Otizm Spektrum Bozukluğu Olan Bir Çocukta DIR/Floortime Müdahalesinin Duyusal İşlemleme ve Uyum Davranışı Üzerine Etkisi: Olgu Sunumu
Yıl 2020,
Cilt: 8 Sayı: 2, 175 - 184, 09.09.2020
Sinem Kars
,
Meral Huri
,
Hülya Kayıhan
,
Çiğdem Ergül
Öz
Ebeveyn-çocuk
etkileşimi ve oyun becerilerinin geliştirilmesi otizm spektrum bozukluğu (OSB)
olan çocuklarda önemli bir hedeftir. DIR Floortime (Gelişimsel, Bireysel
Farklılık ve İlişki Temelli) bu hedeflere odaklanan bir müdahale yaklaşımıdır.
Çalışmamızdaki amacımız DIR Floortime yaklaşımının kullanıldığı bir yıllık
müdahale programının OSB’li bir çocukta sosyal beceri ve adaptif davranış
üzerine etkisini incelemekti. OSB
tanısı olan 3 yaş 10 aylık erkek çocuk çalışmaya dahil edildi. Duyusal
işlemleme becerilerinin değerlendirilmesinde Duyu Profili; adaptif davranışının
değerlendirilmesinde ise Amerikan Zeka Geriliği Birliği Uyumsal Davranış Ölçeği
(ABS) uygulandı. Müdahale öncesi ve sonrası değerlendirmeler tekrarlandı. Duyusal işlemleme becerilerinde ve
uyumsal davranışta gelişmeler belirlendi. Ayrıca anne, ebeveyn-çocuk
etkileşiminde ve çocuğun iletişim becerilerinde olumlu değişimler olduğunu
belirtti. DIR Floortime yaklaşımı,
çocuğun bireysel farklılıklarının ve fonksiyonel duygusal gelişimsel
kapasitesinin yetişkin-çocuk etkileşimi sırasında dikkate alınmasını
önermektedir. Oyun sırasında, çocuğun liderliğinin takip edilmesi çocuğun oyuna
aktif katılımını sağlayarak OSB’li çocuklarda fonksiyonel gelişim kapasitesinin
güçlenmesini veya oluşmasını sağlayacaktır.
Kaynakça
- Baranek, G. T., David, F. J., Poe, M. D., Stone, W. L., & Watson, L. R. (2006). Sensory Experiences Questionnaire: Discriminating sensory features in young children with autism, developmental delays, and typical development. J Child Psychol Psychiatry, 47(6), 591-601. https://doi.org/10.1111/j.1469-7610.2005.01546.x
- Baron-Cohen, S. (1997). Mindblindness: An essay on autism and theory of mind. Cambridge, MA, US: The MIT Press.
- Başal, H. A. (1997). İlkokul Çocukları İçin Uyumsal Davranış Ölçeği (AAMD Adaptive Behavior Scale, Public School Version, 1974) bir geçerlik-güvenirlik çalışması. Eğitim ve Bilim, 21(105), 37-43.
- Bryson, S. E., Rogers, S. J., & Fombonne, E. (2003). Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management. The Canadian Journal of Psychiatry, 48(8), 506-516. https://doi.org/10.1177/070674370304800802
- Castillo, R., Carlat, D., Millon, T., Millon, C., Meagher, S., Grossman, S., et al. (2007). Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association Press.
- Cullinane, D. (2012). Evidence base for the DIR®/Floortime approach. Erişim tarihi 31 Temmuz 2019, https://sa1s3.patientpop.com/assets/docs/62315.pdf
- Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Dev Psychopathol, 20(3), 775-803. https://doi.org/10.1017/S0954579408000370
- Dionne, M., & Martini, R. (2011). Floor time play with a child with autism: A single-subject study. Can J Occup Ther, 78(3), 196-203. https://doi.org/10.2182/cjot.2011.78.3.8
- Dunn, W. (1999). The sensory profile manual. San Antonio, TX: Psychological Corporation.
