?????? 2007 ??????? ????? ?_??????_???_??_?_????_???_??
- 1. ÌØJouÊârn”œalÓýofÔÙSp»îec¿ÆialŒWE³xdu¾¿cation & Rehabilitation Science Vol. 46, No. 4, pp.103~130, 2007. ??????? ????? ? ?????? ??? ?? ? ???? ??? ??: ?? ?? ??* The Effects of Sensory Integrative Intervention on the Balance and Attention of Children with Attention Deficit Hyperactivity Disorder: Single-Subject Research Design ? ? ?**?? ? ?*** Kim, Kyeong Mi?Kim, Jin Mi < ? ? > ? ??? ??????? ?? ADHD ??? ?? ? ??? ?? ??? ??? ?? ???. ????? P?? ???? ? 7? 6?? ? ??? ?????? 2?? ? ?? ???, ADHD? ??? ???. ? ??? ?? ?? ?? ? ABAB ??? ?????. ????? ???1 ??(A) 3?, ??1 ??(B) 3?, ???2 ??(A') 5?, ??2 ??(B') 6?? ?????. ???1? 2 ???? ??????? ?? ????, ?? ???? ??????? ?????. ?? ??? Tetrax? ???? ??????, ???? Mesulam and Weintraub Cancellation Test(MWCT)? ?? ?? ?????. ? ??? ??? ??? ??. ??? ?? ??? ???1?2 ??? ???? ? ?1?2 ??? ?? ?????. ??? ???? ???1?? ??2 ???? ??? ?? ???? ???? ??????? ??? ???? ????, ???2 ???? ??2 ???? ??? ??? ? ??? ??????? ??? ??? ???? ? ?? ???. ??? ??????? ADHD ??? ?? ? ??? ??? ???? ??. ? ??? ADHD ??? ??? ????? ???? ?? ???? ???? ???? ??????? ??? ??????, ???? ??? ?? ???? ??? ??. ??? ?? ???? ?? ?? ????? ?? ???????? ???? ? ??? ???? ??? ? ????? ????? ? ???. ??? : ??????, ????? ? ??????, ??, ??? * ? ??? 2006? ?????? ??????? ?? ??? This work was supported by the Inje University Grant 2006 ** ????? ?????? ??(???? : kmik321@inje.ac.kr) Department of Occupational Therapy, Inje University *** ????? ??? ??????? ???? Graduate program in Neuroscience, Inje University
- 2. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) ¢ñ. ? ? ????? ??????(Attention Deficit Hyperactivity Disorder: AD HD)? ??? ? ??? ?? ?? ??? ????? ??? ??? ???? ???? ???, ?? ??, ?? ??? ????(American Psychiatric Association, 1994). ADHD? ???? ???? ?? ???? ?????? ??, ???? ? 2~18%??, ????? ?? ? 6?~12? ??? 3~8%, ??? ?? 7.7%? ?? ??? ???? ??? ???? 3? ?? ?? (Brown, Freeman, & Perrin, 2001). ADHD ??? ??? ??? ???? ? ?? ????? ?? ????? ?? ??????, ???? ??? ? ?? ???, ??? ??? ?? ???? ???? ??? ???? ?? ?? ?? (Barkley, 2003). ?? ???? ? ??, ??? ??, ??? ??? ??? ???, ???, ????, ????, ??? ????, ???? ?? ????? ??(Leung ?, 1994). ADHD? ????? ?????? ?? ???? ??, ?? ??, ??? ??, ??? ??, ??? ?? ???, ?? ?? ? ?? ???? ?????(Jensen, Mrazek, & Knapp, 1997). ??? ?????? ???? ???? ?????? ??? ????? ??? ???? ??? ? ????, ???, ????? ? ?? ??? ??? ??? ? ?? ???-? ?? ??(fronto-striatal network)? ????? ??? ADHD? ?? ?? ?? ??? ? ??(Durston, 2003: Bush ?, 2005). ???? ADHD? ??? ????? ????? ???????(methylphe nidylacetate hydrochloride: MPH)? ?? ????, ? ??? ?????? ? ADHD ??? 70~80%?? ???? ????? ????, ???? ??? ???. ??? MPH? ?? ??? ????? ??? ??? ????? ??, ????, ????? ?? ?? ???? ???? ?? ???? ??? ?? ? ?? ??? ?? ???? ???? ??? ?????. ?????? ?? ?? ???? ??? ?????? ??? ????? ????? ?? ??? ? ??? ????? ?? ???(Ernst ?, 1994). ???? ?? ADHD? ?? ???? ????, ????, ????, ??? ?, ??? ?? ?? ??. ?????? ??? ??? ?? ??? ? ? ? ?????? ????, ???, ???, ???? ??? ???? ????? ? A. Jean Ayres? ?????(Ayres, 1972). ??????? ??? ?? ?? ??? ?? ??? ?????? ???? ??? ???? ???? ? - 104 -
- 3. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? ??? ??? ??? ? ??? ??, ?? ??? ???? ????? ?? ?? ??? ?? ???? ???? ???? ????? ?? ??? ??? ?? ????(Fisher, Murray, & Bundy, 1991). Ayres(1972)? ??? ? ?? ??? ?? ??-?? ????? ????? ???? ??? ???? ? ?????. ??? ????? ??? ??? ?? ??? ??? ??, ? ?? ??? ????? ?? ?????, ?? ?? ???? ??? ?? ? ??? ? ??. ?? Ayres? ??? ??? ??? ?? ???? ?? ?? ??? ?? ??? ?????? ??? ??????? ???? ?? (Schaaf & Miller, 2005). ???? ?? ???? ??, ??, ??? ???? ? ????? ?? ?? ???? ??? ???? ???? ? ???? ?? ?? ????