ファンタジー没入によって生活障害を呈する広汎性発達障害男児への支援

Occupational therapy for a boy with pervasive developmental disorders affecting daily activities due to fantasy addiction

要旨：自閉症スペクトラム児の対人社会性を阻害する要因の一つに，ファンタジーへの没入現象が指摘されている．今回，ファンタジー没入行動により，様々な日常生活の遂行に支障をきたしていた広汎性発達障害男児に対し，ファンタジーを外在化する作業活動を通した支援を行った．本児は，架空のカードゲームを頭の中で展開する遊びに，様々な日常生活場面で没頭していた．作業療法では，頭の中に描いているファンタジーを外在化し，それを用いて一緒に遊べるよう模索した．また，徐々に交流の場が広がるよう促した．これらの支援により，本児の頭の中のファンタジーが整理され，現実とのつながりを築いていき，生活障害が軽快したと考えられる．

　Research indicates that the addiction to fantasy among children with autism spectrum disorder negatively affects interpersonal communication. We provided occupational support to externalize the fantasy for a male child with a pervasive developmental disorder. This child was having difficulty executing activities of daily living due to immersive fantasy activities, which consisted of mentally forming a fictional card game as a diversional fantasy. For that reason, we externalized his fictional card game by writing out his imagined characters on actual cards and encouraged him to communicate with hospital staff and school friends using these cards. This support enabled him to mentally organize the fantasy, allowing him to use it as a communication tool. Moreover, he alleviated his troubles in daily living by reflecting on his fantasy and building a connection with reality.