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研究生: 劉芳妤
Liu, Fang-Yu
論文名稱: 「感官為基礎之音樂活動」提升自閉症兒童非口語溝通能力之家長訓練模式探究
A Study on a Parent Training Model of Sensory-Based Music Activities to Enhance Nonverbal Communication Skills in Children with Autism Spectrum Disorder
指導教授: 吳舜文
Wu, Shun-Wen
學位類別: 博士
Doctor
系所名稱: 音樂學系
Department of Music
論文出版年: 2017
畢業學年度: 105
語文別: 英文
論文頁數: 212
中文關鍵詞: 感官為基礎之音樂活動非口語溝通能力家長訓練模式自閉症兒童
英文關鍵詞: sensory-based music activities, nonverbal communication skills, parent-training model, autism spectrum disorder
DOI URL: https://doi.org/10.6345/NTNU202203094
論文種類: 學術論文
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  • 本研究旨在瞭解自閉症兒童之家長藉由家長訓練模式學習「感官為基礎之音樂活動」的介入技巧並提升其子女非口語溝通能力的歷程。在正式研究開始前,本研究透過前導研究探究「感官為基礎之音樂活動」對提升一位自閉症兒童之非口語溝通能力的成效,此前導研究採用單一受試跨行為多基線實驗設計,研究結果發現「感官為基礎之音樂方案」能有效提升一位自閉症兒童模仿、被動式相互注意力以及主動式相互注意力等非口語溝通能力。
    本研究之「感官為基礎之音樂活動」家長訓練模式共分為「成人引導」、「成人回應」以及「幼兒引導」等三個階段,訓練內容分為線上資料庫與實地訓練兩種形式。線上資料庫包含「感官為基礎之音樂活動」各階段說明,以及各活動示範與說明;實地訓練為研究者至參與者家中進行親子音樂活動的觀察與討論,必要時進行訓練與示範。此介入每周兩次、每次50至90分鐘,共九週14至15次的介入。此研究採用個案研究法,共有兩對親子參與研究,此研究以質性資料為主、量化資料為輔。家長執行「感官為基礎之音樂活動」的過程全程錄影,並在每次介入結束後進行訪談,以進行資料分析與歸納。量化資料以單一受試研究中的A-B-M設計蒐集兩位家長在家長執行技巧上的資料,每次擷取十分鐘的介入以進行編碼,過程中亦蒐集幼兒的非口語溝通能力以瞭解其改變情形。
    研究結果發現兩位家長皆能在九週內學會並執行三個階段的家長介入技巧。兩位家長的執行方式主要跟隨本研究三個階段的模式:(1)第一階段:提供以歌曲、教學為主的活動,主要活動來源為線上資料庫;(2)第二階段:透過音樂建構一來一往的溝通形式,並且透過音樂回應幼兒的行為;(3)第三階段:跟隨幼兒的行為後,將幼兒的行為融入音樂互動中。藉由相關係數進行探討後發現,家長的執行技巧精熟與否與幼兒非口語溝通能力的行為展現有正相關。
    研究者根據以上研究結果加以討論並提出建議,以提供實務工作者、未來研究者以及自閉症兒童之家長之參考依據。

    The purpose of this study was to understand whether the parent of the child with autism spectrum disorder (ASD) was able to acquire the techniques of implementing the sensory-based music activities with his or her child through the parent-training model aimed to enhance nonverbal communication skills, including imitation, responding joint attention (RJA), and initiating joint attention (IJA) skills.
    Before the study started, a pilot study was conducted. The purpose of the pilot study was to investigate whether the sensory-based music activities were able to enhance nonverbal communication skills in a child with ASD. A “multiple probe design across behaviors of the single subject experimental design” was adopted. The result of the pilot study found that sensory-based music activities were able to enhance a child with ASD’s nonverbal communication skills.
    For the main study, a “case study” was adopted and two parent-child dyads participated in this study. The parent-training model included three phases: adult-guided, adult-responded, and child-guided phases. The parent-training model was delivered through two forms: an online database and direct training. The online database included the demonstration videos of each sensory-based music activity and the handouts of each activity. The direct training means that the researcher was physically present in the participants’ home setting as a trainer. This researcher observed and discussed with the parents regarding parental implementation and parent-child interaction, as well as coached and modeled the activities when needed. The intervention of parent-training model in this study took place for a 50- to 90-minute session twice per week over nine weeks for 14 to 15 sessions in total.
    The result found both parents obtained three-phase parental implementation techniques over nine weeks. Both parents followed the framework of three phases: (1) Phase I: provided song-based and teaching-oriented activities, and mainly followed the activities from the database; (2) Phase II: formed back and forth communications musically, and responded to their child’s behaviors musically; (3) Phase III: followed their child’s behaviors first and combined their behaviors into the music activities. The Pearson correlation coefficient between the proficiency rates of parental implementation techniques and frequency rates of NVC behaviors was computed and showed a positive correspondence, which indicated that while parents demonstrated a higher proficiency level in their parental implementation techniques, the frequency of the child’s NVC behaviors were usually enhanced.
    Finding from the implementation were discussed and recommendations were provided for practitioners, future researchers, and parents of children with ASD.

