Bir vaka Ssnumu: Otizm için risk taşıyan bir çocukta Uygulamalı Davranış Analizine dayalı eğitim

Öz

Erken eğitim, otizm spektrum bozukluğu için risk altında olan ya da tanı almış çocukların gelişimleri için oldukça önem taşımaktadır. Bu çocuklara yönelik erken eğitim seçeneklerinden birisi olan uygulamalı davranış analizi (UDA) pek çok küçük çocukta olumlu gelişmeler sağlamaktadır. Bu vaka sunumunda, otizm spektrum bozukluğu için yüksek risk taşıyan 28 aylık bir çocuğa, uygulamalı davranış analizine dayalı yöntemler kullanılarak sunulan eğitimin ilk yılına ilişkin betimleyici bilgiler sunulmuştur. Ayrıca, çocuğun gelişimine ilişkin toplanan nitel ve nicel nitelikteki veriler aktarılmıştır. Bulgular; (a) çocuğun bireyselleştirilmiş eğitim programında yer alan becerilerde ilerlediğini, (b) otizm belirtilerinin yoğunluğunun azaldığını, (c) gelişimsel alanlarda performansının arttığını göstermiştir.

Anahtar Kelimeler

• Otizm spektrum bozukluğu, uygulamalı davranış analizi, erken yoğun davranışsal uygulama

The case report: ABA-based education for a toddler at high risk for Autism

Abstract

Early education using the methods of applied behavioral analysis (ABA) has shown to produce important gains in many children with autism spectrum disorders (ASD) or at risk for ASD. This case report focuses on descriptive information about the first year of education given to a child who runs high risk of autism spectrum disorder is provided. The findings based on the data gathered throughout the process demonstrate that the child has achieved progress and improved performance in the skills targeted to be gained throughout the education. In addition, there are findings showing that the intensity of autism symptoms and the behavioral problems have lessened.

Keywords

• Autism
• applied behavior analysis
• early intensive behavioral intervention.

Kaynakça

1. Altunel, M. (2007). Otistik özellik gösteren öğrencilere soru cevaplama becerilerinin öğretiminde küçük grup düzenlemesi ile sunulan eşzamanlı ipucuyla öğretimin etkililiği. Yayınlanmamış Yüksek Lisans Tezi, Anadolu Üniversitesi, Eğitim Bilimleri Enstitüsü, Eskişehir.
2. Akmanoğlu-Uludağ, N. ve Batu, S. (2005). Teaching relative names to children with autism using simultaneous prompting. Education and Education in Developmental Disabilities, 40, 401-410.
3. Anderson, R. S. ve Romanczyk, G. R. (1999). Early intervention for young children with autism: Continuum-based behavioral models. JASH, 24, 162-173.
4. Birkan, B. (2009). Erken çocukluk eğitimi. A. G. Akçamete (Ed.). Genel eğitim okullarında özel gereksinimi olan öğrenciler ve özel eğitim (s. 141-168). Ankara: Kök Yayıncılık.
5. Birnbrauer, S. J. ve Leach, J. D. (1993). The Murdoch Early Intervention Program after 2 years. Behaviour Change, 10, 63-74.
6. Boyd, D. R. ve Corley, J. M. (2001). Outcome survey of early intensive behavioral intervention for young children with autism in a community setting. Autism, 5, 430-441.
7. Bryson, E. S., Rogers, S. J. ve Fombonne, E (2003). Autism spectrum disorders: early detection, intervention, education, and psychopharmacological management. Canada Journal of Psychiatry, 48, 506-516.
8. Butter, M. E., Mulick, A. J. ve Metz, B. (2006). Eight case reports of learning recovery in children with pervasive developmental disorders after early intervention. Behavioral Interventions, 21, 227-243.

