Earticle

스펙트럼자폐 장애를 가진 아이가 있는 가정은 전반적인 가족생활에 대해 많은 영향이 미칠 수 있다. 이 질환은 다 른 사람과의 상호관계를 맺는 아이들의 능력에 영향을 미치기 때문에, 가족 구성원들 모두가 겪는 힘든 시간적 결합 을 가질 수 있다. 또한, 아이의 일상 관리에참여하는 사람, 특히 응집력이 큰 가족 구성원 등은 더욱 스트레스에 노출 될 수 있다. 스펙트럼자폐 장애 아동을 둔 대부분의 부모들은 고가의 치료비를 필요로 하는데, 종종 부모 중 하나는 모든 치료와 아이를 돌보기 위하여 자신의 일을 포기하기도 하며, 더욱이 아이의 치료를 위해 자격을 갖춘 전문가에 지불할 비용 을 마련해야하는 경제적 어려움에 처해 있다. 따라서 많은 가족이 고가의 치료비용을 지불하기 위해 자신의 집을 담 보로 대출을 받기도 하지만 그들 중 대부분은 경제적 어려움으로 보험이 적용되지 않거나 제한되는 어려움이있다. 이에 본 논문은 어려움을 겪고 있는 가족과 특히 부모를 위한 재정 부담을 최소화하고 자녀에 대한 치료 효과를 극 대화하기 위해, 1990년에서 2014년 사이에 발표되었던 논문 가운데1) 자폐증, 2) 사회적 기술 '자폐 스펙트럼 장애 아동을위한 그룹의 개입' 3) 치료, 중재, 또는교육, 4) 효과, 5) 증거 기반의 영역에서 위와 같은 용어의 다양한 조합 을 사용하여 확인된 연구의 문헌 검토와 이제까지 실시되었던 스펙트럼자폐 장애 아동을 위한 전문실무자들의 실천 프로그램을 바탕으로 효과적 증거를 분석하고자 하였다. 위의 논문들을 분석한 증거 기반실천에서 알 수 있듯이 개 입을 준비하는데 필요한 두 가지 중요한 구성 요소를 다음과 같이제안한다: 1) 정확한 진단 테스트, 예후 마커로 잠 재적 효과와 치료의 안전성 평가 등을 식별하여 진료의 정확한 선택과 임상적 연구를 체계적으로 활용하여야 한다. 2) 실무자는 정보가자신의 치료 결정을 알리기 위해 여러 소스에서 그릴 것으로 예상된다. 요약 제시된 <표 1>은 자폐증 스펙트럼을 가진 아동에 대한 집단 개입을 보장하기 위한 연구에서 미국의 저널에 발 표 된 논문 가운데 최고의 증거를 기반으로, 가장 효과적인 것으로입증된 14개 논문을 분석한 한 결과이다. 따라서 검토의 결과로 개입 모델과 기술의 유형을밝힘으로 실천현장에서 치료에 애쓰는 전문실무자들과 부모들에게 도움 을 주고자 한다.

Having a child with an autism spectrum disorder can have a profound effect on family life. Since thesedisorders affect the ability of children to have relationships with others, they may have a hard time bonding withother family members. In addition, a great amount of stress can be placed on family members, particularly thosewho are involved in daily care of the child. Often one of the parents has to give up their job to take care of thechild and help with all the therapies, and because of the difficulty and cost of finding qualified help. Mostchildren with autism require many expensive therapies. Many of them are not covered by insurance, or arelimited. Many families end up taking out loans or a second mortgage on their home to pay for all the therapies. In order to minimize the financial burden for parents and to maximize the treatment effectiveness for the child,practitioners must keep following two components in preparing for intervention as evidence-based practicesuggests: 1) Practitioners make systematic use of clinically relevant research to select accurate and precisediagnostic tests, identify prognostic markers, and assess the potential effectiveness and safety of different kinds oftreatments; 2) Practitioners are expected to draw from multiple sources for information to inform their treatmentdecisions. To ensure the intervention for a child with Autism Spectrum is based on the best evidence fromwell-conducted research, fourteen articles published in U.S journals were carefully selected and reviewed based onthe criteria. The results of review were summarized in a table to inform the practitioners and parents of whattype of intervention model and skills/techniques were proven to be the most effective.

목적 : 본 연구는 수예공작 프로그램을 이용하여 자폐아동과 지적장애아동의 시지각 효과를 비교함으로써 그 필요성을 밝히고자 한다. 연구방법 : 선정기준에 따라 자폐아동 10명, 지적장애 아동 10명을 선별한 후 시지각 프로그 램을 적용하였다. 사용된 수예공작 프로그램은 수예공작을 치료로 적용하고 있거나 적용 한 경험이 있는 전문가에 의해 의뢰되고 만들어졌다. 항목에 들어가는 것은 도예작업, 모 빌공예작업, 밀가루 반죽작업, 지점토작업, 골판지공예작업, 칼라믹스작업이 선택되었다. 이 프로그램은 4주 동안 일주일에 두 번 적용하였고, 치료 전후의 효과를 확인하기 위해 MVPT-3를 사용하였다. 결과 : 첫째, 수예공작 프로그램이 자폐아동과 지적장애아동 모두 효과가 있었다. 둘째, 수예 공작 프로그램 적용 후 각각을 비교하였을 때, 지적장애아동에게 더 높은 효과가 있었다. 결론 : 수예공작 프로그램이 자폐아동과 지적장애아동의 시지각 기능 발달에 영향을 미친다 는 것을 알 수 있었다.