(McKenzie ?, 2003). Ayres(1972)? ??? ?? ??? ??, ?? ??? ???, ??? ?? ?? ??? ?? ? ??? ??? ??? ??? ?? ????? ????, ??? ?? ??? ???? ???? ????. ?? ??? ?? ??? ? ?????? ????, ?? ?? ??? ???? ???? ??? ???? (Ayres, 1972). ??? ???? ???? ?? ???? ??? ???? ? ?? ????? ???? ????? ??? ???? ??? ????. ?? ? ??? ??? ??? ADHD? ?? ???? ??? ??-?? ??? ? ??? ??, ?? ??? ??? ??? ?? ??? ???, ?? ???? ? ? ?? ? ???? ????? ??? ??? ? ? ??(Stratton & Gailfus, 1998). ?? ???? ????? ADHD ??? ????? ???? ? ???? ???(Prudhomme White, & Mulligan, 2005), ??? ???? ? 10.3%? ??????? ?? ?? ADHD ??? 84.3%? ?????? ? ???? ?????(Guo ?, 1999). ?? ADHD ??? Sensory Integration and Praxis Test? ?? ? ?? ??, ?????, ????, ? ? ? ???? ???? ?? ??? ????, ?? ???? ??? ?? (praxis)?? ? ?? ??? ??? ???? ???(Mulligan, 1996). ?? ADHD ??? ???? ??? ???, ????? ??? ???, ??? ? ?? ???, ???? ??? ????? ?????? ??? ??? ?? (Teicher ?, 2000). ??? ADHD ???? ??? ??? ??? ??? ? ??. Hern & Hynd(1992)? ????? ??? ???? ????? ?? ? ???? ? ???? ??, ?? ?? ? ?? ?? ???, ????? ?? ??? ?? ??? ???? ??? ???? ???. ??? ADHD ??? ???? ??? ??? ???? ?? ??? ???? ???(Dunn & - 105 -
- 4. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) Bennett, 2002), ?? ??, ?? ??, ????? ?? ??? ??? ?? ??? ? ? ??. ?? ADHD ??? ????? ??? ???? ??? ? ???? ??? ???? ???(Whitmont & Clark, 1996), ?-?? ??? (Raggio, 1999), ?? ????? ?? ?? ? ? ???(Pitcher, 2001). ? ?? Piek, Pitcher, & Hay(1999)? ????? ?? ?? ? ?? ???? ??? ??? ??? ??? ? ???? ??? ??? ? ? ??. ADHD ??? ????? Leiter-P(Leiter International Performance Scale) ?? ?? ????? ??? ??? ???, ???? ?? ? ????? ???? ? ??, ?? ??? ??? ??? ??? ????(Mangeot ?, 2001). Ayres(1979)? ??? ??, ?? ? ????? ??? ?? ??? ??? ? ??? ??? ? ?? ????? ?? ????? ????, ? ?? ?? ??? ???? ?? ??? ???? ? ??? ??? ???, ???, ?? ?, ?? ?? ?? ????? ????? ??. ??? ADHD??? ???? ? ????? ?? ??, ??, ???, ??? ???? ??, ?? ???, ? ?? ???? ???? ???? ?? ?? ??? ????? ??????? ????? ????? ??(DeGangi, 2000). Stonefelt & Stein(1998)? ADHD ?? ????? ??? ???? 8?? ??? ???? ?? ???? ?????? ? ????? ? ?? ??, ????? ????, ??, ?? ? ??? ??? ????? ??? ?? ???, ????, ??, ??, ????, ??, ??, ?? ??, ???, ??, ????? ????? 6?? ????, 2 ?? ??? ?????? ???. ? ?? ????? ADHD ?? 22?? ? ???? ??? ???? ???? ?? ??? ??? ????, ????? ?? ?? ??(sensory diet)? ????, ???? ? ???? ?? ??? ??? ?? ??? ???? ???? ?? ??, ?? ?? ?? ?????? ?????(Nikharge & Mulgaonkar, 2002). ?? ?????? ??????? ?? ADHD ??? ??? ???? ? ????? ??? ?????, ??? ??? ???? ????? ADHD ? ?? ???? ????, ??? ?? ???? ??? ?? ??? ?? ?? ?, ??????? ?? ?? ? ????? ?? ??? ADHD ???? ? ???, ????, ??????? ???? ?? ???? ?? ????. ?? ? ADHD ?? ?? ???? ???? ??? ??, ????, ??, ??-? ?? ??? ?? ??? ????? ? ??. ??? ? ????? ADHD ??? ?? ? ?? ?? ??? ???? ? ?? ???? ???? ?? ??? ? ??? ??? ???? ????? ? - 106 -
- 5. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? ???? ???? ??????? ?? ??? ??? ??? ????? ? ?. ? ??? ????? ??? ??. ??, ??????? ADHD ??? ??? ??? ??? ???? ????. ??, ??????? ADHD ??? ???? ??? ??? ???? ?? ??. ¢ò. ?? ?? - 107 - 1. ???? P?? ???? ? 7? 6?? ? ??? 2007? ?? ?????? 2??? ?? ???, 2004?? ?? ??? ??? ??? ??? ?? ???? ? ?? P ????? ??? ?? ADHD? ??? ???. ??? ????, ? ???? ???, ??? ???? ??? ??? ??, ????? ???? ? ??, ??????? ?? ??? ? ??? ?????. ??? 40?? ?? ???, ?? ? ???? 3.4kg????, ?? ??? ???. ?? ? 2? ? ? ? ??? ??? ??? ????, ?? ?? ? ??? ?? ??? ?? ?. ?? ??? ???????, 14??? ?? ?????, ??? ???? 20???? ??????, ????? ?? ?? ????. ????? ??? ???, ? ??? ? ????, ? 3??? ????? ???. ???? ?? ??? 14??? ??, ???? ?? ?? ? ?, 30???? ?? ?? ?? 2006? ??? ????? ???. ??? ????? ?? ?? ????. ? ?? ???, ???, ???? ???? ?? ?? ???, 2004??? ??? ?? ????? ?? ??. ??? ?? 1? ??? ??, ??? ??? ?? ? ???, ?? ??? ??? ????? ??? ??? ??? ???. ?? ?? ??? ??? ?? ?? ???, ?? ?? ? ? ???? ????? ?? ?? ??, ????? ???? ??? ??? ???? ???. ??? ?? ?? ??? <? 2-1>? ??.
