اثربخشی برنامه خانواده محور مدیریت رفتارهای اضافه اٌتیسم

نوع مقاله : علمی - پژوهشی

نویسندگان

1 دانشگاه شهید بهشتی

2 شهید بهشتی

3 محقق اردبیلی

چکیده

مداخلات والدمحور، روشی مؤثر برای درمان کودکان دارای اوتیسم محسوب می‌شوند. بیشتر این مداخلات متمرکز بر نقائص ارتباطی ـ اجتماعی هستند و کمتر به رفتارهای اضافه پرداخته‌اند. برای رفع این نیاز برنامه خانواده‌محور مدیریت رفتارهای اضافه اوتیسم تهیه شد. هدف این مطالعه بررسی اثربخشی این برنامه روی سه تن از والدین کودکان دارای اوتیسم است. این مطالعه از نوع طرح‌های تک‌آزمودنی است که روی سه کودک دو تا سه‌ساله دارای اختلال اوتیسم انجام شده است. این والدین 10 جلسه انفرادی مداخله را دریافت کردند. ارزیابی‌ها در 9 مرحله (سه ارزیابی خط پایه، پنج ارزیابی در مدت درمان و یک ارزیابی پیگیری) انجام شد. ابزار مورد استفاده در پژوهش حاضر پرسشنامه تجدیدنظرشده رفتارهای تکراری، چک‌لیست رفتار ناهنجار و سیاهه ارزیابی درمان اوتیسم بود. جهت تجزیه و تحلیل داده‌ها از روش تحلیل بصری و اندازه اثر استفاده شد. نتایج مطالعه نشان داد رفتارهای اضافه چون رفتار کلیشه‌ای (82/0d=)، رفتار خودجرحی (100/0d=)، رفتار وسواسی (85/0d=)، رفتار آیینی (69%d=)، رفتار یکنواختی (100/0d=)، رفتار محدود (83/0d=)، بی‌قراری (79/0d=)، پژواک‌گویی (84%d=) و بیش‌فعالی (26/0d=) کاهش یافت. هم‌زمان، کمبودهای رفتاری (چون گفتار، ارتباط، معاشرت) بهبود یافت، بدون آنکه هیچ مداخله‌ای روی کمبودهای رفتارهای اجرا شده باشد. نتایج این مطالعه از اثربخشی برنامه خانواده‌محور مدیریت رفتارهای اضافه اوتیسم حمایت می‌کند. پیشنهاد می‌شود این برنامه به عنوان یکی از درمان‌های زودهنگام رفتارهای اضافه، حتی مقدم بر مداخلات کمبودهای رفتاری مورد استفاده قرار گیرد تا فواید برنامه‌های خانواده‌محور، حاصل شود.  

کلیدواژه‌ها

عنوان مقاله [English]

Evaluation effectiveness of the family-based program of the management on Behavioral Excesses with children autism

نویسندگان [English]

  • esmaeil shiri 1
  • hamidreza Pouretemad 2
  • Jalil fathabadi 2
  • Mohammad narimani 3
1 shahid beheshti
2 department of psychology and education, Shahid Beheshti University, Tehran, Iran
3 mohaghegh ardebili
چکیده [English]

Parent-mediated interventions are considered an effective way to treat children with autism Most of these interventions focus on the social-communicative deficits of these children, and less study is focused on Behavioral Excesses. To overcome this need, a Family-Based Intervention for the management of Behavioral Excesses was developed. The purpose of this study is to evaluate the effectiveness of this program on a group of parents of children with autism. This study was a single-subject design. Three children with autism disorder were selected using the convenience sampling method. Parents of all three children received 10 individual sessions of the Family Based program for the management of behavioral excessive in autism.
Evaluations were Completed in 9 stages (3 baseline evaluations, 5 evaluations during treatment and 1 follow up evaluation). The instrument used in this study was the Repetitive Behavior Scale- Revise, Autism treatment evaluation checklist and The Aberrant Behavior Checklist. Visual analysis and effect size were used to analyze the data. The results of the study showed that Behavioral Excesses (such as Stereotyped, Self-Injurious, Compulsive, Ritualistic, Sameness, Restricted behaviors) have decreased and adaptive behaviors (such as Speech/ communication, Sociability, Sensory/cognitive awareness, Health/physical/behavior (have increased. Also, the effect size showed that this training program is effective on the improvement of Behavioral Excesses on autistic children. The results of this study support the effectiveness of the family-based program for the management of Behavioral Excesses in autism. It is recommended that this program be used as an early intervention for the treatment of autism disorder and with the aim of transferring treatment of autism from centered-based to family-based.