Objective : We try to show the necessity of crafts and arts comparing visual perception of autism with that of mental retardation using craft programmes. Methods : We applied a visual perception programme after sorting 10 autism and 10 mental retardation according to criteria. A used craft programmes are consulted and produced by specialist who are applying crafts as treatment or have experienced applying crafts. The items included potter, mobile art, wheat flour kneading, clay, corrugated cardboard work and color mix work. We applied the programmes twice a week during 4 weeks and used motor-free visual perception test-third edition(MVPT-3) to investigate the effect before and after treatments. Results : First, craft programmes had effect on both autism and mental retardation. Second, craft programmes had more effect on mental retardation. Conclusion : We could know that craft programmes influenced on visual perceptional development of autism and mental retardation.

본 연구에서는 자폐증이 있는 아동의 공동주의집중에 관한 선행연구를 분석하였 다. 자폐아 아동이 대인관계 내에서 공동주의집중 하는 것을 경험하지 못하면 이 후의 발달 단계에서 언어 발달이 지연될 뿐만 아니라, 의사소통 및 사회적 상호 작용에서 어려움을 겪게 됨이 보고되어 왔다. 선행연구 분석을 통해, 관계 중심 의 중재 전략이 제안된 바 있으며, 특히, 부모의 자기 효능감은 부모가 자폐증이 있는 자녀와 부모 간의 관계의 질을 향상 시키도록 지원할 수 있는 주요한 중재 변인 중의 하나였음이 공통되게 보고되어 오고 있다. 자폐아 아동이 공동주의집 중을 할 수 있도록 함으로써, 자폐아 아동과 부모 간의 관계는 개선될 것으로 예 상된다. 개선된 부모-자녀 관계는 자폐아를 양육하는 부모에게 정서적인 보상을 제공할 수 있을 뿐 아니라, 궁극적으로 부모의 자녀 양육과 관련된 스트레스를 감소시킬 수 있을 것으로 예상된다. 궁극적으로 자폐증을 가진 아동의 부모의 자 녀 양육과 관련된 스트레스의 감소는 부모들로 하여금 정서적인 보상을 제공할 수 있을 것으로 예상된다.

In this study, the literatures on the joint attention in the children with ASDs were reviewed. The failure to achieve joint attention in children with autism often portends later difficulties with communication and social interaction, as well as delay in language development. Based on the literature review, relationship focused intervention strategies was suggested and parental self-efficacy was one of the mediators that made parents make efforts to improve the quality of relationship between children and parents. By the achievement of joint attention, the relationship between children with autism and their parents will be improved. The enhanced relationship provide parents emotional rewards, ultimately parents’ caretaking stress is expected to be decreased. Ultimately the decrease of caretaking stress of parents of children with ASDs will provide parents emotional rewards.

목적 : 본 연구의 목적은 자폐아동이 영상 매체에 관심을 보이는 특성을 활용해서 컴퓨터 동영상 활동스케줄 사용법 지도가 자폐아동의 자발성과 독립성을 향상시키는데 효과가 있는지 알아보는 것이다. 연구방법 : 이 연구 A-B 개별실험 연구설계를 통해 실시되었다. 연구대상은 자폐로 진단된 43개월 된 남아로 현재의 발달수준은 2～3세로 평가되었다. 이 아동은 주의가 산만하고, 부모님이나 교사의 지시를 따르지 않으며, 한 과제를 지속해서 수행하지 못하고, 할 수 있는 과제도 자발적으로 수행하거나 자신이 원하는 것을 자발적으로 요구하지 못하는 것으로 관찰되었다. 독립변인은 컴퓨터에 입력된 동영상 활동스케줄에 따라 아동 스스로 동영상의 각 장면을 본 후, 동영상에 담긴 활동 과제물을 스스로 준비해서 수행하는 것이다. 아동이 할 수는 있지만 자발적으로 수행하지 않는 놀이나 일상생활 활동 11가지의 수행 장면을 10초간씩 동영상으로 촬영한 후 제작된 동영상 활동스케줄을 컴퓨터에 입력해 놓았다. 동영상 활동스케줄 수행과정은 1단계, enter key 누르기, 2단계, 화면에 나오는 장면을 응시하기, 3단계, 화면에서 나오는 동일한 물건을 바구니에서 가져오기, 4단계, 가져온 과제를 수행하기, 5단계, 수행한 과제물을 제자리에 정리하기의 다섯 단계로 구성되었다. 동영상 활동은 1회기에 5회씩 반복 되었으며, 실험은 주 2회기씩 총 8주 진행 되었다. 종속변인은 (1) 지시 따르기, (2) 주어진 과제 수행하기, (3) 자발적으로 행동하기의 3개로 정하였고, 동영상 활동스케줄을 수행한 후 바로 종속변인을 측정하였다. ‘지시 따르기’는 연구자가 임의로 정한 10개의 항목으로 구성되었고 (예, “의자에 앉으세요”), 과제수행 측정을 위해 Grooved Pegboard를 사용하였고, 자발적 행동은 아동이 과제수행 시에 필요한 물건을 아동 주변에 놓아두는 상황을 만들어 놓은 후 자발적 행동이 일어나는지 조사하였다. 결과 : 동영상 활동스케줄의 평균 수행률은 87.5%이었는데, 수행률이 증가할수록 지시 따르기, 과제 수행, 자발적 수행이 향상되는 현상을 보였다. 지시 따르기는 기초선 때보다 평균 46.9%(간격 = 26.7～73.6%), 과제 수행은 평균 48.3%(간격 = 12～60.3%), 자발적 수행은 평균 40%(간격 = 29～69%) 향상되었다. 결론 : 동영상 활동스케줄 활용은 자폐아동의 자발성을 증진과 더불어 과제수행 기능과 지시 따르기 행동을 학습시키는데 효과가 높은 것으로 나타났다. 동영상 활동스케줄 활용은 치료실이나 가정에서 자폐아동의 독립적인 일상생활을 향상시키는데 유용하게 사용될 수 있을 것으로 기대된다.

