Korean Journal of Occupational Therapy (대한작업치료학회지)

Korean Society of Occupational Therapy (대한작업치료학회)
권호 표지
DOI QR코드

DOI QR Code

Application of Occupation-Based Practice for Neurodevelopmental Children's Subway Use

신경발달 장애 아동의 지하철 이용하기 작업에 대한 작업기반 중재의 적용

  • Ra, Dae-Yeop (Department of Occupational Therapy, Solparan Children's Research Institute, Occupational Therapist) ;
  • Kong, Myung-Ja (Dept. of Occupational Therapy, Woosong University) ;
  • Chang, Ki-Yeon (Dept. of Occupational Therapy, Woosong University)
  • 라대엽 (솔파란 아동연구소) ;
  • 공명자 (우송대학교 작업치료학과) ;
  • 장기연 (우송대학교 작업치료학과)
  • Received : 2018.05.02
  • Accepted : 2018.11.06
  • Published : 2018.12.30
⟨ Previous Next ⟩

Abstract

Objective : This study implemented occupation-based practice as a group program for children with neurodevelopmental disabilities, and investigated the quality of occupational performance, performance and satisfaction, and efficacy levels of the program. Methods : ADOC-S(Aid for Decision making in Occupation Choice-School) and COPM(Canadian Occupational Performance Measure) were used to establish common meaningful occupational goals for 10 children with neurodevelopmental disabilities. After occupational analysis of the 'subway use', the Performance Quality Rating Scale(PQRS) were used to evaluate the quality of occupational performance. Occupation-based interventions were implemented by participants individually performing meaningful occupations in the most natural and real-life environments as possible. The trial consisted of 1 session of pre-intervention assessments, 8 sessions of intervention, where a single session of 100 minutes is provided once a week. Post-intervention evaluation was conducted over one session. Results : The quality of occupational performance by PQRS was 38.10 higher than before intervention. The occupation-based intervention as a group program used the maintain and modify(compensation, adaptation) approaches and acquisition model. In the early stages of intervention (1 to 4 sessions), the occupational performance was greatly improved. The performance level of COPM increased by 5.80 and the satisfaction level was increased by 7.00. In addition, high scores were found in program satisfaction through parental interview. Conclusion : The results of implementing occupation-based interventions to children with neurodevelopmental disabilities showed increase in quality of occupational performance, performance, and satisfaction along with positive effects of satisfaction levels for the program.

목적 : 본 연구는 신경발달 장애 아동들에게 작업기반(occupation-based) 중재를 그룹 프로그램으로 적용하여 작업 수행의 질, 수행도 및 만족도, 프로그램에 대한 만족도의 효과를 알아보고자 하였다. 연구방법 : 신경발달 장애 아동 10명을 대상으로, ADOC-S(Aid for Decision making in Occupation Choice-School) 및 COPM(Canadian Occupational Performance Measure)을 사용하여, 모든 클라이언트에게 의미 있고 공통된 작업 목표를 수립 하였다. '지하철 이용' 작업수행 분석한 후에 PQRS(Performance Quality Rating Scale)를 사용하여 작업수행의 질 변화를 조사하였다. 작업기반 중재는 가장 자연스럽고 실제생활과 비슷한 상황에서 의미 있는 작업을 직접 수행하며 진행되었다. 실험은 사전 평가 1회기, 중재기는 주 1회, 회기당 100분, 8주간, 총 8회기 진행되었고 사후 평가 1회기 실시되었다. 결과 : 작업수행의 질인 PQRS에서는 중재 전에 비해 중재 후 38.10의 증가를 보였다. 유지, 보상 및 적응접근을 적용하여 초기 회기(1~4회기)에 큰 증가율이 나타났다. COPM의 수행도는 중재 전에 비해 5.80, 만족도는 7.00의 증가가 나타났다. 또한 보호자 인터뷰를 통한 프로그램 만족도에서 높은 점수가 나타났다. 결론 : 작업기반 중재는 신경발달장애 아동의 작업수행을 향상시킬 수 있는 중재방법이며, 수행도 및 만족도, 프로그램 만족도에 긍정적인 결과를 도출할 수 있었다.

