輔助溝通系統使用者的學校溝通參與評量工具發展與應用之研究
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2011
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本研究旨在探究AAC使用者不同類型、使用現況與在學校溝通參與表現之間的關係。依據本研究目的，分為兩個子研究，子研究一為發展評量表，子研究二為應用此量表以探測研究問題。本研究所發展的「AAC使用者學校溝通參與量表」是依據Light(1988, 2003)所提出的四個溝通目的與其界定的溝通要求，以及延伸ICF參與概念為溝通參與編製而成。本量表分為第一部份「AAC使用者類型調查表」和第二部份「AAC使用者學校溝通參與量表」，兩部分量表的分向度皆以Light(1988, 2003)的四個溝通目的為命名，即表達需求、實現社會性禮節的要求、發展社交的親近性和交換資訊。
子研究一共透過五個階段的發展過程，逐步形成最後的正式量表，其研究結果除了獲得內容效度外，兩個部份的量表也各具有良好的評分者一致性信度、重評一致性與內部一致性信度。
子研究二運用描述性統計(如：平均數、百分比)、卡方考驗、t-test考驗、單因子變異數分析(one-way ANOVA)等統計方法進行分析，其研究結果摘要如下：
(一)AAC使用者類型和使用現況以非輔助性AAC使用者為最多
第一部份量表「AAC使用者類型調查表」的結果，依據研究中的自編比例，顯示多數樣本為一種類型，即非輔助性AAC使用者。又將整體樣本中，分為有使用輔助性AAC和無使用輔助性AAC的現況，結果顯示以完全無使用過輔助性AAC為最多數。整體樣本在第一部份評量表的四個溝通目的上的評量結果顯示，整體樣本平均使用較多的溝通方式數量來滿足溝通目的一(表達需求)，最沒有機會觀察到是在溝通目的四(交換資訊)。
不同教育階段(國中和高職)的AAC使用者在有無使用輔助性AAC的情形並無顯著差異，但是在第一量表上的四個溝通目的與全量表的溝通方式使用數量上，則以高職部學生的溝通方式使用數量顯著高於國中部學生。不同障礙類別(自閉症、智能障礙、腦性麻痺)的AAC使用者在有無使用輔助性AAC的情形並無顯著差異，但是除了溝通目的一未達顯著差異之外，其餘的三個溝通目的與全量表，智能障礙的溝通方式使用數量皆顯著高於自閉症。
(二)AAC使用者在學校以向度二和向度一的溝通參與較多，向度三和向度四則較少獲得溝通參與的機會
第二部份量表「AAC使用者學校溝通參與量表」的結果顯示，整體樣本平均使用AAC參與題數的比例只有全量表的50%，在向度二(實現社會性禮節的要求)和向度一(表達需求)上使用AAC參與的比例較多，但是在向度三(發展社交的親近性)和向度四(交換資訊)則比較少。整體樣本在第二部份量表的得分結果顯示，在全量表上使用AAC參與的平均每題得分頗低，四個分向度上依高低順序排列為，向度一、向度二、向度三、向度四。
再者，AAC使用者在學校溝通參與的表現不會因教育階段(國中或高職)的不同而有顯著差異，唯在向度二(實現社會性禮節的要求)，高職階段AAC使用者在主動性參與和三種參與層次加總皆比國中階段者佳。且AAC使用者在學校溝通參與的表現，除了在向度一(表達需求)之外，多數情形會因障礙類別的不同而有顯著差異，且智能障礙和腦性麻痺學生的溝通參與表現比自閉症佳。
(三)有使用輔助性AAC者在學校溝通參與的向度一(表達需求)和全量表的得分高於無使用輔助性AAC者。
(四)AAC使用者溝通方式數量與學校溝通參與表現呈中度相關。
最後，研究者依據研究結果，針對AAC使用者的學校溝通參與評量等議題，提出未來研究與應用的建議。
The purposes of this study were to explore the AAC users’ implementation of AAC systems, types of AAC users, school communicative participation outcomes and relationship between these variables. We developed “School Communicative Participation Scale for AAC users” based on four main goals in communicative interactions and their communication demands (Light, 1988, 2003), and extended the ICF definition of participation to communicative participation. The whole scale was divided into two subscales, the first was “the Augmentative and Alternative Communication Users Classification Scale, AACUCS)”, the second was “the School Communicative Participation Scale, SCPS)”, and both of them were also divided into four dimensions as “Express Needs and Wants”, ”Fulfill Social Etiquette Requirements”, “Develop Social Closeness”, and “Exchange Information”. The first result showed the content validation was established, and the scale had good quality of inter-rater reliability, test-retest reliability, and the Cronbach’s α was also high. Next, the data was analyzed and tested by means of statistical methods, t-test, one-way ANOVA, and Pearson’s product-moment correlation. The findings of this research were as follows: 1.The results of the first subscale (AACUCS) showed most of AAC users were unaided AAC users according to the proportions. The whole subjects were also divided into AAC users with aided AAC and those with no aided AAC, and the results showed most of them didn’t use any kind of aided AAC. They assessed had most quantity of communicative acts in dimension I (Express Needs and Wants), however, few in dimension IV (Exchange Information). Both of different grades and different disabled types have no significant influence in using with aided AAC systems. However, as for the quantity of communicative acts, senior high school AAC users have significantly higher communicative acts than junior high school AAC users in the four dimensions and the full scale. AAC users with mental retardation have significantly higher communicative acts than AAC users with autism in the other dimensions except dimension I. 2.The results of the second subscale (SCPS) showed the whole subjects used AAC to participate most in dimension II (Fulfill Social Etiquette Requirements) and dimension I (Express Needs and Wants), however, few in dimension III (Develop Social Closeness) and dimension IV (Exchange Information). The whole subjects got low scores average in SCPS, and the ranking was dimension I, II, III, IV according to average scores. Different grades have no significant influence in all kinds of scores in SCPS, except senior high school AAC users have significantly higher than junior high school AAC users in the active part and accumulative part of scores in dimension II (Fulfill Social Etiquette Requirements). Except dimension I (Express Needs and Wants), different disabled types have significant influence in SCPS, and AAC users with mental retardation and cerebral palsy have significantly higher scores than those with autism. 