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1、Interventions and Strategies for Educating Young Children with Autism in the Public SchoolsKathy M. Small, M.A.1Developmentally-Based Public School Program for Young Children with Autism Provides:以發展為基礎的學校方案Normalized educational experience 普通教育經驗Enjoying normal educational experience, however adapt
2、ed 合適且有趣的普通教育經驗Opportunity for social interaction 社會互動的經驗Daily experience 日常經驗Same players 相同的玩伴Structured 結構化Broad educational approach 廣泛的教學方案Multiple learning experiences 多元學習經驗No single approach 非單一的方案Opportunity for spontaneous imitation 給予模仿的經驗Familiar environment 和善的環境Peers, experiences incre
3、ase possibility of learning to imitate 同儕學習經驗的模仿2Developmentally-Based Program以發展為主的計畫Opportunity to benefit from peers as models 製造從同儕中學習的機會Learn to respond to others 學習回應他人 Incorporate peers into daily learning experiences 把同儕當做每日學習的經驗Opportunity to develop play skills 製造發展遊戲技巧的機會Play emphasized i
4、n developmental program 遊戲著重在發展性的計畫Familiar peers, relationship熟悉的同儕和關係Childs interests and strengths as source of information for program planning:設計計劃要考慮孩子的興趣及能力Motivation considered要考慮動機Consideration of child in developing curriculum/learning experiences/daily activities 考慮孩子的發展性課程/學習經驗/每日例行活動Goo
5、d for all children, critical for children with ASD 對每個孩子都有益，尤其是ASD兒童3Developmentally-Based Program以發展為主的計畫Opportunity to develop and use language 製造發展和使用語言的機會Familiar environment with familiar peers provides context for language 使用熟悉的環境和同儕做為語言的內容Daily activities reinforcing for language 利用每日例行活動可加強語
6、言Parent support and advocacy 家長的支持和擁護Parent and educator can share knowledge, concerns, triumphs and goals 親師可以分享新知、要事、喜悅和目標Supports generalized learning 家長的支持可以概括到學習4Specific Classroom Practices in an Early Intervention Program for Children with ASDASD兒童早期介入方案中的特別教室練習Evaluate communication and lang
7、uage abilities 評估溝通和語言能力Non-verbal and verbal by observation/parent 透過觀察及家長得知有無語言Behavior is communication行為是一種溝通Communication priority as core deficit/challenge 視核心缺陷/挑戰發展溝通的優先順序Physically structure room so verbal directions are supported by physical realities 製造結構化物理環境以利於口語發展Defined areas in room
8、教室中定出固定空間Planned areas can reduce distractions/escape 設定的區域要能降低分心/離開位子Visual schedules 視覺化功課表5Specific Classroom Practices特別教室練習Create environment where relationships are possible and frequently unavoidable 製造一個經常有人際互動產生的環境Children in proximity鄰近的孩子Partners for transitions同伴的轉換Activities/materials/t
9、oys staged to increase shared participation and enjoyment 多種活動/物品/玩具以增加分享的參與度和享受能力Support childs desired outcomes as contingent upon adult/peer interactions 以大人/同儕互動為條件去支持孩子想要的結果Set up routine and be faithful to it 設定例行活動並遵守Crucial in development of ability to predict and anticipate activities/event
10、s in the day 能力的發展很重要，它可以預測一天中活動/事件的發生6Specific Classroom Practices特別教室練習Curriculum that is meaningful and appropriate 課程是有意義且適當的Thematic teaching for natural context 對自然情境內容做主題式教學Consider child as concrete learner: objects/materials 以小孩為學習者：物體/材料Incidental teaching: Embedded learning experiences (e
11、.g. Music for motor imitation, mechanical animals for language, rainbow ribbon for turn-taking, participation) 附帶教學：學習經驗印象加深Incorporate interests and motivations 合併與趣和動機7Specific Classroom Practices特別教室練習Incorporate other programs and approaches to provide a broad but philosophically unified program
