DOI QR코드

DOI QR Code

다감각스토리텔링 기반의 활동중심중재가 뇌성마비 아동의 사회적 상호작용에 미치는 영향

Effects of the Multisensory Storytelling-Based Activity-Oriented Intervention on Social Interaction in Children with Cerebral Palsy

  • 이은정 (울산광역시장애인종합복지관) ;
  • 권해연 (동의대학교 물리치료학과)
  • 투고 : 2021.11.16
  • 심사 : 2021.11.22
  • 발행 : 2021.12.31

초록

본 연구의 목적은 뇌성마비 아동에게 다감각스토리텔링에 기반한 활동중심중재를 적용하고 사회적 상호작용에 미치는 영향에 대해 알아보는 것이다. 유사실험연구로 단일눈가림, 두 집단 사전-사후검사로 설계하였고, 경직형 뇌성마비로 진단받고, 대동작기능분류체계(GMFCS) I~III단계에 속하는 7~8세 아동 24명을 대상으로 하였다. 실험군과 대조군에 12명씩 무작위 배정하고 아동과 보호자는 집단이 어디에 속하는지 알 수 없도록 하였다. 집단별 프로그램은 회기당 60분, 주 2회, 8주간, 총 16회기 동안 진행되었고, 실험군은 다감각스토리텔링에 기반한 활동중심중재를 하였고, 대조군은 구조화된 신체활동을 실시하였다. 아동의 중재 전과 후에 사회적 상호작용의 변화정도를 확인하기 위해 또래관계기술척도를 사용하여 측정하였다. 수집된 자료는 SPSS 25.0 for windows (IBM Corp, USA) 프로그램을 이용하여 분석하였고, 통계적 검증을 위한 유의수준(α)은 0.05로 하였다. 실험군과 대조군의 또래관계기술의 집단 내 변화는 윌콕슨부호순위검정(Wilcoxon Signed-Rank test)으로 확인하고, 두 집단 간 변화량 차이의 비교는 맨휘트니검정(Mann-Whitney U test)으로 분석하였다. 연구결과 또래관계기술의 집단 내 변화에서 또래관계기술의 전체 값과 하위평가의 협동과 공감영역에서 실험군과 대조군 모두 유의한 차이가 있었고, 주도성 영역에서는 실험군은 유의한 차이를 나타냈으나 대조군은 유의한 차이가 없었다. 두 집단 간 변화량 차이에서 또래관계기술의 하위평가의 주도성영역과 전체 값에서 유의한 차이를 나타냈고, 협동과 공감 영역에서는 유의한 차이가 없었다. 본 연구에서는 뇌성마비 아동을 대상으로 다감각스토리텔링에 기반한 활동중심중재를 적용하여 또래관계기술에 유의한 향상을 확인하였다. 다감각스토리텔링에 기반한 활동중심중재는 뇌성마비 아동의 사회적 상호작용에 효과적인 중재방법으로 제안할 수 있다.

This study aimed to verify how a multisensory storytelling-based activity-based intervention affects social interaction in children with cerebral palsy. As a quasi-experimental investigation, this study used a single-blind, two-group pre-post test design. This study comprised 24 children aged 7 to 8 y who had been diagnosed with spastic cerebral palsy and were classified as having GMFCS stages I to III. Twelve children were randomly assigned to experimental and control groups, with neither the children nor their guardians knowing which group they were placed in. The group program comprised 16 sessions of 60 min each, twice a week for eight weeks. The experimental group engaged in an activity-centered intervention centered on multisensory storytelling, whereas the control group engaged in structured physical activity. The activities were assessed using the peer relations skills scale to determine the extent to which social interaction had changed prior to and during the child's intervention. The SPSS 25.0 for Windows (IBM Corp, USA) application was used to analyze the data, and the significance level (α) for statistical verification was set to 0.05. Furthermore, the Wilcoxon Signed-Rank and Mann-Whitney U tests were used to assess the differences in social interaction between the experimental and control groups. Significant differences were observed in the total of the peer relationship skill scale and cooperation and empathy areas of the subtest in the intragroup change of the peer relationship skill scale between the experimental and control groups. However, the experimental group demonstrated a significant difference in the initiative area, whereas the control group demonstrated no significant difference. A significant difference was observed in the amount of change between the two groups in the initiative area and total of the subtest of peer relationship skills but no significant difference in the collaboration and empathy areas. We gave a multisensory storytelling-based activity-based intervention based on multisensory storytelling to children with cerebral palsy and saw a significant improvement in peer relationship skills. It may be proposed as an effective intervention strategy for children with cerebral palsy who struggle with social contact.