- 6. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) <? 2-1> ?? ?? ?? ?? ???? ???? - 108 - ??? ???? ?? (Canadian Occupational Performance Measure: COPM) ???? ??? ? ???? ??? ???? ?? ???? ?? ??? ???? ?? ???? ???, ? ??? ?? ??? ? ?? ?? ???? ???. ?? ???? ???? ??? ?? ??? ????? ???? ??? ?????? ?? (Functional Independence Measure for Children: Wee-FIM) ??: 114/126? ???? ???? ????? ????? ???????? ??? ???? ?? ??? ?? (Sensory History) ?? ?? ???? ?? ??, ? ?? ?? ?? ??? ? ?? ?? ??. ??? ??? ?? ??? ??, ??? ???. ?? ? ?? ?????? ??? ????? ?? ??? ????? ?? ? ?? ??? ??. ??? ???? ??? ?? ?????, ?? ? ?? ??? ????? ???. ????? ???? ???, ? ???? ? ??? ??? ?? ???? ??? ?? ??? ?? ?? ?? ???? (Short Sensory Profile) ??: 141/190? ????? ????? ???? ???, ?? ??????? ?? ??? ????? ?? ???? ?? ???? (Clinical observation) ??? ????? ?? ???, ?? ????? ?? ??. ??? ?? ??? ????? ??? ?? ?? ??. ??? ?? ?? (??? ??:supine flexion, ??? ??:prone extension)? ? ? ?? ??(ocular motor planning), ???? ? ???? ?? ?? ??. ??? ?? ??? ????? ?? ??? ????? ? ???? ??? ???? ?????? ?? ?? (Bruininks-Oseretsky Test of Motor Proficiency: BOTMP) ??: 123/147? ?????? ?? ??? ?? ??? ?? ??? ????? ? ???? ????? ??? ????? ?? ??? ? ??? ? ? ?? ???? ???? ???? ????? ??? ??? ??? ??? - 10?? ?? ???? - 1? 4?? ?? ???? - 2? 7?? ?? ?? ? ? ??? ????, ??? ? ??? ??? ?? ??? ??? ??? ?? ?? (Korean Developmental Test of Visual Perception-2) ?? ???(GVP): 108? ??-?? ???(MRP): 112? ??-?? ??(VMI): 103? ??? ???? ???? ? ??? ??? ????, VMI? MRP ? ???? ?? ?? ?? ???? ???, ?-? ??? ??? ? ?? ??? ?? ??? ??? ??? ? ???? ???, ? ?-??????? ??? ?? ?? ????? ?? ??: 75? ????: 8? ????: 123 ??? ???? ? 4?? ??? ??? ??
- 7. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? - 109 - 2. ?? ?? ? ??? ???? ????(single subject research design) ? ABAB ??? ?????. ????? 2007? 5? 5??? 7? 23??? ? 12?? ???, ????? ???1 ??(A) 3?, ??1 ??(B) 3?, ???2 ?? (A') 5?, ??2 ??(B') 6?? ?????. ???1? ???2 ???? ? ?????? ?? ????, ?? ???? I??? ?????? ????? ??????? 50?? ?????. ?? ??? Tetrax(Sunlight Medical, Israel)? ???? ??????, ? ??? Mesulam and Weintraub Cancellation Test(MWCT)? ???? ?? ???. 3. ?? ?? 1) ?? ?? ?? ??? Tetrax? ???? 0.01~0.25Hz ??? ??? ???? ?? ? ?????(Fourier transformation) ??? ?????. Tetrax? ?? ???(platform)? A, B, C, D? ???? ?? ?? ?? ?, ?? ???, ??? ???, ??? ????? ??? ?? ??? 4?? Plot plates ?? ??? ???? ???? ????. ???? ??? ??? ? ???? ??? ??? ????, ?? ??(postural sway)? ????. ????? ??? ?? ???? ??? ?? ??? ???? ??, ?? ? ?? (1) ? ?? ?? ???? ??(Normal position, eyes open, solid surface: NO), (2) ? ?? ?? ???? ??(Normal position, with eyes closed: NC), (3) pillow ?? ??? ? ?? ?? ???? ??(Eyes open, on pillows: PO), (4) pillow ?? ??? ? ?? ?? ???? ??(Eyes closed, on pillow: PC)??. ? ???? 32?? ????? ??, ??? ?? ? ???? ??? ??? ???. ?????? ?? ??? ???? ?????? ??? ??? Hz? ?? ?? ?????? ?? ?? ??? ??? ????. ???? ????? ? ?? ????? ?? ??, ????, ?? ??? ????? ??? ??? ? ? ???, ??? ???? ?? ??? ???, ??? ???? ???? ? ??? ????.
- 8. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) - 110 - 2) ??? ?? Cancellation test? ?????? ????? ???? ?????(Dawes, 2000). Cancellation test? ??? ??? ??? ???? ????, ?? (target)? ????? ???? ??? ???? ?? ???? ??? ??? ?? ?? ?? ? ?? ??? ??? ???? ???? ??? ?? ???. Cancellation test? ?? ??? ??? ????? ??? ??, ?? ??, ? ? ?? ??? ????. Cancellation test?¡®The C¡¯s and E¡¯s test¡¯,¡®2 and 7 Cancellation¡¯,¡®Star Cancellation¡¯,¡®The Bells test¡¯? ??? ?? ????. MWCT? 1980?? M. Marsel Mesulam? Sandra Weintraub? ? ? ??????, ?? ????? ??? ??? ???? ?? ??? ??? ???. ??? 1990???? ?? ????? MWCT? ??? ??, ??? ?, ?????, ??? ???? ??? ????? ?????(Lezak, 1995). ?? ??? ????? ??? ???(Geldmacher & Riedel, 1999), ??? ???? ???? ?? ?????(Amieva ?, 1999). ?? MWCT? ??? ? ??? ?? ??? ?? ??? ???? ??(Lauer ?, 1999), ???? ???? ?? ??? ???? ??(Kapczinski ?, 1996), ???????? ?? ?? ??? ???? ?? ??? ??? ???? ?? ??? ?? ?? ? ???? ?? ?????(Casco, Tressoldi, & Dellantonio, 1998). ? ????? ???? MWCT?? 60?? ?? ????? ??? ??? ? ??? ??? ????, ??? ??? ????? ??? ?? ???? ?? ???? ??? ??? ??? ??? ???? ???? ????, ?? ? ????? ?? ??? ?????. 4. ?? ?? 1) ???1(A)? ???2(A') ?? ???1? ???2 ??? ??????? ???? ????, ???1 ?? ? 2? ?? ??? 2?, ?? ?? 3?? ?????. ???2 ??? 2? ? ? ???? ?? ??? ? 5? ?????. ?? ??? I??? ????? ? ???? ??? ??? ?? ??? ?? ??? ??????, ?? ?? ? ? 15??? ?????.