- Epir, S. (1976). İlkokul çocukları için AAMD Uyumsal Davranış Skalası (1974 revizyonu), Türkçe adaptasyon el kitabı. Ankara: MEB Talim Terbiye Dairesi.
- Greenspan, S. I., DeGangi, G., & Wieder, S. (2001). The functional emotional assessment scale for infancy and childhood, FEAS. Bethesda, MD: Interdisciplinary Council on Developmental and Learning Disorders.
- Güleç-Aslan, Y. (2011). Bir vaka sunumu: Otizm için risk taşıyan bir çocukta Uygulamalı Davranış Analizine dayalı eğitim. International Journal of Early Childhood Special Education, 3(2), 129-147. https://doi.org/10.20489/intjecse.107950
- Hess, E. B. (2015). DIR®/Floortime™: A Developmental/Relational Play Therapy Approach Toward the Treatment of Children With Developmental Delays, Including Autism Spectrum Disorder (ASD) and Sensory Processing Challenges. Kevin O’Connor, Charles Schaefer & Lisa D. Braverman (Eds.) In Handbook of Play Therapy (Second Edition) (pp. 357-379). New York: John Wiley & Sons, Inc. https://doi.org/10.1002/9781119140467.ch18
- Jacobson, J. W., Mulick, J. A., & Green, G. (1998). Cost–benefit estimates for early intensive behavioral intervention for young children with autism—general model and single state case. Behavioral Interventions: Theory & Practice in Residential & Community‐Based Clinical Programs, 13(4), 201-226. https://doi.org/10.1002/(SICI)1099-078X(199811)13:4<201::AID-BIN17>3.0.CO;2-R
- Jasmin, E., Couture, M., McKinley, P., Reid, G., Fombonne, E., & Gisel, E. (2009). Sensori-motor and daily living skills of preschool children with autism spectrum disorders. J Autism Dev Disord, 39(2), 231-241. https://doi.org/10.1007/s10803-008-0617-z
- Kayıhan, H., Akel, B. S., Salar, S., Huri, M., Karahan, S., Turker, D., & Korkem, D. (2015). Development of a Turkish version of the Sensory Profile: Translation, cross-cultural adaptation, and psychometric validation. Percept Mot Skills, 120(3), 971-986. https://doi.org/10.2466/08.27.PMS.120v17x8
- Kaynaroğlu, N. (1984). Orta sosyo-ekonomik düzeydeki boşanmış ailelerin, altı yaş grubu çocuklarındaki psiko-sosyal özelliklerinin incelenmesi (Yayınlanmamış doktora tezi). Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
- Klin, A., Saulnier, C. A., Sparrow, S. S., Cicchetti, D. V., Volkmar, F. R., & Lord, C. (2007). Social and communication abilities and disabilities in higher functioning individuals with autism spectrum disorders: The Vineland and the ADOS. J Autism Dev Disord, 37(4), 748-759. https://doi.org/10.1007/s10803-006-0229-4
- Lal, R., & Chhabria, R. (2013). Early intervention of autism: A case for Floor Time approach. In Recent Advances in Autism Spectrum Disorders-Volume I: InTech. https://www.doi.org/10.5772/54378
- Liao, S.-T., Hwang, Y.-S., Chen, Y.-J., Lee, P., Chen, S.-J., & Lin, L.-Y. (2014). Home-based DIR/Floortime™ intervention program for preschool children with autism spectrum disorders: Preliminary findings. Phys Occup Ther Pediatr, 34(4), 356-367. https://doi.org/10.3109/01942638.2014.918074
- Mailloux, Z., & Smith Roley, S. (2010). Sensory integration. H. Kuhaneck & R. Watling (Eds.), In Autism: A Comprehensive Occupational Therapy Approach (3rd ed., pp. 469–507). Bethesda, MD: AOTA Press.
- Mercer, J. (2017). Examining DIR/Floortime™ as a treatment for children with autism spectrum disorders: A review of research and theory. Res Soc Work Pract, 27(5), 625-635. https://doi.org/10.1177/1049731515583062
- Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. J Autism Dev Disord, 20(1), 115-128. https://doi.org/10.1007/bf02206861
- Ottenbacher, K. J. (1986). Evaluating clinical change: Strategies for occupational and physical therapists. Berlinck: Williams and Wilkins.