키워드

참고문헌

  1. Anggerainy, S. W., Wanda, D., & Nurhaeni, N. (2019). Music therapy and story telling: Nursing interventions to improve sleep in hospitalized children. Comprehensive Child and Adolescent Nursing, 42(sup1), 82-89. DOI: 10.1080/24694193.2019.1578299
  2. Baek, S. R. (2017). Storytelling through early childhood dance education program (Unpublished master's thesis). Korea national sport University, Seoul, Republic of Korea. Retrieved from http://www.riss.kr/
  3. Bricker, D., Pretti-Frontczak, K., & McComas, N. (1998). An activity-based approach to early intervention. Paul H Brookes Publishing Company.
  4. Cameron, M. H., & Monroe, L. G. (2008). Physical rehabilitation; Evidence-based examination evaluation, and intervention. Elsvier Inc. 2007. Physical Therapy, 88(8), 973. DOI: 10.2522/ptj.2008.88.8.973
  5. Cho, H. J., & Kim, S. Y. (2018). Emotion perception and multisensory integration in autism spectrum disorder: A review of behavioral and cognitive neuroscience studies. The Korean Society For Emotion & Sensibility. 21(4) 77-90. DOI: 10.14695/KJSOS.2018.21.4.77
  6. Cho, K. S. (2005). Issues and future directions of assessment for young children with developmental disabilities in Korea. Journal of Speech-Language & Hearing Disorders, 14(1), 127-148.
  7. Crompton, J., Imms, C., McCoy, A. T., Randall, M., Eldridge, B., Scoullar, B., & Galea, M. P. (2007). Group-based task-related training for children with cerebral palsy: A pilot study. Physical & Occupational Therapy in Pediatrics, 27(4), 43-65. PMID: 18032149.
  8. Eyre, E. L. J., Clark, C. C. T., Tallis, J., Hodson, D., Lowton-Smith, S., Nelson, C., Noon, M., & Duncan, M. J. (2020). The effects of combined movement and storytelling intervention on motor skills in south asian and white children aged 5-6 years living in the united kingdom. International Journal of Environmental Research and Public Health, 17(10), 3391. DOI: 10.3390/ijerph17103391
  9. Ferdjallah, M., Harris, G. F., Smith, P., & Wertsch, J. J. (2002). Analysis of postural control synergies during quiet standing in healthy children and children with cerebral palsy. Clinical Biomechanics, 17(3), 203-210. DOI: 10.1016/s0268-0033(01)00121-8
  10. Foley, L., & Maddison, R. (2010). Use of active video games to increase physical activity in children: A (virtual) reality? Pediatric Exercise Science, 22(1), 7-20. DOI: 10.1123/pes.22.1.7
  11. Fornefeld, B. (2012). Storytelling with all our senses: Mehr-Sinn geschichten. In N. Grove(ed). Using storytelling to support children and adults with special needs. Routledge London, New York. 78-85.
  12. Fuller, C. H. (1999). Bag books tactile stories. SLD Experience, 23, 20-21.
  13. Gao, Z., Zhang, T., & Stodden, D. (2013). Children's physical activity levels and psychological correlates in interactive dance versus aerobic dance. Journal of Sport and Health Science, 2(3), 146-151. DOI: 10.1016/j.jshs.2013.01.005
  14. Goncalves, L. L., Voos, M. C., de Almeida, M. H. M., & Caromano, F. A. (2017). Massage and storytelling reduce aggression and improve academic performance in children attending elementary school. Occupational Therapy International, Article ID 5087145, 7 pages. DOI: 10.1155/2017/5087145
  15. Kaale, H. K., Sorsdahl, A. B., & Rieber, J. (2007). Intensiv motorisk trening for barn med CP i en habiliteringsramme. (Intensive motor training for children with CP in a habilitation context) Bergen, Barnas Fysioterapisenter Bergen, Hogskolen i Bergen, Universitetet i Bergen. 2007. DOI: 10.1186/1471-2431-10-26
