強度行動障害を呈する長期間保護室対応の自閉スペクトラム症者に対する作業に焦点を当てた実践の効果

The effect of occupation-focused therapy to improve behavior of an inpatient with autism spectrum disorder and severe behavioral disturbances during long-term treatment in a seclusion room

要旨：強度行動障害を呈し長期間保護室対応となっている自閉スペクトラム症者に対し，大切な作業に焦点を当てた個別作業療法を実施した．その有効性を単一事例実験研究に基づき，強度行動障害やパニック回数の変化により検討した．その結果，強度行動障害やパニック回数が個別作業療法開始月より減少し，介入の即時的効果が認められた．また，パニックに対する振り返りが可能となり，パニックの対処法を作業療法士と共に考えられるようになったことから，多床室への転室が月に数日程度可能となった．これらより，大切な作業に焦点を当てた個別作業療法は，自閉スペクトラム症者における強度行動障害の変容をもたらすうえで有効であると示唆された．

　This study examined the effect of individual occupational therapy focusing on personal and meaningful occupations for an inpatient with autism spectrum disorder who had spent a long time in a seclusion room because of severe behavioral disturbances. In this single-case experimental study, the effect of the intervention was assessed by counting and comparing the number of behaviors based on severe behavioral disturbance and panic pre- and post-treatment. The results showed that the number of behaviors based on severe behavioral disturbance and panic of the patient decreased from the initial month of individual occupational therapy, indicating an immediate effect of the intervention. In addition, with the aid of the occupational therapist, the patient was able to reflect on his panic situations and began to think about how to cope with panic, which made it possible for him to move to and use a multi-bed room for a few days a month. These results suggest that individual occupational therapy focusing on personal and meaningful occupations could be effective in improving behavior based on severe behavioral disturbances of patients with autism spectrum disorder.