کلیدواژه‌ها [English]

  • Parent-mediated interventions

مراجع

  1. احمدی، ج.، صفری، ط.، همتیان، م.، خلیلی، ز. (1390). بررسی شاخه‌های روانسنجی آزمون تشخیصی اوتیسم (GARS)، مجله پژوهش‌های علوم شناختی و رفتاری، 1 (1): 78-0104.
  2. Aman, M. G., Mcdougle, C. J., Scahill, L., Handen, B., Arnold, L. E., Johnson, C., ... & Sukhodolsky, D. D. (2009). Medication and parent training in children with pervasive developmental disorders and serious behavior problems: results from a randomized clinical trial. Journal of the American Academy of Child & Adolescent Psychiatry, 48(12), 1143-1154.
  3. Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects. American journal of mental deficiency.
  4. Baird, G., Simonoff, E., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., & Charman, T. (2006). Prevalence of disorders of the autism spectrum in a population cohort of children in South Thames: the Special Needs and Autism Project (SNAP). The lancet, 368(9531), 210-215.
  5. Berkson G, Tupa M, Sherman L. Early development of stereotyped and self-injurious behaviors: I. Incidence. American Journal on Mental Retardation. 2001 Nov;106(6):539-47.
  6. Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of autism and developmental disorders, 30(3), 237-243.
  7. Boyd, B. A., Conroy, M. A., Asmus, J. M., McKenney, E. L., & Mancil, G. R. (2008). Descriptive analysis of classroom setting events on the social behaviors of children with autism spectrum disorder. Education and Training in Developmental Disabilities, 186-197.
  8. Boyd, B. A., McDonough, S. G., & Bodfish, J. W. (2012). Evidence-based behavioral interventions for repetitive behaviors in autism. Journal of autism and developmental disorders, 42(6), 1236-1248.
  9. Boyd, B. A., McDonough, S. G., Rupp, B., Khan, F., & Bodfish, J. W. (2011). Effects of a family-implemented treatment on the repetitive behaviors of children with autism. Journal of autism and developmental disorders, 41(10), 1330-1341.
  10. Brown, E. C., Aman, M. G., & Havercamp, S. M. (2002). Factor analysis and norms for parent ratings on the Aberrant Behavior Checklist-Community for young people in special education. Research in developmental disabilities, 23(1), 45-60.
  11. Campbell, J. M. (2003). Efficacy of behavioral interventions for reducing problem behavior in persons with autism: A quantitative synthesis of single-subject research. Research in Developmental Disabilities, 24(2), 120-138.
  12. Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and psychopathology, 20(3), 775-803.
  13. Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23.
  14. Derby, K. M., Wacker, D. P., Sasso, G., Steege, M., Northup, J., Cigrand, K., & Asmus, J. (1992). Brief functional assessment techniques to evaluate aberrant behavior in an outpatient setting: A summary of 79 cases. Journal of Applied Behavior Analysis, 25(3), 713-721.
  15. Disabilities, 28(3), 166-174.
  16. Goldman, S., Wang, C., Salgado, M. W., Greene, P. E., Kim, M., & Rapin, I. (2009). Motor stereotypies in children with autism and other developmental disorders. Developmental Medicine & Child Neurology, 51(1), 30-38.
  17. Grahame, V., Brett, D., Dixon, L., McConachie, H., Lowry, J., Rodgers, J., ... & Le Couteur, A. (2015). Managing repetitive behaviours in young children with autism spectrum disorder (ASD): pilot randomised controlled trial of a new parent group intervention. Journal of autism and developmental disorders, 45(10), 3168-3182.
  18. Hemati, G. h & Rezaei, S. (2013). The effect of horseback riding on the repetitive behaviors of children with autism spectrum disorders. Elixir International Journal, 59, 15833-15838
  19. Hodgetts, S., Nicholas, D., & Zwaigenbaum, L. (2013). Home sweet home? Families’ experiences with aggression in children with autism spectrum disorders. Focus on Autism and Other Developmental
  20. Kaat, A. J., Lecavalier, L., & Aman, M. G. (2014). Validity of the aberrant behavior checklist in children with autism spectrum disorder. Journal of autism and developmental disorders, 44(5), 1103-1116.
