學會如何獨立生活，如何選擇與安排自己的生活是成人世界裡不可獲缺的能力，有一定程度的自我決策能力有助於個體在成人後的生活有更多的自主性，但目前較多文獻探討輕度身心障礙人群的自我決策能力，對於中重度障礙程度的身心障礙人群的自我決策能力探討較為缺乏。本研究的主要目的爲探討使用視覺支持介入包裹對中重度自閉症族群之自我決策能力之提升效果。本研究採用單一受試研究法之多基線跨受試者設計，共有三位研究對象參與。視覺支持介入包裹主要以視覺流程表爲主體，結合環境結構化調整與配對概念進行設計，在介入過程中使用由少到多的提示系統教導中重度自閉症患者使用視覺流程表，以提升中重度自閉症患者自我決策中選擇與獨自執行活動的能力。本研究以視覺流程表的獨立執行率檢核研究對象自我決策中選擇與執行活動能力的表現，研究對象在視覺分析上均有顯著的行爲改變，說明視覺支持介入包裹能提升中重度自閉症的自我決策能力，兩者之間具有功能關係，從中也顯示，中重度族群在自我決策能力的學習與提升上具有潜力，後續也可嘗試教導更深層次的自我決策技能。

Learning how to live independently, how to choose and arrange one’s own life is an ability with necessity in the adult world. A certain degree of self-determination ability helps individuals to have more autonomy in life. However, there is more literature discussing the self- determination ability of people with mild physical and mental disability, and not of those with moderate or severe disability. The main purpose of this study was to investigate the effect of using visual support intervention package on self-determination of persons with moderate to severe autism. The author used a multiple baseline probe design across three participants. The visual support intervention package consisted of appropriate cognitive level of symbol (i.e., miniature, tactile, photo, picture, word character) generated activity schedule, combined with structured environment adjustment and symbol-object matching mechanism. In the intervention process, the author utilized video modeling and least-to-most prompt system to teach the participants to select preferred activities and to engage in chosen activities on the activity schedule. The outcome measure was the percentage of independent steps completed in selecting and performing the activities on the schedule. Significant behavioral changes were observed in visual analysis. The functional relationship was established in between the visual support intervention package and self-determination ability of adults with moderate to severe autism. This study suggested further advanced self-determination skills may be potentially taught to this population in the future.

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