9. Chance, P. (2006). First course in applied behavior analysis. Long Grove, I.L.: Waveland.Cohen, Amerine-Dickens ve Smith.
10. Cohen, H., Amerine-Dickens, M. ve Smith, T. (2006). Early intensive behavioral treatment: replication of the UCLA Model in a community setting. Developmental and Behavioral Pediatrics, 27, 145-155.
11. Cooper, O. J., Heron, E. T. ve Heward, L.W. (1987). Applied behavior analysis. Columbus: O.H.: Merrill
12. Corsello, M. C. (2005). Early intervention in autism. Infants and Young Children, 18, 74-85.
13. Craig, R.F., Simpson, L. R., & Clark, M. D. (2007). Parents and families of children with disabilities. Effective school-based support services. New Jersey: Pearson Prentice Hall.
14. Çuhadar, S. (2008). Resimli etkinlik çizelgeleri ile sunulan öğretim sürecinin otistik özellikler gösteren çocukların serbest zaman becerilerini öğrenmeleri üzerindeki etkililiği. Yayınlanmamış Doktora Tezi: Eskişehir: A.Ü. Eğitim Bilimleri Enstitüsü.
15. Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Development and Psychopathology, 20, 775–803.
16. Dib, N. ve Sturmey, P. (2007). Reducing student stereotypy by improving teachers’ implementation of discrete-trial teaching. Journal of Applied Behavior Analysis, 40, 339-343.
17. Diken, İ.H. (2007b). Okulöncesi çocuklar için doğal ortamlarda öğretim teknikleri: Örnek olaylarla ve resimlerle zenginleştirilmiş anne-baba ve eğitimci el kitabı. Ankara: Maya Akademi Yayınevi.
18. Eikeseth, S., Smith, T., Jahr, E. ve Eldevik, S. (2002). Intensive behavioral treatment at school for 4- to 7-year-old children with autism. Behavior Modification, 26, 49- 68.
19. Eikeseth, S., Smith, T., Jahr, E. ve Eldevik, S. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 to 7: A comparison controlled study. Behavior Modification, 31, 264-278.
20. Eldevik, S., Hastings , P. R., Hughes, C. J., Jahr, E., Eikeseth, S. ve Cross, S. (2009). Meta-analysis of early intensive behavioral intervention for children with autism. Journal of Clinical Child & Adolescent Psychology, 38(3): 439–450.
21. Fenske, E.C., Zalenski, S., Krantz, P.J., ve McClannahan, L.E. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5, 49-58.
22. Ferraioli, S., Hughes, C. ve Smith, T. (2005). A model for problem solving in discrete trial training for children with autism. Journal of Early and Intensive Behavior Intervention, 2, 224-246.
23. Fovel, T. J. (2002). The ABA program companion, organizing quality programs for children with autism and PDD. New York, USA: DRL Books Inc.
24. Ghezzi, M., P. (2007). Discrete trials teaching. Psychology in the Schools, 44(7), 667- 679.
25. Green, G., Brennan, C. L. ve Fein, D. (2002). Intensive behavioral treatment for a toddler at high risk for autism. Behavior Modification, 26, 69-102.
26. Green, N. B. ve Johnson, D.C. (2000). Writing patient case reports for peer-reviewed journals: secrets of the trade. Journal of Sports Chiropratic and Rehabilitation. 14(3), 51-59.
27. Guralnick, M, J. (2000). Second-generation research in the field of early intervention. M. J. Guralnick (Ed.). The Effectiveness of Early Intervention (s. 3-20). Baltimore: Brookes.
28. Gül, S.,O. ve Diken, İ., H. (2009). Erken çocuklukta özel eğitime ilişkin Türkiye’de gerçekleştirilmiş lisansüstü tez çalışmalarının gözden geçirilmesi. International Journal of Early Childhood Special Education (INT-JECSE), 1, 46-78.
29. Güleç-Aslan, Y. (2008). Otistik Çocuklar İçin Davranışsal Eğitim Programı (OÇİDEP) Ev Uygulaması Sürecinin ve Sonuçlarının İncelenmesi. Doktora Tezi: Eskişehir: A.Ü. Eğitim Bilimleri Enstitüsü.
30. Güleç-Aslan, Y., Kırcaali-İftar, G., & Uzuner, Y. (2009). Otistik Çocuklar İçin Davranışsal Eğitim Programı (OÇİDEP) Ev Uygulamasının Bir Çocukla İncelenmesi. Ankara Üniversitesi Eğitim Bilimleri Fakültesi Özel Eğitim Dergisi, 10(1), 1-25.
