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对一名患有脑瘫的多模态沟通女童进行的以家庭为中心干预的单一案例研究。

A single case study of a family-centred intervention with a young girl with cerebral palsy who is a multimodal communicator.

作者信息

Wadnerkar M B, Pirinen T, Haines-Bazrafshan R, Rodgers J, James D

机构信息

NIHR National Biomedical Research Unit in Hearing, University of Nottingham, UK.

出版信息

Child Care Health Dev. 2012 Jan;38(1):87-97. doi: 10.1111/j.1365-2214.2011.01214.x. Epub 2011 Mar 11.

Abstract

BACKGROUND

This paper describes the impact of a family-centred intervention that used video to enhance communication in a young girl with cerebral palsy. This single case study describes how the video-based intervention worked in the context of multimodal communication, which included high-tech augmentative and alternative communication (AAC) device use. This paper includes the family's perspective of the video intervention and they describe the impact of it on their family.

METHODS

This single case study was based on the premise that the video interaction guidance intervention would increase attentiveness between participants during communication. It tests a hypothesis that eye gaze is a fundamental prerequisite for all communicative initiatives, regardless of modality in the child. Multimodality is described as the range of communicative behaviours used by the child and these are coded as AAC communication, vocalizations (intelligible and unintelligible), sign communication, nodding and pointing. Change was analysed over time with multiple testing both pre and post intervention. Data were analysed within INTERACT, a computer software to analyse behaviourally observed data. Behaviours were analysed for frequency and duration, contingency and co-occurrence.

RESULTS

Results indicated increased duration of mother's and girl's eye gaze, increased frequency and duration in AAC communication by the girl and significant change in frequency [χ(2) (5, n = 1) = 13.25, P < 0.05] and duration [χ(2) (5, n = 1) = 12.57, P < 0.05] of the girl's multimodal communicative behaviours. Contingency and co-occurrence analysis indicated that mother's eye gaze followed by AAC communication was the most prominent change between the pre- and post-intervention assessments.

CONCLUSIONS

There was a trend for increased eye gaze in both mum and girl and AAC communication in the girl following the video intervention. The family's perspective concurs with the results.

摘要

背景

本文描述了一项以家庭为中心的干预措施的影响,该措施利用视频来加强一名脑瘫女童的沟通能力。这个单病例研究描述了基于视频的干预措施在多模态沟通背景下的运作方式,其中包括使用高科技辅助和替代沟通(AAC)设备。本文纳入了家庭对视频干预的看法,并描述了其对家庭的影响。

方法

这个单病例研究基于这样一个前提,即视频互动指导干预将提高沟通参与者之间的注意力。它检验了一个假设,即目光注视是所有沟通行为的基本前提,无论儿童采用何种沟通方式。多模态被描述为儿童使用的一系列沟通行为,这些行为被编码为AAC沟通、发声(可理解和不可理解)、手势沟通、点头和指物。通过干预前后的多次测试分析随时间的变化。数据在INTERACT(一种用于分析行为观察数据的计算机软件)中进行分析。分析行为的频率、持续时间、偶然性和共现情况。

结果

结果表明,母亲和女童目光注视的持续时间增加,女童AAC沟通的频率和持续时间增加,女童多模态沟通行为的频率[χ(2)(5, n = 1) = 13.25, P < 0.05]和持续时间[χ(2)(5, n = 1) = 12.57, P < 0.05]有显著变化。偶然性和共现分析表明,干预前后评估之间最显著的变化是母亲目光注视后紧接着进行AAC沟通。

结论

视频干预后,母亲和女童的目光注视有增加的趋势,女童的AAC沟通也有增加。家庭的看法与结果一致。

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