自閉スペクトラム症の社会モデル的な支援に向けた情報保障のデザイン 当事者研究の視点から
目的：自閉スペクトラム症の概念は純粋なインペアメントではなくディスアビリティを記述しているために，社会的排除の個人化を通じて有病率が大きく影響するだけでなく，医療モデルに基づく社会適応が支援の目標とされる状況が続いている．社会モデルに基づく自閉スペクトラム症者に対する支援を実現するために，本研究では，コミュニケーション障害を個人のインペアメントではなく，情報保障の不十分と読み替え，個々人に固有のインペアメントの探求と，インペアメント理解を踏まえたうえでの情報保障の探求の 2 点を目的とする．方法：2008年以降，自閉スペクトラム症の診断を持つ綾屋とともに，本人固有のインペアメントを探究する当事...
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| Published in | 保健医療科学 Vol. 66; no. 5; pp. 532 - 544 |
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| Main Author | |
| Format | Journal Article |
| Language | Japanese |
| Published |
国立保健医療科学院
01.10.2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1347-6459 2432-0722 |
| DOI | 10.20683/jniph.66.5_532 |
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| Abstract | 目的：自閉スペクトラム症の概念は純粋なインペアメントではなくディスアビリティを記述しているために，社会的排除の個人化を通じて有病率が大きく影響するだけでなく，医療モデルに基づく社会適応が支援の目標とされる状況が続いている．社会モデルに基づく自閉スペクトラム症者に対する支援を実現するために，本研究では，コミュニケーション障害を個人のインペアメントではなく，情報保障の不十分と読み替え，個々人に固有のインペアメントの探求と，インペアメント理解を踏まえたうえでの情報保障の探求の 2 点を目的とする．方法：2008年以降，自閉スペクトラム症の診断を持つ綾屋とともに，本人固有のインペアメントを探究する当事者研究を継続的に行ってきた．研究では，綾屋の主観的経験の中に立ち現れる，通状況的なパターンの抽出と，1回性のエピソードの物語的統合の 2 つに取り組み，後者に関しては2011年以降，綾屋と類似した経験をもつ当事者との研究を継続して行った．また，2012年以降は，当事者研究で提案されたインペアメントに関する仮説を検証する実験も並行して行った．結果：情報保障に関連したインペアメントには，音声や文字といった記号表現や，事物の認識におけるパターン化の粒度が，定型発達者よりも細かいという点が重要だとわかった．情報保障の具体例としては，音声の伝達場面ではパソコンや手話の使用，残響の生じない部屋，同時発話のないコミュニケーション様式，短い面談時間と面談での筆記用具の持ち込みなど，文字の伝達においてはコミックサンズというフォントの使用，文字の大きさや行間の調整，光沢のない紙の使用，文字の背景色を薄茶色にするなど，そして全般的に同期的マルチモーダルな情報提示が有効であった．また事物の認識に関しては，音声言語と日本語対応手話の同期的マルチリンガル情報提示や，事後的な「意味づけ介助」が有効だった．結論：自閉スペクトラム症と診断される人々のインペアメントは異種混淆的なので，一人一人に合った情報保障の在り方も多様性がある．したがって，本研究の方法を参考にし，個別の対象者と当事者研究を行うことが望ましい． |
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| AbstractList | 目的：自閉スペクトラム症の概念は純粋なインペアメントではなくディスアビリティを記述しているために，社会的排除の個人化を通じて有病率が大きく影響するだけでなく，医療モデルに基づく社会適応が支援の目標とされる状況が続いている．社会モデルに基づく自閉スペクトラム症者に対する支援を実現するために，本研究では，コミュニケーション障害を個人のインペアメントではなく，情報保障の不十分と読み替え，個々人に固有のインペアメントの探求と，インペアメント理解を踏まえたうえでの情報保障の探求の 2 点を目的とする．方法：2008年以降，自閉スペクトラム症の診断を持つ綾屋とともに，本人固有のインペアメントを探究する当事者研究を継続的に行ってきた．研究では，綾屋の主観的経験の中に立ち現れる，通状況的なパターンの抽出と，1回性のエピソードの物語的統合の 2 つに取り組み，後者に関しては2011年以降，綾屋と類似した経験をもつ当事者との研究を継続して行った．また，2012年以降は，当事者研究で提案されたインペアメントに関する仮説を検証する実験も並行して行った．結果：情報保障に関連したインペアメントには，音声や文字といった記号表現や，事物の認識におけるパターン化の粒度が，定型発達者よりも細かいという点が重要だとわかった．情報保障の具体例としては，音声の伝達場面ではパソコンや手話の使用，残響の生じない部屋，同時発話のないコミュニケーション様式，短い面談時間と面談での筆記用具の持ち込みなど，文字の伝達においてはコミックサンズというフォントの使用，文字の大きさや行間の調整，光沢のない紙の使用，文字の背景色を薄茶色にするなど，そして全般的に同期的マルチモーダルな情報提示が有効であった．また事物の認識に関しては，音声言語と日本語対応手話の同期的マルチリンガル情報提示や，事後的な「意味づけ介助」が有効だった．結論：自閉スペクトラム症と診断される人々のインペアメントは異種混淆的なので，一人一人に合った情報保障の在り方も多様性がある．したがって，本研究の方法を参考にし，個別の対象者と当事者研究を行うことが望ましい． |
| Author | 熊谷, 晋一郎 |
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| Copyright | 2017 国立保健医療科学院 |
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| Title | 自閉スペクトラム症の社会モデル的な支援に向けた情報保障のデザイン |
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