대한감각통합치료학회지 (The Journal of Korean Academy of Sensory Integration)

  • 제21권3호
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  • Pages.79-102
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  • 2023
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  • 1738-0405(pISSN)
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  • 2384-115X(eISSN)
대한감각통합치료학회 (Korean Academy of Sensory Integration)
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자폐 스펙트럼 장애 아동의 섭식장애: 문헌 고찰

Feeding Disorders in Autistic Spectrum Disorders

  • 민경철 (서울특별시 어린이병원 재활의학과 작업치료실) ;
  • 신진용 (서울대학교 병원 어린이병원 작업치료실) ;
  • 김은혜 (대한연하재활학회)
  • 투고 : 2023.08.23
  • 심사 : 2023.12.08
  • 발행 : 2023.12.31
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초록

목적 : 자폐 스펙트럼 장애(Autistic Spectrum Disorders, 이하 ASD)는 비전형적 감각 적응, 의사소통 문제, 상동 행동 등이 특징인 발달 장애로 섭식장애가 흔하게 동반된다. ASD 아동의 섭식장애는 감각, 구강운동, 행동, 인지, 사회성 등 다양한 원인으로 발생하며 주요 증상으로는 까다로운 먹기, 선택적 먹기, 음식 거부, 새로운 음식 거부, 음식 다양성 제한, 음식 혐오 등 다양하다. 또한 건강 및 영양 섭취 문제, 섭식 발달, 섭식 관련 사회성, 가족과 보호자의 스트레스 등 다양한 문제가 동반되기도 한다. ASD 아동의 섭식장애는 출생 후부터 나타날 수 있으며 일반적으로 진단이 이루어지는 3세 이전에 발생하기 때문에 적절한 중재 제공 전 공백이 발생할 수 있다. 보통 섭식장애 증상은 연령이 증가할수록 감소되는 경향이 있으나 증상 자체는 남아 있는 경우가 많아서 조기 평가 및 중재, 지속적인 확인이 필요하다. 본 연구에서는 ASD 아동의 섭식장애 특성과 영향을 주는 요인, 중재법에 대한 일반적인 내용을 문헌 고찰을 통해 확인하였다. 결론 : ASD 아동의 섭식장애 중재로는 감각 기반 중재와 행동 기반 중재가 일반적이다. 감각 기반 중재는 음식 민감성, 행동 기반 중재는 음식 선택성에 효과적인 방법이다. 또한 ASD 아동의 섭식장애 증상이 다양한 만큼 감각 및 행동 기반 중재를 기본으로 놀이와 참여, 구강운동, 식이와 일상생활까지 포함된 종합적인 접근이 필요하다. 그러나 아직 ASD 아동의 섭식장애 중재를 위한 적절한 평가와 중재 프로토콜 및 가이드라인이 부족한 상황으로 보다 체계적인 이해를 바탕으로 한 복합적인 접근이 필요하다. 작업치료사 등 연하재활 전문가는 종합적인 이해를 바탕으로 ASD 아동의 섭식장애 해결을 위한 적절한 평가 및 중재를 제공해야 할 것이다.

Objective : Autistic Spectrum Disorders(ASD) is a developmental disorder characterized by atypical sensory adaptation, communication problem, stereotyped behavior, and feeding disorders. The reasons for ASD feeding disorders are oral sensory motor, cognitive, behavioral, and social problems. Major symptoms include picky eating, selective eating, food refusal, food neophobia, limited food variety, and food aversion. ASD feeding disorders could be accompanied by various problems such as health and nutrition intake problems, feeding development, eating-related sociability, and family and caregiver stress. Feeding problems and disorders in ASD can present from birth. However, ASD is diagnosed by the age of 3, and there might be an appropriate treatment gap. Usually, symptoms of feeding disorders tend to decrease with age. However, the symptoms often remain, so early evaluation, intervention, and periodic checking are necessary. In this study, the general information about the feeding disorder characteristics of ASD, influencing factors, and intervention were described through a literature review. Conclusion : Sensory-based therapy and behavior-based therapies are generally used for feeding disorders in ASD. Sensory-based therapy is effective for food sensitivity and behavior-based therapy for food selection. As the symptoms of feeding disorders in ASD are diverse, a comprehensive approach includes play and participation, oral motor exercise, diet, and daily life. However, appropriate evaluation, intervention protocol, and guidelines for the treatment of feeding disorders in ASD are limited. Therefore, a complex approach based on a more systematic understanding is needed. Feeding rehabilitation specialists, such as occupational therapists, should provide appropriate evaluation and intervention.

키워드

과제정보

본 연구는 2023년 대한연하재활학회의 지원으로 진행되었음.

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