THE EFFECT OF FACIAL SCREENING ON PICA TREATMENT IN A CHILD WITH SEVERE RETARDATION

이미증(pica) 치료에 있어서 얼굴가리게 사용의 효과

The main purpose of this study was to treat pica in a 2.8 year old child with severe mental retardation along with autistic tendencies. His developmental age ranged from 12 to 15 month on the DDST and he had no means of communication. He was on Tegretol 200mg for seizure control. His pica involved thumb sucking, putting toys into his mouth, and licking furniture wherever he went Besides pica, he had a rumination problem. The treatment strategies for his pica consisted of two phases : In phase 1, The child was taught toy play through a 3-step guided compliance training, while his pica and rumination behaviors were recorded to investigate whether active toy play could effect any change in the untreated pica and rumination behaviors of this child. In phase 2, a facial screening was used as a means to control his pica, while his rumination was recorded to see whether controlling his pica could bring any change in the untreated ruminating behavior. The results showed that the facial screening was very effective in decreasing his pica from an average of 18.6 times per 15 minute in the baseline to 2.3 times post-treatment. Response covariation was observed across pica and rumination while toy play compliance training alone was being conducted, and covariation across rumination was observed while pica alone was being treated with facial screening.

2세 10개월된 중증 정신지체아동의 이미증 치료에서 지시따르기 훈련을 통한 장난감 놀이지도(DRO)와 이미증 제재수단으로 얼굴가리개(Facial Screening)가 사용되었다. 이 아동의 이미증은 주로 손가락 빨기, 장난감 입에 넣고 빨기, 주위의 물건에 닥치는 대로 입을 대고 빠는 형태이다 빠는 행위의 발생은 장난감 놀이지도 전에는 15분 당 평균 18.6회였으나, 놀이지도 기간에는 평균 5.4회, 얼굴가리개를 통해 빠는 행위를 제재한 치료기간에는 평균 2.3회로 감소되어, 얼굴가리개의 사용이 이 아동의 이미증 치료에 큰 효과를 보였다. 이 아동은 이미증 이외에 구토행위를 보였는데, 본 연구에서는 구토행위를 치료하지 않았으나, 놀이지도 및 이미증 치료기간 동안 구토행위가 저절로 감소된 현상을 보인 것은 기존 연구에서 밝혀진 바와 같이 한 행동의 치료가 다른 문제행동의 감소에 영향을 줄 수 있음을 증명하고 있다.