Keywords

References

  1. 장기연, 공명자, 우희순, 민유선. (2018). 작업으로 이야기하는 작업치료. 서울, 한국: 현문사.
  2. Amini, D. A., Kannenberg, K., Bodison, S., Chang, P., Colaianni, D., Goodrich, B., & Lieberman, D. (2014). Occupational therapy practice framework: Domain & process (3rd ed.). American Journal of Occupational Therapy, 68, S1-S48.
  3. Boyt Schell, B. A., Gillen, G., & Scaffa, M. E. (2013). Willard and Spackman's occupational therapy (12th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
  4. Carpenter, L., Baker, G. A., & Tyldesley, B. (2001). The use of the canadian occupational performance measure as an outcome of a pain management program. Canadian Journal of Occupational Therapy, 68(1), 16-22. doi:10.1177/000841740106800102
  5. Case-Smith, J. (2014). An overview of occupational therapy for children. In J. Case-Smith, & J. C. O'Brien (Eds.), Occupational therapy for children and adolescents (7th ed., pp. 1-26). St. Louis, MO: Elsevier.
  6. Chang, K. Y. (2017). A study of awareness and implementation of OBP (Occupation-Based Practice). Journal of Korean Society of Community-Based Occupational Therapy, 7(2), 19-31. doi:10.18598/kcbot.2017.07.02.03
  7. Chang, K. Y., Lee, H. J., Kim, K. S., Ra, D. Y., Jang, A. J., & Shin, S. Y. (2014). The relationships between the auditory behavioral characteristic and the sociality of children with autism spectrum disorder. Journal Korean Academy of Sensory Integration, 12(2), 1-12
  8. Choi, E. J. (2018). A study on occupational performance activity items of elementary school students (Unpublished master's thesis). Woosong University, Daejeon.
  9. Colaianni, D., & Provident, I. (2010). The benefits of and challenges to the use of occupation in hand therapy. Occupational Therapy in Health Care, 24, 130-146. doi:10.3109/07380570903349378
  10. Dunn, M. L., & Loukas, K. M. (2014). Instrumental activities of daily living, driving, and community participation. In J. Case-Smith, & J. C. O'Brien (Eds.), Occupational therapy for children and adolescents (7th ed., pp. 461-482). St. Louis, MO: Elsevier.
  11. Estes, J., & Pierce, D. E. (2012). Pediatric therapists' perspectives on occupation-based practice. Scandinavian Journal of Occupational Therapy, 19(1), 17-25. doi:10.3109/11038128.2010.547598
  12. Fisher, A. (2009). Occupational therapy intervention process model. Fort Collins, CO: Three Star Press Inc.
  13. Fisher, A. G. (2014). Occupation-centred, occupation-based, occupation-focused: Same, same or different? Scandinavian Journal of Occupational Therapy, 21(sup1), 96-107. doi:10.3109/11038128.2014.95 2912
  14. Goldstein-Lohman, H., Kratz, A., & Pierce, D. (2003). A study of occupation-based practice. In D. E. Pierce, & D. Pierce (Eds.), Occupation by design: Building therapeutic power (pp. 239-261). Philadelphia, PA: F. A. Davis.
  15. Hilton, C. L. (2014). Interventions to promote social participation for children with mental health and behavioral disorders. In J. Case-Smith, & J. C. O'Brien (Eds.), Occupational Therapy for Children and Adolescents (7th ed., pp. 193-219). St. Louis, MO: Elsevier.
  16. Hocking, C. (2001). Implementing occupation-based assessment. American Journal of Occupational Therapy, 55, 463-469. doi:10.5014/ajot.55.4.463
  17. James, A. B. (2014). Activity of daily living and instrumental activities of daily living. In B. A. Boyt Schell, G. Gillen, & M. E. Scaffa (Eds.), Willard and Spackman's occupational therapy (12th ed., pp. 610). Philadelphia, PA: Lippincott Williams & Wilkins.
