تعیین اثربخشی مداخلهٔ عصبی‌‌حرکتی آنت بنیل بر رفتار کلیشه‌ای و تعامل اجتماعی کودکان مبتلا به اختلال طیف اتیسم

زمینه و هدف: اختلال طیف اتیسم، اختلالی رشدی‌عصبی است که ازطریق نقص در تعاملات اجتماعی و الگوهای تکراری و محدود رفتار مشخص می‏شود. پژوهش حاضر با هدف تعیین اثربخشی مداخلهٔ درمانی عصبی-حرکتی آنت بنیل بر رفتار کلیشه‏ای و تعاملات اجتماعی کودکان مبتلا به اختلال طیف اتیسم انجام شد.روش‌بررسی: روش پژوهش نیمه‌تجربی با طرح پیش‏آزمون و پس‏آزمون همراه با گروه گواه بود. جامعهٔ آماری را تمامی کودکان مبتلا به اختلال اتیسم در دامنهٔ سنی 4تا10 سال تشکیل دادند که در سال 1399 به مرکز اتیسم ماندگار شهرستان خمین مراجعه کردند. از این جامعهٔ آماری، سی کودک مبتلا به اختلال اتیسم و دارای شرایط ورود به پژوهش با روش نمونه‏گیری هدفمند وارد مطالعه شدند. سپس به‌صورت تصادفی در دو گروه آزمایش و گواه ‏(هر گروه پانزده نفر) قرار گرفتند. از مقیاس رتبه‌بندی اتیسم گیلیام (گارز-2) (گیلیام، 1995) برای جمع‏آوری اطلاعات و به‌عنوان پیش‏آزمون و پس‏آزمون استفاده شد. گروه آزمایش روش آنت بنیل را به‌مدت هشت جلسهٔ نوددقیقه‏ای دریافت کرد؛ درحالی‌که برای گروه گواه آموزشی ارائه نشد. داده‏ها با استفاده از آزمون‏های شاپیروویلک و تحلیل کوواریانس چندمتغیری با سطح معناداری 0٫05 تجزیه‌وتحلیل شدند.یافته‌‏ها: نتایج نشان داد که پس از حذف اثر پیش‌آزمون، میانگین نمرات رفتار کلیشه‌ای (p<0/001 , η=0/89) و تعاملات اجتماعی (p<0/008 , η=0/39) بین دو گروه آزمایش و گواه در پس‏آزمون تفاوت معناداری دارد. نتیجه‌‏گیری: باتوجه به یافته‏های پژوهش می‏توان گفت، روش درمانی عصبی-حرکتی آنت بنیل در پس‏آزمون منجربه کاهش رفتار کلیشه‏ای و بهبود تعاملات اجتماعی شده است.

determining the effectiveness of anat baniel neuro-motor intervention on stereotyped behavior and social interactions of children with autism spectrum disorder

abstractbackground & objective: autism spectrum disorder (asd) is a lifelong neurodevelopmental disorder that presents with difficulties in social communication as well as restricted and repetitive behaviors. children and adults with asd have difficulty with verbal and nonverbal communication, social interactions, and play–related activities. this disorder makes it difficult for them to communicate with others. these deficits tend to present in early childhood and usually lead to impairments in functioning across various settings. moreover, these deficits have negatively impacted adaptive behavior and functioning. thus, early diagnosis and intervention are vital for future success within this population. the autism and developmental disabilities monitoring (addm) network reports that approximately 1 in 54 children are diagnosed with asd. the prevalence of this disorder is higher in boys than girls. currently, no treatment has been shown for asd, but several interventions have been developed and studied for use with young children. anat baniel method is a neuro–movement therapy. movement provides information the brain needs to grow and organize itself. this method is an approach based on motor learning. anat believes that the child’s awareness of all body movements and the environment leads to awakening the child’s brain and its development. the nine essentials form the core of the neuro–movement approach of the anat baniel method. each of the nine essentials describes one of the brain’s requirements for waking up and doing its job well. these nine essentials include movement with attention, slowness, variation, subtlety, enthusiasm, flexible goals, the learning switch, imagination & dreams, and awareness. the main elements of this intervention method include encouraging the child to play sensory–motor games, accompanying the child to experience each other’s movements, increasing awareness of the senses and learning new motor skills, strengthening the child’s different senses, and increasing the ability to understand differences better. the purpose of this research was to study the effectiveness of anat baniel neuro–motor therapy on stereotyped behavior and social interactions of children with asd.methods: this research was quasi–experimental with a pretest–posttest design and a control group. the statistical population includes all children with autism aged 4–10 years who were referred to khomein mandegar autism center, khomein city, iran, in 2020. from whom, 30 children with autism disorder were selected by convenience sampling. the inclusion criteria were lacking physical disabilities, having an iq between 50 and 70 (educable), and having parents’ consent. the exclusion criteria were severe mental disabilities and severe physical disabilities.then, they were assigned into experimental and control groups. the gars–2 (gilliam autism rating scale) test was used to collect information in the pretest and posttest. gilliam autism rating scale, second edition, is a screening tool for autism spectrum disorder for individuals between the ages of 3 and 22. it was designed to help differentiate those with autism from those with severe behavioral disorders. coefficients of reliability of the gars–2 test for the subscales and autism index range from 0.80 to 0.90. to conduct the research, in the first session, the gars–2 test questionnaire was completed as a baseline (pretest), and the informed consent form was completed by the children’s parents. after the pretest, the interventions were performed by the occupational therapist of the center autism and the first researcher, so the experimental group received the anat baniel intervention for eight 90–minute sessions. however, the control group received only routine rehabilitation interventions.results: the ancova data showed a significant difference between the mean of stereotyped behavior (p<0.001, η=0.89) and social interaction (p=0.008, η=0.39) in the experimental and control groups.conclusion: evidence was found to support anat baniel intervention (abm) of neuro–motor therapy as an effective tool in reducing stereotypical behaviors and improving social interactions in children diagnosed with asd. the results of the present study can be used for treatment planning and clinical interventions, and by teaching this treatment to parents and educators of rehabilitation centers and children with autism, a step was taken to improve the performance of these children.