CO-OP 적용이 ADHD 아동의 작업수행에 미치는 효과: 예비연구
Effect of the CO-OP Approach on Occupational Performance in ADHD : A Pilot Study
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목적 : 본 연구는 다양한 진단군에서 운동기술이 향상된 결과를 보여주는 CO-OP접근을 ADHD아동에게 적용하여기술의 습득 및 변화를 살펴 본 후 ADHD아동에게 CO-OP접근의 가능성을 살펴보고자 하였다. 연구방법 : 연구대상자는 ADHD진단을 받고 유치원에 재학 중인 만 7세 2개월의 남아 1명으로 개별실험연구설계(single subject research design) 중 AB로 설계하여 5주간 10회기로 총 7주간 진행되었다. 보호자와 COPM을통해 목표를 정하였으며 설정된 목표는 아동의 젓가락 질 향상이었다. 중재과정에서 CO-OP의 전반적인 과정을설명하였고 젓가락질의 기술을 습득하게 하기 위해 수행에 대한 분석 및 실행을 지속하도록 하였으며, DSS를 가이드 하였다. 수행측정은 젓가락을 들고 시작과 동시에 콩이 담긴 접시에서 다른 접시로 콩을 집어 옮기는 시간으로 하였다. 결과 : 콩을 집는 시간은 중재 전 22.3초 걸렸지만 중재 후 15.1초로 7.2초 단축되었고 부모님의 COPM 점수는 수행도 3점, 만족도 4점의 향상을 보여 임상적으로 유의한 변화를 가져왔다. 결론 : ADHD아동에게 CO-OP접근은 작업수행을 향상시킬 수 있는 중재방법이다.
Abstract
Objectives : This research was conducted to plan a strategy on the activities for ADHD who want to improve, and to use the strategy to find out how it influences the occupational performance when applying Cognitive Orientation to a daily Occupational Performance (CO-OP) approach. Methods : A single Subject AB design was employed. The subjects was one children with ADHD. The experiment consisted of 10 sessions spread over 7 weeks. The objective selected through COPM with guardians was improvement of chopstick use by children. In the course of the intervention, the overall CO-OP process was explained, continued analysis of performance and practice were encouraged in order to learn the skill of chopstick use, and guidance was given for DSS. Performance was measured by the time to move beans from one plate to another, starting from when the chopsticks were picked up. Results : The time to pick up the beans was 22.3s before the intervention, which was decreased by 7.2s to 15.1s after the intervention. The parents’ COPM score showed an improvement of 3 points for performance and 4 points for satisfaction, demonstrating a clinically significant change. Conclusion : This study provides evidence that CO-OP is beneficial in occupation performance in children with ADHD.
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