Objective : The purpose of this study was to investigate the effect of computer activity scheduling(CAS) on increasing initiation behavior in a child with autism aged 3.5 years. Methods : The participant’s developmental level was assessed around 2 years old. His behavior problems were characterized by disruptive, inattentive, running around, noncompliant behaviors, and absence of initiation in performing a task. He never initiated either a toy play or a task given to him unless he was forced to do with physical prompt, although he could perform the task. A computer activity scheduling was used as an intervention to increase his initiation behavior. However, data on following directions and task performance were collected to see side effects of the CAS intervention besides the initiation behavior. The computer activity scheduling with 11 play pictures was composed of the following 7 steps: Step 1 to click page turner, Step 2 to click activity picture, Step 3 to watch play pictures , Step 4 to obtain materials for the play, Step 5 to engage in the play activity, Step 6 to put things away, and Step 7 to return to click page turner. The CAS was implemented 2 times a week for 8 weeks. Dependent variables were ‘initiating to perform 7 given tasks’, ‘following simple directions’, and ‘working on Grooved Pegboard’. Results : The performance rate of computer activity scheduling with success was 87.5%. The higher the CAS performance rate was, the higher the following directions, task performance, and self initiation behaviors occurred. After the CAS intervention, the following direction was increased by 46.9%(range = 26.7～73.6%). the task performance by 48.3%(range = 12～60.3%), and self initiation by 40%(29～69%). Conclusion : The results revealed that the CAS was effective in teaching an initiation behavior for task performance in a child with autism and might be applicable to teaching self help skills to a child with autism at home as well as in a clinical setting.

목적 : 본 연구는 자폐스펙트럼장애 아동을 대상으로 한 부모 매개 중재 프로그램의 효과를 체계적으로 검토하고, 메타분석을 통해 효과를 알아보고자 하였다. 연구방법 : 본 연구는 부모 매개 중재의 효과를 확인하기 위해, 2015년 1월부터 2024년 12월까지 발표된 논문을 대상으로 하였다. 문헌 검색은 PubMed, MEDLINE, PsycINFO, Web of Science, ProQuest, Google Scholar 등 주요 국외 데이터베이스를 통해 체계적으로 수행되었다. 최종적으로 선정된 12편의 논문에 대해 Cochrane의 Risk of Bias 2를 활용하여 연구의 질을 평가하고, R 프로그램을 이용하여 효과 크기 산출, 이질성 분석, 출판 편의 검정을 실시하였다. 결과 : 메타분석 결과, 사회적 상호작용 기술에서는 중간 수준의 효과 크기가 나타났으며, 자폐증상, 적응행동, 부모의 양육 스트레스에서는 작은 효과 크기가 확인되었다. 언어기능에서는 유의미한 효과가 나타나지 않았다. 포함된 연구 간 이질성은 낮았으며, 출판 편의의 영향은 확인되지 않았다. 결론 : 자폐스펙트럼장애 아동을 대상으로 부모 매개 중재를 실시한 결과 자폐증상이 감소, 사회적 상호작용 기술 향상, 적응행동 향상, 부모 양육 스트레스가 감소하는 결과를 확인하였다. 본 연구는 국내 조기중재 및 가족 중심 중재 확립에 있어 임상적 근거를 제공하며, 향후 임상 및 정책 현장에서 부모 역량 강화를 위한 프로그램 개발의 기초 자료로 활용될 수 있다.

