知的能力障害に自閉症スペクトラム障害を伴った1例における対人コミュニケーション行動の変化の検討—FOSCOMの臨床的応用

Changes in social communication behavior in a case of autism spectrum disorder and intellectual disability: The clinical application of Format of Observation for Social Communication

　知的能力障害に自閉症スペクトラム障害(以下，ASD)を伴った1例において対人コミュニケーション行動に変化を認めたので，その要因と対人コミュニケーション行動観察フォーマット(以下，FOSCOM)の臨床的応用について考察する．本症例は言語指示に応じることが困難であったが，認知・言語課題中にFOSCOMで得られた対人コミュニケーション行動の特徴を意識した働きかけを行った結果，対人コミュニケーション行動に変化を認めた．他者への注目を目的として，応答性は過剰行動の抑制，意思表示は過小行動の促進を意識した働きかけが，課題遂行態度の形成やコミュニケーション機能の拡大につながり，認知・言語発達促進の相乗効果によって変化したと示唆された．またFOSCOMは，対人コミュニケーション行動における根拠ある支援方法の検証などの臨床的応用が可能と示唆された．

　We report on a patient with autism spectrum disorder (ASD) and intellectual disability for whom the findings obtained by Format of Observation for Social Communication (FOSCOM) were used to successfully improve social communication behavior. In this case, in addition to language delay accompanying ASD with intellectual disability, there was a marked delay in the development of social communication behavior. However, by undertaking therapy based on the results of FOSCOM assessment during cognitive and language tasks, changes in his social communication behavior were noted. While undergoing therapy to improve his ability to pay attention to others, suppress excessive behavior, and express of his wishes, his communication functions increased and his attitude towards therapy tasks improved. FOSCOM was clinically useful for our case and it may be suitable for assessing and validating the effectiveness of the methods of support and intervention on social communication behavior.