Ebeveyn-Çocuk Etkileşim Terapisinin Otizmin Sosyal Etkileşim Boyutu ile İlgili Belirtileri Üzerindeki Etkisinin İncelenmesi

Abstract

Otizm spektrum bozukluğu sosyal etkileşim, iletişim ve sınırlı ilgi kümelerinde çeşitli semptomlar içeren bir nörogelişimsel bozukluktur. Bu semptomlara bağlı olarak çocukların çeşitli uyum ve davranış problemleri yaşadıkları alan yazında açıkça belirtilmiştir. Bu çalışmanın amacı ise Türk kültürü için geçerlilik çalışması henüz yapılmış olan ebeveyn çocuk etkileşim terapisinin (PCIT) otizm tanısı ve davranış problemleri olan 67 aylık bir kız çocuğu üzerinde etkisini incelemektir. Ebeveyn ile çocuk arasındaki etkileşimi oyun terapisi teknikleri ile ele alan PCIT, terapist odaklı değil ebeveyn aracılı bir erken dönem müdahale yaklaşımıdır. Davranış ve uyum problemlerinin yanı sıra etkileşim temelli bir yaklaşım olan PCIT’nin otizm belirti kümelerinden sosyal etkileşim belirtileri üzerinde herhangi bir etkisinin olup olmadığının belirlenmesi hedeflenmiştir. Bu hedefe bağlı olarak çalışma vaka incelemesine uygun olarak yürütülmüştür. Yapılan çalışmada davranış ve uyum problemleri için Eyberg Çocuk Davranışları Ölçeği (ECBI) ve PCIT’de Çocuk Davranışlarının Haftalık Değerlendirme Aracı (WACB-P) kullanılırken otizm belirtileri üzerindeki etkinin belirlenmesi için Sosyal İletişim Kontrol Listesi-Revize Form (SİLKOL-R-OTV) kullanılmıştır. Çalışma sürecinde etik kurul onayı alınmış ve aydınlatılmış onam formu ile katılımcıların onayı alınmıştır. Gözlem verisi olarak DPICS kodlama formu kullanılmıştır. Elde edilen sonuçlar PCIT’nin atipik otizm tanısı olan çocukların uyum ve davranış problemleri üzerinde olduğu kadar sosyal etkileşim, iletişim, taklit ve oyun becerilerini iyileştirme noktasında da etkili olduğunu göstermiştir. Elde edilen sonuçlar alanyazın ile tartışılarak araştırmacılara öneriler sunulmuştur.

Keywords

• otizm
• sosyal etkileşim
• davranış problemleri
• ebeveyn-çocuk etkileşim terapisi

An Investigation of the Effect of Parent-Child Interaction Therapy on Symptoms Related to Social Interaction Dimensions of Autism

Abstract

Autism is a disorder that includes a variety of symptoms related to social interaction, communication, and limited sets of interests. It has been clearly stated in the literature that children experience various compliance and behavioral problems due to these symptoms. The purpose of the present study is to examine the effect of parent-child interaction therapy (PCIT), which has just been validated for Turkish culture, on a 67-month-old girl with an autism diagnosis and behavioral problems. PCIT, which takes the interaction between the parent and the child with play therapy techniques, is a parent-mediated early intervention approach, not therapist-oriented. In addition to behavioral and compliance problems, this study aimed to determine whether PCIT, an interaction-based approach, has any effect on social interaction symptoms, one of the clusters of autism symptoms. Based on this aim, the study was conducted in accordance with a case report. In this study, the Eyberg Child Behavior Scale (ECBI) and Child Behavior Weekly Assessment Tool (WACB-P) in the PCIT were used to assess behavioral and compliance problems, while the Social Communication Checklist-Revised Form (SILKOL-R-OTV) was used to determine the effect on autism symptoms. Ethics committee approval was obtained during the study process and the consent of the participants was obtained with an informed consent form. The DPICS coding form was used for observation data. The results showed that PCIT was effective in improving social participation, communication, imitation, and play skills, as well as compliance and behavioral problems in children diagnosed with atypical autism. The obtained results were discussed in the light of the literature, and suggestions were presented to the researchers.

