自閉症スペクトラム障害児に対する早期集中型の応用行動分析学的アプローチの実践—作業療法士による行動コンサルテーション

Early intensive applied behavior analysis approach in a child with autistic spectrum disorder: Behavioral consultations performed by an occupational therapist

要旨：応用行動分析学（以下，ABA）に基づき，2歳4ヵ月の自閉症スペクトラム障害（以下，ASD）児に早期の集中的な介入を行った．コンサルタントである作業療法士（以下，OT）は，母親だけでなく，障害福祉施設のOTおよび言語聴覚士とも連携し，不連続試行法および機軸的行動発達支援法を活用した介入を，1日30分以上，週10時間未満の範囲で実施した．2ヵ月後，数十種類のコミュニケーションスキルが獲得された．本報告は，ASD児への早期の集中的なABA介入の有効性を示唆する．加えて，行動コンサルテーションは，家庭内だけでなく地域の療育機関の連携を可能とし，集中的なABA介入の実現に寄与する可能性がある．

　Intensive intervention based on Applied Behavior Analysis (ABA) was performed in a 2-year and 4-month-old child with autistic spectrum disorder (ASD). An occupational therapist (OT) was in charge of the consultations and cooperated not only with the mothers, but also with the speech therapist and OT working in welfare institutions for disabled persons. Intervention using discrete trial teaching and pivotal response treatment was performed over ≥30 min/day for <10 hours/week. After two months, the subject acquired several dozen communication skills. Our report suggests that intensive ABA interventions are effective in children with ASD. Additionally, behavioral consultation facilitates cooperation not only within families, but also with local institutions involved with the rehabilitation of disabled children and may contribute to effective intensive ABA interventions.