保育所等訪問支援における巡回型学校作業療法

School-based occupational therapy

要旨：筆者らは，巡回型学校作業療法の方法を検討し実践を重ねてきた．本稿では事例を通し，その内容を報告する．事例は9歳の女児で，友達や先生とうまく行かず，相談室にてソーシャルワーカーと1日を過ごしていた．作業療法士は，ADOC for Schoolを通して教員と保護者が届けたい教育（友達との交流）の実現でつながる協働関係を作り，この実現に向け必要な作業遂行上の情報を提供し，支援方法は教員と保護者に考えてもらった．そして，どういう支援があればできるのかという表現方法でGoal Attainment Scaleを作成し，段階的な作業可能化を促しながら保護者，学校関係者，本人の主体性を引き出した．

　This report introduces the school-based occupational therapy practice of a 9-year-old girl with psychogenic stress induced by discord with friends and a teacher. After changing schools, she spent all day in a separate classroom with only the school social worker. Occupational therapy involved developing collaborative relationships between parents, the school, the child, and external experts focusing on shared goals toward activities they expected of the child through ADOC for School, rather than setting goals around the disability or impairment. This support intended to enable the teacher, parents and/or child to achieve these goals. In this context, the role of the occupational therapist is to give advice based on occupational performance analyze the goals, and increase and maintain the motivation of teacher. The occupational therapist and teacher created a Goal Attainment Scale by expressing expected outcomes in terms of what the child should be able to do with specific support.