상호적 악기 연주 프로그램이 자폐범주성장애 성인의 사회적 상호작용 기능 향상에 미치는 효과
The Effects of Interactive Instrument Playing Program on Social Interaction of Adults With Autism Spectrum Disorder
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초록
본 연구는 그룹홈에 거주하는 자폐범주성장애 성인들을 대상으로 진행된 상호적 악기연주 프로그램이 사회적 상호작용 기능 향상에 미치는 효과를 살펴보고자 하였다. 연구참여자는 발달장애 주간보호센터에 소속된 공동생활가정(그룹홈)에 거주하는 20대 후반 자폐범주성장애 1급 성인 남성 3명이다. 단일대상연구설계 중 참여자간 중다기초선설계를 적용하여 총 3개월 동안 각 참여자별로 기초선, 중재, 유지 구간을 포함하여 총 25회기 세션이 실시되었다. 중재 효과를 확인하기 위하여 사전에 조작적으로 정의된 상호작용 시도 행동과 반응 행동을 매회기 촬영된 동영상 자료를 바탕으로 관찰 및 측정하였다. 각 참여자는 음악적 환경 안에서 사회적 상호작용 시도 및 반응 행동 시점을 알려주는 음악구조와 큐에 의해 구조화된 상호적 악기 연주에 참여하였는데, 중재 이후 모든 참여자의 상호작용 시도 행동, 반응 행동 발생률이 증가하는 추세를 보였다. 이러한 결과는 상호적 악기 연주가 자폐범주성장애 성인의 자발적 상호작용 행동을 유도하는 데 효과적인 중재 방법으로 적용될 수 있음을 보여준다. 또한 음악적으로 전달된 사회적 정보가 사회적 맥락 안에서 타그룹원의 의도를 이해하고 사회적 상호작용에 참여하도록 촉진하는 효과적인 매체가 될 수 있음을 시사한다. 향후 자폐범주성장애 성인의 사회성 향상뿐만 아니라 삶의 질 향상을 위한 음악치료 중재가 지속적으로 개발되고 적용될 필요가 있음을 제안하였다.
Abstract
This study examined the effect of an interactive instrument playing program on the social interaction of adults with autism spectrum disorder (ASD). A single subject design with multiple baselines across participants was applied, and three adults with severe ASD in their late 20s living at a group home participated in this study. Participants received a total of 25 group sessions. During the intervention, participants engaged in structured instrument playing in which initiation and response to socially interactive behaviors were musically cued, and target behaviors were reinforced in the musical environment. At pre- and posttest, the frequency of initiation of and responding to social interaction behaviors were recorded and analyzed. The results of this study showed that the frequency of both initiation of, and response to, social interaction increased for all participants during the intervention phase, compared to the baseline phase. This result demonstrates that interactive instrument playing increased social behaviors of adults with ASD. It also shows that musically delivered social information can facilitate adults with ASD understanding the intention of social partners in social contexts and motivate this population to engage in social interaction.
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