3.AAC users with aided AAC systems have significantly higher scores than with unaided AAC systems in dimension I (Express Needs and Wants) and the full scale of SCPS. 4.For AAC users, the correlation between the quantity of communicative acts and the scores of school communicative participation was moderate. Implications for the scale were discussed and some suggestions were provided for future studies.
The purposes of this study were to explore the AAC users’ implementation of AAC systems, types of AAC users, school communicative participation outcomes and relationship between these variables. We developed “School Communicative Participation Scale for AAC users” based on four main goals in communicative interactions and their communication demands (Light, 1988, 2003), and extended the ICF definition of participation to communicative participation. The whole scale was divided into two subscales, the first was “the Augmentative and Alternative Communication Users Classification Scale, AACUCS)”, the second was “the School Communicative Participation Scale, SCPS)”, and both of them were also divided into four dimensions as “Express Needs and Wants”, ”Fulfill Social Etiquette Requirements”, “Develop Social Closeness”, and “Exchange Information”. The first result showed the content validation was established, and the scale had good quality of inter-rater reliability, test-retest reliability, and the Cronbach’s α was also high. Next, the data was analyzed and tested by means of statistical methods, t-test, one-way ANOVA, and Pearson’s product-moment correlation. The findings of this research were as follows: 1.The results of the first subscale (AACUCS) showed most of AAC users were unaided AAC users according to the proportions. The whole subjects were also divided into AAC users with aided AAC and those with no aided AAC, and the results showed most of them didn’t use any kind of aided AAC. They assessed had most quantity of communicative acts in dimension I (Express Needs and Wants), however, few in dimension IV (Exchange Information). Both of different grades and different disabled types have no significant influence in using with aided AAC systems. However, as for the quantity of communicative acts, senior high school AAC users have significantly higher communicative acts than junior high school AAC users in the four dimensions and the full scale. AAC users with mental retardation have significantly higher communicative acts than AAC users with autism in the other dimensions except dimension I. 2.The results of the second subscale (SCPS) showed the whole subjects used AAC to participate most in dimension II (Fulfill Social Etiquette Requirements) and dimension I (Express Needs and Wants), however, few in dimension III (Develop Social Closeness) and dimension IV (Exchange Information). The whole subjects got low scores average in SCPS, and the ranking was dimension I, II, III, IV according to average scores. Different grades have no significant influence in all kinds of scores in SCPS, except senior high school AAC users have significantly higher than junior high school AAC users in the active part and accumulative part of scores in dimension II (Fulfill Social Etiquette Requirements). Except dimension I (Express Needs and Wants), different disabled types have significant influence in SCPS, and AAC users with mental retardation and cerebral palsy have significantly higher scores than those with autism. 3.AAC users with aided AAC systems have significantly higher scores than with unaided AAC systems in dimension I (Express Needs and Wants) and the full scale of SCPS. 4.For AAC users, the correlation between the quantity of communicative acts and the scores of school communicative participation was moderate. Implications for the scale were discussed and some suggestions were provided for future studies.
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輔助溝通系統, 輔助溝通系統使用者, 參與, 學校溝通參與, 評量工具, Augmentative and Alternative Communication (AAC), AAC users, participate, school communication participation, scale