- 9. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? - 111 - 2) ??1(B)? ??2(B') ?? ??1 ??? 3?, ??2 ??? 6?? ? 50? ?? I??? ?????? ????? ??????? ?????. ??????? Ayres(1972)? ?? ? ??? ???? ADHD ??? ?? ? ??? ??? ????????? ?? ??? ???? ? ??? ??????, ? ??? ??????? ?? ? <? 2-2>? ??. ??? ? 1~2?, ??? ???? ??????, ?? ? ???? ?? ??? ?????. 3) ?? ?? ??????? ?? ??? ??? ??? ?? ??? ??? ?? ??? ??. (1) ??? ??? ??? ??? ??? ??? ???? ???? ?? ? ? ????? ???? ??? ??? ? ?? ??? ???? ??? ???? ???? ?????? ? ?? ?? ?? ?? ?? ? ??? ??. ?? ? ????? ??? ???? ??? ??? ??????. (2) ??????? ???? ??? ?????? ??? ???? ?? ?? ?? ??? ??? ????? ??????, ??? ??? ???? ? ?? ??(child-centered)?? ?? ??? ???. ?? ???? ?? ????? ?? ??? ?? ??? ??? ????? ????? ?? ?. (3) ????? ? ?? ?? ?? ??? ???? ???? ?? ???? ?, ??? ???? ????? ?? ????? ?? ????(pretend situation)? ???? ??? ? ????? ?? ?? ???? ??? ?? ???. (4) ?? ??? ????, ???, ??? ???? ?????. ????? ???? ??? ???? ???? ????? ??? ??? ??? ? ??? ???? ? ????? ??? ????, ???? ??? ?? ? ? ?? ??? ???? ???? ????, ??? ??? ??? ?? ??? ??? ??? ???? ????? ??? ??? ???? ????. (5)?? ??? ?? ??? ?? ? ????? ?? ???? ??? ?? ? ?? ??????, ??? ? ??? ?? ? ?? ??? ??? ? ???, ????, ??? ??? ???.
- 10. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) (6) ? ?? ?? ??? ? ???? ??? ??? ???? ?????? ??????, ?? ??? ???? ?? ? ????? ?? ???? ? ????? ???? ?? ???? ??? ?? ?? ??? ??? ????????. ?? ?? ? ?? ???? ? ???? ???? - 112 - 1 ????? ?? ?? ?? ??? ??? ?? ? ????? ?? ?? ??? ?? ???? ? ? ? ?? ?? ?? ???? ?? ??? ? ??? ???? ? ? ??? ??? ????? ???? ??? ??? ?? ? ????? ?? ??? ????? ??? ??? ?? ?? ???? ??? ?? ?? ?? ???? ????? ??? ? ??? ??? ???? ? ??? ? ??? ??? ? ? ??? ? ?? ??? ?? ??? ?? ??? ?? ?? ? ?? ?? ?? ?? ????? ??-?? ?? ?? ??? ????/????? ??? ?? ???? prone??? ??, ? ? ??? ??? ?? ???? ?? ?? ? ?? ??? ?? ?? ?? ?? ??? ?? ?weighted blanket? ??? ??? ???? ?? ? ?? ? ????? ???? ??? ???? ????? ? ???? ??? 2 ?? ??? ???? ?? ?? ??? ????? ??? ?? ??? ???(???) ?? ????? ? ???? ??? ?????? ? ?????? ?? ????? ??? ? ??? ????? ????? ?? ? ??? ????? ??? ???? 1? ??? ?? ?????? ? ????? 2? ?? ??? ?????? ??? ? ?????? ? ? ???? ??? ?????? ?? ?? ?? ?? ? ?? ??? ??? ??? ?? ??? ?? ? ??? ? ? ??? ??? ? ?? ??? ?? ??? ?? ????? ?? ? ?? ?? ?? ?? ????? ??-?? ?? ?? ??????? ?? ??? ????? ?? ??? ???: ? ???? ??? ?? glider bolster? ???? ??? ?? ? ??? ?? ???? ??? ??? ?? ?prone??? frog swing ?? ??? ???? ???? ?????? ?? ? ?????? ?? ??? ? ??? ?? ???? ???? ?? ?? ??? ?? ???? ???? ?therapy ball? ?? ???? ????? ? ???? ??? 3 ??? ??? ?? ?? ???? ???? ???? ?? ?? ?? ??? ????? ? ???? ??? ?????? ?? ? ??? ?? ??? ?? ??? ?? ???? ?? ??? ?? ??? ? ???? ?¡®??? ???¡¯??? ?? ? ? ??? ??? ??? ?? ???? ??? ?? ?? ? <? 2-2> ?????? ?? ? ????
