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Analysis of Social Communication Measurement in the Music Therapy Intervention Literature for Children With Autism Spectrum Disorder

자폐범주성장애 아동을 위한 음악치료 중재 문헌 내 사회적 의사소통 측정 도구 분석

  • Received : 2016.04.30
  • Accepted : 2016.05.20
  • Published : 2016.05.30

Abstract

With broad individual variability in social communication skills of children with autism spectrum disorders and increasing focus on interventions targeting social communication of this population, there is a need for systematic analysis of how social communication outcomes are measured. This study aimed to systematically analyze the measurement tools used in the music therapy interventions for improving social communication of children with ASD. Electronic databases and music therapy journals were searched for controlled studies published between 1980 and 2015. A total of 21 studies were included for the analysis. The results demonstrated that direct observation of behaviors was the most frequently used and the combination of targeted social communication areas and specific measurements used for a specific skill varied among the studies. In addition, 90.4% of studies reported interrater reliability. These results indicate that there has been a diversity in approaches to measure social communication skills despite increasing attempts for systematic measurements. In consideration of the nature of social communication development in children with ASD, multifaceted strategy to understand and assess the target skills in terms of specific behavior acquisition, social functioning in general, and social cognition was recommended.

자폐범주성장애 아동은 사회적 의사소통 발달에 있어 넓은 범주의 개별적 변이성을 보이기 때문에 이에 대한 중재 개입 시 효과적인 전략이 매우 중요하며, 이를 정확하게 평가할 수 있는 사회적 의사소통 평가도구의 중요성이 지속적으로 강조되고 있다. 본 연구에서는 음악 중재 문헌 내에서 사용된 사회적 의사소통 측정 도구에 대해 고찰하고 이를 분석하였다. 전자데이터베이스 및 음악치료 학술지 검색을 통해 자폐범주성장애 아동의 사회적 의사소통을 변인으로 한 중재 연구 중 1980년에서 2015년까지 출간된 통제된 디자인의 연구가 검색되었고, 최종 분석에는 21개의 연구가 포함되었다. 분석 결과, 측정 도구 유형으로는 행동 직접 관찰이 가장 많이 사용되었고, 측정 도구 유형과 그에 따른 목표 영역 간 조합에 있어 변이성이 크게 나타났다. 또한 선정된 연구 중 90.4%를 차지하는 연구에서 측정 도구 사용의 적절성 검증을 위한 평가자 간 신뢰도가 보고되고 있음이 나타났다. 이러한 결과는 음악치료 중재문헌 내에서 객관적, 체계적 평가 시도가 증가함에도 불구하고, 동일 기능 수준에 접근하는 개별 연구 간 평가 방안 및 전략에 있어 일관성이 떨어지고, 이로 인한 임상근거 도출에 제한이 있음을 시사한다. 결론적으로 자폐범주성장애의 고유한 특성을 고려하여, 사회적 의사소통 평가 시 전반적 기능 수준 변화뿐만 아니라 특정한 행동 습득, 사회 인지 수준 등을 고려할 필요가 있음을 제언하였다.

Keywords

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