母子関係における遊びへの介入と展開—自発性の低下した幼児2症例を通して

Occupational therapy to help developmental play in the relationship between mother and child: Through occupational therapy for two children with severe motor skill retardation

要旨：重度な運動発達の遅れを示し母親の誘いかけへの反応も乏しい2症例に対し，母親も作業療法場面に一緒に参加させ，母子間での遊びを展開した．母子相互の遊びの中で作業療法士は，子どもの姿勢への援助と共に母親の誘いかけへの反応として手のリーチや追視などを誘発した．そして，これに作業療法士は，子どもが発声するかのように言語的表現を加えた．2症例の母親は，子どもの欲求や意志活動としてこの運動を受け取り遊びを展開できた．作業療法期間前後に実施した家庭での遊びに対するアンケートでも，子どもへの関わり方や遊びに変化が見られた．作業療法士が介入した母子相互の遊びの展開と家庭での療育について症例の経過から考察する．

　We got the mothers of two children with severe motor skill retardation to participate in occupational therapy. We had the mother and child play together in the course of the therapy. The occupational therapist supported the child from behind and set him/her in a "natural" straight back position with head up, induced him/her to perform such self-motivated movements as reaching out his/her hands pursuing an object and so forth, while they were playing together. Furthermore, the occupational therapist added verbal expression as if the children were speaking. In both cases, the mothers interpreted their children's behavior as their own desire and motive, and they both developed a sense of play. The questionnaires answered by the mothers about play at home were conducted before and after the occupational therapy. The results showed examples of change in how they approach the children and how they play with their children. We concluded from the two cases that there is a connection between the development of play and therapy for the mother-child reciprocal reactions in which the occupational therapist took part.