بررسي اثر بخشي بازي‌ درماني مبتني‌ بر رژيم حسي در تعديل حس لامسهٔ كودكان اتيستيك

The Effects of Sensory Diet-Based Play Therapy on Tactile Touch Sensation in Children With Autism

زمينه و هدف: كودكان اتيستيك داراي آشفتگي‌هاي حسي به‌ ويژه نبود تعديل در حس لامسه با چالش‌هاي بسياري مواجه مي‌شوند؛ لذا پژوهش حاضر به‌منظور تعيين اثربخشي بازي‌درماني مبتني‌بر رژيم حسي بر تعديل حس لامسهٔ كودكان داراي اختلال طيف اتيسم شهر تهران انجام شد. روش‌ بررسي: روش اين پژوهش به‌صورت نيمه‌آزمايشي از نوع طرح پيش‌آزمون‌پس‌آزمون با گروه گواه و آزمون پيگيري بود. از جامعهٔ آماري تمامي كودكان 7 تا 12سالهٔ انجمن اتيسم شهرتهران، 20 نفر با استفاده از روش دردسترس انتخاب شده و به‌صورت تصادفي در گروه آزمايش (10 نفر) و گروه گواه (10 نفر) جايگزين شدند. گروه آزمايش 17 جلسهٔ 45تا60دقيقه‌اي مداخلات بازي‌درماني مبتني‌بر رژيم حسي را دريافت كرد و گروه گواه در ليست انتظار باقي ماند. گردآوري داده‌ها براساس پرسشنامهٔ حسي (دان، 1997) انجام پذيرفت. سپس داده‌ها با استفاده از نرم‌افزار SPSS نسخهٔ 23 و تحليل واريانس با اندازه‌گيري مكرر در سطح معناداري 0٫01 تجزيه‌وتحليل شدند. يافته‌ها: بلافاصله بعد از پايان مداخله و يك‌ونيم ماه بعد از مداخله تفاوت آماري معنا‌داري در ميانگين نمرهٔ تعديل حس لامسهٔ دو گروه وجود داشت (0٫001>p). نتايج تحليل واريانس با اندازه‌‌گيري مكرر نشان داد كه تغييرات ميانگين تعديل حس لامسه در طول زمان متفاوت و اثر متقابل گروه و زمان دربارهٔ حس لامسه معنادار است (0٫001>p). نتيجه‌گيري: باتوجه به يافته‌هاي پژوهش حاضر و اثربخشي بازي‌درماني مبتني‌بر رژيم حسي بر تعديل حس لامسهٔ كودكان اتيستيك، استفاده از روش مذكور به متخصصان و درمانگران در اين زمينه توصيه مي‌شود.

Background & Objectives: Autism Spectrum Disorder (ASD) is a pervasive developmental condition, i.e., often referred to as a neurological disorder that develops in early childhood. This disorder generates during the first 3 years of a child's life. The affected children cannot use language as a means of communicating with others. These children also encounter difficulty processing sensory information. In recent years, the use of play therapy has increased in extensive areas and disorders, especially in ASDs. Therefore, the present study was conducted to determine the effects of sensory diet–based play therapy on tactile touch sensation in children with autism. Methods: This was a quasi–experimental study with a pretest–posttest–follow–up and a control group design. The follow–up stage was conducted 45 days after the initial screening. The statistical population of the study included all children aged 7–12 years referring to the Autism Association of Tehran City, Iran, in 2019. Accordingly, the intervention program was identified and coded after several meeting sessions. The statistical sample of this study consisted of 20 individuals (both genders) who were selected by the convenience sampling method. The study participants were randomly assigned to the test and control groups (n=10/group). All children with ASD received 17 sessions of 45–60 minutes of sensory diet–based play therapy; however, the control group remained on the waiting list and received no therapeutic interventions. The therapy sessions, games, and practical exercises were conducted 3 days a week. These sessions were held in the presence of the parents of these children. The family, especially the parents, play an important role in such interventions. The games were held at home and outdoors. Data collection was based on the Sensory Profile Questionnaire (Dunn, 1997). This questionnaire consists of 9 factors and a total of 125 items, i.e., assigned scores for each item. The test includes 4 processing concepts, including low recording, sensory search, sensory sensitivity, and sensory avoidance. The obtained data were analyzed in SPSS by repeated–measures Analysis of Variance (ANOVA) at a significance level of 0.01. Results: The mean±SD modulation scores of the experimental group's sense of touch changed from 59.20±6.40 in the pretest to 78.00±4.54 in the posttest, and 77.40±3.71 in the follow–up phase; however, such alternations were negligible in the controls. Immediately after and 1.5 months after the intervention completion, there was a statistically significant difference in the mean score of the two groups' sense of moderation (p<0.001). The repeated–measures ANOVA results suggested that the mean changes in the sense of adjustment of the sense of touch differed over time; the interaction of group and time was significant on the sense of touch (p<0.001). Conclusion: The present research findings revealed that sensory diet–based play therapy has improved the sense of touch in the studied children with ASD. Therefore, according to the study data and the effectiveness of the provided intervention on the tactile touch sense in children with ASD, applying this method is recommended to specialists and therapists in this field.