Objective: This study aimed to systematically review the effectiveness of parent-mediated intervention (PMI) programs for children with autism spectrum disorder (ASD) and analyze their effect sizes on key developmental domains, including autism symptoms, social interaction skills, adaptive behavior, language abilities, and parental stress, through a meta-analysis. Methods: Literature published from January 2015 to December 2024 was searched in PubMed, MEDLINE, PsycINFO, Web of Science, ProQuest, and Google Scholar databases. Twelve eligible studies were selected, and the quality of each study was assessed using the Cochrane Risk of Bias 2 tool. The meta-analysis was conducted using R software, examining effect sizes, heterogeneity, and publication bias. Results: The meta-analysis revealed a moderate effect size for social interaction skills and small effect sizes for autism symptoms, adaptive behavior, and parental stress. No significant effects on language ability were observed. Low heterogeneity was observed across studies, and no evidence of publication bias was detected. Conclusion: Parent-mediated interventions were found to reduce autism symptoms, improve social interaction skills and adaptive behavior, and alleviate parental stress in children with ASD. This study provides empirical evidence supporting the application of PMI in early intervention and family-centered models in Korea and can serve as a foundational reference for developing clinical programs aimed at enhancing parental competence in future practice and policy.

목적 : 자폐아동의 상동행동 감소를 위한 중재방법으로 조건부 운동방법을 통한 응용행동분석과 감각통합치료의 효과를 비교하고자 한다.연구방법 : 본 연구는 개별실험 연구 설계인 교차중재설계(alternating treatment design)방법을 사용하여 응용행동분석의 조건부 운동방법과 감각통합치료를 상호 교차해서 상동행동을 치료 하였다. 연구대상은 중증 정신지체와 자폐증상을 갖고 정신지체아동 시설에서 생활하는 만 8세 10개월 된 남아였다. 상동행동 감소를 위한 중재방법으로 1회기에 20분씩 감각통합 치료와 조건부 운동 방법을 교차하면서 각 5회씩 실시하였다. 상동행동은 시각적 상동행동과 손가락 상동행동으로 나누어 측정하였다. 종속변인의 측정은 페그를 끼우는 과제수행 과정 중에 발생하는 상동행동을 비디오로 촬영한 후, 등간 기록법(interval recording)으로 기초선 2회, 교차중재과정 10회, 일반화과정 1회 실시하였다.결과 : 치료 전에는 시각적 상동행동이 10분에 평균 21회(4～40회) 발생했으나 중재 후에는 감각통합 치료 후에 평균 1회(0～3회), 조건부 운동 후에는 평균 1.6회(0～10회)로 감소했고, 손가락 상동행동은 치료 전에는 평균 28회(10～36회), 감각통합치료 후에는 평균 3.5회(0～12회), 조건부 운동 후에는 평균 5.7회(0～16회)로 감소하였다. 치료 종료 3주 후에 상동행동을 10분간 페그를 끼우는 상태에서 1회 측정했을 때, 시각적 상동행동이 4～10회, 손가락 상동행동이 4～6회 발생한 것으로 보아 상동행동 치료효과가 적절히 유지된 것으로 보인다.결론 : 상동행동 감소를 위해 사용된 감각통합치료와 조건부 운동 방법을 통한 응용행동분석 모두 효과가 높은 것으로 나타났지만, 이 두 방법의 치료효과 비교에서는 현저한 가시적 차이를 보이지는 않았다.

Objective : The purposes of this study are to compare the effects of the sensory integration therapy and the applied behavior analysis to decreasing stereotypic behaviors in a child with autism.Methods : This study used an alternating treatment design including baseline. The participant was a boy, age 8 years and 10 months, with autistic disorder. To decrease his stereotypic behavior, we approached the sen-sory integration therapy and the contingent exercise. Dependent variables were collected by interval record-ing of video-recording 2 baseline, 10 intervention, 1 generalization while the participant implemented the task. Results : In the intervention, stereotypic behaviors defined to 4 operational definition presented relatively low-er frequency than the baseline observation. Especially, rolling the object with thumb and index finger and watching a object in the hand over a second, revealed relatively higher decrease than other behaviors. In the generalization, the decreased stereotypic behaviors except for watching his hand within a span over a second maintained because of low behavior frequency. Conclusion : The results revealed that the sensory integration therapy and the contingent exercise was ef-fective to decrease the stereotypic behavior in participant. However, the comparison of the effects of the two approaches didn't appear the typically differences.

목적: 본 연구는 자폐 스펙트럼 장애 아동을 대상으로 DIR/FLOORTIME 중재의 효과, 종속변수 및 프로토콜을 확인하는 것을 목적으로 하였다. 연구방법: Cumulative Index of Nursing and Allied Health Literature, Excrepta Media Database, MEDLINE 및 Google Scholar를 데이터베이스로 사용하여 수집하였다. 연구는 체계적 연구 및 메타 분석 흐름도를 위한 선호도 항목에 따라 선택되었다. 최종적으로 11개의 연구가 최종 분석에 포함되었고, 선택된 연구들은 Arbesman 등(2008)이 제시한 증거 기반 연구의 질적 수준 모델을 사용하여 평가되었다. 결과: 4편의 무작위 대조군 연구가 Level I에 해당된 것으로 미루어보아 DIR/FLOORTIME에 대한 근거 수준이 높은 편이었다. DIR/FLOORTIME 중재의 종속변수는 의사소통 및 정서, 부모 스트레스, 자폐성 중증도, 감각처리, 발달 이정표, 인지, 언어, 놀이 순이었으며 모든 연구에서 유의미한 결과가 도출되었다. 결론: 본 연구는 자폐스펙트럼장애 아동을 대상으로 DIR/FLOORTIME 중재기법의 적용애 대한 문헌들을 연구하였으며, 향후 자폐스펙트럼 장애 아동들을 대상으로 DIR/FLOORTIME 중재를 활용하기 위한 전략과 프로토콜의 근거를 제시하고자 한다.

