2016年2月15日 星期一

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)     

˙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.(routine2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 (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)



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