- 11. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? - 113 - ??? ?? ?? ? ?? ??? ?? ?? ????? ?? ? ?? ?? ?? ???? ??? ??? ?? ??? ?? ??? ??? ???? ?????? ?? ???? ?? ? ???? ???? ??? 1 ?? ????? ?? ???? ?? ?? ????? ?? ? ???? ?? ???? ?? ??? ?? ?? ??? ??? ???? ? ?? ????? ?? ? ????? ?? ??? ??? ?? ??? ??? ??? ??? ?? ? ?? ????? ??? ??? ?? (heavy work) ? ?? ?? ?? ??? 4 ?? ??? ?? ?? ???? ???? ?? ???? ? ? ? ??? ?? ??? ??? ?? ?? ????? ?? ?? ??? ????? ??? ?? ???? ? ????? ??? ? ?? ???? ?? ??? ? ?? ????? ??? ??? ????? ??? ? ?????? ?? ?? ?? ?? ? ??? ?bolster swing? ???? ?? ?? ?? ?? ????? ???? ? ? ?? ? ? ??? ???? ?? ?? ????? ?? ?? ? ????? ?? ??? ??? ?? ?? ?? ? ?? ??? ???? ?? ?? ?? ???? ?? ? ?? ?? ? ???? ? ?? ?? ?? ?? ??? ??? ? ?? ??? ??? ?? 120cm? ? 4?? ??? ? ?? ??? ???? ???? ??? ?? ????? ????? ??? ? ?? ?? ? ???: ????- ?? ? ?? ??? ??? ???? ??? ? ?12? ??? ??? ? ??? ?? ? ? ?? ???? ??? ?? ?? ? ? ???? ?? ?? ?? ?? ??? ?? ????? ???? ???? ???? ???? ??? ??? ???? ????? ????? ?? ?? ???? ??? 5 ??? (???) ?? ?? ???? ?? ??? ?? ??? ? ????, ???? ???? ???? ?? ??? ??? ? ?? ?????? ??????? ????? ?? ?? ? ??? ?? ? ?? ???, ? ? ??? ?? ? ? ? ???? ??? ?? ???? ?? ? ??? ???? ?? ?? ? ?? ???? ???? ??? ? ??? ????? ????? ???? ????? ?? ????? ? ? ?? ? ??? ???? ?? ?? ???? ??? ? ?? ??? ?? ??? ??? ? ?? ?? ?? ?? ??? ? ?? ?? ?? ????? ??-?? ?? ?? ??? ??? ??? ?1? ??? ???? ??? ? ?? ?? ?? ??? ??: 2? ? ??? ?? ???? ??? ?? ? ??? ? ?? ? ? ?? ?? ??? ? ?? ? ???? ?? ????? ??- ?? ?? ?? ??? ?? ??? ??? ??? ??? ?? ? ? ???? ??? ?? (heavy work) ? ?? ?? ?? ???
- 12. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) - 114 - 6 ???? ?? ?? ???? ?? ??? ??, ?? ?? ??? ??? ??????? ? ???? ??????? ? ?? ?? ? ?? ?? ??? ?? ?? ?????? ?? ? ???? ???? ? ?: ?? ?? ???, ??? ? ?? ?? ?? ? ? ???? ??? ? ?? ?? ??? ???? ???? ? ???? ?????? ?? ????? ? ???? ? ? ?? ???? ?? ?? ???? ?? ? ?? ?? ? ? ??? ?? ??? ???(???, ??)? ???? ??? ?? ??????? ?? ??? ?? ? ?? ??? ??? ?? ? ?: ??? ? ????, ??? ?? ????? ??: ??? ? ????? ?? ??, ?? ? ???? ???? ????? ? ???? ?? ?? ??? ? ??? ?? ?? ?? ?? ???? ?? ?? ??? ?? ???? ??? ?? ???? ?? ????? ???? ???? ???? ??? ?? (heavy work) ? ?? ?? ?? ??? ??????? ???? 7 ?? ?? ?? ?? ???? ? ???? ???? ???? ????? ? ? ???? ?? ???? ???? ?? ?? ??? ????? ?, ???? ?? ???? ??? ??? ??? ?? ?? ?? ??? ?, ???? ?? ? ?? ??? ????? ??-?? ?? ?? ??? ??? ? ???? ?? ?? ???? ?? ?? ??? ?prone ??? ??? ??, ? ??? ?????? ???? ? ?? ???? ??? ?? ??? ??? ??? ? ???? ?? ?? ???? ?? ?? ????? ?? ??? ?? ?therapy ball? ?, ??, ?? ???? 10?? ?? ????? ??? 8 ?? ?? ???? ?? ?? ????? ???? ???? ? ? ??? ?????? ?? ??? ?? ????? ??? ?? ???? ?? ?? ? ? ? ? ?? ???? ??? ?????? ??? ? ?? ????? ??? ??? ?? ?? ??? ??? ?? ??? ??? ???? ?? ? ? ??? ??? ? ?? ??? ?? ??? ?? ?? ?flexor swing ?? ? ???? ? ? ? ??? ??? ? ?? ??? ? ??? ?? ??: ??? ? ??? ?, ??? ??? ??? ?????? ?? ? ?? ?? ?? ?? ?? ??? ?? ?? ?? ???? ? ????, ??? ?? ?? ???? ?? ? ?? ?? ? ? ??? ?? ??? ?therapy ball? flexor swing ? ???? ?? ?? ?? ? ???? ?? ????: ball? ?? ? ????? ??? ??? ?ball, ????? ? flexor swing???? ???? ?? ?? ??? ?? ??? ?? ?? ???? ?? ???? ??? ??? ??? ?? ?? ?? ?????? ?? ? ?? ?? ?? ?? ?? ????? ?? ?? ???? ? ?? ??, ??? ?? ?? ??? ?? ???? ?? ??, ??? weighted blanket??? ??? ??? ?? ? hide-out ? ? ??? ?? ????? ? ???? ???
- 13. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? ??? ?? ???? ????? ?? ?? ??? ????? ? 20? ??? ?? ??? ??, ?? ??? ?? ???? ?? ?? ? ?? ?? ? ?? ?? ???, ?? ? ?? ??? ?? ??? ?? ?? ??? ?? ??? ?? ?therapy ball, ??, ??, ?? ? ? ??? ???? ??? ? ?? ??? ?? ??? ? ????? ?? ??? ??? ? ???? ??? ????? ???? ???? ???? ????? ?? ???? - 115 - 9 ??? ???? ??? ?? ? ?? ?? ????? ? ?-?? ? ? ?? ????? ?? ?? ????? ?? 5. ???? ?? ?? ??? ???? ? ???? ????? ??? ??? ?? ??? ?????, ??? ???? ?? ?? ??? ????? ??? ???? ?? ???? 2? ?? ??? ??? ??????? ?? ? ?? ???, ???? verbal cue? ??? ????? ???? ?? ?? ?? ????? ??? ??? ??? ????? ?? ?? ????? ?? ?? ???? ? ?? ??, ??? ?? ?? ????(body scheme) ?? ??? ?? ??????? ???? ??? ?? ??? Tetrax? ????? ??? ???? ??? ?????? ?? ????, MWCT? ????? ?? ??? ? ????? ????? ?????. ?? ??? ??? 4?? ???? ???? ??????? ??? Excel 2003? ???? ???? ?????. ?? ??? ? ???? ???? ???? ? ??? ?????(Ottenbacher, 1986). ¢ó. ?? ?? 1. ??????? ?? ?? ??? ?? ??? ????? ??? ??????, NO? NC, PO? PC? ???? ? ????. ?? NO? ? ??? ?? ??? ???1(22.91¡À2.39?)? ?? 1(22.03¡À6.32?)? ??? ???? ???, ???2(23.99¡À4.03?)?? ? ??1 ??? 1? ?? ?????? ??2(16.11¡À6.49?)? 8? ?? ?? ?? ?? ? ????? ????? ?????? ??????? ??? ?? ??? ?????? ? ? ???<?? 3-1>. NC? ? ??? ?? ???