Objective: This study aimed to identify the effects, dependent variables, and protocols of the DIR/FLOORTIME intervention in children with autistic spectrum disorder. Methods: Databases were collected using Cumulative Index of Nursing and Allied Health Literature, Excerpta Media Database, MEDLINE, and Google Scholar. Studies were selected according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. Ultimately, 11 studies were included in the final analysis. These selected studies were evaluated using the qualitative level model of evidence-based studies suggested by Arbesman et al. in 2008. Results: Four randomized controlled studies corresponded to level I. The level of evidence for DIR/FLOORTIME was high. The dependent variables of the DIR/FLOORTIME intervention were communication and emotion, parental stress, autism severity, sensory processing, developmental milestones, cognition, language, and play. Significant results were obtained for all studies. Conclusion: This study investigated the application of the DIR/FLOORTIME intervention technique in children with autism spectrum disorder, and the basis for future strategies and protocols for using the DIR/FLOORTIME interventions in these children were presented.

목적 : 본 연구는 발달장애인의 도전적 행동 완화를 위한 작업치료 중재에 대해 알아보기 위하여 체계적으 로 문헌을 고찰하고 중재 효과를 비교하고자 하였다. 연구방법 : 2000년 1월부터 2022년 7월까지 Pubmed, Cumulative Index to Nursing and Allied Health Literature(CINAHL), Education Resources Information Center(ERIC), Cochrane Library, Excerpta Medica Database(EMBASE), 학술연구정보서비스(Research Information Sharing Service; RISS)에서 문헌을 검색하였다. 국문 검색용어은 “행동 문제” OR “문제행동” OR “부적응 행동” OR “비정상 행동” OR “행동 이상” OR “도전적 행동” AND “작업치료” AND “발달장애” OR “자폐” OR “지적장애”를 사용하였다. 영문은 “behavioral disturbance” OR “problem behavior” OR “maladaptive behavior” OR “aberrant behavior” OR “behavioral abnormalities” OR “challenging behavior” AND “occupational therapy” AND “developmental disability” OR “autism” OR “intellectual disability”를 사용하였다. 검색된 문헌을 Patient, Intervention, Comparison, Outcome(PICO)양식에 따라 체계적으로 분석하였다. 결과 : 도전적 행동을 완화하기 위한 작업치료 논문은 총 14편이 선정되었다. 감각치료, 놀이기반 치료, 매개 치료 접근은 도전적 행동 완화에 효과가 있지만 그 외 다른 기능의 향상은 확인할 수 없었다. 반면 인지학습적 접근과 긍정적행동지원 접근은 도전적 행동 완화 및 학교생활 기능향상에 효과가 있었다. 또 한, 부모 교육은 부모의 양육 스트레스를 완화하고 양육 기술을 향상함으로 아동의 도전적 행동 완화에 효과적이었지만, 아동의 일상생활 기능향상까지 치료 효과를 확장하는 데는 제한이 있었다. 결론 : 발달장애인의 도전적 행동을 완화하기 위해 다양한 작업치료 중재가 적용되었다. 작업치료는 도전 적 행동뿐만 아니라 일상생활 기능향상에도 도움이 되었다. 향후 과학적 연구를 통해 도전적 행동 중재 에 대한 임상적 근거가 뒷받침되기를 기대한다.

Objective: This study aimed to find the effects of occupational therapy (OT) as a way to alleviate challenging behaviors for persons with developmental disabilities. Methods: Literature published from January 2000 to July 2022 was searched in Pubmed, CINAHL, ERIC, Cochrane Library, EMBASE, and RISS. The search terms were “Behavioral disturbance” OR “Problem behavior” OR “Maladaptive behavior” OR “Aberrant behavior” OR “Behavioral abnormalities” OR “Challenging behavior” AND “Occupational therapy” AND “Developmental disability” OR “Autism” OR “Intellectual disability.” Both Korean and English were used. The searched literature was systematically analyzed according to the PICO format. Results: A total of 14 papers were selected for review. Sensory therapy, play therapy, and therapeutic mediation therapy approaches were shown to be effective in alleviating challenging behaviors, but demonstrated no improvements in other functions. A cognitive learning approach and a positive behavior support approach were effective in alleviating challenging behaviors and improving the school performance. In addition, parental education was effective in alleviating the challenging behaviors in children, although there was a limit in extending the therapeutic effects on improving their daily life functions. Conclusions: It was found that various OT approaches have been used to mediate challenging behaviors. Future research should highlight the generalized effects in daily life and school performance rather than emphasizing only the mitigation of challenging behaviors.