    TABLE OF CONTENTS LIST OF FIGURES X LIST OF TABLES XI CHAPTER 1 INTRODUCTION 1 1.1 Background of the Study 1 1.2 The Purpose of the Study 6 1.3 Definition of Terms 7 1.3.1 Nonverbal Communication Skills 7 1.3.2 Sensory-Based Music Activities 8 1.3.3 Parent Training Model 9 1.4 Limitations of this Study 9 CHAPTER 2 LITERATURE REVIEW 11 2.1 Development of Nonverbal Communication in Children with ASD 11 2.1.1 Development of Nonverbal Communication Skills in Typically Developing Children 11 2.1.2 The Development of Nonverbal Communication in Children with Autism Spectrum Disorder 13 2.1.3 The Definition of Nonverbal Communication 15 2.1.4 Summary 22 2.2 Sensory-Based Music Activity 22 2.2.1 Sensory-Integration Related Intervention 23 2.2.2 Music, the Sensory Processing, and the Brain 28 2.2.3 The Concepts of Sensory Processing in Early Childhood Music Education 30 2.2.4 Summary 33 2.3 Parent Training for Parents of Children with ASD 34 2.3.1 Family-Centered Approach 34 2.3.2 Parent-Training Program for Parents of Children with ASD 35 2.3.3 Summary 43 2.4 The Rationale of Sensory-Based Music Activities in this Study 43 CHAPTER 3 RESEARCH METHOD 47 3.1 Research Structure 47 3.2 Participants 49 3.2.1 The Participant of the Pilot Study 49 3.2.2 Participant Description in the Pilot Study of this Study 50 3.2.3 The Participants of the Main Study 52 3.3 Research Design 56 3.3.1 Research Design of the Pilot Study 56 3.3.2 Research Design of the Main Study 62 3.3.3 Data Collection 72 CHAPTER 4 RESULTS OF THE PILOT STUDY 75 4.1 Data Analysis of Nonverbal Communication Behaviors 75 4.1.1 Target Behavior: Imitation 77 4.1.2 Targeting Behavior: RJA 77 4.1.3 Targeting Behavior: IJA 78 4.2 Social Validity 80 4.2.1 Pre- And Post-Intervention Questionnaire Regarding The Sensory-Based Music Activities 80 4.2.2 Interview with Faith 81 4.3 Discussion 82 4.3.1 The Discussion of the Intervention of Imitation Behavior 82 4.3.2 The Discussion of the Intervention of RJA Behavior 85 4.3.3 The Discussion of the Intervention of IJA Behavior 86 CHAPTER 5 RESULTS OF THE MAIN STUDY 89 5.1 The Results of Grace and Ben 90 5.1.1 The Visual Analysis of Grace’s Proficiency Rates of Parental Implementation Techniques 90 5.1.2 The Analysis of Ben’s NVC Skills 93 5.1.3 The Correlation Between Grace’s Proficiency Rate and Ben’s Frequency Rate 94 5.1.4 The Qualitative Analysis of Grace’s Intervention 95 5.2 The Results of Hope and Cody 128 5.2.1 The Visual Analysis of Hope’s Parental Implementation Techniques 128 5.2.2 The Analysis of Cody’s NVC skills 131 5.2.3 The Correlation between Hope’s Proficiency Rate and Cody’s Frequency Rate 132 5.3 The Discussion of Daily Logs 159 5.3.1 Grace and Ben’s Daily Music Activities and Logs 159 5.3.2 Hope and Cody’s Daily Music Activities and Logs 160 5.3.3 Self-Rating Scales of Daily Logs 161 5.4 Social Validity 163 5.4.1 Regarding the Effectiveness of the Parent Training Model of the Sensory-Based Music Activity 163 5.4.2 Regarding the Parent’s Techniques of PISBMA 165 5.4.3 The Generalization of PISBMA 166 5.4.4 Regarding the Training Model of PISBMA 168 5.5 Discussion 168 CHAPTER 6 CONCLUSION 173 6.1 The Conclusion of this Study 173 6.1.1 The Conclusion of the Pilot Study 173 6.1.2 The Conclusion of the Main study 173 6.2 Implications for Researchers and Practitioners 175 6.2.1 Regarding Sensory-Based Music Activities 175 6.2.2 Regarding Parental Implemented Sensory-Based Music Activities 176 6.2.3 Implications for Parents 176 REFERENCES 179 Appendix A Consent Forms 187 Appendix B An Example Of The Sensory-Based Music Activity 188 Appendix C The Child’s Nonverbal Communication Skills Observation Form 189 Appendix D A Pre- And Post-Intervention Measure Regarding The Sensory-Based Music Activities 191 Appendix E A Questionnaire Of The Parental Music Learning Experience And The Parental Use Of Music 192 Appendix F The Sample Of Videos And Instructions In Database 193 Appendix G Sensory-Based Music Activity Parental Implementation Checklist And Systematic Observation Form 194 Appendix H The Child’s Nonverbal Communication Skills Observation Form In Parent-Child Music Activities 203 Appendix I Pisbma Daily Log 205 Appendix J The Sample Of The Online Version Of Pisbma Daily Log 209 Appendix K Semi-Structure Interview Regarding The Satisfaction Of The Parent Training Model Of Sensory-Based Music Activities 210 Appendix L Instruments And Materials 211

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