12、 加入其它計劃及方法使其更廣但哲學上統一化的計劃Develop a clear educational philosophy for educating your students on the autism spectrum 發展一套清楚教育哲學來教育ASD學生Avoid implementing methods and strategies learned in trainings that arent paired with a foundation of knowledge and educational practices for the child with ASD 避免實施那些和
13、教育ASD學童理論相違背的方法及策略8Specific Classroom Practices特別教室練習Individualize expectations and tailor, as much as possible, expectations and demands for each child 儘量依個別學童訂定個別化的期待Each child different though share common core challenges 雖然有一樣的核心缺陷，但每個孩子都不一樣Understand childs strengths/weakness to help maximize s
14、trengths and minimize weakness 了解孩子優弱勢，幫助增加優勢減少弱勢9Specific Classroom Practices特別教室練習Expect student to be part of class during ALL activities 期待每個學生在所有活動中都能參與Not negotiable不可妥協Physical participation may precede active interest in participation 肢體參與可以在參與時增進活動興趣 Benefits from activities cannot occur wi
15、thout being part of activities 若無參與活動則無法從活動中獲益May seem easier to let child entertain self but short term gain with long term consequences 似乎讓孩子自己玩較容易，但短期長期結果When child with autism not expected to participate in classroom activities, child may be satisfied for the moment, but has gained no internal s
16、trategies to achieve greater goal of being part of a social environment 當ASD孩子如預期不參與活動時，他可能一時會感覺滿足，但無法獲得社交所需的更進階的策略10Why Incorporate Other Programs and Approaches into the Classroom?為何要加入其它的計畫和方法於教室中Children with autism have unique ways of learning, relating and communicating that influence their ab
17、ility to learn 自閉症孩童有其獨特的學習方法及溝通方式會影響其學習能力Educational supports needed to accommodate core deficits/challenges in children with ASD 需要教育的支持以適合ASD孩童的核心缺陷/挑戰Classroom curriculum that is enjoyed by most students may not be appreciated by the child with autism who may retreat into self-absorption, apathy
18、 or difficult behavior 適合大部份學生的課程不一定適合自閉症學生，他們可能會自我刺激、表現冷淡、出現嚴重行為問題Individualized learning experiences (e.g. TEACCH) can contribute to childs educational experience 個別化學習經驗(如TEACCH)有助於孩子的學習經驗11Other Programs and Approaches其它的計畫和方法Opportunity and proximity do not always translate into successful lear
19、ning 提供機會與時常接觸並不一定會得到成功的學習Core challenges of ASD can make educational experiences inaccessible without specific support 若無特殊支持，由於ASD的核心缺陷將使得教育成效難以達成Classroom is natural environment for introducing tools for learning/overcoming core challenges 教室是個天然環境可供學習及克服其核心缺陷Integrating other programs and approa
20、ches allows the child with autism the ability to express himself in his most idiosyncratic ways while providing him with skills to ultimately abandon those idiosyncratic ways and replace them with more useful and acceptable behaviors and learning strategies 在統合其它計劃和方法時,在教技巧時，允許ASD學童用他獨特方式表達他自己，最終希望可
21、以改掉怪異方式而以更有用且可被接受的行為和學習策略來取代。Accept the student you have, understand her challenges, and develop methods and approaches that target those challenges defined by ASD 接受你的學生、了解他困難、發掘方法去解決那些ASD的缺陷12The Importance of Structure and Some Forms Structure Takes in the Classroom結構化的重要性和在教室中可使用的結構化做法Map in new
