筆記具の使用に課題のあった就学前の発達障害児への取り組み

Handwriting intervention for preschool children with developmental disorders

要旨：自閉症スペクトラム障害児2例に対し筆記具の使用に関する介入を実施した．事例Aにおいて視覚有意の特性を踏まえ，指の位置をシールで示すことが把持方法の理解に有効であった．また，まとまりを理解することに困難さがあると考え，円を描く際の始まりと終わりを明確にすることで動作の獲得が可能であった．事例Bにおいては自己流の不適切な把持形態の改善と，発達が不十分であった手指の分離運動に取り組むことで，書字時の遠位部の動作が獲得され，微細な書字動作に改善がみられた．これらの事例から，自閉症スペクトラム障害の認知特性に配慮すること，発達が十分でない機能に着目すること，不適切な方法を定着させないことの重要性が考えられた．

　We provided occupational therapy programs to improve the handwriting skills for two children with Autistic Spectrum Disorder (ASD). Case A did not know how to hold a pencil properly, and the visually presented positions of three fingers on a pencil enabled him to understand the appropriate grip. In addition, visual and auditory cues informed him when to start and stop while drawing a single circle. Case B lacked ability to adequately move fingers separately. This retardation might affect his ability to improve fine motor movement which is important for writing and drawing. We gave practice moving his hands and fingers and also used an assistive tool. After the intervention, he could manage to hold a pen with the appropriate force and to move his distal fingers more efficiently. The results suggest that it is important to consider cognitive features of ASD and the level of motor development of their hands and fingers throughout therapy for handwriting skills of children with ASD.