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부모교육을 통한 섭식장애 아동의 행동치료

Parental Implementation of Behavior Intervention Program for Children with Feeding Disorder

정경미|양소정
한국정서행동장애학회 (The Korean Society of Emotional and Behavioral Disorders)|2007.12|정서·행동장애연구 (JOURNAL OF EMOTIONAL & BEHAVIORAL DISORDERS)|제23권 제4호|pp. 99-117

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참고문헌

키워드

행동치료응용행동분석Parent training부모교육Applied Behavior AnalysisBehavioral InterventionChildhood Feeding Disorder아동기 섭식장애성장장애비교설계연구.Failure-to-ThriveComparison (AB) Design.

초록

아동기 섭식장애는 정상발달과 장애아동 모두에게서 비교적 높은 비율로 보고되는 문제이며, 미숙아 생존율과 함께 증가하고 있는 추세임에도 불구하고 국내에서는 임상상황에서 정확히 분류나 진단이 되지 않거나 체계적인 치료사례가 극히 드문 실정이다. 본 연구에서는 성장장애(Failure-to-thrive) 진단을 받은 정상발달 여아 두 명을 대상으로 응용행동분석을 이용한 행동치료의 효과를 검증하고자 하였다. 치료에는 선행사건 조작(유아용 식탁의자, 식사시간 조절 등), 정적 강화, 문제행동의 소거(Non-Removal of Spoon), 자극 용암법과 같은 기법이 사용되었고, 모델링, 리허설, 피드백을 통하여 아동의 어머니를 치료자로 활용함으로써 비용을 최소화시키고 가정에서의 자연스러운 일반화를 돕고자 하였다. 비교설계를 활용하여 치료 전후의 평균적인 섭취량, 음식 받아들임, 문제행동, 식사소요시간을 비교해본 결과, 두 아동 모두 개인차는 있으나 섭취량과 음식을 받아들이는 비율은 증가하고 문제행동과 1g당 식사소요시간은 감소하였다. 본 연구에 따른 임상적 함의와 한계점에 대해서도 논의하였다.

Abstract

Applied behavioral analysis was used for treating 2 typically developing girls with Failure-to-thrive. Mothers were served as a therapist to minimize costs and to increase generalization. Using an AB-design, the mean amount of food, acceptance, problem behavior, and meal duration time were compared. Treatment components used in this program were positive reinforcement, extinction, NRS, stimulus fading, and mealtime management and parental training was conducted via modeling, rehearsal, and feedback. After four days of intensive treatment at hospital, treatment was continued at home by parents via weekly consultation for 4 months. Though having individual differences, the amount of food intake and acceptance were increased, and problem behaviors and meal duration time were decreased. Both girls gained weights; one reached the normal range. Limitations as well as clinical and research implications were discussed.

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