22、 town新市鎮的地圖Student master environment 學生了解環境Structure through classroom routines 教室例行活動的結構化Vacation and new routine休假和例行活動Child creates own routines to create predictability 孩子自己創造例行活動以產生可預測性Participation as a means to create internal structure 參與是產生內在結構化的一種方式Classroom experiences and participation
23、create meaning, and help child with ASD connect and relate experiences that lead to internal structure 教室經驗和參與可以引起有意義的、可幫助ASD連結經驗以達到內在結構化13Group Time Goals for Children with Autism Spectrum DisorderASD學童的團體活動目標Joint Attention 相互注意協調能力Joint Action 共同的行為Social Interaction 社交互動Social Reciprocity 社交相互對等
24、Shared Perspective 分享看法Awareness of Others 覺知他人Imitation 模仿Anticipation 期望Ability to Predict 預測力Turn-Taking 輪流Impulse Control 衝動控制Learning concepts embedded into highly desired material/routines 由高度興趣的例行活動中產生學習概念Communication 溝通14Strategies and Benefits of Group Time for Children with Autism Spectru
25、m Disorder團體時間可使用於自閉症者的策略及優勢Social opportunities embedded in activities/routines 活動中的社交機會Use appealing high-interest materials to capture interest and maintain attention 使用可吸引高度興趣的教材來引起興趣及保持注意力Exploit the need children with ASD have for routines by maintaining them 包含ASD兒童的一些儀式化行為Use familiar materi
26、als and revisit materials/activities for generalized learning 使用熟悉教材及重複活動來引導類化的學習Use music to teach imitation 使用音樂教導模仿能力15Strategies and Benefits策略和優勢Avoid passive learning; involvement supports participation 避免消極的學習並支持其活動參與Use most capable student as model利用能力好的學生當作學習模範Dont be intimidated to use fr
27、eedom of movement. Childs ability to move takes away some adult control, but has several benefits for child 不要害怕讓學生使用移動的自由，孩童的自由移動會減少成人的控制，但對於他卻有多種的好處16Common Practices in Education/Therapy教育與治療中常用的實施Behavioral 行為的Developmental 發展的Peer Emphasis 同儕的加強17The Lovaas 1987 Study:Behavioral Lovaas1987研究：行為
28、的Ivar Lovaas, UCLA psychology professor Ivar Lovaas，UCLA心理學教授1987 study of 19 young children with autism 研究19名自閉症兒童Lovaas claimed a “recovery” rate of 47% Lovaas聲稱47復原率2 criteria of recovery 復原的兩個標準 : IQ scores IQ分數 Classroom placement 教學安置 No adaptive outcomes measured沒有合適結果的測驗Controversy over rese
29、arch and methodological questions involving:對於研究及教學問題的爭論包括以下:Representativeness of children: biased sample as external validity threat (replication) 孩童的典型：極端樣本的威脅Experimental design: children matched rather than assigned: selection bias實驗設計：應選和式的孩童而非指定的選擇上的偏見Age onset variables between control and e
30、xperimental groups控制組及實驗組的年齡變項Differences in pre and post tests前後測的差別 Gresham and MacMillian, 199840 hour a week Discrete Trial Training Program (DTT) (also called Intensive Behavioral Program (IBP) and Early Intensive Behavior Program (EIB) ) 每週40小時的分段測驗訓練計畫（DTT），也稱為密集行為計畫（IBP）和早期密集行為計畫（EIB）18SCERT
31、S MODEL: Developmental SCERTS模式：發展性的Developed by Barry Prizant, Ph.D, Amy Wetherby, Ph.D., Emily Rubin, M.S., Amy Laurent, OTR-L (http:/)Comprehensive, multidisciplinary approach綜合的、多元的方法Primary goal to enhance Social Communication, Emotional Regulation and Transactional Support (SCERTS) as primary
32、developmental dimensions for a comprehensive program for young children with ASD ASD孩童綜合發展課程的主要目標及基礎為增加社交溝通、情緒管理、人際關係（SCERTS）等能力19SCERTS ModelTransactional Model人際關係模式SCERTS: Barry Prizant & Amy WetherbySC = Social Communication社交溝通 ER = Emotional Regulation / Self and Mutual Regulation情緒管理/自我和相互的管理
