중도장애아동을 위한 가족중심 보완대체의사소통(AAC) 중재가 부모의 의사소통 전략 및 아동의 의사소통 능력에 미치는 영향 = The Effect of the Family-centered AAC Intervention on Communication Skills of Children with Severe Disabilities and Communication Strategies of Parents

다국어 초록 (Multilingual Abstract)

Children with severe disabilities are subject to various problems such as problem behavior and restricted social interaction due to limited communication skills. Therefore, the use of augmentative and alternative communication(AAC) should be considered as effective communication intervention of children with severe disabilities. The purpose of this study was to describe two effects of family-centered AAC intervention such as the communication skills of the children, communication strategies of the parents. The participants of this study were 6 children with severe disabilities and their families. The experiment design was the small group single-case design. It conducted over approximately 3 months, in the order of pre-test, intervention, and post-test. The intervention consisted of 12 sessions of the program. The results of the study were as follow: First, study has shown the increase in use of communication strategies by parents. Second, improvements of communication involvement and communication trials were observed to the children with severe disabilities, and differences were observed between snack activities and play activities for the communication turn taking. After AAC device used, the modes of communication resulted in decrease in the use of gestures, whereas remained the same or increase in the use of speech. As a result, communication effectiveness was increased in post-treatment rather in pre-treatment. These results suggest that family-centered intervention can be a positive influence on children-parent communication skills.

국문 초록 (Abstract)

본 연구는 가족중심 보완대체의사소통(alternative and augmentative communication. 이하 AAC) 중재가 중도장애 아동의 의사소통 능력과 부모의 의사소통 전략 사용에 미치는 효과를 살펴보았다. 이를 위해 6명의 중도장애 아동을 대상으로 사전-사후 분석을 통해 복합분석 단위의 소규모 단일사례연구를 실시하였다. 본 연구에서 실시한 가족중심 AAC 중재는 지원단계와 실행단계로 구분되며 7회의 소그룹 교육과 5회의 개별 가정방문으로 구성되었다. 본 연구결과에 따르면, 첫째, 가족중심 AAC 중재를 통해 부모의 의사소통 전략 사용이 유의미하게 증가하였고, 특히 요구하기 중심에서 반응하기와 모델링 사용으로 변화하였다. 둘째, 아동의 의사소통 발생 비율에서 유의미한 차이에 영향을 주었고, 사전에 비하여 사후에 아동의 의사소통 활동 참여도 및 의사소통 발생 비율, 대화 주고받기, 의사소통 형태, 의사소통 시도 효율성에서 변화가 나타났다. 이에 본 연구 결과에 따라, 부모와 중도장애 아동의 의사소통 전략 사용과 의사소통 능력에 긍정적 영향을 미친 가족중심 AAC 중재의 구성 요소 및 영향들에 대해 논의하였고 추후 연구를 위한 제언을 하였다.

참고문헌 (Reference)

1 박은혜, "파라다이스 보완대체의사소통 기초능력평가(PAA)" 파라다이스 복지재단 2008

2 한선경, "태블릿 PC를 이용한 AAC 중재가 무발화 중도 자폐범주성장애학생의 의사소통 양상에 미치는 영향" 한국언어청각임상학회 17 (17): 92-106, 2012

3 임장현, "참여모델을 적용한 태블릿 PC기반의 AAC중재가 통합된 장애학생의 의사소통행동에 미치는 영향" 한국특수교육학회 46 (46): 85-106, 2011

4 김정연, "지체장애 학생 교육" 학지사 2010

5 한경근, "중도장애학생의 교육 제6판" 시그마프레스 2008

6 백유순, "조기 중재 및 유아특수교육에서의 가족중심 실제를 위한 실천 과제" 한국유아특수교육학회 8 (8): 89-111, 2008

7 김영태, "영유아언어발달검사(SELSI)" 도서출판 특수교육 2003

8 김영태, "아동언어장애의 진단 및 치료" 학지사 2003

9 이금진, "소집단 부모참여프로그램이 어머니와 발달지체 영유아의 상호작용행동 및 영유아의 언어능력에 미치는 영향" 한국특수교육학회 42 (42): 1-25, 2008

10 정필연, "상호작용촉진 부모교육프로그램이 취학전 뇌성마비아동과 어머니의 의사소통행동에 미치는 영향" 한국특수교육학회 47 (47): 39-62, 2012

11 신경식, "사례연구방법" 한경사 2011

12 김정연, "비구어 뇌성마비 아동의 의사소통 중재를 위한 부모교육 프로그램 실행에 대한 질적 연구" 한국특수교육문제연구소 9 (9): 209-231, 2008

13 이은경, "부모중심 언어중재가 인공와우이식 아동의 어휘능력에 미치는 영향" 한국언어치료학회 16 (16): 13-29, 2007

14 이은경, "부모중심 언어중재가 인공와우이식 아동의 수용언어능력에 미치는 영향" 한국음성과학회 14 (14): 147-160, 2007

15 김경양, "보완대체의사소통(AAC) 가족 참여연구 동향 분석 통한 중재 요소 고찰" 특수교육연구소 10 (10): 219-243, 2011

16 박현주, "보완대체의사소통" 학지사 2008

17 이윤숙, "발달장애아동을 위한 보완․대체의사소통체계 연구 동향 분석: 2000～2009년 논문을 중심으로" 한국특수교육학회 45 (45): 39-67, 2010

