반응적 상호작용 전략 중심의 부모교육 프로그램이 다문화가정 내 자폐 범주성 장애 유아의 모아 상호작용에 미치는 영향

봉귀영,이소현 한국특수교육학회 2013 특수교육학연구 Vol.47 No.4

본 연구에서는 반응적 상호작용 전략을 포함한 부모교육 프로그램을 다문화가정의 특수성에 맞게 적용함으로써 다문화가정 내 자폐 범주성 장애 유아와 어머니의 사회적 상호작용에 미치는 영향을 알아보고자 하였다. 총 20회기의 부모교육 프로그램이 이루어졌으며, 이후에는 피드백 제공 회기가 시행되었다. 연구 설계는 대상자간 중다 간헐 기초선 설계를 사용하였다. 중재가 종료된 4주 후에는 중재효과의 유지 여부를 확인하였으며, 기초선, 부모교육, 피드백 제공, 유지 기간 동안 각 1회씩 가정 내에서의 일반화를 측정하였다. 연구 결과 세 쌍의 자폐 범주성 장애 유아와 어머니 모두 사회적 상호작용 발생률이 증가한 것으로 나타났으며, 중재 종료 후에도 중재 효과가 유지되었다. 또한 중재 효과는 가정으로 일반화가 이루어졌다. 이러한 연구 결과는 유아에게 가장 많은 영향을 미칠 수 있는 부모에게 전략을 교육하여 사회적 상호작용을 증가시키고 일반화를 이끌어 냈다는 측면과, 국내에서 거의 이루이지지 않은 다문화가정 내 자폐 범주성 장애 유아의 사회적 상호작용에 관한 연구라는 측면에서 논의되었으며, 다문화가정 내 자폐 범주성 장애를 비롯한 장애아동에 대한 보다 많은 근거 기반의 연구들이 이루어질 필요가 있다는 것을 제안하고 있다. The purpose of this study was to evaluates the effects of parental training on the social interaction between mothers and their children with ASD. Parents of children with ASD were provided training on ASD and a Responsive Interaction Strategy, which promotes social interaction in children with ASD. The study was conducted with the understanding that the interactions between parents and children would be from a multicultural perspective. A multiple probe baseline design across subjects are used in order to confirm the intervention effect. After four weeks of intervention terminated, the maintenance was recorded. The intervention effect for the three sets of participants generalization on home setting was measured on each condition. The results of the study are as follow. First, the rate of social interaction increased in all three sets of foreign mothers and children with ASD. Second, the rate of social interaction was maintained, at the level similar to late intervention, after intervention was terminated. Third, the intervention effect was generalized in all three sets of foreign mothers and children with ASD. The significance of the study performed can be measured by the range expansion of existing research on disabled children in multicultural families; the inclusion of additional considerations in parental training programs for multicultural families with special circumstances; the development of parental training strategies for those who have the most influence on their children, and increased social interaction in children with ASD. Our finding suggested that more evidence-based research about children with ASD in multicultural families needs to be done.

가정 기반의 긍정적 행동중재 및 지원 관련 연구의 동향 고찰

김혜선,박지연,봉귀영,이애진,김은윤 한국지적장애교육학회 2023 지적장애연구 Vol.25 No.3

본 연구는 가정 기반의 긍정적 행동중재 및 지원과 관련된 국내외 선행연구를 분석하여 가정 기반의 긍정적 행동중재 및 지원의 실행방안과 후속 연구에 대한 시사점을 모색하고자 하였다. 이를 위해 2012년부터 2023년까지 국내외에서 발표된 관련 논문 28편을 선정하여 전반적인 동향과 중재 관련 요소를 분석하였다. 분석 결과는 다음과 같다. 첫째, 지난 2012년부터2023년까지 이루어진 가정 기반의 긍정적 행동중재 및 지원 연구 28편 중 국내 연구는 7편으로 국외 연구에 비해 그 수가 적었다. 둘째, 총 28편의 연구 중 절반 정도의 연구가 다양한방법으로 가족 맥락적 적합성을 고려하고 있었다. 셋째, 대부분의 연구에서 직접기능평가와간접기능평가를 병행하고 있었으나 생태학적 정보를 수집한 연구는 많지 않았고, 긍정적 행동중재 및 지원 과정에서 부모의 역할은 주로 기능평가를 전문가와 함께 실행하고 전문가로부터 전략 코칭을 받아 중재를 실시하는 것이었다. 연구 결과를 토대로 가정 기반 행동지원의 실제와 후속연구를 위한 시사점을 논의하였다. Purpose: The purpose of this study is to examine the research trend on family-based positive behavioral interventions and supports (PBIS) in order to find out the implications for practices and research. Method: Twenty-eight domestic and foreign articles published from 2012 to 2023 were selected for analysis. The articles were analyzed in terms of intervention components in addition to overall research trends. Results: The results of the analyses were as follows. First, among the 28 studies on family-based PBIS conducted over the past 10 years, only seven were domestic studies, a much smaller number than foreign studies. Second, about half of the total 28 studies considered family contextualization in various ways. Third, most of the studies performed both direct and indirect functional assessment, but only a few studies collected ecological information. In the process of PBIS, the roles of parents were mainly to complete functional assessment with professionals and implement interventions with strategy coaching from professionals. Conclusion: Finally, discussions of the results were presented and implications for practices and future studies were suggested.

