Razi Journal of Medical Sciences

fa تدوین و اعتباریابی برنامه آموزشی مبتنی بر تحلیل رفتار کاربردی و ارزیابی اثربخشی آن بر شاخص‌های زبانی کودکان اوتیسم با عملکرد بالا Developing and Validating an Educational Program Based on Applied Behavior Analysis and Evaluating Its Effectiveness on and Linguistics Indexes of Autistic Children with High Performance روانشناسی بالینی Clinical Psychiatry پژوهشي Research <div style="text-align: justify;"> زمینه و هدف: درخودماندگی یا اوتیسم، نوعی اختلال رشدی است که با نقص در ارتباطات و تعاملات اجتماعی مشخص می‌شود. هدف از انجام این پژوهش تدوین و اعتباریابی برنامه آموزشی مبتنی بر تحلیل رفتار کاربردی و ارزیابی اثربخشی آن بر شاخصهای زبانی کودکان اوتیسم با عملکرد بالا است. روش کار: این پژوهش به صورت نیمهآزمایشی با طرح پیشآزمون- پسآزمون با گروه کنترل انجام پذیرفت. 24 دانشآموز پسر دچار اختلال طیف اوتیسم با عملکرد بالا از بین دانشآموزان استثنایی مدرسه ابتدایی پسرانه ضیافت در محدوده شهریار که در سال تحصیلی 98-1397 مشغول به تحصیل بودند، با روش نمونهگیری در دسترس انتخاب و به صورت تصادفی در دو گروه آزمایش و کنترل جایگزین شدند و از ابتدای مهر تا آخر اردبیهشت ماه طی 60 جلسه در معرض آموزش تحلیل رفتارکاربردی قرار گرفتند. برای جمع آوری دادهها از پرسشنامه درجه بندی اوتیسم گیلیام (1995) استفاده شد. دادهها با استفاده از نرمافزار SPSS16 و با استفاده از آمار توصیفی و استنباطی مورد تحلیل قرار گرفتند. <a name="_Hlk160107502">در تحلیل توصیفی از میانگین و انحراف معیار و در تحلیل استنباطی از </a>آزمون آماری تحلیل کوواریانس تک متغیره (آنکووا) استفاده شد. یافته ها: نتایج پژوهش حاکی از آن بود که الف) برنامه طراحی شده براساس تحلیل رفتار کاربردی از اعتبار مطلوبی برخوردار است به طوری که برای تعیین حداقل ارزش نسبی روایی محتوای برنامه با توجه به تعداد ناظران (10 نفر) و براساس محاسبه جدول لاوشه بالاتر از 80/0 انتخاب شد و شاخص روایی محتوا بالاتر از 7/0 به دست آمد؛ ب) همچنین بعد از مداخله بین گروه آزمایش و کنترل در شاخصهای زبانی در سطح معناداری 001/0 تفاوت معناداری مشاهده شد. نتیجه گیری: با توجه به یافتهها میتوان نتیجه گرفت که مداخله تحلیل رفتار کاربردی بر کاهش علائم اوتیسم و بهبود شاخصهای زبانی مؤثر است. نتایج این مطالعه بیانگرآن است که با توجه به افزایش شیوع اوتیسم در دهه گذشته، توجه بیشتر، کاربرد مداخلات رفتاری و برنامههای پیشگیرانه ضروری است. </div> <div style="text-align: justify;">Background & Aims: Autism spectrum disorder is one of the neuro-developmental disorders that, according to the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), has two major symptoms: deficits in social communication and social interaction, as well as behaviors, interests and limited and repetitive activities are identified (1). This disorder is one of the childhood disorders that attracts many studies in the field of psychology every year (2). The average rate of autism disorder in epidemiological studies is 5 cases per 10,000 people. The range of reports varies from 2 to 20 cases per 10,000 people. But more recent studies about the prevalence of autism disorder is 1 in every 100 births. The prevalence rate in boys is 3 to 4 times that of girls. These children show undesirable behaviors, such as stereotypic movements, aggression and self-harming behaviors. They also have problems in understanding and using social rules and behaviors, conversational gestures, non-verbal behaviors and movement coordination (3). Methods: This research was semi-experimental with a pre-test-post-test design with a control group, which is one of the practical studies. The statistical population of the present study consisted of all children with autism disorder with high functioning under education in schools of Shahryar city in 2018-2019. Among the mentioned children, 24 people were randomly selected in two experimental and control groups using available sampling method. Gilliam's Autism Rating Questionnaire (1995) was used to collect the required data, and Lovas's (1987) applied behavior analysis program was used for intervention. The data were analyzed using univariate analysis of covariance (ANCOVA). Results: The applied behavior analysis program has improved the linguistic indices of children with autism spectrum, so that after the intervention, a significant difference was observed between the experimental and control groups. In general, it can be concluded that the intervention of applied behavior analysis is effective in reducing autism symptoms and increasing skills. After organizing the training sessions, the credibility of the program was evaluated based on the agreement of the supervisors, which included 10 teachers and specialists in the education of exceptional children with a history of teaching and training autistic children and other exceptional children at least 7 years old and at most 18 years old, in such a way that The agreement coefficient of the observers of the program was calculated based on the Content Validity Indexcoefficient of 0.82, which is why it is necessary to mention that the applied behavior analysis program had good validity. In order to clarify the findings of the present study and other similar existing studies, it is necessary to mention that the applied behavior analysis approach is performed using Skinner's behavior change methods. The basis of this method is to increase the probability of repeating and increasing behaviors that are encouraged, and on the other hand, the probability of removing behaviors that are not paid attention to increases (20). Another factor that causes the applied behavior analysis method