作業中心の実践により描画の作業遂行の改善および参加が促された幼児期AMC児の事例

A child with early childhood Arthrogryposis Multiplex Congenita in whom occupation-centered practice improved drawing occupational performance and participation: A case report

要旨：本報告の目的は作業中心の実践（以下，OCP）が幼児期の先天性多発性関節拘縮症（以下，AMC）児の心理面と活動や参加の改善に寄与した要因を明らかにすることである．方法は単一事例報告で，描画用の自助具を導入し，月に1回，合計6回の介入を実施した．結果，描画の作業遂行，活動，参加，心理面の改善が認められた．結論として，幼児期AMC児の心理面の改善に寄与する要因として，代償手段の適応，児の強みの活用が有益である可能性が示唆された．また活動や参加を促す要因として，保護者の希望に基づく目標設定，描画を生活場面へ移行するための支援，母親が自身の行動の意義を実感するための支援が有益である可能性が示唆された．

　The purpose of this case report is to clarify the factors by which Occupation-Centered Practice (OCP) contributed to the improvement of psychological aspects, activity, and participation in a child with Arthrogryposis Multiplex Congenita (AMC) in early childhood. The method included introducing a self-help drawing device. A total of six interventions were carried out once a month. Results showed improvements in drawing occupational performance, activity, participation, and psychological aspects. In conclusion, the adaptation of compensatory strategies and the utilization of the child's strengths were suggested as potential factors contributing to psychological improvements of AMC children in early childhood. Additionally, setting goals based on the parents' wishes, supporting the transition of drawing activities to everyday situations, and assisting mothers in recognizing the significance of their actions were suggested as potentially beneficial factors for promoting activities and participation.