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研究生: 羅美雯
Lydia M. V. Loh
論文名稱: PTR-F家庭支持模式對發展遲緩行為問題兒童及父母之研究
The Study of Prevent-Teach-Reinforce for Families (PTR-F) on Developmentally Delayed Young Children with Behavior Problems in Taiwan
指導教授: 洪儷瑜
Hung, Li-Yu
學位類別: 碩士
Master
系所名稱: 特殊教育學系
Department of Special Education
論文出版年: 2020
畢業學年度: 108
語文別: 英文
論文頁數: 139
中文關鍵詞: 以家庭為本位預防-教導-增強正向行為支持發展遲緩
英文關鍵詞: family-based intervention, Prevent-teach-reinforce, Positive behavior support, developmental delay
DOI URL: http://doi.org/10.6345/NTNU202000929
論文種類: 學術論文
相關次數: 點閱:191下載:22
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  • 過去的研究證實,以家庭為本位的介入方案可以有效幫助父母處理兒童在家中所出現的挑戰行為以及減少父母的親職壓力。因此,本研究的主要目的是為了探討以家庭為本位的預防-教導-增強介入模式(Prevent-Teach-Reinforce for Families, PTR-F)對於具有挑戰行為的發展遲緩兒童之家庭的影響。本研究以兩個家庭有出現挑戰行為問題的發展遲緩兒童為研究對象,並採用PTR-F 模式作為以家庭為本位的介入,並探討孩子挑戰行為之變化、兩位母親對於孩子的行為支持計劃(Behavioral Support Plan, BSP)之執行精準度,以及團隊(研究者和母親)在介入過程中之精準度。PTR-F模式主要分五個階段實施:(一)組隊(Teaming);(二)評量(Assessment);(三)介入(Intervention);(四)教練(Coaching);(五)評價(Evaluation)。本研究採用單一受試撤回實驗設計,整個實驗為期約四個月。在實驗結束時,研究者透過訪問兩位母親所得的質性內容,建立本研究之社會效度。研究結果顯示,兩位孩子的挑戰行為在實驗階段間變化(基線期一至介入期一;基線期二至介入期二)具超過50%之差距。此證明了PTR-F模式對兩位孩子的挑戰行為具有明顯的介入效果。此外,兩位母親也達到了平均值80%以上的高執行精準度以及平均值90% 以上的高介入過程精準度。本研究的觀察者間一致性為95%以上。最後,本研究亦討論PTR-F家庭介入模式的建議和限制,並提出未來PTR模式之執行和研究之建議,以供相關研究與實務人員參考。

    The past studies had proven family-based intervention programs helped parents in addressing their child’s at home challenging behaviors and reduced parenting stress level. The purpose of this study is to investigate the impact of the Prevent-Teach-Reinforce for Families (PTR-F) model as the main family-based intervention program on families with developmentally delayed young children who have challenging behavior problems. Two Taiwanese families with developmentally delayed children who have challenging behavior problems were involved by using the PTR-F model as the family-based intervention. The dependent variables included the changes of the child’s challenging behaviors, the implementation fidelity of both mothers based on their child’s behavioral support plan (BSP), and the procedural fidelity of the researcher and the mother. The PTR-F is implemented in the 5-Steps process: (a) Teaming; (b) Assessment; (c) Intervention; (d) Coaching; and (e) Evaluation. Follow-up was conducted three weeks after the end of the intervention for one family. An ABAB single-subject design is utilized which took about four months in both families. The results showed both children have more than 50% changes in their level of challenging behavior across phases (A1 to B1; A2 to B2). The PRT-F was proved effective for both children. Besides, a high mother’s implementation fidelity with an average of above 80% and a high procedural fidelity were reported with an average of above 90% in this study. The average mean of inter-observer agreement (IOA) was obtained for both families at about 95%. The social validity of the study was confirmed by both mothers, too. Lastly, this study also provided the limitations and recommendations for future study and implementation for reference.

    ACKNOWLEDGEMENT ABSTRACT Ⅰ CHINESE ABSTRACT Ⅱ TABLE OF CONTENTS Ⅲ LIST OF TABLES Ⅶ LIST OF FIGURES Ⅷ APPENDIXES Ⅸ CHAPTER I INTRODUCTION 1 Background 1 Purpose of Study 3 Research Questions 3 CHAPTER II LITERATURE REVIEW 4 Challenging Behavior 4 Definition of Challenging Behavior 4 Positive Behavior Support (PBS) 5 Definition of Positive Behavior Support (PBS) 5 Positive Behavior Support through Family-School Collaboration 7 Positive Behavior Support through Family 10 Current Evidence-Based Family Intervention Programs 15 Prevent-Teach-Reinforce (PTR) 23 Definition of Prevent-Teach-Reinforce (PTR) 23 PTR Intervention Programs Beyond Home Setting 26 PTR Family-Based Interventions Programs 26 Summary 29 CHAPTER III METHODOLOGY 31 Pilot Study 31 Participants 31 Settings and Routines 32 Materials 32 Procedures 33 Finding of the Pilot Study 33 Feasibility of the Intervention 33 The Translated Mandarin Version of PTR-F Assessment 34 Amendments in the Methodology made in the Formal Study 34 Conclusion 35 The Formal Study 35 Participant 36 Settings and Routines 38 Materials 39 Independent Variable 42 Dependent Variables 42 Procedures in Formal Study 53 Baseline (A1) 54 Intervention (B1) 54 Withdrawal (A2) 55 Intervention (B2) 55 Follow-up 56 The Roles of the Researcher in this Study 59 Data Analysis 60 Visual Analysis within a Phase 61 Visual Analysis across Phases 61 Social Validity 62 CHAPTER Ⅳ RESULTS AND DISCUSSION 63 Results 63 PTR-F Decreases Challenging Behavior of the Two Boys 64 Data Analysis within a Phase for Leon 65 Data Analysis across Phases for Leon 67 Data Analysis within a Phase for Danny 68 Data Analysis across Phases for Danny 71 High Implementation Fidelity Level of both Mothers 72 High Procedural Fidelity Rate across the 5-Steps of PTR-F 77 High Social Validity on PTR-F 78 The Generalization of PTR-F at a Home-Based Setting 80 Discussion 81 The PTR-F is Effective in Decreasing Children’s Challenging Behavior 82 The PTR-F Help to Promote Positive Parenting 82 The PTR-F Help Children to Develop Desirable Behavior 83 The Parents Can Practice the Intervention Independently 85 The Feasibility of PTR-F 85 CHAPTER Ⅴ CONCLUSION 87 Conclusion 87 The PTR-F Family Intervention is Effective on Challenging Behaviors of Developmentally Delayed Young Children 87 A High Fidelity in Both Parents as a PTR-F Implementer 87 The Feasibility of PTR-F Intervention in Both Taiwanese Family 89 Limitations 90 The Impact of COVID-19 Pandemic and Confounding Variable on this Study 90 The Challenge of Having a Blind Coder 92 The Characteristics of the Researcher 92 Social Validity 93 Implications for Practices 93 The Need of Publication of Mandarin Translated PTR-F Manual 93 Dual Role of PTR-F Implementer 94 Parent’s learning with Scaffolding and Fading 95 Recommendations Future Research 95 REFERENCES 98 APPENDICES 107

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