목적: 본 연구는 자폐증세(장애등급2~3급) 대상자 10명과 2년 가까이 63회(126시간)을 함께하며 Body-EU 교 육프로그램에 따라서 교육한 후에 변화를 조사하는 것이 목적이었다. 방법: 바디유 습관실습, 노트 쓰기, 토론, 노래 부 르기, 성경공부, 질문 및 소통, 수업 정리 등으로 매주 2시간씩 총 63회를 교육하였다. 결과: 대상자들은 호흡이 편해지 고 기력이 좋아졌다. 팔자걸음 및 등을 구부리고 걷는 습관을 개선되었다. 말하기가 편해져 말할 때 힘이 안 든다. 호 흡할 때 코막힘이 개선되었고, 안구가 시원해졌고, 시력도 향상된 기분이고, 손발이 따스해졌다. 머리가 청소된 기분이 다. 심장 답답함이 없어졌다. 자신감이 생기면서 마음이 편해진 기분이다. 상대가 누구든 눈을 보는 자신감이 생겼다. 기 면증이 완화되었다. 발음이 정교해져 자신감이 생겼다. 입의 히죽 현상이 완화되었다. 안구운동이 잘되는 대상자들은 비교적 교육시간에 집중력이 높게 나타났다. 결론: 대상자들이 아침부터 잠자리에 들기까지 몸의 전반적 습관 방법을 교육받았다. 본 연구는 정상인을 위한 연구프로그램이었으나 자폐증이있는 육체적 정상인에게도 신체와 의식의 개선 이 가능하다고 판단하였다. 선천적 자폐증이든, 후천성 자폐증이든 다소 완화할 수 있다는 기초자료라 생각한다.

Purpose: According to the Body-EU education program, this study investigates changes after conducting education with ten subjects with autism symptoms (disability level 2~3) 63 times (126 hours) for nearly two years. Methods: Body-EU habit practice, note writings discussion, singing, Bible study, question and communication, class arrangement, etc., a total of 63 times were educated for 2 hours each week. Results: Subjects felt comfortable breathing and improved energy. Other subject's habit of an out-toed gait step and bending back alleviated. One subject made it easier to speak, so if talking with no strength. When breathing, the stuffy nose improved, the eyes became calm, and the hands and feet were warm. Subject felt like my head was cleaned. Heart tightness disappeared. Subject felt at ease as gaining confidence. The subject gained confidence in seeing whoever the other person was. The subject’s pronunciation became more sophisticated, with more confidence, and his mouth cramping alleviated. Subjects with right eye movements showed a relatively high concentration in education time. Conclusions: Subjects are educated and trained in making general habits of their body from morning to going to bed. This study was a research program for ordinary people, but it confirmed with autism. Whether it was genetic autism or acquired autism, they could be somewhat relieved.

Autism is a complex developmental disorder with impairments in social interaction, communication, repetitive behavior and motor skills. Exer-cise enhances cognitive function, ameliorates motor dysfunction, and provides protective profits against neurodegeneration. In the present study, we evaluated the effect of treadmill exercise on the motor coor-dination and Purkinje cell loss in relation with reactive astrocytes and microglial activation in the cerebellum using valproic acid (VPA)-in-duced autism rat model. On the 12th day of pregnancy, the pregnant rats in the VPA-exposed group received intraperitoneal injections of 600-mg/kg VPA. After birth, the rat pups were divided into four groups: the control group, the exercise group, the VPA-treated group, the VPA- treated and exercise group. The rat pups in the exercise groups were forced to run on a treadmill for 30 min once a day, 5 times a week for 4 weeks. In the present results, motor balance and coordination was dis-turbed by induction of autism, in contrast, treadmill exercise alleviated motor dysfunction in the autistic rats. Purkinje cell loss, reactive astro-cytes, and microglial activation were occurred by induction of autism, in contrast, treadmill exercise enhanced survival rate of Purkinje neu-rons through inhibition of reactive astrocytes and microglia in the autis-tic rats. The present study showed that exercise may provide a potential therapeutic strategy for the alleviation of motor dysfunction in autistic patients.

Autism is a neurodevelopmental disorder and this disorder shows im-pairment in reciprocal social interactions, deficits in communication, and restrictive and repetitive patterns of behaviors and interests. The effect of music on short-term memory in the view of cell proliferation in the hippocampus was evaluated using valproic acid-induced autistic rat pups. Animal model of autism was made by subcutaneous injection of 400-mg/kg valproic acid into the rat pups on the postnatal day 14. The rat pups in the music-applied groups were exposed to the 65-dB com-fortable classic music for 1 hr once a day, starting postnatal day 15 and continued until postnatal day 28. In the present results, short-term memory was deteriorated by autism induction. The numbers of 5-bro-mo-2ʹ-deoxyridine (BrdU)-positive, Ki-67-positive, and doublecortin (DCX)-positive cells in the hippocampal dentate gyrus were decreased by autism induction. Brain-derived neurotrophic factor (BDNF) and ty-rosine kinase B (TrkB) expressions in the hippocampus were also sup-pressed in the autistic rat pups. Music application alleviated short-term memory deficits with enhancing the numbers of BrdU-positive, Ki-67-positive, and DCX-positive cells in the autistic rat pups. Music ap-plication also enhanced BDNF and TrkB expressions in the autistic rat pups. The present study show that application of music enhanced hip-pocampal cell proliferation and alleviated short-term memory impair-ment through stimulating BDNF-TrkB signaling in the autistic rat pups. Music can be suggested as the therapeutic strategy to overcome the autism-induced memory deficits.