  18. Kang, D. H. (2012). Utility of the canadian occupational performance measure in evaluating the outcome of rehabilitation services for people with mental disorders. Journal of Korean Society of Occupational Therapy, 20(4), 125-136.
  19. Kweon, H. Y., & Jeon, B. U. (2016). The change of diagonstic criteria on DSM-5: Based on neurodevelopmental disorders. Journal of Intellectual Disabilities, 18(2), 117-139.
  20. Law, M., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (2014). Canadian occupational performance measure (5th ed.). Ottawa, ON: CAOT Publications.
  21. Law, M., Polatajko, H., Baptiste, W., & Townsend, E. (1997). Core concepts of occupational therapy. In E. Townsend (Ed.), Enabling occupation: An occupational therapy perspective (pp. 29-56). Ottawa, ON: CAOT Publications.
  22. Law, M., Polatajko, H., Pollock, N., Mccoll, M. A., Carswell, A., & Baptiste, S. (1994). Pilot testing of the canadian occupational performance measure: Clinical and measurement issues. Canadian Journal of Occupational Therapy, 61, 191-197. doi:10.1177/000841749406100403
  23. Leland, N. E., Fogelberg, D., Sleight, A., Mallinson, T., Vigen, C., Blanchard, J., ... Clark, F. (2016). Napping and nighttime sleep: Findings from an occupation-based intervention. American Journal of Occupational Therapy, 70(4), 1-7. doi:10.5014/ajot.2016.017657
  24. Lexues Incorporaed. (2013). Aid for Decision-making in Occupation Choice-S (ADOC-S) user manual (version 1.0). Okinawa, Japan: Author.
  25. Loukas, K. M., & Dunn, M. L. (2010). Instrumental activities of daily living and community participation. In J. Case-Smith, & J. C. O'Brien (Eds.), Occupational therapy for children (6th ed., pp. 518-539). Maryland Heights, MO: Mosby.
  26. Martini, R., Rios, J., Polatajko, H., Wolf, T., & McEwen, S. (2015). The Performance Quality Rating Scale (PQRS): Reliability, convergent validity, and internal responsiveness for two scoring systems. Disability and Rehabilitation, 37, 231-238. doi:10.3109/09638288.2014.913702
  27. Murad, M. S., Idris, S. N. H., Kannan, C., & Danis, A. (2016). Impact of occupationally based intervention program in relation to quality of life of spinal injury people. Procedia-Social and Behavioral Sciences, 222, 442-449. doi:10.1016/j.sbspro.2016.05.134
  28. O'Brien, J. (2014). Application of motor control/motor learning to practice. In J. Case-Smith, & J. C. O'Brien (Eds.), Occupational therapy for children and adolescents (7th ed., pp. 193-219). St. Louis, MO: Elsevier.
  29. Oh, S. I. (2015). The effects of improved quality of daily life activities through a occupation-based intervention on the depression of stroke patient (Master's thesis). Hanseo University, Seosan.
  30. Orellano, E., Colon, W. I., & Arbesman, M. (2012). Effect of occupation and activity-based interventions on instrumental activities of daily living performance among community-dwelling older adults: A systematic review. American Journal of Occupational Therapy, 66, 292-300. doi:10.5014/ajot.2012.003053
  31. Park, J. Y., & Kang, Y. S. (2015). The effects of video self-modeling on the use of subway skills for students with intellectual disabilities. Korean Journal of Special Education, 50(3), 1-21. doi:10.15861/kjse.2015.50.3.1
  32. Park, S. J. (2008). An analysis on factors to influence services satisfaction of parents with handicapped children at of occupational therapy (Master's thesis). Daegu University, Daegu.
  33. Pfeiffer, B., Clark, G. F., & Arbesman, M. (2018). Effectiveness of cognitive and occupation-based interventions for children with challenges in sensory processing and integration: A systematic review. American Journal of Occupational Therapy, 72(1), 1-9. doi:10.5014/ajot.2018.028233
