Developing QOL oriented behavioral family support program for children with developmental disabilities who exhibited challenging behavior

本研究旨在针对发育性障碍儿童的挑战性行为，开发面向生活品质的行为家庭支持方案。通过概念和方法分析、纵向研究和交叉案例研究进行了三种讨论。1)积极行为支持是近年来处理挑战性行为的有效方法，提供了以人为本的家庭支持火焰。论文分别是：a)以人为本的价值；b)功能评估方法；c)情境契合方法。其次，对一个家庭进行了纵向研究，提出了如何制定综合行为家庭支持方案。包括生活方式、活动水平、母亲需求的综合评估和问题行为的功能评估。然后，根据孩子和母亲的需求和实际情况，选择项目中的目标行为和干预程序。结果：减少挑战性行为，增加期望的日常活动，实现生活方式的改变，并获得较高的社会效度。分析了影响项目成功实施的因素。结果表明，关键是a)早期期望变更，b)基于增强策略的易于实施的流程，c)支持伴随非期望变更的流程排放。然后，将这些项目应用于多个家庭，从学龄儿童到表现出挑战行为的成年人。结果重复了纵向研究。然后，分析了影响项目成功实施的因素。结果表明：a)缺乏挑战性行为的功能评估信息和如何实施干预程序的信息，b)支持解决干预实施者的需求和实用性差距，c)基于增强策略的容易实施程序和基于直接互动策略的困难程序。d)随着人生的发展，在家庭成员或社区中发展支持网络的重要性。最后，提出了三个需要解决的问题。这些是发展方法，(1)收集母亲的功能评估信息，(2)通过向母亲告知准确的程序或使用辅助策略来增加母亲的实施，以及(3)在家庭成员或社区内建立支持网络，并随生命阶段发展。少

This study aimed to develop QOL-oriented behavioral family support program for children with developmental disabilities exhibited challenging behavior. Three kinds of discussions were made by means of 1) conceptual and methodological analysis, 2) longitudinal study, and 3) cross case study.First, 1) Positive Behavioral Support which were the recent effective approach for dealing with challenging behavior offered the person-centered family support flame. Theses were, a) person centered value, b) methodology of functional assessment, and c) methodology of contextual fit.Next, 2) longitudinal study on one family offered how to develop the comprehensive behavioral family support program. These were consisted of comprehensive assessment of life style, activities level, needs of mother, and functional assessment of problem behavior. And then, target behaviors and intervention procedures in program were selected based on the needs and practicality of both child and mother. This program result … More ed to decrease challenging behavior, increase desired daily activities, and accomplish life style change, and get high social validity. Factors for success and implementation of the program were analyzed. Result suggested that a) early desired change, b) easy implementation procedure based on augmentative strategy, and c) support for emission of procedures accompanied with non-desired change were critical.Then, 3) these programs were applied to multiple families from with school age children to adult exhibited challenging behavior. Result replicated the longitudinal study. Then, factors for success and implementation of the program were analyzed. Results suggested that a) limited effectiveness were related to be shortage of functional assessment information of challenging behavior and information to mother how to implement intervention procedures, b) support to solve gaps of needs and practicability for implementor of intervention, c) easy implementation procedure based on augmentative strategies and difficulties procedures based on the direct interaction strategies, and d) the importance of developing support network within family member or community along with life-stage.Lastly, Three problems to be solved were documented. These were to develop methodologies, (1) to gather functional assessment information by mother, (2) to increase implementation by mother by informing accurate procedure to mother or by using augmentative strategies, and (3) to establish support network within family members or community along with life-stage. Less