The discovery of mirror neurons has been recognized as one of the ma-jor developments in neuroscience, with possible implications for the explanation of many important cognitive functions, including action and perception understanding, imitation, and empathy. In the mirror neuron system, action observation, imitation, and empathy are represented in the same basic motor circuit as action execution. The present paper presents basic neurophysiological findings about mirror neuron system and discusses the effects of perceptual and motor resonance on other people’s actions. Finally, this paper examines strategies informed by mirror neuron research in an empathy-fostering program for autism and in a motor rehabilitation program for stroke patients.

Autism is a complex neurodevelopmental disability with impairments of social interaction and communication, and repetitive behavior. Reelin is an extracellular glycoprotein that is essential for neuronal migration and brain development. Neuroprotective effects of exercise on various brain insults are well documented, however, the effects of exercise on autism in relation with reelin expression are not clarified. In the present study, we investigated the effects of treadmill exercise on the functional recovery and on the expressions of reelin and its downstream molecules, phosphatidylinositol-3-kinase (PI3K), phosphorylated Akt (p-Akt), phosphorylated extracellular signal-regulated protein kinase 1 and 2 (p-ERK1/2), using autistic rats. For the induction of autism-like animal model, 400 mg/kg valproic acid was subcutaneously injected into the rats on the postnatal day 14. The rat in the treadmill exercise groups were forced to run on a treadmill for 30 min once a day, five times a week for 4 weeks, starting postnatal day 28. To investigate autism-like behaviors and memory deficit, open field, social interaction, and radial 8-arm maze were performed. Immunohistochemistry and western blotting were conducted. In the present results, treadmill exercise alleviated aggressive tendency and improved correct decision in the spatial learning memory in the autistic rats. Treadmill exercise increased neurogenesis and the expressions of reelin and its down-stream molecules, PI3K, p-Akt, and p-ERK1/2, in the hippocampus of the autistic rats. The present study showed that treadmill exercise ameliorated aggressive behavior and improved spatial learning memory through activation of reeling signaling pathway in the valproic acid-induced autistic rats.

이 연구는 자폐 유아의 상호작용을 촉진하는 음악치료의 효과를 알아보기 위한 것이다. 연구에는 유아특수학교에 재학 중인 세 명의 자폐 유아가 참여하였으며, 총 34회기 동안중다기초선 설계를 사용하여 음악치료 프로그램이 자폐 유아의 상호작용을 촉진하는지를 측정하였다. 연구 결과 세 명의 자폐 유아 모두 음악치료 중재 시에 상호작용이 현저히 증가하였다. 증가된 상호작용 요소를 분석한 결과 세 명의 자폐 유아 모두 ‘반응행동’이 가장 많이 나타났으며, ‘의도인식행동’, ‘시작행동’, ‘주고받기행동’, ‘창의적 표현행동’ 순으로 상호작용이 나타났다. 인사 노래와 구조적 및 비구조적 기악 활동, 노래 활동, 동작 활 동, 헤어지는 노래로 구성된 음악치료 프로그램 중 대부분의 활동에서 상호작용 중 ‘반응행동’이 현저히 높게 나타났다. 즉흥연주가 포함된 비구조적 기악연주 활동에서는 ‘반응행동’과 함께 ‘시작행동’의 빈도가 높게 나타났으며, 노래 부르기 활동에서는 ‘주고받기행동’이 높게 나타났다. 따라서 자폐 유아를 위한 음악치료 프로그램 개발에는 ‘반응행동’을 촉진하는 구조적인 음악 활동과 함께 ‘시작행동’과 ‘주고받기행동’ 등의 다양한 상호작용행동을 촉진하기 위한 비구조적인 즉흥연주 활동이 포함되어야 할 것이다.

The purpose of this study was to investigate the effect of the music therapy program that developed autistic children's social interactions. Three autistic children attending a special kindergarden participated in 34 sessions. A multiple baseline design was taken in the study. Results showed markedly improvement in their interaction skills. Among those skills, response behavior was most frequently observed in all the children, which was followed by intention recognition behavior, initiation behavior, give-and-take behavior, and creative expression behavior. It was noticed that activities such as greeting song, structured and unstructured instrumental activities, singing activities, motion activities, and farewell songs elicited more response behavior with initiation behavior frequently observed with it. On the other hand, unstructured instrumental activities such as improvising elicited more initiation and give-and-take behavior.