  34. Polatajko, H. J., & Mandich, A. (2004). Enabling occupation in children: The Cognitive Orientation to daily Occupational Performance (CO-OP) approach. Ottawa, ON: CAOT Publications.
  35. Polatajko, H., & Davis, J. A. (2012). Advancing occupation-based practice: Interpreting the rhetoric. Canadian Journal of Occupational Therapy, 79, 259-260. doi:10.2182/CJOT.2012.79.5.1
  36. Pontes, T. B., & Polatajko, H. (2016). Enabling occupation: occupation-based and client centred practice in occupational therapy. Cadernos de Terapia Ocupacional, 24, 403-412. doi:10.4322/0104-4931.ctoARF0709
  37. Rodger, S., & Brandenburg, J. (2009). Cognitive Orientation to (daily) Occupational Performance (CO‐OP) with children with asperger's syndrome who have motor‐based occupational performance goals. Australian Occupational Therapy Journal, 56(1), 41-50. doi:10.1111/j.1440-1630.2008.00739.x
  38. Shikako-Thomas, K., Shevell, M., Lach, L., Law, M., Schmitz, N., Poulin, C., & Majnemer, A. (2013). Picture me playing-a portrait of participation and enjoyment of leisure activities in adolescents with cerebral palsy. Research in Developmental Disabilities, 34, 1001-1010. doi:10.1016/j.ridd.2012.11.026
  39. Thapar, A., Cooper, M., & Rutter, M. (2016). Neurodevelopmental disorders. Lancet Psychiatry, 4, 339-346. doi:10.1016/S2215-0366(16)30376-5
  40. Tomori, K., Nagayama, H., Ohno, K., Nagatani, R., Saito, Y., Takahashi, K., ... Higashi, T. (2015). Comparison of occupation-based and impairment-based occupational therapy for subacute stroke: A randomized controlled feasibility study. Clinical Rehabilitation, 29, 752-762. doi:10.1177/0269215514555876
  41. Tomori, K., Nagayama, H., Saito, Y., Ohno, K., Nagatani, R., & Higashi, T. (2015). Examination of a cut-off score to express the meaningful activity of people with dementia using iPad application (ADOC). Disability and Rehabilitation: Assistive Technology, 10(2), 126-131. doi:10.3109/17483107.2013.871074
  42. Tomori, K., Saito, Y., Nagayama, H., Seshita, Y., Ogahara, K., Nagatani, R., & Higashi, T. (2013). Reliability and validity of individualized satisfaction score in aid for decision-making in occupation choice. Disability and Rehabilitation, 35(2), 113-117. doi:10.3109/09638288.2012.689919
  43. Tomori, K., Uezu, S., Kinjo, S., Ogahara, K., Nagatani, R., & Higashi, T. (2012). Utilization of the iPad application: Aid for decision‐making in occupation choice. Occupational Therapy International, 19(2), 88-97. doi:10.1002/oti.325
  44. Wasmuth, S., Pritchard, K., & Kaneshiro, K. (2016). Occupation-based intervention for addictive disorders: A systematic review. Journal of Substance Abuse Treatment, 62, 1-9. doi:1 0.1016/j.jsat.2015.11.011 https://doi.org/10.1016/j.jsat.2015.11.011
  45. Weinstock-Zlotnick, G., & Hinojosa, J. (2004). Bottom -up or top-down evaluation: Is one better than the other? American Journal of Occupational Therapy, 58, 594-599. doi:10.5014/ajot.58.5.594
  46. Wilcock, A. A., & Townsend, E. A. (2014). Occupational justice. In B. A. Boyt Schell, G. Gillen, & M. E. Scaffa (Eds.), Willard and Spackman's occupational therapy (12th ed., pp. 541-552). Philadelphia, PA: Lippincott Williams & Wilkins.
  47. Wolf, T. J., Chuh, A., Floyd, T., McInnis, K., & Williams, E. (2015). Effectiveness of occupation-based interventions to improve areas of occupation and social participation after stroke: An evidence-based review. American Journal of Occupational Therapy, 69(1), 1-11. doi:10.5014/ajot.2015.012195