자폐스펙트럼장애에 대한 보육교사의 인식: 포커스 그룹 인터뷰 분석

장정윤,선우현정,전주연,봉귀영,노남훈,정성준,노동현,유희정 한국자폐학회 2016 자폐성 장애연구 Vol.16 No.2

The purpose of this study was to inquire a child-care teachers’ perception of autism spectrum disorder using focus group interviews targeting child-care center teachers and directors. After three group interviews, we analyzed interview contents using the constant comparison method. From the qualitative analysis, five themes and eleven categories emerged: (1) perceptions of early screening and intervention of autism spectrum disorder, (2) understanding of diagnosis and symptoms of autism spectrum disorder, (3) difficulties in autism spectrum disorder at the child-care field, (4) coping plans with autism spectrum disorder, and (5) demands for autism spectrum disorder. Based on these results, implications and suggestions for child-care teachers training in early screening and interventions of autism spectrum disorder and demands for specialized and systematic early screening and intervention services were discussed. 본 연구는 보육교사의 자폐스펙트럼장애에 대한 인식을 알아보기 위해 어린이집 교사 및 원장을 대상으로 포커스 그룹 인터뷰를 실행하였다. 30명의 어린이집 교사 및 원장을 세 그룹으로 나누어 인터뷰를 진행한 후, 반복적 비교분석법에 의해 인터뷰 내용을 분석하였다. 인터뷰 내용을 질적 분석한 결과, 5개의 연구주제와 11개의 범주가 도출되었다. 연구 주제는 (1) 자폐스펙트럼장애 조기 선별 및 개입에 대한 인식, (2) 자폐스펙트럼장애 진단명 및 증상에 대한 이해, (3) 자폐스펙트럼장애와 관련한 보육현장에서의 어려움, (4) 자폐스펙트럼장애와 관련한 대처방안, (5) 자폐스펙트럼장애와 관련한 요구로 나타났다. 연구 결과를 바탕으로 보육현장에서 자폐스펙트럼장애 조기 선별과 개입을 위한 교육, 전문적이고 체계적인 조기 선별 및 개입 서비스가 필요하다는 점을 논의하였다.

지역사회 가정어린이집 방문간호사 네트워크를 활용한 자폐스펙트럼 장애 선별도구의 효용성

김일옥 ( Il-ok Kim ),봉귀영 ( Gui-young Bong ),강태웅 ( Taewoong Kang ) 한국간호과학회 정신간호학회(구 대한간호학회정신간호학회) 2015 정신간호학회지 Vol.24 No.3

Purpose: The purpose of this study was to explore the utility of autism spectrum disorder (ASD) screening tools using community network of home childcare center visiting nurses. Methods: The design of this study is multilevel survey to find the ASD using modified checklist for autism in toddlers (M-CHAT) for first screening by childcare teachers, checklist for autism in toddlers (CHAT) for secondary screening by nurses, Autism diagnostic observation schedule (ADOS) and Autism diagnostic interview revised (ADI-R) for final diagnosis by pediatric psychiatrists. Results: In first screening by using M-CHAT, 61 subjects(0.56%) were detected among 8,926 subjects. Among the first screened 61 subjects, 13 subjects were exempted for normal finding in CHAT. 24 subjects consented participation for final diagnosis and 23 of them were diagnosed ASD. Conclusion: In conclusion, M-CHAT and CHAT were verified their utility as screening tools for ASD in the community and the community health networks as a childcare visiting nurses can be useful network in early detection and referral of ASD.