- 14. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) ???1 ??? ?? ???? ??????? ??? ???? ????? ? ??? ???1(37.1¡À8.92?)?? ??2(28.31¡À10.24?)?? ?? ??? ? 9??? ????? ????? ????? ? ? ???. PO? ? ??? ?? ??? ???1(27.16¡À6.77?)? ???2(27.09¡À 5.66?)? ??????, ??1(23.50¡À1.67?)? ??2(20.54¡À7.88?)?? ? ???? ????? ??? ??? ?? ??? ?? ??? ???? ? ? ???<?? 3-2>. PC? ??? ?? ??? ???1(49.14¡À42.66?) ?? ? ??1(39.13¡À14.41?)? ?? ?? ??????, ???2(40.21¡À12.78 ?)???? ?? ?????? ??2(32.27¡À13.69?)? ???1? ???? 17? ?? ???? ??????? ?? ????? ?????, ?? ?? ? ?? ?? ??? ?? ??? ?????? ? ? ???. ? ??? ???? ????? ??? <?? 3-1>? <?? 3-2>? ??. ??? 1 ?? 1 ??? 2 ??2 20 I ~ I ',",'" ¡¢I ¡® r! _________ | NC??| <?? 3-1> NO? NC ????? ?? ?? - 116 - 5C ? 4C ? ?? tl~-~r~~.r-_ :- .....¡¢ - ¡¢/ ?? ? -c _ ¦Ó ? .. ... ? / 1-- N¡£?? T< ?O I 0 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 ??
- 15. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? <?? 3-2> PO? PC ????? ?? ?? 2. ??????? ?? ???? ?? ???? MWCT? ????? ?? ??? ???? ??????, ? ??? ??? <?? 3-3>? <?? 3-4>? ??. ????? ??? ??? 1(279¡À9.89?)? ???? ??1(145.7¡À4.16?)? ??? ??????, ? ??2(131.8¡À19.31?)???? ??1(87¡À14.97?)??? ???? ???? ? ??? 14? ??? ???2? ??2 ??? 55? ??? ??? ?? ??? ? ? ???. ?? ??????? ????? ? ???? ? ?????? ?? ??. ?? ??? ??? ???1(58¡À1.41?)? ??2(60?)? ????? ? ?? ??? ??? ?? ??????? ??? ??? ?? ???? ??2 ?? ? ?? ?? ???? 60? ??? ?? ??? ???? ?????? ? ? ? ??. - 117 - ?? """= ?? ??? 1 ??1 ???2 ??2 ? 00 ~U 60 40 ? ? ? ? ?¡¹ ?g < T 20 9 ?O ?? ? 2 ? 3 ? 4 ? 5 ? 6 ? 7 ?? 2 3 4 5 6 7 8 0
- 16. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) <?? 3-3> MWCT? ????? ?? ? ?? 1 ?? ¡ü ? "?2 ? ?2 <?? 3-4> MWCT? ?? ??? ?? - 118 - 60 59 g ¡£ I nm R ? ? ( 1 56 55 2 3 4 5 6 1 S 9 10 11 12 13 14 15 16 ??
- 17. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? ¢ô. ? ? ? ????? ADHD ??? ???? ??????? ???? ?? ? ??? ? ?? ??? ????? ???. ?????? ?? ?? ??? ??? ??? ?? ?? ??? ??? ???? ???1 ??? ??2 ? ?? 8?, 9? ??? ??. ?? pillow ?? ??? ?? ?? ??? ??? ????? ???1 ?? ? 7? ??????, pillow ??? ?? ?? ????? 17? ??? ???. ? ?? ????? ???? ?? ??? ? ???? ???? ????, ?? ?? ??? ?? ??? ?? ?? ??? ?????? ????. Zang ?(2002)? ??? ??? ?? ?? ??? ??? ??? ?? ?? ??? ????? ?? ?? ??? ??? ???, ?? ?? ??? ??? ??? ?? ?? ? ??? ?? ?? ?? ??? ??? ??, pillow ?? ??? ?? ? ????? ?? ??? ?? ??? ??? ??? ??. ?? ??? ??? ??? ??? ?? ? ??? ???, ????? ??? ??? ??? ????? ?? ?? ??? ?? ??? ????(Fisher ?, 1991). ??? ??????? ?? ?? ? ? ???? ?? ?? ??? ????, ????? ???? ? ??? ?? ??? ??????? ???? ??? ???? ??? ? ??. ?? ??? ????? ???(1992)? 2?? ?????? ??????? ??? ?? ?? ?? ??? ???? ??? ?????? ????, ??? (2004)? ???????? ???? ????? ??? ?? ??? ???? ? ??? ??? ?? ??? ??? ?????? ???. ???(2005)? ?? ??? ?????? 20?? ???? ? 30?? ??????? ??? ? ?? ??? ???? ??????, ?? ????? ??, ? ? ??, ? ?? ??? ?? ?? ?? ???? ??? ???. ??(2007)? ???? ??????? ? ???? 3?? ???? ???? ??????? ? ?? ? ? ?? ??? ??? ? ??? ??? ?? ??????? ??? ? ?? 1.4~2.5%? ??? ? ?? ?? ???? ????? ?? 54~82%? ???? ?? ?????? ? ?? ???? ???? ?????? ?????. ??? ???(2003)? ? ????? 3??? ??????? 30? ??? ? ?????? ?????? ? ????? ??? ?? ?? ?? ?? ??? ?? ?? ?? ???? ??? ???? ?? ? ?????? ???? ???. Stonefelt & Stein(1998)? ADHD ? ADD? ???? ??? ??? ?? ???? ???? ????? ?? ???? ?? ???????? ?? ????? ???? ??????? - 119 -
- 18. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) ??? ?? ???????? ? 88%? ????? ?? ???? ????? ?? ?????, ??? ???? ????? ??? ?? ?? 88%? 72%? ???? ??????? ????. ??? ?????? ? ????? ??? ? ????? ????? ???? ????. ADHD ??? ?? ??, ?? ??, ??? ??? ??? ?? ?? ??. ??? ??? ??? ?? ??? ???? ??? ??? ???? ??? ? ??, ?? ? ?? ??? ???? ???? ??? ??(Aranha, 2006). ? ? ??? ??? ?? ?? ? ???? ????, ADHD ??? ??? ?? ? ???(Harvey & Reid, 2003), DSM-¢ô(Diagnostic and Statistical Manual)? ?? ???? ???? ?? ??. Zang? ???(2002)? ??? ???? ??? ?? ADHD ?? ?? ??? ??? ??? ??? ???? ??, Iwanaga ?(2006)? ADHD ??? ?? ???? ?? 46?? ??? ? ????, ??, ?? ??? ??? ??? ?? ?? J-MAP(Japanese version of the Miller Assessment for Preschoolers)? ???? ??? ? ?? ??? ?? ???? ?? ??? ?? ??? ??, ????, ?? ?? ????, ???? ?? ????? ?????. ?? ADHD ??? ??? ?? ? ?? ??? ???? ??? ????, ADHD ??? ?? ??? ? ??? ????? ???? ? ???? ???? ??? ????