Therapeutic Science for Rehabilitation (재활치료과학)

Korean Society of Neurological Occupational Therapy (대한신경계작업치료학회)
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Understanding Assessment for Feeding Disorders in Autistic Spectrum Disorders: A Literature Review

자폐 스펙트럼 장애 섭식장애 평가의 이해: 문헌 고찰

  • 민경철 (원광대학교 의과대학 작업치료학과) ;
  • 김보경 (서울특별시 어린이병원 재활의학과)
  • Received : 2024.03.21
  • Accepted : 2024.04.19
  • Published : 2024.05.31
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Abstract

Objective : Children with autism spectrum disorder (ASD) commonly suffer from feeding disorders. Major feeding problems include mealtime behavior problems, picky eating, and a lack of food variety can lead to nutritional problems, developmental and social limitations, and stress for the caregivers. A review of the latest literature was conducted to gain an in-depth understanding of assessment tools for feeding disorders in children with ASD. Method : This study analyzed assessments to identify feeding problems in ASD based on previous studies searched through keywords such as ASD, ASD feeding problem, and ASD feeding evaluation. Results : The ASD feeding disorder assessment was divided into direct and indirect assessments. Indirect assessment, in which caregivers measure a child's situation using questionnaires, is mainly used. The assessment of feeding disorders in children with ASD was divided into 1) mealtime behavior, 2) sensory processing, 3) food consumption, and 4) others. Conclusion : As the main feeding disorder characteristics of children with ASD are very diverse, a comprehensive evaluation is necessary but is still limited. Swallowing rehabilitation experts, such as occupational therapists, should apply comprehensive assessment tools based on a basic understanding of the feeding problems, behaviors, and sensations in ASD.

목적 : 자폐 스펙트럼 장애(Autistic Spectrum Disorders: ASD) 아동은 감각 처리, 제한된 흥미, 행동, 인지, 사회성, 구강 운동, 소화 등 복합적인 원인으로 인해 섭식장애가 흔하게 동반된다. 주요한 섭식장애 문제로는 식사 시간 행동 문제, 까다로운 먹기, 선택적 먹기, 새로운 음식 거부, 음식 다양성 저하 등이며 이로 인해 영양 섭취 및 건강 문제, 발달, 사회적 활동 참여 제한, 가족과 보호자 스트레스를 유발하기도 한다. 따라서 ASD 아동의 섭식장애를 조기에 확인하여 적절한 중재 제공과 적합한 평가도구 사용이 필요하다. 본 논문에서는 최신 문헌 고찰을 통해 ASD 아동의 섭식장애 평가도구에 대한 심도 있는 이해를 위한 고찰을 실시하였다. 연구방법 : 본 연구는 ASD, ASD의 섭식문제, ASD의 섭식평가 등의 키워드를 검색하여 최근 약 10년간의 선행연구를 바탕으로 ASD 섭식문제 평가도구를 분석하였다. 결과 : ASD 섭식장애 평가는 직접 평가와 간접 평가로 나뉘는데 그 중, 부모와 보호자가 아동의 전반적인 상황을 척도화 한 질문지나 평가도구로 측정하는 간접 평가가 주로 사용되고 있었다. 평가는 주로 식사 시간 중 아동이 보이는 섭식 행동, 구강 및 미각 관련 감각 처리, 음식 선택 및 선호도를 확인하였으며 보호자의 섭식 태도가 아동의 섭식 행동에 미치는 영향을 평가하기도 하였다. 결론 : ASD 아동의 섭식 장애 평가는 1) 식사 시간 섭식 행동, 2) 감각 처리, 3) 섭취 음식, 4) 기타로 구분되었다. ASD 아동의 주요한 섭식장애 특징은 매우 다양하기 때문에 종합적인 평가가 이루어져야 하지만 아직 제한적이다. 또한 구강 운동 기능, 소화 등 추가적인 영역의 평가도 고려되어야 할 것으로 보인다. 작업치료사 등 연하재활 전문가는 ASD 아동의 섭식 문제, 행동, 감각 등에 대한 기본적인 이해를 바탕으로 한 종합적인 평가도구를 적용해야 할 것이다.

Keywords

Acknowledgement

본 연구는 2024년 대한연하재활학회의 지원으로 진행되었습니다.

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