Otizm Spektrum Bozukluğu Olan Bir Çocukta DIR/Floortime Müdahalesinin Duyusal İşlemleme ve Uyum Davranışı Üzerine Etkisi: Olgu Sunumu

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.

Effect of DIR/Floortime Intervention on Adaptive Behavior of a Child with Autism Spectrum Disorder

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.

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