• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.4 no.1
• /
• pp.3-26
• /
• 1993

Leo Kanner (1943)의 자폐증에 관한 획기적 논문발표 50주년을 맞아, 자폐증의 개념변천, 분류, 의학, 원인설 및 자폐증의 본질을 문헌고찰을 통해 살펴 보았다. 초기에 자폐증을 정신병의 아형으로 보다가 1980년 (DMS-III)을 기점으로 전반적 발달장애로의 개념 변천이 일어났다 원인설도, 초기의 심리${\cdot}$환경설은 지지 받지 못하고 1960년대에는 신경${\cdot}$생물학적 이상이 자폐병리의 기저를 이룸이 분명해 졌고 1970년대에는 지각과 운동, 감각과 인지 통합의 결함, 심각한 언어, 인지의 장해가 일차적인 결함으로 생각 되었다 최근 1980년 후반기 부터 상징적${\cdot}$표상적 인지의 결함, 타인의 감정과 생각의 이해 결함, 사회적${\cdot}$정감적 표현의 결함등 사회${\cdot}$정서발달의 이상이 자폐의 근본적 결함이라는 비교 관찰 연구가 많이 보고되어, 자폐증의 근본적이고 일차적인 결함이 정감적 접촉의 선천적 장애라는 Kanner의 놀라운 임상적 통찰을 증명해 주고 있다. 저자는 이상의 광범위한 문헌 고찰을 통해 자폐장애를 일차성 애착장애로 개념화하고 앞으로 치료, 교육의 방향도 일차적으로 사회${\cdot}$정서발달에 촛점을 두어야 하며, 특히 어머니와의 애착증진 치료가 필요함을 제안하고 있다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.11 no.2
• /
• pp.198-208
• /
• 2000

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.