  21. Kodak, T., Miltenberger, R. G., & Romaniuk, C. (2003). The effects of differential negative reinforcement of other behavior and noncontingent escape on compliance. Journal of Applied Behavior Analysis, 36(3), 379-382.
  22. Lang, R., O'Reilly, M., Sigafoos, J., Machalicek, W., Rispoli, M., Lancioni, G. E., Aguilar, J., Fragale, C. (2010). The effects of an abolishing operation intervention component on play skills, challenging behavior, and stereotypy. Behavior Modification, 34(4):267-89.
  23. Lewis, M. H. (2004). Environmental complexity and central nervous system development and function. Mental retardation and developmental disabilities research reviews, 10(2):91-5.
  24. Lewis, M. H., Baumeister, A. A., & Mailman, R. B. (1987). A neurobiological alternative to the perceptual reinforcement hypothesis of stereotyped behavior: A commentary on “self‐stimulatory behavior and perceptual reinforcement”. Journal of Applied Behavior Analysis, 20(3), 253-258.
  25. Matson, J. L., Minshawi, N. F., Gonzalez, M. L., & Mayville, S. B. (2006). The relationship of comorbid problem behaviors to social skills in persons with profound mental retardation. Behavior Modification, 30(4), 496-506.
  26. Matson, J. L., Smiroldo, B. B., & Bamburg, J. W. (1998). The relationship of social skills to psychopathology for individuals with severe or profound mental retardation. Journal of Intellectual and Developmental Disability, 23(2), 137-145.
  27. Matson, J. L., Wilkins, J., & Macken, J. (2008). The relationship of challenging behaviors to severity and symptoms of autism spectrum disorders. Journal of Mental Health Research in Intellectual Disabilities, 2(1), 29-44.
  28. Matson, J. L., Benavidez, D. A., Compton, L. S., Paclawskyj, T., & Baglio, C. (1996). Behavioral treatment of autistic persons: A review of research from 1980 to the present. Research in developmental disabilities, 17(6), 433-465.
  29. Memari, A. H., Shayestehfar, M., Mirfazeli, F. S., Rashidi, T., Ghanouni, P., & Hafizi, S. (2013). Cross-cultural adaptation, reliability, and validity of the autism treatment evaluation checklist in Persian. Iranian journal of pediatrics, 23(3), 269.
  30. Morrison, K., & Rosales-Ruiz, J. (1997). The effect of object preferences on task performance and stereotypy in a child with autism. Research in Developmental Disabilities, 18(2), 127-137.
  31. Nock, M. K., & Kazdin, A. E. (2005). Randomized controlled trial of a brief intervention for increasing participation in parent management training. Journal of Consulting and Clinical Psychology, 73(5), 872.
  32. Pierce, K., & Courchesne, E. (2001). Evidence for a cerebellar role in reduced exploration and stereotyped behavior in autism. Biological psychiatry, 49(8), 655-664.
  33. Reese, R. M., Richman, D. M., Belmont, J. M., & Morse, P. (2005). Functional characteristics of disruptive behavior in developmentally disabled children with and without autism. Journal of Autism and Developmental Disorders, 35(4), 419-428.
  34. Rimland, B., & Edelson, S. M. (2000). Autism treatment evaluation checklist (ATEC). Retrieved October, 23, 2006.
  35. Rogers, S. J., & Vismara, R. L. (2008). Evidence-based comprehensive treatments for early autism. Journal of Clinical Child & Adolescent Psychology, 37, 8–38.
  36. Sawyer, A., Lake, J. K., Lunsky, Y., Liu, S. K., & Desarkar, P. (2014). Psychopharmacological treatment of challenging behaviours in adults with autism and intellectual disabilities: A systematic review. Research in Autism Spectrum Disorders, 8(7), 803-813.
  37. Sigafoos, J., Arthur, M., & O'Reilly, M. F. (2003). Challenging behavior and developmental disability. London: Whurr.
  38. Wacker, D. P., Berg, W. K., Harding, J. W., Derby, K. M., Asmus, J. M., & Healy, A. (1998). Evaluation and long-term treatment of aberrant behavior displayed by young children with disabilities. Journal of Developmental and Behavioral Pediatrics.

فایل ها

هم رسانی

ارجاع به این مقاله

آمار