다감각스토리텔링 기반의 활동중심중재가 뇌성마비 아동의 사회적 상호작용에 미치는 영향
Effects of the Multisensory Storytelling-Based Activity-Oriented Intervention on Social Interaction in Children with Cerebral Palsy
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본 연구의 목적은 뇌성마비 아동에게 다감각스토리텔링에 기반한 활동중심중재를 적용하고 사회적 상호작용에 미 치는 영향에 대해 알아보는 것이다. 유사실험연구로 단일눈가림, 두 집단 사전-사후검사로 설계하였고, 경직형 뇌성마 비로 진단받고, 대동작기능분류체계(GMFCS) Ⅰ~Ⅲ단계에 속하는 7~8세 아동 24명을 대상으로 하였다. 실험군과 대조군에 12명씩 무작위 배정하고 아동과 보호자는 집단이 어디에 속하는지 알 수 없도록 하였다. 집단별 프로그램은 회기당 60분, 주 2회, 8주간, 총 16회기 동안 진행되었고, 실험군은 다감각스토리텔링에 기반한 활동중심중재를 하였 고, 대조군은 구조화된 신체활동을 실시하였다. 아동의 중재 전과 후에 사회적 상호작용의 변화정도를 확인하기 위해 또래관계기술척도를 사용하여 측정하였다. 수집된 자료는 SPSS 25.0 for windows (IBM Corp, USA) 프로그램을 이 용하여 분석하였고, 통계적 검증을 위한 유의수준(α)은 0.05로 하였다. 실험군과 대조군의 또래관계기술의 집단 내 변 화는 윌콕슨부호순위검정(Wilcoxon Signed-Rank test)으로 확인하고, 두 집단 간 변화량 차이의 비교는 맨휘트니검정 (Mann-Whitney U test)으로 분석하였다. 연구결과 또래관계기술의 집단 내 변화에서 또래관계기술의 전체 값과 하위 평가의 협동과 공감영역에서 실험군과 대조군 모두 유의한 차이가 있었고, 주도성 영역에서는 실험군은 유의한 차이 를 나타냈으나 대조군은 유의한 차이가 없었다. 두 집단 간 변화량 차이에서 또래관계기술의 하위평가의 주도성영역 과 전체 값에서 유의한 차이를 나타냈고, 협동과 공감 영역에서는 유의한 차이가 없었다. 본 연구에서는 뇌성마비 아 동을 대상으로 다감각스토리텔링에 기반한 활동중심중재를 적용하여 또래관계기술에 유의한 향상을 확인하였다. 다감 각스토리텔링에 기반한 활동중심중재는 뇌성마비 아동의 사회적 상호작용에 효과적인 중재방법으로 제안할 수 있다.
Abstract
This study aimed to verify how a multisensory storytelling-based activity-based intervention affects social interaction in children with cerebral palsy. As a quasi-experimental investigation, this study used a single-blind, two-group pre-post test design. This study comprised 24 children aged 7 to 8 y who had been diagnosed with spastic cerebral palsy and were classified as having GMFCS stages I to III. Twelve children were randomly assigned to experimental and control groups, with neither the children nor their guardians knowing which group they were placed in. The group program comprised 16 sessions of 60 min each, twice a week for eight weeks. The experimental group engaged in an activity-centered intervention centered on multisensory storytelling, whereas the control group engaged in structured physical activity. The activities were assessed using the peer relations skills scale to determine the extent to which social interaction had changed prior to and during the child’s intervention. The SPSS 25.0 for Windows (IBM Corp, USA) application was used to analyze the data, and the significance level (α) for statistical verification was set to 0.05. Furthermore, the Wilcoxon Signed-Rank and Mann-Whitney U tests were used to assess the differences in social interaction between the experimental and control groups. Significant differences were observed in the total of the peer relationship skill scale and cooperation and empathy areas of the subtest in the intragroup change of the peer relationship skill scale between the experimental and control groups. However, the experimental group demonstrated a significant difference in the initiative area, whereas the control group demonstrated no significant difference. A significant difference was observed in the amount of change between the two groups in the initiative area and total of the subtest of peer relationship skills but no significant difference in the collaboration and empathy areas. We gave a multisensory storytelling-based activity-based intervention based on multisensory storytelling to children with cerebral palsy and saw a significant improvement in peer relationship skills. It may be proposed as an effective intervention strategy for children with cerebral palsy who struggle with social contact.
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