継続的な食事指導により，食具の使用に改善がみられたアンジェルマン症候群の一症例

Occupational therapy through continuous eating training and improved use of utensils during mealtimes for a child with Angelman syndrome: A case study

要旨：アンジェルマン症候群児（欠失型）に対し，2歳8ヵ月時より作業療法を行ってきた．家族の主訴に基づき，5歳時より10分間の食事指導を1年間（計30回）継続して行った．介入以前は全介助であり，上肢の失調様の動作により食具を持続的に把握することが困難であった．介入では児の行動を観察し，失調様の動作が起こりにくい操作方法を検討し指導を行った．食事指導を継続していく中で，失調様の動作の軽減と，食具の把握に改善がみられた．また食具操作の介助量軽減と能動的な動作が増加した．作業療法士による食事指導にて，アンジェルマン症候群児の食具操作と介助量の軽減に好影響をもたらす可能性が示されたため，作業療法経過と工夫を報告する．

　Occupational therapy was carried out for 2 years and 8 months for a child with Angelman syndrome (interstitial deletion type). From the age of 5, eating training for 10 minutes was carried out for one year for a total of 30 times per the family's request. Prior to the intervention the child received assistance in grasping objects due to ataxia-like movement of upper limbs. The occupational therapy consisted of observing the child's behavior, determining an eating method which was less likely to induce ataxia-like movements, and instructing accordingly. Through continuous eating training using spoons and forks, the child's ataxia-like movements decreased and grasping function improved, which resulted in a reduction in the amount of assistance given and an increase in active movement. The eating training by the occupational therapist showed the possibility of positively affecting the utilization of spoons and forks and reducing the assistance of the child with Angelman syndrome.