Patterns of Restricted and Repetitive Behaviors in Toddlers and Young Children with Autism Spectrum Disorder

송다예,김다빈,이한나,봉귀영,한재현,유희정 대한소아청소년 정신의학회 2022 소아청소년정신의학 Vol.33 No.2

Objectives: Restricted and repetitive behaviors (RRBs) are a core symptom in the diagnosis of autism spectrum disorder (ASD). The complexity of behavioral patterns has called for the creation of phenotypically homogeneous subgroups among individuals with ASD. The purpose of this study was 1) to investigate the different types of RRBs and 2) to explore whether subgroups created by RRBs would show unique levels of functioning in toddlers and young children with ASD. Methods: A total of 313 children with ASD, aged 12–42 months were included in the analysis. The Autism Diagnostic Interview-Revised was used to obtain information on the different types of RRBs by grouping 15 items into six categories. The Vineland Adaptive Behaviors Scale, a parent-reported questionnaire, was used to measure adaptive functioning. A portion of the children were analyzed separately for verbal-related RRBs based on their expressive language level. Two-step cluster analysis using RRB groups as features was used to create subgroups. Analysis of covariance while covarying for age and language was performed to explore the clinical characteristics of each cluster group. Results: Sensory-related RRBs were the most prevalent, followed by circumscribed interests, interest in objects, resistance to change, and repetitive body movements. A subset of the children was analyzed separately to explore verbal-related RRBs. Four cluster groups were created based on reported RRBs, with multiple RRBs demonstrating significant delays in adaptive functioning. Conclusion: Heterogeneity of RRBs emerges at a young age. The different patterns of RRBs can be used as valuable information to determine developmental trajectories with better implications for treatment approaches.

Loss of Acquired Skills: Regression in Young Children With Autism Spectrum Disorders

김예림,Song Da-Yea,봉귀영,한재현,유희정 대한소아청소년 정신의학회 2023 소아청소년정신의학 Vol.34 No.1

Objectives: Regression, while not a core symptom of autism spectrum disorder (ASD), has been suggested to be a distinct subtype by previous studies. Therefore, this study aimed to explore the prevalence and clinical differences between those with and without regression in children with ASD. Methods: This study includes data from toddlers and young children aged 2–7 years acquired from other projects at Seoul National University Bundang Hospital. The presence and characteristics of regression were explored using question items #11–28 from the Autism Diagnostic Interview-Revised. Chi-square and independent t-tests were used to compare various clinical measurements such as autistic symptoms, adaptative behavior, intelligence, and perinatal factors. Results: Data from 1438 young children (1020 with ASD) were analyzed. The overall prevalence rate of regression, which was mainly related to language-related skills, was 10.2% in the ASD group, with an onset age of 24 months. Regarding clinical characteristics, patients with ASD and regression experienced ASD symptoms, especially restricted and repetitive interests and behaviors, with greater severity than those without regression. Furthermore, there were significant associations between regression and hypertension/placenta previa. Conclusion: In-depth surveillance and proactive interventions targeted at young children with ASD and regression should focus on autistic symptoms and other areas of functioning.

청소년 자폐스펙트럼장애에서 사회기술훈련의 효과에 미치는 우울, 불안 증상의 영향

홍정경,노동현,오미애,김주현,봉귀영,유희정 대한불안의학회 2018 대한불안의학회지 Vol.14 No.2

Objective : The purpose of this study was to investigate effects of depression and anxiety on treatment response of social skills training in adolescents with autism spectrum disorders (ASD). Methods : A total of 107 teenagers that participated in the Program for the Education and Enrichment of Relational Skills (PEERS®) between 2011 and 2015 were analyzed using linear regression. Outcome measures used were the Korean version of Social Responsiveness Scale (SRS), the Test of Adolescent Social Skills Knowledge-Revised (TASSK-R), and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS). Depression and anxiety were assessed by the Korean version of Child Depression Inventory (CDI), the Korean version of State and Trait Anxiety Inventory for Children (STAIC), and the Korean version of Child Behavior Checklist (K-CBCL). Results : As a result, depressive symptoms measured by CDI (p<0.05) and anxiety symptoms measured by STAIC (p<0.05) had significant influence on score change of social interaction domain of ADOS. It remained significant even after the baseline score was adjusted as covariates (p<0.05). Conclusion : We observed that pre-treatment anxiety and depressive symptoms of teenagers had significant effects on the treatment outcome of PEERS®, especially in terms of face-to-face social interaction. (Anxiety and Mood 2018;14(2):99-105)