Keywords

• autism
• social interaction
• behavioral problem
• parent-child interaction therapy.

Thanks

I would like to thank Yağmur's parents, who voluntarily participated in this study and internalized therapy skills with dedication. I would like to thank Prof. Dr. Sheila Eyberg, who conceptualized and implemented PCIT, on behalf of all children and parents who benefited from the therapy. I would like to thank Prof. Dr. Cheryl B McNeil and Prof. Dr. İsmail Seçer for their important support in becoming PCIT therapists.

References

1. Agazzi, H., Tan, R., & Tan, SY (2013). A case study of parent interaction therapy for the treatment of autism spectrum disorder. Clinical Case Studies, 12(6). https://doi.org/10.1177/1534650113500067
2. Allen, K., Harrington, J., Quetsch, L. B., Masse, J., Cooke, C., & Paulson, J. F. (2022). Parent–Child Interaction Therapy for children with disruptive behaviors and autism: a randomized clinical trial. Journal of Autism and Developmental Disorders. https://doi.org/10.1007/s10803-022-05428-y
3. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing
4. Bearss, K. (2018). Mapping PCIT onto the Landscape of Parent Training Programs for Youth with Autism Spectrum Disorder. In McNeil, C., Quetsch, L., Anderson, C. (Eds) Handbook of Parent-Child Interaction Therapy for Children on the Autism Spectrum. Springer. https://doi.org/10.1007/978-3-030-03213-5_12
5. Center for Disease Control and Prevention (2018). Data & Statistics on Autism Spectrum Disorder: Prevelance. https://www.cdc.gov/ncbddd/autism/data.html
6. DeFilippis, M. (2018). Depression in children and adolescents with autism spectrum disorder. Children, 5(9), https://doi.org/10.3390/children5090112
7. Eyberg, S. M. (1998). Maintenance of treatment effects: Introduction to the special series. Clinical Psychology, 5, https://doi.org/10.1111/j.1468- 2850.1998.tb00169.x.
8. Eyberg, S. M., & Pincus, D. B. (1999). Eyberg child behavior inventory and Sutter-Eyberg behavior inventory-revised: Professional manual. Psychological Assessment Resources