to reduce destructive behaviors and communication defects and increase the language skills of children with autism is the division of each skill into smaller components, so that whenever these components If they are done correctly and carefully, the child is encouraged and therefore the child's motivation and desire to learn linguistic indicators and its other components increases (21). It can also be pointed out that by practicing and repeating skills at home and by family members and in fact with the support of parents and other close people, it can lead to the permanence of the linguistic indicators of the affected child; Because maintaining and generalizing the learned skills requires exercises and guidelines outside the school environment and requires continuous parental intervention in the language skills of the child with autism. In fact, linguistic indicators, like social skills, should be generalized from one educational environment to other suitable environments and from the form of mutual relations with one group to mutual relations with other groups and maintained over time. On the other hand, the results of the present study indicated the favorable validity of the program developed based on the principles of applied behavior analysis. In such a way that the implementation of an intervention program on a group of high-functioning autistic children led to a significant improvement in language indicators compared to the control group. In this regard, it should be noted that teaching communication and language skills with a child with autism spectrum disorder will lead to the improvement of these skills and the reduction of the symptoms of this disorder. Also, since the improvement of verbal skills forms the basis of every person's life and leads to social growth, which in turn accelerates intellectual, linguistic and other developmental aspects of a person; Therefore, teaching these skills to high-functioning autistic children is of particular importance. On the other hand, in applied behavior analysis, it has been tried to reveal the relationship between the environment and the child's behavior through careful observation of the child's behavior, its detailed evaluation and analysis, as well as those characteristics of the environment that can lead to the creation of new behavior. or reduce behavior in the child, be discovered. Therefore, the interventions made by applied behavior analysis can be done by child therapists, parents, teachers and other relatives of the person and it is hoped that with this method the child's language indicators can be improved. Since the improvement of linguistic and verbal indicators of children on the autism spectrum causes the improvement of other symptoms of the autism spectrum and the hope of academic progress in this group is seen with the development of verbal and non-verbal language; Therefore, it is recommended that in order to use the compiled program based on the principles of applied behavior analysis, other audio-visual devices and music should be used in order to develop vocabulary and use words correctly. By holding educational workshops for teachers of exceptional schools and parents of children on the autism spectrum and highlighting the importance of improving the communication and language skills of these children, parents and teachers should try to familiarize themselves with the implementation methods of the applied behavior analysis program and how to proceed with the sessions. The program should be given to families and coaches in the form of instructions for implementing the program. Conclusion: According to the findings, it can be concluded that the applied behavior analysis intervention is effective in reducing autism symptoms and improving language indicators. The results of this study indicate that due to the increase in the prevalence of autism in the last decade, it is necessary to pay more attention to the use of behavioral interventions and preventive programs.</div> تحلیل رفتار کاربردی, شاخص‌های زبانی, کودکان طیف اوتیسم Applied Behavior Analysis, Language Indicators, Children with Autism Spectrum 1 17 http://rjms.iums.ac.ir/browse.php?a_code=A-10-5825-1&slc_lang=fa&sid=1 Zahra Tohidi Manesh زهرا توحیدی منش 3900319475328460080581 3900319475328460080581 No PhD Student, Educational Psychology, Science and Research Branch, Islamic Azad University, Tehran, Iran دانشجوی دکتری روانشناسی تربیتی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران Noorali Farrokhi نورعلی فرخی farrokhinoorali@yahoo.com 3900319475328460080580 3900319475328460080580 Yes Professor, Department of Measurement and Assessment, Faculty of Psychology and Education, Allameh Tabatabae’i University, Tehran, Iran استاد، گروه سنجش و اندازه‌گیری، دانشگاه علامه طباطبائی، تهران، ایران Hasan Asadzadeh حسن اسدزاده 3900319475328460080582 3900319475328460080582 No Professor, Department of Educational Psychology, Faculty of Psychology and Education, Allameh Tabataba’i University, Tehran, Iran استاد، گروه روان‌شناسی تربیتی، دانشگاه علامه طباطبائی، تهران، ایران Parviz Sharifi daramadii پرویز شریفی درآمدی 3900319475328460080583 3900319475328460080583 No Professor, Department of Psychology and Education of Exceptional Children, Faculty of Psychology and Education, Allameh Tabataba’i University, Tehran, Iran استاد، گروه روانشناسی و آموزش کودکان استثنایی، دانشگاه علامه طباطبائی، تهران، ایران