상호작용 로봇을 이용한자폐 범주성 장애 아동의 중재 치료에 관한 예비연구

윤상석,김동환,최종석,박성기,봉귀영,유희정 한국자폐학회 2015 자폐성 장애연구 Vol.15 No.1

The purpose of this paper is to propose and examine the feasibility of the robot-assisted intervention system for facilitating the eye contact of the children with autism spectrum disorder (ASD). The treatment system was based on the discrete trial teaching (DTT) protocol with three task modes of treatment process; reward, encouragement, and pause. In child-robot interaction architecture, the robot was designed to offer therapeutic training elements of mutual greeting and interplay game, and evaluates the level of children’s reactivity by recognition modules for frontal face and touch features. We compared the reactivity of the children depending on the diagnostic groups (3 subjects with ASD and 3 subjects with non-ASD) and on the type of robotic stimuli (K, D, and KD) type. Also, we surveyed the parents’ subject satisfaction and children’s friendliness to the robotic stimuli using the questionnaire developed by research group. As the results, the children’s response showed difference depending on the diagnostic group and type of stimuli in terms of response time and gaze ratio, though statistical analyses were unavailable due to small sample size. The treatment process and robotic stimuli showed high level of user satisfaction. The results suggest that the reinforcement and facilitation using robotic stimuli are generally feasible to incorporate into the standard treatment process 본 연구의 목적은 상호작용 로봇을 이용하여 ASD를 가진 아동의 눈맞춤을 용이하게 향상시키기 위한 행동적 치료 중재 시스템을 제안하고, 예비실험을 통해 치료 시스템의 적용 가능성을 탐색하는 것이다. 이를 위해 아동-로봇 상호작용에서 비연속 개별시도교수(Discrete Trial Teaching, 이하 DTT) 이론을 바탕으로 자폐범주성장애(autism spectrum disorder, 이하 ASD)를 가진 아동에 대한 로봇보조의 행동적 중재 치료 시스템을 고안하였다. 치료 프로토콜 적용 후 로봇 자극제의 타입(K, D, 및 KD)과 그룹 구성(3명의 non-ASD 아동과 3명의 ASD 아동) 측면에서의 정량적인 비교분석 및 훈련 이후 설문 평가를 시행한 결과 중재 치료 시스템에서 로봇이 자극제와 강화를 제공하는 보조 치료자로서 ASD아동의 눈맞춤 향상에 도움을 줄 수 있을 가능성을 검증하였다.

자폐 범주성 장애 아동의 실행기능 중재 연구의 동향 및 과제

이소현(SoHyun Lee),이귀남(Kwinam Lee),봉귀영(Guiyoung Bong),이해나(Haena Lee) 한국자폐학회 2023 자폐성 장애연구 Vol.23 No.2

Executive function, a cognitive ability closely related to the core deficit areas of autism spectrum disorders, necessitates a thorough understanding of every child’s profile and provision of appropriate support. This study aimed to review the latest research trends and analyze the interventions targeting the enhancement of executive function in children with autism spectrum disorders. In accordance with the criteria, a total of 29 experimental studies were selected. An overview of general characteristics and a detailed analysis of specific intervention attributes were conducted. Executive function intervention studies among children with autism spectrum disorders have been underway since 2004, mostly in the fields of psychology and psychiatry, targeting primary school-aged children with high functioning autism spectrum disorders. The most used interventions were cognitive behavioral/instructional strategies (CBIS) and exercise and movement (EXM). Notably, a high proportion of interventions were used to facilitate flexibility and inhibition subcategories of the executive function. Based on the findings, the future directions and educational implications regarding intervention aimed at enhancing executive function in children with autism spectrum disorders were discussed.

깊은 신경망을 활용한 음성 기반의 자폐 스펙트럼 장애 판별에 관한 기초 연구

이정혁(Jung Hyuk Lee),이건우(Geon Woo Lee),김성주(Seong Ju Kim),봉귀영(Guiyoung Bong),유희정(Hee Jeong Yoo),김홍국(Hong Kook Kim) 한국통신학회 2020 한국통신학회 학술대회논문집 Vol.2020 No.8