- Öner, N. (1997). Türkiye’de kullanılan psikolojik testler. İstanbul: Boğaziçi Üniversitesi Yayınları.
- Öztürk, M. A. (2012). TEACCH otizm programı unsurlarının beden eğitimi ve sporda kullanımı. Dicle Üniversitesi Ziya Gökalp Eğitim Fakültesi Dergisi, 19, 259-268.
- Patricia, H. (1998). Practitioner review: Psychological and educational treatments for autism. J Child Psychol Psychiatry, 39(3), 307-322. https://doi.org/10.1111/1469-7610.00327
- Ryan, J. B., Hughes, E. M., Katsiyannis, A., McDaniel, M., & Sprinkle, C. (2011). Research-based educational practices for students with autism spectrum disorders. Teaching Exceptional Children, 43(3), 56-64. https://doi.org/10.1177/004005991104300307
- Sealy, J., & Glovinsky, I. P. (2016). Strengthening the reflective functioning capacities of parents who have a child with a neurodevelopmental disability through a brief, relationship‐focused intervention. Infant Ment Health J, 37(2), 115-124. https://doi.org/10.1002/imhj.21557
- Solomon, R., Necheles, J., Ferch, C., & Bruckman, D. (2007). Pilot study of a parent training program for young children with autism: The PLAY Project Home Consultation program. Autism, 11(3), 205-224. https://doi.org/10.1177/1362361307076842
- Szatmari, P., Bryson, S., Boyle, M., Streiner, D., & Duku, E. (2003). Predictors of outcome among high functioning children with autism and Asperger syndrome. J Child Psychol Psychiatry, 44(4), 520-528. https://doi.org/10.1111/1469-7610.00141
- Wieder, S., & Greenspan, S. (2004). Can children with autism master the core deficits and become empathetic, creative, and reflective? Paper presented at the Presented at the National Conference of the Interdisciplinary Council for Developmental and Learning Disorders.
- Ziviani, J., Boyle, M., & Rodger, S. (2001). An introduction to play and the preschool child with autistic spectrum disorder. Brıt J Occup Ther, 64(1), 17-22. https://doi.org/10.1177/030802260106400104
Effect of DIR/Floortime Intervention on Adaptive Behavior of a Child with Autism Spectrum Disorder
Yıl 2020,
Cilt: 8 Sayı: 2, 175 - 184, 09.09.2020
Sinem Kars
,
Meral Huri
,
Hülya Kayıhan
,
Çiğdem Ergül
Öz
Improving the quality of parent–child interaction and play skills are
important outcomes for children with autism spectrum disorder (ASD). DIR
Floortime (Developmental, Individual difference, and relationship-based) is an
intervention approach that addresses these issues; however, there are few
published studies on its effectiveness. We investigated the effects of 1-year Floortime
intervention in social skills and adaptive behavior of children with ASD. A
three years ten month old boy with ASD participated. Sensory Profile (SP) was
used to analyze child’s sensory processing patterns, AAMR Adaptive Behavior
Scale (ABS) was applied to measure child’s adaptive behaviour. Measurements
were applied pre and post of 12-month (2 session/week) DIR Floortime
intervention programme. According to statistical analysis, the child showed
significant development in sensory processing patterns (p≤0.05) and adaptive
behaviour (p≤0.05) positively. Moreover, the mother perceived positive changes
in their parent-child interactions and child’s communication skills. DIR
Floortime model suggests that child’s biological individual differences and
functional emotional developmental capacities should be considered during
adult-child interactions. Following the
child’s lead at play increases the active participation of child, which helps
us toward strengthen or construct the functional developmental capacities for
relating, communicating, and thinking of children with ASD.
Kaynakça
- Baranek, G. T., David, F. J., Poe, M. D., Stone, W. L., & Watson, L. R. (2006). Sensory Experiences Questionnaire: Discriminating sensory features in young children with autism, developmental delays, and typical development. J Child Psychol Psychiatry, 47(6), 591-601. https://doi.org/10.1111/j.1469-7610.2005.01546.x
- Baron-Cohen, S. (1997). Mindblindness: An essay on autism and theory of mind. Cambridge, MA, US: The MIT Press.
