以圖片交換溝通系統強化重度聽障兒童溝通行為之成效

Abstract

重度聽障兒童要面對的不只是聽力喪失，還要因應後續造成的溝通障礙。重度聽障兒童常有口語、手語及書面語皆詞不達意的現象，相較於聽障成人更容易發生「溝通中斷」的情形。當聽者無法有效接收其表達時，重度聽障兒童可以改變其他的溝通形式來修補溝通。本研究採用單一受試跨受試、多試探、多基線研究法，在遊戲情境中探討PECS對重度聽障兒童溝通行為之影響。在基線期與PECS使用期分析三位國小學生之表達完整性、溝通次數、使用詞彙數及溝通管道。在PECS訓練前期三位參與者完整學習PECS六個階段。結果指出PECS強化參與者之表達完整性與建立圖片交換溝通系統(PECS)與重度聽障兒童溝通行為之功能關係。但是在溝通次數與使用詞彙數並無一致的改變，溝通形式則因為使用PECS而擴增。PECS在重度聽障生學習快速且成為溝通修補策略。討論研究之成效與重度聽障生學習PECS的特性，並提出未來研究之方向和建議。

Children with severely hearing disability need to adjust not only with their hearing loss, but also with the difficulty in communication. Those children often express themselves with incomplete speech、sign or text resulted in communication breakdown which happened more than adults with hearing disability. However, those children might benefit from other forms of communication (e.g., Picture Exchange Communication System, aka PECS) to repair the breakdown when listeners fail to comprehend their expressions. In the present study, we used single subject, multiple probe design across participants to investigate the effects of the PECS on facilitating communication behaviors for children with severely hearing disability in play activities. In the baseline phase, three elementary students were analyzed of their expression integrity、 the number of communication 、the number of words used andthe form of communication. In the PECS pre-training phase, they were taught to use the PECS till mastery criterion according to the manual. The results indicated that the PECS facilitated the students’ expression integrity and a functional relationship was established. However, the effects on number of communication and the number of words used showed no consistent change. For participants with severely hearing disability, the forms of communication had been expanded to use the PECS. PECS was acquired quickly as a repair strategy to children with severely hearing disability. The strengths of the study and the characteristics of participants in learning PECS were discussed. Clinical implications and future research directions were also provided.