中國大陸語言治療師提供早期療育兒童（0~6歲）輔助溝通系統（AAC）的觀點

中國大陸有9443萬學齡前兒童，其中溝通障礙兒童約5~20%。2022年1~11月底，共有33.2萬兒童接受早期療育，由語言治療師為溝通障礙兒童提供AAC服務。中國大陸早期療育及語言治療起步較晚，2012年教育部設立專門的聽語科系學士學位。許多語言治療師學歷背景各不相同，提供AAC服務專業技能水平差距較大。已有研究探究其他國家及地區的語言治療師提供AAC的經驗及現況，中國大陸也有研究探究語言治療師的服務現況，但尚無針對語言治療師提供兒童AAC服務現況的研究。為瞭解中國大陸早期療育的語言治療師提供輔助溝通系統(AAC)的經驗及觀點，本研究欲探討中國大陸語言治療師提供早期療育兒童使用AAC的觀點。本研究招募16位年資一年以上的中國大陸語言治療師，進行半結構式深度訪談瞭解其對於早療兒童AAC使用的觀點。訪談大綱由研究者與指導教授共同圍繞現況、決定因素及需求期待三個研究目標編制，包括6個訪談問題，同時邀請2位來自中國大陸的語言治療的專家協助修改內容並建立專家效度。通過騰訊會議(VooV Meeting)進行遠端視訊訪談，過程將錄影錄音作為訪談資料並謄寫為逐字稿後依研究對象意見進行適當調整。採用主題分析法分析資料，由研究者編碼後與指導教授討論形成類別與主題，同時搭配研究對象檢核等技術確保研究品質。主題分析法揭示了9個主題與若干子主題，現況包括「AAC介入目標」、「AAC的發展」及「外部環境的支持與阻礙」等。決定因素包括「兒童自身因素」與「外部環境因素」。需求及期待包括「實行的需求」、「態度的需求」、「政策的需求」以及「知識與技能面的需求」。研究結果描述了中國大陸語言治療師提供早期療育兒童AAC特有的醫療、文化與教育現況，強調AAC的需求是基於現況的延伸，建議了未來AAC推廣、法規制定、教育培訓與輔具服務的方向。然而，本研究存在5個限制，可能無法代表整個中國大陸所有語言治療師提供早期療育兒童AAC的現況。

This study focuses on the experiences and perspectives of Speech-Language Pathologists (SLPs) providing Augmentative and Alternative Communication (AAC) services to children in early intervention in Chinese mainland. With 94.43 million pre-school children in China, 5-20% of whom have communication disorders, only 332,000 received early intervention and AAC services from January to November 2022. Early intervention and speech therapy in Chinese mainland started relatively late, with the Ministry of Education establishing a specialized bachelor's degree program specifically for Speech-Language Pathology and Audiology in 2012. SLPs in Chinese mainland exhibit diverse educational backgrounds and varying professional skills in AAC service provision. While studies have examined SLPs' AAC experiences and current situations in other regions, none have specifically focused on children's AAC services in Chinese mainland.This study recruited 16 SLPs with more than one year of experience in Chinese mainland for semi-structured in-depth interviews. The interview outline, developed around three research objectives (current situation, determinants, and needs and expectations), consisted of six questions. Two experts as SLPs from Chinese mainland assisted in refining the content and establishing expert validity. Remote video interviews were conducted via Tencent Meeting, with recordings transcribed into verbatim scripts and adjusted based on participant feedback. Thematic analysis was employed, involving coding by the researcher and discussion with the supervising professor to form categories and themes, ensuring study quality through techniques like participant checking.The analysis revealed nine themes and several sub-themes, including AAC intervention goals, AAC development, and support and barriers from the external environment. Determinants encompassed children's own factors and external environmental factors. Needs and expectations comprised implementation, attitudinal, policy, and knowledge and skill needs. The study outcomes describe the medical, cultural, and educational status of SLPs providing AAC to children in early intervention in Chinese mainland. It emphasizes that AAC needs extend from the current situation and suggests future directions for AAC promotion, regulation, education, training, and communication aids. However, the study has five limitations and may not be representative of all SLPs providing AAC to children in early intervention across Chinese mainland.