- Başal, H. A. (1997). İlkokul Çocukları İçin Uyumsal Davranış Ölçeği (AAMD Adaptive Behavior Scale, Public School Version, 1974) bir geçerlik-güvenirlik çalışması. Eğitim ve Bilim, 21(105), 37-43.
- Bryson, S. E., Rogers, S. J., & Fombonne, E. (2003). Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management. The Canadian Journal of Psychiatry, 48(8), 506-516. https://doi.org/10.1177/070674370304800802
- Castillo, R., Carlat, D., Millon, T., Millon, C., Meagher, S., Grossman, S., et al. (2007). Diagnostic and statistical manual of mental disorders. Washington, DC: American Psychiatric Association Press.
- Cullinane, D. (2012). Evidence base for the DIR®/Floortime approach. Erişim tarihi 31 Temmuz 2019, https://sa1s3.patientpop.com/assets/docs/62315.pdf
- Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Dev Psychopathol, 20(3), 775-803. https://doi.org/10.1017/S0954579408000370
- Dionne, M., & Martini, R. (2011). Floor time play with a child with autism: A single-subject study. Can J Occup Ther, 78(3), 196-203. https://doi.org/10.2182/cjot.2011.78.3.8
- Dunn, W. (1999). The sensory profile manual. San Antonio, TX: Psychological Corporation.
- Epir, S. (1976). İlkokul çocukları için AAMD Uyumsal Davranış Skalası (1974 revizyonu), Türkçe adaptasyon el kitabı. Ankara: MEB Talim Terbiye Dairesi.
- Greenspan, S. I., DeGangi, G., & Wieder, S. (2001). The functional emotional assessment scale for infancy and childhood, FEAS. Bethesda, MD: Interdisciplinary Council on Developmental and Learning Disorders.
- Güleç-Aslan, Y. (2011). Bir vaka sunumu: Otizm için risk taşıyan bir çocukta Uygulamalı Davranış Analizine dayalı eğitim. International Journal of Early Childhood Special Education, 3(2), 129-147. https://doi.org/10.20489/intjecse.107950
- Hess, E. B. (2015). DIR®/Floortime™: A Developmental/Relational Play Therapy Approach Toward the Treatment of Children With Developmental Delays, Including Autism Spectrum Disorder (ASD) and Sensory Processing Challenges. Kevin O’Connor, Charles Schaefer & Lisa D. Braverman (Eds.) In Handbook of Play Therapy (Second Edition) (pp. 357-379). New York: John Wiley & Sons, Inc. https://doi.org/10.1002/9781119140467.ch18
- Jacobson, J. W., Mulick, J. A., & Green, G. (1998). Cost–benefit estimates for early intensive behavioral intervention for young children with autism—general model and single state case. Behavioral Interventions: Theory & Practice in Residential & Community‐Based Clinical Programs, 13(4), 201-226. https://doi.org/10.1002/(SICI)1099-078X(199811)13:4<201::AID-BIN17>3.0.CO;2-R
- Jasmin, E., Couture, M., McKinley, P., Reid, G., Fombonne, E., & Gisel, E. (2009). Sensori-motor and daily living skills of preschool children with autism spectrum disorders. J Autism Dev Disord, 39(2), 231-241. https://doi.org/10.1007/s10803-008-0617-z
- Kayıhan, H., Akel, B. S., Salar, S., Huri, M., Karahan, S., Turker, D., & Korkem, D. (2015). Development of a Turkish version of the Sensory Profile: Translation, cross-cultural adaptation, and psychometric validation. Percept Mot Skills, 120(3), 971-986. https://doi.org/10.2466/08.27.PMS.120v17x8
- Kaynaroğlu, N. (1984). Orta sosyo-ekonomik düzeydeki boşanmış ailelerin, altı yaş grubu çocuklarındaki psiko-sosyal özelliklerinin incelenmesi (Yayınlanmamış doktora tezi). Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