31. Güven, G. ve Efe Azkeskin (2010). Erken çocukluk eğitimi ve okul öncesi eğitim. İ.H. Diken (Ed.). Erken çocukluk eğitimi, (s. 2-50). Ankara: PEGEM.
32. Harris, L. S. ve Delmolino, L. (2002). Applied behavioral analysis: Its application in the treatment of autism and related disorders in young children. Infants and Young Children, 14, 11-17.
33. Harris, L. S. ve Handleman, S. J. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four- to six-year follow-up. Journal of Autism and Developmental Disorders, 30, 137-142.
34. Heflin L. J. ve Alaimo, D. F. (2007). Students with autism spectrum disorders: Effective instructional practices, Columbus, Ohio: Pearson.
35. Irmak-Yılmaz, T., Y, Sütçü-Tekinsav, S, Aydın A. ve Sorias O (2007). Otizm Davranış Kontrol Listesinin Geçerlik ve Güvenirliğinin İncelenmesi. Çocuk ve Gençlik Ruh Sağlığı Dergisi, 14, 13-23.
36. Kırcaali-İftar, G. ve Tekin, E. (1997). Tek denekli araştırma yöntemleri. Ankara: TürkPsikologlar Derneği Yayınları.
37. Kırcaali-İftar, G. (2005). Otistik özellik gösteren çocuklara iletişim becerilerinin Kazandırılması, İstanbul: YA-PA Yayın Pazarlama.
38. Kırcaali-İftar, G. (2006). Otistik çocuklar için davranışsal eğitim programı (OÇİDEP). Yayımlanmamış eğitim semineri notları.
39. Kırcaali-İftar, G. (2007).Otizm spektrum bozukluğu. İstanbul: Daktylos Yayınları.
40. Kırcaali-İftar, G. (2007). Otistik çocuklar için davranışsal eğitim programı izleme aracı (OÇİDEP-İZ). Yayımlanmamış Değerlendirme Aracı.
41. Leblanc, M-P, Ricciardi, N. J. ve Luiselli, K. J. (2005). Improving discrete trial instruction by paraprofessional staff through an abbreviated performance feedback intervention. Education and Treatment of Children, 28, 76-82.
42. Lovaas, O. I. (1981). Teaching developmentally disabled children: The me book. Baltimore, MD: University Park Press.
43. Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3-9.
44. Lovaas, O. I. (2003). Teaching individuals with developmentay delays: Basic intervention techniques. Austin, Texas: Pro-Ed.
45. Luiselli, K. J., Cannon, O.B., Ellis, T. J. ve Sisson, W. R. (2000). Home-based behavioral intervention for young children with autism/pervasive developmental disorder. Autism, 4, 426-438.
46. McEachin, J., Smith, T. ve Lovaas, O. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. American Journal on Mental Retardation, 97, 359-372.
47. Merriam, B. S. (1998). Qualitative research ans case study applications in education. San Francisco: Jossey-Bass Publishers
48. National Research Council (2001). Educating children with autism. C. Lord ve P. McGee (Eds). Washington, DC: National Academy Press.
49. Ogletree, B. T. ve Thomas, O. (2001). Application of ABA principles to general communication instruction. Focus on Autism and Other Developmental Disabilities, 16(2): 102-110.
50. Perera, H, Weerasinghe, D., de Silva, Y I P, Weliwatta, P. ve Dharmalatha, H N K (2007). Outcome of early intervention in infants at risk of developmental delay: a pilot study. Sri Lanka Journal of Child Health, 36, 48-2.
51. Perry, R., Cohen, I. ve DeCarlo, R. (1995). Case study: Deterioration, autism, and recovery in two siblings. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 232-237.
52. Ramey, C. T., Campbell, F. A., Burchinal, M., Skinner, M. L., Gardner, D. M., ve Ramey, S. L. (2000). Persistent effects of early intervention on high-risk children and their mothers. Applied Developmental Science, 4, 2-14.
53. Reichow, B ve Wolery, M. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model. Journal of Autism and Developmental Disorders, 39, 23-41.
54. Rosenwasser, B. ve Axelrod, S. (2001). The contributions of applied behavior analysis to the education of people with autism. Behavior Modification, 25, 671-677.
