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| Title: | 台灣自閉症類群障礙兒童丹佛早療模式之縱貫研究：學齡期兒童療效追蹤
A Follow-up Study on the Implementation of Early Start Denver Model for School-Age Children with Autism Spectrum Disorder in Taiwan: Children Outcomes |
| Authors: | 湯于萱
Tang, Yu-Syuan |
| Contributors: | 姜忠信
Chiang, Chung-Hsin
湯于萱
Tang, Yu-Syuan |
| Keywords: | 自閉症
丹佛早療模式
早期介入
學齡期
縱貫研究
Autism Spectrum Disorder
Early Start Denver Model
Early Intervention
School-age
Longitudinal Study |
| Date: | 2025 |
| Issue Date: | 2025-07-01 14:12:17 (UTC+8) |
| Abstract: | 研究目的：國內外的自閉症類群障礙症（Autism Spectrum Disorder, ASD）盛行率皆在上升，然而目前國內外針對早期介入（early intervention, EI）的長期追蹤研究仍不多，結果亦不一致。丹佛早療模式（Early Start Denver Model, ESDM）為一項結合行為、發展和關係基礎取向的綜合性早期介入模式， Chiang等人（2023）曾進行一項短期、低密集度的ESDM個別介入方案，本研究以同一群研究參與兒童為對象，進行四年後於各項發展領域的追蹤評估，以瞭解ESDM的長期影響。
研究方法：本研究為準實驗設計，參與者在2至4歲時曾接受ESDM個別介入（ESDM介入組）或一般早療介入（一般社區介入組），已於三個時間點進行資料收集（T1：介入前；T2：介入後；T3：介入後6個月）。本研究於介入後四年（T4）對兩組參與者進行追蹤評估，以認知能力、語言能力及適應行為作為初級療效指標，並以症狀嚴重度、挑戰行為、特殊教育服務時數及同儕關係作為次級療效指標。
研究結果：在各項初級及次級療效指標方面，ESDM介入組與一般社區介入組T3至T4的變化趨勢皆無顯著差異，兩組參與兒童在語言能力方面皆隨著時間有所進步，而症狀嚴重度則皆隨著時間顯著上升。在特殊教育服務資源的使用上，ESDM介入組於T4時所接受的特殊教育服務時數顯著高於一般社區介入組。
結論：T4時，ESDM介入組與一般社區介入組在語言和症狀嚴重度方面呈現相似的發展趨勢，且組間差異未達統計顯著。然而，ESDM介入組在T4接受的特殊教育服務時數顯著較多，顯示特定的介入經驗可能影響後續服務參與型態。
Objective: The prevalence of Autism Spectrum Disorder (ASD) has been increasing globally. However, longitudinal studies on the long-term effects of early intervention (EI) remain limited, with inconsistent findings. The Early Start Denver Model (ESDM) is a comprehensive EI approach that integrates behavioral, developmental, and relationship-based principles. Chiang et al. (2023) previously conducted a short-term, low-intensity individual ESDM intervention. This study followed the same cohort to assess their developmental outcomes four years later and examine the long-term effects of ESDM.
Methods: This study employed a quasi-experimental design. Participants had received either individual ESDM intervention (ESDM group) or general early intervention (community intervention group) between the ages of 2 and 4. Data were collected at three previous time points: T1 (pre-intervention), T2 (post-intervention), and T3 (6 months post-intervention). At T4 (four years post-intervention), a follow-up assessment was conducted on both groups (n = 17 per group, mean chronological age = 99.05 and 99.30 months, respectively). Primary outcome measures included cognitive ability, language ability, and adaptive behavior, while secondary outcome measures included symptom severity, challenging behavior, and hours of special education services received.
Results: Across all primary and secondary outcome indicators, no significant group-by-time interaction was observed between the ESDM intervention group and the community intervention group from T3 to T4. Both groups showed improvement in verbal abilities over time, while autism symptom severity significantly increased in both groups. Regarding the use of special education services, children in the ESDM group received significantly more hours of special education services at T4 compared to those in the community group.
Conclusion: At T4, the ESDM and community intervention groups exhibited similar trends in language development and symptom severity, with no statistically significant differences between groups. However, the ESDM group received significantly more hours of special education services, suggesting that the type of early intervention may influence patterns of subsequent service utilization. |
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| Description: | 碩士
國立政治大學
心理學系
110752022 |
| Source URI: | http://thesis.lib.nccu.edu.tw/record/#G0110752022 |
| Data Type: | thesis |
| Appears in Collections: | [Department of Psychology] Theses
|
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