(Piek & Dyck, 2004) ??????? ?? ??????? ????? ?? ??? ? ???? ????? ??. ?? ADHD ??? ??? ???? ???? ?? ?? ??? ?? ?????? ????? ??? ???? ?? ???? (Blondis, 1999). ??? ???? ????? ??? ?? ?? ????? ??? ???1? ???? ??1 ? ??? ?????. ?? ???2 ???? ??2 ? ???? ? ?? ?? ???? ??????? ?? ???? ???? ?? ??? ?? ???? ? ? ??. ?? ??? ??? ???1?? ??2 ?? ?? ???? ? ??????, ?? ??? ??? ?? ??????? ??? ??? ??? ????. ??? ???? ??? 60?? ???? ? 57?? ??? ??? ? ??? ?? ?? ??? ????. ??? ??2 ??? ??? ?? ?? ??? ? ??? ?? ??? ???? ???1, 2???? ?????? ? ? ???. ???? ?? ??? ????? ???? ??? ??? ????. ?? ?? ? ??? ???? ???? ??? ?? ??? ????? ??, ????? ??? ???? ?? ?? ???? ???? ??? ?? ???? ???? ????? ??? ?? ? ????? ??? ??(Kranowitz, 1998). ??? - 120 -
- 19. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? ??????? ?? ???? ???? ??? ?? ? ????? ??? ? ? ? ????? ??? ????? ??????, ?????? ???? ? ?? ????, ????? ?? ????? ?????? ????. ???(2003)? ???? ?? 3??? ???? ????? ??? ??? ? ??????? ??? ??, ??? ???? ???? ???? 7~16?? ? ?????, ?? ???? ??? ??? ?????? ?????. ? ?? ?(2005)? ???? ?? 20?? ???? ? 24? ??????? ? ?? ??? ? ??? ????? ??? ??? ???? ?? ? ????? ?? ???. Sheda & Ralston(1997)? ADHD ???? ????? ??? ?? ? ??? ?? ?? ? ?? ??? ???? ??????, ?? ??? ?? ? ??? ??? ?? ??? ???? ???? ???? ? ?? ??? ? ? ???? ?????. ?? ????? ADHD ???? ??????? ? ?? ?? ?? ??? ???? ??? ?????, ???? ??? ????, ?? ? ????, ??? ? ???? ?????? ??(Stratton & Gailfus, 1998). Linderman & Stewart(1999)? ??? ???? ?? 2?? ??? ? ?????? ??? ???? 15? ??????? ? ?? ??? ??? ? ??? ???? ???, ???? ??? ??????, ??? ??? ?? ? ??? ?????? ???. ???? ADHD? ???? ????? ?? ????? ??????? ??? ? ??? ????? ?? ?????? ? ??? ?? ??? ??? ???????, ??? ???? 88%, ???? 57%? ??? ??? ??????? ????(Stonefelt & Stein, 1998). ? ? ?? ??? ??????? ?? ADHD ??? ???? ?????? ? ??? ? ????? ???? ????. ? ????? ?? ??? ?? ? ??? ?? ???? ?????? ? ???? ??? ???. ?? ??? ?? ?? ?? ??? ?? ????? ????? ?? 3?? ???? ?? ?? ??, ??? ?? ?????? ? ?. ?? ?? ?? ? ??? ???? ??? ???? ??? ??????, ????? ???? ?? ???? ?? ?? ????? ?????. ??? ??????? ?? ??? ???, ?? ??, ?? ??? ?? ??? ?? ??? ??? ???? ?????? ?? ???(Roley, Blanche, & Schaaf, 2001)??? ??? ??? ???? ????. ?????? ??? ?? ? ?? ??? ??? ???(McIntosh ?, 1999), ??? ????? ??? ? ?? ???? ??? ??? ??? ??(Schaaf ?, 2003). ??? ? ??? ???? ?? ??? ?????? ?? ????? ?? ?? ??? ? ? - 121 -
- 20. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) ???? ????? ??? ?? ?? ??? ???? ??? ? ??. ? ??? ??? ???? ?? ADHD ??? ??? ???, ????, ??? ?? ???? ?? ?? ??? ???? ???? ??????? ?? ADHD ??? ???? ??? ?? ??? ?????. ?? ADHD ??? ????? ?? ? ??????? ??? ?? ??? ????? ??? ??? ????. ?? ??????? ADHD ??? ??? ??? ???? ??? ???? ?? ? ? ???. ??????? ??, ?? ? ????? ???? ??? ??? ?, ???? ?????, ??? ?? ??? ???? ???? ?? ????? ??? ? ?? ??? ??????. ?? ? ??? ?? ???? ??? ? ? ?? ? ???? ?????? ??? ????? ????? ????? ???? ?? ?? ?? ?????. ?? ? ??? ??? ABAB ???? ?? ??? ?? ??? ??? ???? ?????, ??? ?????? ? ?? ????? ? ? ???. ?? ?? ???? ???? ??? ??? 2 ?? ???? ??? 2?? ??? ??? ? ??? ???? ???? ?? ? ??? ??????, ?? ???? ??? ???. ? ??? ???? ???? ??, ???1 ??? 2~3??? ?? ??? ????? ????. ??, ???? ??? ? 1? ???? ??? ???? ???? ???? ???1?? ??2?? ????? ???? ??? ??? ??????? ???? ??? ???? ????? ???? ???. ??, ?? ? ???? ?? ??? ????? ??? ??? ? ???? ???? ???? ?? ??? ?2???? ?? ??? ???? ???? ????. ??, ????? 1???, ????? ???, ?? ? ??? ??? ?? ? ?? ??? ??? ??? ????? ?? ????. ??? ?? ????? ????? ???, ?? ??? ?? ????, ?? ??? ????? ??, ?? ADHD ??? ??? ???? ??? ?? ? ?-?? ?? ? ?? ??? ???? ????? ??? ??. ¢õ. ? ? ? ??? ??????? ?? ADHD ??? ?? ? ??? ?? ??? ?? ??? ???. ? ??? ??? ??? ??. ??, ??? ?? ??? ???1? ???2 ??? ???? ??1 ? ??2 ??? ?? ?????. - 122 -