  16. Karg, L. (2012). Geschichtenerzaehlen fuer Menschen mit komplexer Behinderung - Vergleichende Studie zu einem internationalen Projekt. Schriftliche Hausarbeit im Rahmen der Ersten Staatspruefung. Univ. zu Koeln.
  17. Kim, E. M., & Sohn, S. M. (2019). Development and effects of a sociality enhancement program using children's picture book-focusing on emotional intelligence and peer relationship. (2019). The Korean Society for the Study of Child Education. 28(4), 133-154. DOI: 10.17643/KJCE.2019.28.4.08
  18. Kim, J. H., & Kim, T. H. (2016). An ICF-core sets for children and youth with cerebral palsy based approach from a physical therapist perspective: A single case study. Physical Therapy Korea, 23(1), 55-64.
  19. Kim, J. W., Oh, M. H., & Chung, H. A. (2013). Disabled people of activities of daily living and quality of life relationship. The Journal of The Korea Institute of Electronic Communication Sciences, 8(1), 173-180. https://doi.org/10.13067/JKIECS.2013.8.1.173
  20. Kim, M. J., & Parkm, J. K. (2006). The effect of balance and visual attention concentration behaviors in child with cerebral palsy who receive sensory integration program. Korean Journal of Occupational Therapy, 14(1), 81-90.
  21. Lambe, L., & Hogg, J. (2012). Sensitive stories-tackling challenges for people with profound intellectual disabilities through multisensory storytelling. In N. Grove(ed.). Using Storytelling to support children and adults with special needs. Routledge London, New York, 86-94.
  22. Law, M., King, G., King, S., Kertoy, M., Hurley, P., Rosenbaum, P., & Hanna, S. (2006). Patterns of participation in recreational and leisure activities among children with complex physical disabilities. Developmental Medicine & Child Neurology, 48(5), 337-342. DOI: 10.1017/S0012162206000740
  23. Lee, E. J., & Kwon, H. Y. (2020). The effect of group activity using storytelling on playfulness of children with intellectual disability. The Journal of Humanities and Social Sciences21, 11(2), 2061-2074.
  24. Leroux, A., Pinet, H., & Nadeau, S. (2006). Task-oriented intervention in chronic stroke: Changes in clinical and laboratory measures of balance and mobility. American Journal of Physical Medicine & Rehabilitation, 85(10), 820-830. DOI: 10.1097/01.phm.0000233179.64769.8c
  25. McCarthy, M. L., Silberstein, C. E., Atkins, E. A., Haryman, S. E., Sponseler, P. D., & Hadley-Miler, N. A. (2002). Comparing reliability and validity of pediatric instruments for measuring health and well-being of children with spastic cerebral palsy. Developmental Medicine and Child Neurology, 44(7), 468-476. DOI: 10.1017/s0012162201002377
  26. McManus, V., Corcoran, P., & Perry, I. J. (2008). Participation in everyday activities and quality of life in pre-teenage children living with cerebral palsy in South West Ireland. BMC Pediatrics, 8(1), 50. DOI: 10.1186/1471-2431-8-50
  27. Moll, I., Vles, J. S. H., Soudant, D. L. H. M., Witlox, A. M. A., Staal, H. M., Speth, L. A. W. M., Janssen-Potten, Y. J. M., Coenen, M., Koudijs, S. M., & Vermeulen, R. J. (2017). Functional electrical stimulation of the ankle dorsiflexors during walking in spastic cerebral palsy: A systematic review. Developmental Medicine and Child Neurology, 59(12), 1230-1236. DOI: 10.1111/dmcn.13501
  28. Moradi, H., & Chen, H. (2019). Digital storytelling in language education. Behavioral Science(Basel), 9(12), 147. DOI: 10.3390/bs9120147
  29. Morgan, C., Novak, I., Dale, R. C., Guzzetta, A., & Badawi, N. (2014). GAME(Goals - Activity - Motor Enrichment): Protocol of a single blind randomised controlled trial of motor training, parent education and environmental enrichment for infants at high risk of cerebral palsy. BMC Neurology, 14, 203. DOI: 10.1186/s12883-014-0203-2
