• 한국사회복지학
• /
• 제65권3호
• /
• pp.207-238
• /
• 2013

이 연구의 목적은 ADHD성향 아동과 지지체계를 대상으로 한 통합적 지원 프로그램의 영향을 평가하려는 것이다. ADHD성향 아동과 지지체계의 변화를 목표로 ADHD성향 아동과 그를 둘러싼 가족 중심의 환경체계에 대한 개입을 중심으로 한 프로그램을 설계하고 수행하였다. 구체적으로는 ADHD성향 아동에 대한 개별 미술심리치료, 집단생활적응력향상프로그램, 문화체험을 진행하였으며, 부모에게 개별상담 제공과 학교 및 교사와의 정기적인 네트워크 회의를 실시하였다. 세부프로그램별로 표준화된 척도와 기록물, 면접 등을 통해 자료를 수집하고 분석한 결과, ADHD성향 아동의 심리 정서적 안정과 문제행동의 감소라는 변화가 나타났으며, 지지체계의 구성원들에게는 ADHD성향 아동의 변화가능성을 확인하고 긍정적으로 인식하는 계기를 제공해주는 효과가 나타났다. 이러한 결과를 통해 ADHD성향 아동에 대한 지원시 주변환경에 대한 개입과 지지체계 구축을 통해 통합적으로 지원할 필요성이 있음을 확인하였으며, 이와 관련된 실천 지침들을 제언하였다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제25권2호
• /
• pp.65-72
• /
• 2014

Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.