注意欠如・多動症の診断がある女児と母親に対して目標指向型アプローチのホームプログラムを実践した一例

Implementation of goal-directed training home program for a child with attention deficit/hyperactivity disorder and her mother: A case study

要旨：小児作業療法において目標指向型のトップダウンアプローチのエビデンスが示されている．本報告の目的は，注意欠如・多動症（以下，ADHD）児と母親の目標に対するホームプログラムの有用性を検討することである．今回，ADHDの診断がある女児と母親に対して，親子との協働の目標設定，家庭の文脈に適応したホームプログラム，適時的なコーチングを行った，その結果，Canadian Occupational Performance MeasureとGoal Attainment Scalingが向上し，目標とした活動に変化が生じた．子どもと保護者の意味のある作業に焦点を当てたホームプログラムを通じて，子育ての文脈の中でサポートを行うことが目標達成に影響する可能性が示された．

　Evidence for a top-down approach utilizing Goal-Directed Training in pediatric occupational therapy is presented. The purpose of this report is to assess the efficacy of a home program for the goals of child with attention-deficit/hyperactivity disorder and her mother. In the present report, child with attention-deficit/hyperactivity disorder and her mother engaged in collaborative goal setting with mother and child, a home program adapted to the home context, and timely coaching, which resulted in improved Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS) scores and changes in targeted activities. This study demonstrates that a home program focused on meaningful work with child and mother has the potential to facilitate goal achievement through the provision of supportive parenting within the context of parenting.