  30. Novak, I., McIntyre, S., Morgan, C., Campbell, L., Dark, L., Morton, N., Stumbles, E., Wilson, S. A., & Goldsmith, S. (2013). A systematic review of interventions for children with cerebral palsy: State of the evidence. Developmental Medicine and Child Neurology, 55(10), 885-910. DOI: 10.1111/dmcn.12246
  31. Park, I. S. (2009). The effects of storytelling with songs on the young children's language abilities and musicality (Unpublished master's thesis). Chosun University, Gwangju, Republic of Korea. Retrieved from http://www.riss.kr/
  32. Peurala, S. H., Titianova, E. B., Mateev, P., Pitkanen, K., Sivenius, J., & Tarkka, I. M. (2005). Gait characteristics after gait-oriented rehabilitation in chronic stroke. Restorative Neurology and Neuroscience, 23(2), 57-65. PMID: 15990412
  33. Polatajko, H. J., & Cantin, N. (2010). Exploring the effectiveness of occupational therapy interventions, other than the sensory integration approach, with children and adolescents experiencing difficulty processing and integrating sensory information. The American Journal of Occupational Therapy, 64(3), 415-442. DOI: 10.5014/ajot.2010.09072
  34. Pretti-Frontczak, K., Barr, D., & Carter, A. (2003). Research and resources related to activity-based intervention, embedded learning opportunities, and routine-based instruction: An annotated bibliography. Topics in Early Childhood Special Education, 23(1), 29-39. DOI: 10.1177/027112140302300104
  35. Rosenbaum, P., Paneth, N., Leviton, A., Goldstein, M., Bax, M., Damiano, D., Dan, B., & Jacobson, B. (2006). A report: The definition and classification of cerebral palsy April 2006. Developmental Medicine and Child Neurology. Supplement. 109, 8-14. PMID: 17370477
  36. Stankov, I., Olds, T., & Cargo, M. (2012). Overweight and obese adolescents: what turns them off physical activity?. The International Journal of Behavioral Nutrition and Physical Activity, 9, 53. DOI: 10.1186/1479-5868-9-53
  37. Stubbs, P. W., & Diong, J. (2016). The effect of strengthening interventions on strength and physical performance in people with cerebral palsy (PEDro synthesis). British Journal of Sports Medicine, 50(3), 189-190. DOI: 10.1136/bjsports-2015-094929
  38. Theis, N., Korff, T., & Mohagheghi, A. A. (2015). Does long-term passive stretching alter muscle-tendon unit mechanics in children with spastic cerebral palsy?. Clinical Biomechanics, 30(10), 1071-1076. DOI: 10.1016/j.clinbiomech.2015.09.004
  39. Valvano, J. (2004). Activity-focused motor interventions for children with neurological conditions. Physical & Occupational Therapy In Pediatrics, 24(1-2), 79-107. DOI: 10.1300/j006v24n01_04
  40. Wichers, M., Hilberink, S., Roebroeck, M. E., van Nieuwenhuizen, O., & Stam, H. J. (2009). Motor impairments and activity limitations in children with spastic cerebral palsy: A Dutch population-based study. Journal of Rehabilitation Medicine, 41(5), 367-374. DOI: 10.2340/16501977-0339
  41. Woo, J. Y. (2011). The effects of activity-based intervention on the social interaction of the children with intellectual disability (Unpublished doctoral dissertation). Woosuk University, Wanju, Jeollabuk-do, Republic of Korea. Retrieved from http://www.riss.kr/
  42. World health organization. international classification of functioning disability, and health. (2001). Geneva, Switzerland.
  43. Yang, S. Y. (2012). The effect of maternal anger expression upon both children's anger expression and interaction with friends (Unpublished master's thesis). Hanyang University, Seoul, Republic of Korea. http://hanyang.dcollection.net/common/orgView/200000419116.