的物品) & physically (與大人成ㄧ水平視線)

 -verbal prompt : open-ended question(what?) & direct commands (給我)

˙Models (increase vocal &gestural)

  -vocal models:使用孩子曾發出過的聲音, 當孩子有明確的指示再使用nonlinguistic model

  -gestural model: point

˙Providing natural consequences (提供自然的結果)

  -兒童會有要求是因為有想要的物品/行為,因為大人注意兒童所以會給予解說

˙Teaching intentional communication(教導溝通意圖)

 -arranging the environment, following the child’s attention lead & social routine building

 - linguastic mapping

 - the quality and quantity of interaction is important (互動的品質和量很重要)

 - according Prelinguistic Milieu Teaching process, but you can base on the children’s ability to

  choose the appropriate level.(依據PMT進展表執行，但可視孩子的能力選擇適合的層級)

˙Teaching proro-imperatives (nonverbal request) (教導非口語的要求)

  -building the social routine turn-taking (建立輪替)

   à change the turn-taking model(改變/調整輪替的模式-步調)

   à increase the communication intention of request.(增加要求的溝通意圖)

  - when the routine achieve twice, you can try to break the routine and gaze at children with

   expected.(routine達2次以上可嘗試打斷並用期待的眼神看著兒童)

  -if the children no any respond, you can use some strategy, e.g. verbal prompt/ gestural model

   (若兒童未回應再給予適切的協助)

  -respond to children with linguistic mapping skills

   (當回應兒童的要求時仍需使用linguistic mapping技巧)

˙Teaching proro-declaratives(nonverbal comment) (教導非口語的評論)

  -recruitment of another’s attention and the sharing of affective state (需先建立正向關係)

  -modeling(point), break the routine, look at children play…(大人的示範/指/打破輪替常規/在孩子身旁看著孩子玩...)

  -the proro-declaratives occurs due to the children believe that adults have been noticed that.

   (兒童會出現proro-declaratives是因孩子相信大人已經有注意到某事)

 ** Prelinguistic Milieu Teaching process table (PMT 介入階層表格 資料連結)