55. Ryan, S. C. ve Hemmes, S. N. (2005). Post-training discrete-trial teaching performance by instructors of young cvhildren with autism in early intensive behavioral intervention. The Behavior Analyst Today, 6, 1-11.
56. Ryan, B. J., Hughes, M. E., Katsiyannis, A., McDaniel, M., ve Sprinkle, C. (2011). Research-based educational practices for students with autism spectrum disorders. Teaching Exceptional Children, 43(3): 56-64.
57. Sallows, O. G. ve Graupner, D. T. (2005). Intensive behavioral treatment for children with autism: four-year outcome and predictors. American Journal On Mental Retardation, 110, 417-438.
58. Santrock, W. J. (2004). Educational psychology. Boston: McGraw Hill.
59. Scheurmann, B., & Webber, J. (2002). Autism teaching does make a difference. Wadsworth Group, Canada.
60. Sheinkopf, J. S. ve Siegel, B. (1998). Home-Based behavioral treatment of young children with autism. Journal of Autism and Developmental Disorders, 28, 15- 23.
61. Simpson, R.L. (2001). ABA and students with autism spectrum disorders: Issues and considerations for effective practice. Focus on Autism and Other Developmental Disabilities, 16, 68-71.
62. Smith, T. (2001). Discrete trial training in the treatment of autism. Focus on Autism and Other Developmental Disabilities, 16, 86-92.
63. Smith, T., Buch, A. G. ve Gamby, E.T. (2000). Parent-directed, intensive early intervention for children with pervasive developmental disorder. Research in Developmental Disabilities, 21, 297-309.
64. Smith, T, Groen, D. A. ve Wynn, W. J. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. American Journal on Mental Retardation, 105, 269-285.
65. Steege, W. M., Mace, C. F., Perry, L. ve Longenecker, H. (2007). Applied behavior analysis: beyond discrete trial teaching. Psychology in the Schools. 44(1), 91-99.
66. Stephens, E. C. (2005). Overcoming challenges and identifying a consensus about autism intervention programming. The International Journal of Special Education, 20, 35-49.
67. Stoelb, M., Yarnal, R., Miles, J., Takahashi, N. T., Farmer, E. J. ve McCathren, B. R. (2004). Predicting responsiveness to treatment of children with autism: A retrospective study of the importance of physical dysmorphology. Focus on Autism and Other Developmental Disabilities, 19, 66-77.
68. Sucuoğlu, B. (2009). Zihinsel engellilerin eğitimi. B. Sucuoğlu (Ed.). Zihin engelliler ve eğitimi (s. 202-236). Ankara: Kök Yayıncılık.
69. Sutera, S, Pandey, J, Esser, E. L., Rosenthal, M. A., Wilson, L. B., Barton,, M, Green, J, Hodgson, S, Robins, D. L., Dumont-Mathieu, T, Fein, D. (2007). Predictors of optimal outcome in toddlers diagnosed with autism spectrum disorders. Journal of Autism and Developmental Disorders, 37, 98-107.
70. Tekin, E. ve Kırcaali-İftar, G. (2001). Özel eğitimde yanlışsız öğretim yöntemleri. Ankara: Nobel Yayın Dağıtım.
71. Volkmar, F.R., Lord, C., Bailey, A., Schultz, R.T. ve Klin, A. (2004). Autism and developmental disorders. Journal of Child Psychology and Psychiatry. 45(1). 135-170.
72. Weiss, J. M. (2005). Comprehensive ABA Programs: Integrating and evaluating the implementation of varied instructional approaches. The Behavior Analyst Today, 6, 249-256.
73. Wolery, M., Bailey, B. D. ve Sugai, M. G. (1988). Effective teaching principles and procedures of applied behavior analysis with exceptional students. Boston: Allyn and Bacon.
74. Woods, J. J. ve Wetherby, A. M. (2003). Early identification of and intervention for infants and toddlers who are at risk for autism spectrum disorder. Language, Speech, and Hearing Services Schools. 34, 180-193.
75. Zachor, A.D., Ben-Itzchak, E., Rabinovich, A-L ve Lahat, E. (2007). Change in autism core symptoms with intervention. Research in Autism Spectrum Disorders, 1(4), 304-317.