Purpose: promotion program with autistic children. Method: A quasi-experimental design was conducted with a convenience sample of 44 autistic children. The experimental group (n= 23) atended the masage therapy and the atachment promotion made twice for both groups using the social maturity scale and child autism rating scale. Recording of mother-child attachment was done for 15 minutes in only the experimental group twice using video equipment. Results: After 4 months of interventions, there was significant diference on social maturity (F=9.01, p=.005) between the groups. However, there was no significant diference on CARS ((F=2.47, p=.124). The total scores of mother-child atachment between pre- and post-interventions showed a significant diference (Z=-3.42, p=.001). Conclusion:way for providing a chance to increase social maturation and to increase atachment between mother and autistic child.

This study examined different construction of autism according to different groups of people. It is important to know how to examine dominant construction of autism. Dominant construction of autism is medical deficit model. Most people in society believe professionals’ knowledge and judgments. However, the medical deficit model of autism does not take into account people labeled with autism’s motivation or intention. This brings into assumptions on people labeled with autism. In order to deconstruct of assumptions of people labeled with autism, it’s more important to create opportunities to see them closely through interacting with people labeled with autism. ?When society knows and understands what environments make people labeled with autism disability, through removing the barriers, people labeled with autism can fully participate society. Then, society provides people labeled with autism with appropriate environments, not trying to make individuals to fit into social norms or standards.

This study aimed to verify the effectiveness of Family Participation Intervention (FPI) for children with Autism Spectrum Disorders (ASD) by integrating and comparing effect sizes of single-subject studies published in Republic of Korea between 2000 and 2021. For this purpose, twenty-seven dissertations and journals were selected based on predefined criteria and were analyzed. Effect sizes were calculated according to various variables such as treatment approach, goals, subject group charac teristics, and session characteristics using a random effects model. The results are as follows. First, the overall effect size of FPI for children with ASD was Tau-U .88, indicating a medium effect. Additionally, the effect size for the maintenance phase was Tau-U .95, indicating a large effect. Second, this study found that for elementary school students, using a community-cen tered or play (activity)-centered approach with the goal of improving adaptive behavior, involving various family members, conducting at least 20 sessions, showed better effects than other condition. This study is meaningful in that it verifies the ef fectiveness and validity of FPI for children with ASD. Additionally, it provides detailed information on the factors improving the intervention effectiveness.

Increases in the prevalence of autism spectrum disorders have raised global concerns, and the education of children with autism has been the focus of clinicians, educators, and parents worldwide. Although some concepts regarding autism are similar across countries, identification of children with autism and their eligibility for special education services may differ. A systematic review was made of special education laws for eligibility of autism classification in Japan, Korea, the UK, and the US and their relationship to the UN Conventions on the Rights of the Child and the Rights of Persons with Disabilities. The International Classification of Functioning, Disability and Health (ICF ? CY) was used to compare assessment tools for children with autism. The results of the study indicated that there is variability in how children with autism are defined and considered eligible for special education across the four countries. Special education laws were based on the rights of equal and fair educational opportunities for children with special education needs. A match of content of common measures with ICF-CY codes indicated that two of the major measurement tools view children with autism as having restrictions in their abilities to perform activities rather than having a loss of physiological and psychological functions. The common language and framework of the ICF-CY may be a useful approach for teachers and parents in identifying children with autism and providing special education for them.

Purpose: This study aims to investigate the current status of affiliate stigma among parents of autistic children, analyze the influencing factors, explore the relationship among mindfulness, coping styles, and affiliate stigma, and verify the mediating role of coping styles between mindfulness and affiliate stigma in parents of children with autism in China. Method: Between February and April 2023, the Child Development Behaviour Centre of a public hospital in China recruited 345 parents of children with autism. These parents completed the general information questionnaire, the Mindful Attention Awareness Scale, the Affiliate Stigma Scale, and the Simple Coping Style Questionnaire. We then adapted the Hayes Process Macro and Bootstrap methods to examine the mediating effects of coping styles between mindfulness and affiliate stigma. Results: (1) The total affiliate stigma score of parents of children with autism was 48.53 (standard deviation:: 10.74). Parents' age, monthly family income, duration of care, mindfulness, and coping styles were the influencing factors of parental affiliate stigma. (2) Mindfulness was positively correlated with positive coping style (r = 0.33, p < .01) and negatively correlated with negative coping style, affiliate stigma (r = -0.38, -0.39, p < .01), whereas affiliate stigma was negatively correlated with positive coping style (r = -0.34, p < .01) and positively correlated with negative coping style (r = 0.41, p < .01). (3) Positive coping style and negative coping style play a parallel mediating role between mindfulness and affiliate stigma of parents of autistic children. Conclusions: Parents of children with autism experience significant levels of affiliate stigma. Mindfulness has a direct impact on associated stigma in parents of children with autism and also indirectly predicts associated stigma through the intermediary influence of positive and negative coping styles. Healthcare professionals could perform mindfulness interventions from an optimistic psychology viewpoint to boost parents' mindfulness and coping abilities, thereby accomplishing the objective of mitigating affiliate stigma.