GONCA ÖZYURT, Çağla DİNSEVER, SELÇUK AKPINAR, KÜRŞAT ÖZCAN, Yücel ŞAL, YUSUF ÖZTÜRK

Otizm spektrum bozukluğu olan çocuklarda terapötik ata binme aktivitelerinin otizm belirtileri ve yaşam kalitesi üzerine etkisi

Giriş: Otizm spektrum bozukluğu (OSB) sıklığı yıllar içinde giderek artmakta ve tedavisi giderek daha önem kazanmaktadır. Bu çalışmadaki amaç terapötik ata binme aktivitelerinin OSB'li çocuklarda otizm belirtileri ve yaşam kalitesi üzerine etkilerini incelemek amaçlanmıştır. Yöntem: OSB'li 24 çocuk randomize edilerek bir gruba terapötik ata binme aktiviteleri uygulanırken, diğer gruba özel eğitim ve aylık düzenli çocuk psikiyatri kontrolleri dışında herhangi bir eğitim veya tedavi uygulanmamıştır. Çocuklara 8 hafta boyunca haftada 1 saat terapötik ata binme eğitimi verilmiştir. Eğitim öncesi ve sonrasında yaşam kalitesi ölçümü için Çocuklar İçin Yaşam Kalitesi Ölçeği (ÇİYKÖ) kullanılırken, otistik belirtileri Otizm Davranış Kontrol Listesi (ODKL) ile değerlendirilmiştir. Sonuçlar: İki grup arasında terapötik ata binme aktivitelerinin başlangıcında yaşam kalitesi ve otizm belirtileri açısından farklılık bulunmamıştır. Terapötik ata binme aktivitesine katılan çocukların katılmayan çocuklar ile 8 hafta sonunda değerlendirildiğinde fiziksel yaşam kalitesi puanlarında ve ODKL ilişki kurma alt ölçeğinde istatistiksel açıdan anlamlı farklılık sağlanırken, ÇİYKÖ ve otizm davranış kontrol listesinin diğer alt ölçeklerinde iki grup arasında istatistiksel açıdan anlamlı farklılık bulunmamıştır. Terapötik ata binme aktivitesine katılan çocuklar başlangıç ve aktivite sonrası değerlendirildiğinde de ÇİYKÖ fiziksel, duygusal ve psikososyal puanları arasında ve ODKL'nin duyusal, ilişki kurma, beden ve nesne kullanımı, dil becerileri, sosyal ve öz bakım becerileri ve toplam otizm davranış kontrol listesi puanı açısından istatistiksel açıdan farklılık bulunmuştur. Tartışma: OSB'li çocukların terapötik ata binme aktivitelerinden sonra hem fiziksel, hem de psikososyal boyutta olumlu yönde geliştiklerini ve OSB'nin şiddetinin bir miktar azaldığını göstermektedir. Bu sonuç, literatürdeki diğer çalışma sonuçları ile paralellik göstermektedir. Terapötik ata binme aktivitelerinin OSB'li çocuklarda birincil tedavi olmasa da alternatif rehabilitasyon olarak kullanılabilceğini düşündürmektedir.

The effect of therapeutic horseback riding for children diagnosed with autism spectrum disorder on autistic symptoms and the quality of life

Objective: The prevalance of autism spectrum disorder (ASD) is increasing over the years and treatment is becoming more important. The purpose of this study was to investigate the effect of therapeutic horseback riding for children diagnosed with autism spectrum disorder on the quality of life and autistic symptoms. Methods: Twentyfour children with ASD were randomized into one group to perform therapeutic horse-riding activities while the other group did not receive any education or treatment except special education and regular child psychiatric control monthly. Children have been trained in therapeutic horseback riding for 1 hour a week for 8 weeks. Pediatric Quality of Life Inventory (PedsQL) was used for the measurement of quality of life, while autistic symptoms were assessed with the Autism Behavior Checklist (ABC) before and after the training. Results: Statistically significant differences were not found in the quality of life or autism symptoms between the two groups at the beginning of the therapeutic horse-riding activities. There were statistically significant differences between the two groups in terms of physical life quality scores and ABC relationship subscale while there were not statistically significant other subscales of the PedsQL and ABC at the end of 8 weeks. When children participating in therapeutic horse-riding activity were assessed before and after activity, statistically significant differences were found in physical, emotional, and psychosocial scores of the PedsQL and the sensory, relationship building, body and object use, language skills, social and self-care skills of ABC. Discussion: It was shown that children who are diagnosed with ASD developed positively in both physical and psychosocial dimension and the severity of ASD decreased after therapeutic horse-riding activities. This results show parallelism with other studies in the current literature. It was suggested that therapeutic horse-riding activities in children diagnosed with ASD could be used as an alternative rehabilitation, even if they were not primer-treatment.

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