자폐아동을 위한 모-아애착증진 프로그램의 효과

EFFECTS OF THE MOTHER-CHILD ATTACHMENT PROMOTION PROGRAM FOR AUTISTIC CHILDREN

자폐아동을 위해 개발된 모-아애착증진 프로그램의 효과를 평가하고자 참여군과 비참여군의 변화를 비교하였다. 대상자는 S대학교병원 애착증진 프로그램에 참여하는 자폐아동과 어머니 7쌍, 참여하지 않는 자폐아동과 어머니 4쌍이었다. 6개월 간격으로 2회, 비디오 촬영법 등을 통해 자료를 수집하였으며 Wilcoxon Rank(Sign) Sum Test로 모-아애착, 양육행위, 자폐적인 행동 특성의 변화를 비교 분석하였다. 그 결과 참여군의 애착행동의 변화는 같은 기간 비참여군의 애착행동의 변화보다 유의하게 컸으며 일치성을 제외한 근접성, 상호성, 정감성에서 양적으로나 질적으로 긍정적 변화를 보였다(p<.05). 접촉유지, 차별적, 애정적 행동이 크게 증가하였으나 공감적, 일치적, 합동주시 행동의 변화는 적었고 아동간에 개별차가 컸다. 아동의 성장발달을 위한 어머니의 양육행위도 참여군에서 크게 증가하였으나 그룹간 차이는 유의하지 않았다(p<.05). 애착행동의 증진은 또한 자폐적 행동 특성에 긍정적 영향을 미쳐 모-아애착 증진 프로그램이 자폐아동들의 사회적 행동의 증진 뿐만 아니라 문제 행동의 개선에도 유용한 조기중재 프로그램으로서의 가능성을 보였다.

Objectives：This study was conducted to evaluate the effects of the attachment promotion program which was designed to promote attachment between autistic children and their mothers. The program was consisted of play activity centered mother-child interaction, educational activity for mothers by lecture, video-feedback session, and emotional supports. Methods：The subjects were consisted of 11 pairs of mother and child(7 for participant group：PG, 4 for non-participant group：NPG), who were 2-4 years-old autistic children. The data were collected by video-taping, behavioral observations, and analyzed by Wilcoxon Rank(Sign) Sum Test and Content Analysis. Results：The total attachment score increased from pre test to post-test of PG was significantly higher than that of NPG. The scores of attachment behaviors indicating proximity, mutuality and affect increased significantly(p<.05), while some behaviors indicating synchrony and jointattention did not. Especially the affectionate behaviors of PG demonstrated the most notable changes and they became more active, voluntary and reciprocal. After the program, the mother's nurturing behaviors of PG increased more than that of NPG, with no significant difference between two groups. The mother's behaviors to her child of PG became more child-centered, positively responsive, supportively expressive. As the attachment was promoted, there were also positive changes in the children's autistic behaviors with a great deal of individual differences. Conclusion：Our findings suggest that Mother-Child Attachment Promotion Program could be an effective early intervention model for autistic children.