9. Eyberg, S., Chase, R., Fernandez, M., & Nelson, M. (2014). Dyadic parent-child interaction coding system (DPICS): Clinical manual. PCIT International.
10. Forte, L., Boys, D., & Timmer, S. (2012). The use of brief child behavior assessments for weekly check-ins in PCIT: WACB-P-N and WACB-P. [Poster presentation]. 12th Annual PCIT Conference for Traumatized Children, Davis, CA
11. Funderburk, B. W., & Eyberg, S. (2011). Parent–child interaction therapy. In J. C. Norcross, G. R. VandenBos, & D. K. Freedheim (Eds.), History of psychotherapy: Continuity and change (p. 415–420). American Psychological Association. https://doi.org/10.1037/12353-021
12. Furukawa, K., Okuno, H., Mohri, I., Nakanishi, M., Eyberg, S. M., & Sakai, S. (2018). Effectiveness of child-directed interaction training for young Japanese children with autism spectrum disorders. Child & Family Behavior Therapy, 40(2), https://doi.org/10.1080/07317107.2018.1477344
13. Han, R. C., Naguib, S., Owen, C. K., Druskin, L. R., Keen, K. R., Piper, R., Hobert, S., N., Shank, S. D., Victory, E. J., & McNeil, C. B. (2022). An effectiveness trial of PCIT for children with and without autism spectrum disorder in a private practice setting. Evidence-Based Practice in Child and Adolescent Mental Health, 7(1), https://doi.org/10.1080/23794925.2021.1993109
14. Ingersoll, B., & Dvortcsak, A. (2010). Teaching social communication: A practitioner’s guide to parent training for children with autism. New York, NY: Guilford Press.
15. İnan, B., Ökcün-Akçamuş, M. Ç., Bakkaloğlu, H., & Yalçın, S. (2020). Turkish adaptation and validity-reliability study of the revised Social Communication Checklist for children wıth autism spectrum disorder. Journal of Early Childhood Studies, 4(1), https://www.journalofomepturkey.org/index.php/eccd/article/view/193/185
16. Lesack, R., Bearss, K., Celano, M., & Sharp, W.G. (2014). Parent–child interaction therapy and autism spectrum disorder: Adaptations with a child with severe developmental delays. Clinical Practice in Pediatrics Psychology, 2(1), https://doi.org/10.1037/cpp0000047
17. Mannion, A., Brahm, M., & Leader, G. (2014). Comorbid psychopathology in autism spectrum disorder. Review Journal of Autism and Developmental Disorders, 1(2), https://doi.org/10.1007 /s40489-014-0012-y
18. Masse, J. J., McNeil, C.B., Wagner, S.M., & Chorney, D.B. (2007). Parent-child interaction therapy and high operation autism: A conceptual overview. Journal of Early and Intensive Behavior Intervention, 4(4).
19. Masse, J. J., McNeil, C. B., Wagner, S., & Quetsch, L. B. (2016). Examining the efficacy of parent–child interaction therapy with children on the autism spectrum. Journal of Child and Family Studies, 25(8), https://doi.org/10.1007/s10826-016-0424-7
20. Schoorl, J., van Rijn, S., de Wied, M., Van Goozen, S., & Swaab, H. (2016). Emotion regulation difficulties in boys with oppositional defiant disorder/conduct disorder and the relation with comorbid autism traits and attention deficit traits. PloS one, 11(7), https://doi.org/10.1371/journal.pone.0159323
21. Schumacker, R.E., & Lomax, R.G. (2004). A beginner’s guide to structural equation modeling. Psychology Press. Scudder, A., Wong, C., Ober, N., Hoffman, M., Toscolani, J., & Handen, B. L. (2019). Parent–child interaction therapy (PCIT) in young children with autism spectrum disorder. Child & Family Behavior Therapy, 41(4), https://doi.org/10.1080/07317107.2019.1659542
22. Seçer, İ., & Ulaş, S. (2022, 26-29 May). Validity and reliability study of Eyberg child behavior scale in Turkish culture [Oral presentation]. 6th National Interdisciplinary Early Childhood Intervention Congress with International Participation, Eskişehir.
23. Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child & Adolescent Psychiatry, 47(8), https://doi.org/10.1097/CHI.0b013e318179964f
24. Solomon, M., Ono, M., Timmer, S., & Goodlin-Jones, B. (2008). The effectiveness of parent–child interaction therapy for families of children on the autism spectrum. Journal of autism and developmental disorders, 38(9), https://doi.org/10.1007/s10803-008-0567-5
25. Vetter, J. A. (2018). Parent-child interaction therapy for autism spectrum and attention-deficit/hyperactivity disorders: A review of the literature. Child & Family Behavior Therapy, 40(3), https://doi.org/10.1080/07317107.2018.1487740
26. White, S.W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29(3), https://doi.org/10.1016/j.cpr.2009.01.003
27. Zlomke, K.R., Jeter, K., & Murphy, J. (2017). Open-trial pilot of parent-child interaction therapy for children with autism spectrum disorder. Child & Family Behavior Therapy, 39(1), https://doi.org/10.1080/07317107.2016.1267999
28. Zlomke, K. R., & Jeter, K. (2020). Comparative effectiveness of parent–child interaction therapy for children with and without autism spectrum disorder. Journal of Autism and Developmental Disorders, 50(6), https://doi.org/10.1007/s10803-019-03960-y