ﺗﺄﺛﯿﺮ ﺷﻦﺑﺎزي درﻣﺎﻧﯽ ﺑﺎ روﯾﮑﺮد ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري ﺑﺮ ﮐﺎﻫﺶ ﻣﺸﮑﻼت ﺑﺎزﺷﻨﺎﺳﯽ ﻫﯿﺠﺎﻧﯽ و رﺷﺪ اﺟﺘﻤﺎﻋﯽ ﭘﺴﺮان ﻣﺒﺘﻼ ﺑﻪ اﺧﺘﻼل ﻃﯿﻒ اُﺗﯿﺴﻢ

The Effect of Sand Play Therapy with a Cognitive Behavioral Approach on the Reduction of Emotional Recognition Problems and Social Growth in Boys with Autism Spectrum Disorder

ﻣﻘﺪﻣﻪ: ﻧﺎﺗﻮاﻧﯽ در ﺷﻨﺎﺧﺖ ﻫﯿﺠﺎﻧﺎت در ﮐﻮدﮐﺎن ﻣﺒﺘﻼ ﺑﻪ اُﺗﯿﺴﻢ ﺳﺒﺐ ﺑﺮوز رﻓﺘﺎرﻫﺎي ﺧﺸﻮﻧﺖآﻣﯿﺰ آﻧﺎن ﻋﻠﯿﻪ ﺧﻮد و دﯾﮕﺮان ﺷـﺪه و ﺗﻀﻌﯿﻒ راﺑﻄﻪ اﺟﺘﻤﺎﻋﯽ و آﺳﯿﺐﻫﺎي رواﻧﯽ در ﭘﯽ دارد. اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ﺗﺄﺛﯿﺮ ﺷـﻦ ﺑـﺎز ي درﻣـﺎﻧﯽ ﺷـﻨﺎﺧﺘﯽ -رﻓﺘـﺎري ﺑـﺮ ﺑﺎزﺷﻨﺎﺳﯽ ﻫﯿﺠﺎﻧﯽ و رﺷﺪ اﺟﺘﻤﺎﻋﯽ ﭘﺴﺮان ﻣﺒﺘﻼ ﺑﻪ اﺧﺘﻼل ﻃﯿﻒ اُﺗﯿﺴﻢ اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روشﻫﺎ: اﯾﻦ ﭘﮋوﻫﺶ ﻧﯿﻤﻪآزﻣﺎﯾﺸﯽ از ﻧﻮع ﭘﯿﺶآزﻣﻮن، ﭘﺲآزﻣﻮن و ﭘﯿﮕﯿﺮي ﺳﻪﻣﺎﻫﻪ ﺑﻮد. ﭘﺴﺮان ﻣﺒـﺘﻼ ﺑـﻪ اﺧـﺘﻼل ﻃﯿـﻒ اُﺗﯿﺴﻢ ﺑﺎ ﻋﻤﻠﮑﺮد ﺑﺎﻻ ﻣﺮاﺟﻌﻪﮐﻨﻨﺪه ﺑﻪ ﻣﺮﮐﺰ ﺗﺨﺼﺼﯽ اُﺗﯿﺴﻢ )اﺣﯿﺎ( ﺷﻬﺮ ﺗﻬﺮان در ﺳﺎل 1398 ﺟﺎﻣﻌـﻪ آﻣـﺎري را ﺗﺸـﮑﯿﻞ دادﻧـﺪ. از ﺑﯿﻦ آنﻫﺎ 30 ﻧﻔﺮ ﺑﻪ ﺻﻮرت در دﺳﺘﺮس اﻧﺘﺨﺎب و ﺑﻪ ﻃﻮر ﺗﺼﺎدﻓﯽ ﺑﻪ دو ﮔﺮوه آزﻣﺎﯾﺶ و ﮐﻨﺘﺮل در اﻧﺘﻈـﺎر درﻣـﺎن ﺗﻘﺴـﯿﻢ ﺷـﺪﻧﺪ. دادهﻫﺎ ﺑﺎ ﭘﺮﺳﺶﻧﺎﻣﻪﻫﺎي ﺗﺸﺨﯿﺺ اُﺗﯿﺴﻢ Gilliam، ﻣﻬﺎرت اﺟﺘﻤﺎﻋﯽ Matson و آزﻣﻮن ﺑﺎزﺷﻨﺎﺳﯽ ﭼﻬﺮه Benton ﮔﺮدآوري ﺷـﺪ. در ﮔﺮوه آزﻣﺎﯾﺶ، ﺑﺮﻧﺎﻣﻪ درﻣﺎﻧﯽ در 8 ﺟﻠﺴﻪ )ﻫﻔﺘﻪاي 1 ﺟﻠﺴﻪ ﯾﮏ ﺳﺎﻋﺘﻪ( اﺟﺮا ﮔﺮدﯾﺪ. ﮔﺮوه ﮐﻨﺘﺮل اﯾﻦ ﺑﺮﻧﺎﻣﻪ درﻣـﺎﻧﯽ را درﯾﺎﻓـﺖ ﻧﮑﺮد. ﺗﺤﻠﯿﻞ دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از وارﯾﺎﻧﺲ ﺑﺎ اﻧﺪازهﮔﯿﺮيﻫﺎي ﺗﮑﺮاري اﻧﺠﺎم ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: رﺷـﺪ اﺟﺘﻤـﺎﻋﯽ ) 7/36=p=0/007 ،F و 0/543=η( و ﺑﺎزﺷﻨﺎﺳـﯽ ﻫﯿﺠـﺎﻧﯽ ) 22/12=p=0/005 ،F و 0/609=η( در ﮔـﺮوه آزﻣﺎﯾﺶ در ﻣﻘﺎﯾﺴﻪ ﺑﺎ ﮔﺮوه ﮐﻨﺘﺮل ﺑﻪ ﻃﻮر ﻣﻌﻨﯽداري ﺑﻬﺒﻮد ﯾﺎﻓﺖ و اﯾﻦ ﺗﺄﺛﯿﺮات ﻣﺜﺒﺖ در ﻣﺮﺣﻠﻪ ﭘﯿﮕﯿﺮي ﭘﺎﯾﺪار ﻣﺎﻧﺪ. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻣﯽﺗﻮان از ﺷﻦﺑﺎزي درﻣﺎﻧﯽ ﺑﻪ ﺷﯿﻮه ﺷﻨﺎﺧﺘﯽ-رﻓﺘﺎري ﺑﻪ ﻣﻨﻈﻮر ﺑﻬﺒﻮد وﺿﻌﯿﺖ ﻫﯿﺠﺎﻧﯽ-اﺟﺘﻤﺎﻋﯽ ﭘﺴـﺮان ﻣﺒـﺘﻼ ﺑـﻪ اُﺗﯿﺴﻢ ﺑﻪ ﻋﻨﻮان ﯾﮏ روش ﻣﺪاﺧﻠﻪاي ﻣﺆﺛﺮ ﺳﻮد ﺟﺴﺖ.