18 강우정, "국내 보완·대체의사소통 연구 동향 분석: 1994년부터 2011년까지" 한국자폐학회 11 (11): 131-161, 2011

19 김경양, "가족-중심 보완대체의사소통(AAC) 중재가 자폐범주성 장애아동의 의사소통 능력과 가족 인식에 미치는 영향" 한국자폐학회 12 (12): 51-72, 2012

20 김정미, "『It Takes Two to Talk』부모교육프로그램이 언어발달지체아동의 의사소통과 부모의 행동에 미치는 효과" 한국언어청각임상학회 12 (12): 607-624, 2007

21 Cafiero, J. M., "Your child with autism: when is augmentative and alternative communication an appropriate option?" 38 (38): 28-30, 2008

22 Parette, P., "Young African American Children with Disabilities and Augmentative and Alternative Communication Issues" 29 (29): 201-207, 2002

23 Trudeau, N., "Using augmentative and lnternative communication approaches to promote participation of preschoolers during book reading: a pilot" 19 (19): 181-210, 2003

24 Skau, L., "Using Assistive Technicology to Foster Speech and Language Skills at Home and in Preschool" 38 : 12-17, 2006

25 Branson, D., "The use of alternative and augmentative communication methods with infants and toddlers with disabilities: A research review" 25 (25): 274-286, 2009

26 Millar, D. C., "The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: A research review" 49 : 248-264, 2006

27 Best, S. J., "Teaching individuals with physical, health, or multiple disabilities" Merrill 2005

28 Snell, M., "Teaching augmentative and alternative communication to students with severe disabilities: A review of intervention research 1997-2003" 31 : 203-214, 2006

29 Binger, C., "Teaching Tatino parents to support the multi-symbol message productions of their children who require AAC" 24 (24): 323-338, 2008

30 TASH, "TASH resolution on the people for whom TASH advocates"

31 Horn, E., "Supporting Young Children With Multiple Disabilities: What Do We Know and What Do We Still Need To Learn?" 31 : 241-248, 2012

32 Thunberg, G., "Speech-generating devices used at home by children with autism spectrum disorders: a preliminary assessment" 24 (24): 104-114, 2009

33 Stiebel, D., "Promoting augmentative communication during daily routines: a parent problem-solving intervention" 1 (1): 159-169, 1999

34 Stephenson, J., "Parents’ perspectives on the communication skills of their children with severe disabilities" 30 (30): 75-85, 2005

35 Romski, M. A., "Parent perceptions of the language development of toddlers with developmental delays before and after participation in parent-coached language interventions" 20 : 111-118, 2011

36 Lund, S., "Long-term outcomes for individuals who use augmentative and alternative communication: Part I - What is a “good” outcome?" 22 : 284-299, 2006

37 Thunberg, G., "Interaction and use of speech-generating device in the homes of children with autism spectrum disorders- an analysis of conversational topics" 24 (24): 1-16, 2009

38 Pless, M., "Implementation of the International Classification of Functioning, Disability and Health (ICF) and the ICF Children and Youth Version(ICF-CY) Within the Context of Augmentative and Alternative Communication" 28 (28): 11-20, 2012

39 Angelo, D. H., "Impact of augmentative and alternative communication devices on families" 16 (16): 37-47, 2000

40 Dunst, C. J., "Family-centered practices: Birth through high school" 36 : 139-147, 2002

41 Starble, A., "Family-centered intervention and satisfaction with aac device training" 27 : 47-54, 2005

42 Angleo, D. H., "Family perspective on augmentative and alternative communications: families of young children" 11 : 193-201, 1996

43 Clarke. M. T., "Factors associated with the participation of children with complex communication needs" 32 : 774-780, 2011

44 Nunes, D., "Enhancing the alternative and augmentative communication use of a child with autism through a parent-implemented naturalistic intervention" 54 (54): 177-197, 2007

45 Rosa-Lugo, L. I., "Effects of parent instruction on communicative turns of latino children using augmentative and alternative communication during storybook reading" 30 (30): 49-61, 2008

46 Kent-Walsh, J., "Effect of parent instruction on the symbolic communication of children using augmentative and alternative communication during storybook reading" 19 : 97-107, 2010

47 Rowland, C., "Developing the ICF-CY for AAC Profile and Code Set for Children Who Rely on AAC" 28 (28): 21-32, 2012

48 Simeonsson, R. J., "Communication, Disability, and the ICF-CY" 28 (28): 3-10, 2012

49 Thunberg, G., "Children with autistic spectrum disorders and speech generating devices: Communication in different activities at home" 21 (21): 457-479, 2007

50 Romski, M. A., "Breaking the speech barrier: Language development through augmented means" Brookes 1996

51 Romski, M. A., "Augmentative communication and early intervention" 18 (18): 174-185, 2005

52 Parette, H. P., "Augmentative and alternative communication: trends and future directions" 30 (30): 77-98, 1996

53 Beukelman, D. R., "Augmentative and Alternative Communication: supporting children and adults with complex communication needs" Paul H. Brookes Publishing Co, Inc 2012

54 Granlund, M., "AAC interventions for children in a family environment: implementing evidence in practice" 24 (24): 207-219, 2008

55 Hourcade, J., "A history of alternative and augmentative communication for individuals with severe and profound disabilities" 19 : 235-244, 2004