- Klin, A., Saulnier, C. A., Sparrow, S. S., Cicchetti, D. V., Volkmar, F. R., & Lord, C. (2007). Social and communication abilities and disabilities in higher functioning individuals with autism spectrum disorders: The Vineland and the ADOS. J Autism Dev Disord, 37(4), 748-759. https://doi.org/10.1007/s10803-006-0229-4
- Lal, R., & Chhabria, R. (2013). Early intervention of autism: A case for Floor Time approach. In Recent Advances in Autism Spectrum Disorders-Volume I: InTech. https://www.doi.org/10.5772/54378
- Liao, S.-T., Hwang, Y.-S., Chen, Y.-J., Lee, P., Chen, S.-J., & Lin, L.-Y. (2014). Home-based DIR/Floortime™ intervention program for preschool children with autism spectrum disorders: Preliminary findings. Phys Occup Ther Pediatr, 34(4), 356-367. https://doi.org/10.3109/01942638.2014.918074
- Mailloux, Z., & Smith Roley, S. (2010). Sensory integration. H. Kuhaneck & R. Watling (Eds.), In Autism: A Comprehensive Occupational Therapy Approach (3rd ed., pp. 469–507). Bethesda, MD: AOTA Press.
- Mercer, J. (2017). Examining DIR/Floortime™ as a treatment for children with autism spectrum disorders: A review of research and theory. Res Soc Work Pract, 27(5), 625-635. https://doi.org/10.1177/1049731515583062
- Mundy, P., Sigman, M., & Kasari, C. (1990). A longitudinal study of joint attention and language development in autistic children. J Autism Dev Disord, 20(1), 115-128. https://doi.org/10.1007/bf02206861
- Ottenbacher, K. J. (1986). Evaluating clinical change: Strategies for occupational and physical therapists. Berlinck: Williams and Wilkins.
- Öner, N. (1997). Türkiye’de kullanılan psikolojik testler. İstanbul: Boğaziçi Üniversitesi Yayınları.
- Öztürk, M. A. (2012). TEACCH otizm programı unsurlarının beden eğitimi ve sporda kullanımı. Dicle Üniversitesi Ziya Gökalp Eğitim Fakültesi Dergisi, 19, 259-268.
- Patricia, H. (1998). Practitioner review: Psychological and educational treatments for autism. J Child Psychol Psychiatry, 39(3), 307-322. https://doi.org/10.1111/1469-7610.00327
- Ryan, J. B., Hughes, E. M., Katsiyannis, A., McDaniel, M., & Sprinkle, C. (2011). Research-based educational practices for students with autism spectrum disorders. Teaching Exceptional Children, 43(3), 56-64. https://doi.org/10.1177/004005991104300307
- Sealy, J., & Glovinsky, I. P. (2016). Strengthening the reflective functioning capacities of parents who have a child with a neurodevelopmental disability through a brief, relationship‐focused intervention. Infant Ment Health J, 37(2), 115-124. https://doi.org/10.1002/imhj.21557
- Solomon, R., Necheles, J., Ferch, C., & Bruckman, D. (2007). Pilot study of a parent training program for young children with autism: The PLAY Project Home Consultation program. Autism, 11(3), 205-224. https://doi.org/10.1177/1362361307076842
- Szatmari, P., Bryson, S., Boyle, M., Streiner, D., & Duku, E. (2003). Predictors of outcome among high functioning children with autism and Asperger syndrome. J Child Psychol Psychiatry, 44(4), 520-528. https://doi.org/10.1111/1469-7610.00141
- Wieder, S., & Greenspan, S. (2004). Can children with autism master the core deficits and become empathetic, creative, and reflective? Paper presented at the Presented at the National Conference of the Interdisciplinary Council for Developmental and Learning Disorders.
- Ziviani, J., Boyle, M., & Rodger, S. (2001). An introduction to play and the preschool child with autistic spectrum disorder. Brıt J Occup Ther, 64(1), 17-22. https://doi.org/10.1177/030802260106400104