Introduction: Disability to recognize emotions in children with autism will cause their aggressive behaviors against themselves and others, which brings about weakening of social interaction and psychological problems. Therefore, this study was conducted to determine the effect of sand play therapy with a cognitive-behavioral approach on the reduction of emotional recognition problems and social growth in boys with autism spectrum disorder. Materials and Methods: This was a semi-experimental study with pre-test, post-test, and follow-up. Boys with autism spectrum disorder with high performance admitted to the Ehya autism center in Tehran in 2019 formed the statistical population of the study. A number of 30 individuals were selected by available sampling and they were randomly assigned to two experimental and control groups. Data were collected by Gilliam autism rating scale, Matson social skills questionnaire, and Benton facial recognition test. In the experimental group, the treatment program was performed in 8 sessions, 1 session per week and each session for 1 hour, but the control group did not receive this treatment. Data were analyzed using analysis of variance with repeated measures. Results: The results showed that the level of social growth (η=0.543, p=0.007, F=7.36) and Emotional recognition (η=0.609, p=0.005, F=22.12) of the experimental group increased significantly compared to the control group and this increase was remained steady in the follow-up. Conclusion: Based on the findings of this research, sand play therapy with a cognitive-behavioral approach can be used as an effective intervention method to improve the emotional and social status of people with autism.