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美国残疾婴儿和学步儿早期干预计划

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美国残疾婴儿和学步儿早期干预计划
美国残疾婴儿和学步儿早期干预计划

[摘要]美国“残疾婴儿和学步儿早期干预计划”旨在为3岁以下残疾婴幼儿提供早期干预服务,以满足3岁以下残疾婴幼儿及其家庭的特殊需要。“残疾婴儿和学步儿早期干预计划”的重要特点是免费性、普及性和全纳性。已有研究表明,美国“残疾婴儿和学步儿早期干预计划”的效果是积极的。我国可以借鉴美国的做法,逐步采取残疾婴幼儿早期干预措施尽可能为残疾婴幼儿的发展提供帮助。 [关键词]婴儿;学步儿;早期干预计划;美国 近年来,我国开始重视对残疾儿童的早期教育问题,各地建立起许多为残疾儿童服务的早期诊断、早期训练中心。但是和一些发达国家相比,我国为残疾儿童提供的早期教育服务还有待加强。本文详细论述美国“残疾婴儿和学步儿早期干预计划”的制定及实施情况,旨在为发展我国残疾儿童的早期教育服务提供借鉴。 一、早期干预计划的出台 直到上世纪70年代初期,美国仍有一半以上的残疾儿童没有享受到适当的教育服务。为了改变这种状况,美国国会于1975年通过了《全体残疾儿童教育法》,要求各州为所有残疾儿童提供免费的特殊教育和相关服务,并确立了零拒绝、非歧视性评估、适当教育、最少限制环境、适当核查程序和家长参与等六条原则。[1]该法案的实施,促进了美国残疾儿童特殊教育服务的完善。1976年美国有371万名残疾儿童接受了公费特殊教育,到1980年接受公费特殊教育的残疾儿童人数上升到418万,1990年为481万,1998年增加到630万。[2] 但是,1975年颁布的《全体残疾儿童教育法》中的全体残疾儿童只是指3~21岁的残疾儿童,3岁以下残疾婴幼儿的特殊教育服务仍然没有得到法律保障。直到1986年,美国国会对1975年的《全体残疾儿童教育法》进行修正,通过了《99-457公法》,要求各州逐步建立全州范围的、综合的、多学科和多部门合作的早期干预计划,即“残疾婴儿和学步儿早期干预计划”(the Early Intervention Program for Infants and Toddlers with Disabilities),以满足3岁以下残疾婴幼儿及其家庭的特殊需要。该法案颁布后,美国各州先后申请实施这一“残疾婴儿和学步儿早期干预计划”。至1994年9月底,美国所有州都开始全面实施这一干预计划。[3] 1990年,美国国会修订了《99-457公法》,颁布了《残疾个体教育法》,后来又对《残疾个体教育法》进行多次修正。目前最新的版本是2004年的《残疾个体教育法修正案》(Individual with Disabilities Education Improvement Act Of 2004)。[4]需要强调的是,所有修正案都保留了早期干预计划的条款,而且愈来愈重视加强这一条款。 二、早期干预计划的目的 《残疾个体教育法》清楚地阐述了早期干预计划的目的。早期干预计划的目的主要包括四个方面:(1)通过早期干预来促进3岁以下残疾婴幼儿的发展,从而把他们发展滞后的可能性降到最低程度。(2)努力改善早期干预的康复效果,把残疾婴幼儿进入学校后的特殊教育需要降到最低程度,从而降低社会和学校为学龄儿童支付的特殊教育开支。(3)尽可能提高残疾婴幼儿成年后独立生活的能力,把他们进入收容所的可能性降到最低程度。(4)提高家庭满足残疾婴幼儿特殊需要的能力。[5] 三、早期干预计划的服务对象、服务内容和服务提供者 《残疾个体教育法》规定,早期干预计划的服务对象包括以下三类0~3岁的婴幼儿(即月龄36个月以下的婴幼儿):(1)通过适当的诊断程序和工具确诊的具有以下五种情况中的一种或多种的婴幼儿及其家庭:(a)认知发展滞后;(b)生理发展滞后;(c)交流能力发展滞后;(d)社会发展或情绪发展滞后;(e)适应能力发展滞后。(2)通过适当的诊断程序和工具确诊的具有可能导致发展滞后的生理或心理症状的婴幼儿及其家庭。(3)高危(at risk)儿童,即那些被诊断为具有可能导致发展滞后的生理或心理问题的婴幼儿,如出生时体重过低等。各州有权自行决定是否为高危儿童提供早期干预服务。[6]《残疾个体教育法》还规定,一旦确定某个3岁以下婴幼儿需要接受早期干预,专家小组就要在家长的参与下为该婴幼儿制订一份书面的个别化家庭服务计划,然后根据个别化家庭服务计划提供相应的服务。 早期干预服务主要包括家长培训、家长咨询、婴幼儿特殊教学、婴幼儿言语和语言训练以及各种婴幼儿生理、心理康复治疗等内容。从已有资料来看,最常见的早期干预服务是婴幼儿特殊教学和言语训练,听觉矫治则比较少见。[7]

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