33、TS = Transactional Support Self/Education/Family人際關係的支持自我/教育/家庭 Prizant, et al. 200620SCERTS ModelDeveloped over 2 decades of empirical/clinical work發展超過20年以上臨床研究Consistent with “evidence-based” practices持續實證基礎的施行Consistent with tenets of positive behavior support持續正向行為支持的宗旨Integrates visual support
34、s整合視覺的支持Family-centered以家庭為中心Influenced by Hanen Early Language Centre Model 受到Hanen早期語言中心模式的影響Philosophy that most children with ASD are capable of learning in natural activities and inclusive environments認為大多數ASD兒童能從自然的活動和其涵蓋的環境中學習Myth that children with ASD can only learn in 1:1 instruction and t
35、hat natural environments and activities are too overly stimulating不認同ASD兒童只能從1對1的教導中學習，也不認同自然的環境和活動是或於刺激性的21SCERTS ModelProvides information to families提供訊息給家庭Shares resources with families和家庭分享資源Encourages sensitivity to range of reactions family may experience in raising child with ASD鼓勵家庭去分類在扶養AS
36、D兒童成長過程中可能經歷的反應Clinicians/educators respect family priorities and family structures and cultural factors臨床學者/教育者應尊重家庭優先考慮的事項、家庭的結構和文化因素Sets recommendations that are compatible with family belief systems 給予符合家庭信念系統的推薦Helps families develop appropriate expectations and realistic, achievable goals for
37、child幫助家庭發展合適的期望以及孩子實際可達成的目標Respects parents, does not dictateHelps parents maintain hope and identify developmentally appropriate next steps幫助父母保持希望並認同發展合適的下一階段學習Supports parents in celebrating small steps/positive change22Floor Time: Developmental地板時間：發展性的Relationship-Based以人際關係為主要基礎Floor Time DIR
38、: Developmental,Individual-Difference , Relationship-Based: Stanley Greenspan & Serena Wieder地板時間DIR：發展性的、個別差異、以人際關係為基礎Targets emotional development: child-centered focus目標為情緒的激發：以孩童為中心Highly interactive高度互動Teaches parents how to engage with child with outcome of broad gains教導父母如何對待有廣泛發展障礙的孩童Helps t
39、urn childs actions into interactionsCircles of Communication溝通的小圈圈Intensive 20-30 minute sessions 6-10 times daily密集的20-30分鐘課程，一天6-10次 Child with Special Needs Greenspan, 1998234 Floor-Time Goals Parents Help Child Attain父母幫助孩童在地板時間所獲得的四項目標Encourage Attention and Intimacy鼓勵關注和親密的行為Increased attentio
40、n to adult增加對成人的注意Maintaining mutual attention保持相互的注意Enjoy presence享受參與Two-Way Communication雙向溝通Open and close circles of communication, non-verbally, use emotions, body開放及封閉的溝通圈圈，非語言的，使用情緒、身體語言Encouraging the Expression and Use of Feelings and Ideas鼓勵感覺和想法的表達及應用Child expresses feelings/intentions i
41、n words and play孩童使用文字和遊戲來表達感覺和意圖Logical Thought邏輯的思考Child link ideas and feelings: understand world孩童連結想法和感覺：瞭解世界Child connects thoughts in logical ways孩童使用有邏輯的方式連結想法 The Child with Special Needs, Stanley Greenspan, M.D., Serena Wieder, Ph.D. 199824Peer Emphasis同儕間的加強Integrated Play Groups (IPG) (P
42、reschool-Elementary) 整合的遊戲團體: Wolfberg and SchulerAdult support through Guided Participation透過引導參與來展現成人支持IPG occur in natural play experiencesIPG存在於自然的遊戲經驗中Child with ASD is “novice” player ASD兒童為初級的遊戲者Typical peer is “expert” player有代表性的同儕為專家級的遊戲者IPG is composed of small group of expert and novice players organized around play activities with goal of mutual enjoyment, and spontaneous and reciprocal playIPG是由一小群專家和初級遊 戲者所組成，他們參與的活動有待給彼此快樂的目標，以及自然而然、互惠的遊戲Play & Imagination in Children with Autism, Wolfberg, 199925