- 21. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? ?? ??? ???? ??? , 1?? ??2 ???? ????? ???? ??? ? ??????? ??? ???? ????, ???2 ???? ??2 ???? ? ?? ??? ? ??? ??????? ??? ??? ???? ??? ???. ??? ??? ?? ??????? ADHD ??? ?? ??? ?????, ? ?? ???? ???? ??? ???? ? ? ???. ? ??? ADHD ??? ??? ????? ???? ?? ???? ???? ???? ??????? ? ?? ??????, ???? ??? ?? ???? ?????. ??? ?? ?? ?? ?? ?? ????? ?? ???????? ???? ???? ???? ? ?? ? ????? ????? ? ???. ? ? ? ? ??? (2005). ??????? ??????? ??? ??? ???? ? ?? ??? ??? ??. ??? ???? ??, ?????. ??? (2004). ???? ????? ??????? ??? ? ?????? ?? ??? ??? ??. ??? ???? ??, ?????. ??? (2003). ??????? ?????? ????? ?????? ??? ??. ??? ???? ??, ?????. ??? (2003). ???? ??? ?????? ???? ??? ??? ??. ? ?? ???? ??, ?????. ??? (2005). ??????? ??????? ?????? ??? ??. ??? - 123 - ???? ??, ?????. ??? (1992). ??? ??? ?????? ????? ?? ??????? ?? ????? ??. ??? ???? ??, ?????. ?? (2007). ??????? ??????? ??????? ??? ??. ??? ???? ??, ?????. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders(4th Ed.). Washington DC: American Psychiatric Association. Amieva, H., Lafont, S., Dartigues, J. F., & Fabrigoule, C. (1999). Selective attention in Alzheimer¡¯s disease: Analysis of errors in Zazzo¡¯s Cancellation Task. Brain and Cognition, 40, 26-29.
- 22. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) Aranha, K. M. (2006). A comparison of postural control: typically developing children VS. children with ADHD. Master thesis, Texas Tech University. Ayres, A. J. (1972). Sensory Integration and Learning Disorders. Los Angeles: Western Psychological Services. Ayres, A. J. (1979). Sensory Integration and the Child. LA: Western - 124 - Psychological Services. Barkley, R. (2003). Attention-Deficit/Hyperactivity Disorder.(2rd). IN E. Mash & R. Barkley(Eds.), Child Psychopathology(pp. 75-143). New York: Guilford Press. Blondis, T. A. (1999). Motor disorders and attention-deficit/hyperactivity disorder. Pediatric Clinical North American, 46, 899-913. Brown, R. T., Freeman, W. S., Perrin, J. M. (2001). Prevalence and assessment of attention deficit/hyperactivity disorder in primary care settings. Pediatrics, 107, 43. Bush, G., Eve, M., Valera, & Seidman, L. J. (2005). Functional Neuroimaging of Attention-Deficit/Hyperactivity Disorder: A Review and Suggested Future Directions. Biology Psychiatry, 57, 1273-1284. Casco, C., Tressoldi, P. E., & Dellantonio, A. (1998).Visual selective attention and reading efficiency are related in children. Cortex, 34, 531-546. Dawes, S. E. (2000). The Mesulam and Weintraub Cancellation Test: Australian normative data and clinical utility. Brisbane: University of Southern Queensland. DeGangi, G. A. (2000). Pediatric Disorders of Regulation in Affect and Behavior: A Therapist¡¯s Guide to Assessment and Treatment. San Diego, CA: Academic Press. Dunn, W., Bennett, D. (2002). Patterns of sensory processing in children with attention deficit hyperactivity disorder. The Occupational Therapy Journal of Research, 22(1), 4-15. Durston, S. (2003). A review of the biological bases of ADHD: What have we learned from imaging studies? Mental Retardation Development Disability Research Review, 9, 184-195. Ernst, M., Liebenauer, L. L., King, A. C., Fitzgerald, G. A., Cohen, R. M., &
- 23. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? Zametkin, A. J. (1994). Reduced brain metabolism in hyperactive girls. Journal of American Academic Child Adolescent Psychiatry, 33, 858-868. Fisher, A., Murray, E. A., Bundy, A. C. (1991). Sensory integration: Theory and practice. Philadelphia: F.A. Davis Company. Geldmacher, D. S., & Reidel, T. M., (1999). Age effects on random-array letter cancellation tests. Neuropsychiatry, Neuropsychology, and Behavioral Neurology, 12, 28-34. Guo, P., Guo, H., Yang, C. H. et al. (1999). Sensory Integration Therapy on Attention Deficit Hyperactivity Disorder. Chinese Journal of Behavioral Medical Science, 8, 306-306. Harvey, W., & Reid, G. (2003). Attention-Deficit/Hyperactive Disorder: A review of research on movement skill performance and physical fitness. Adapted Physical Activity Quarterly, 20, 1-25. Hern, K. L., & Hynd, G. W. (1992). Clinical differentiation of the attention deficit disorder subtypes: Do sensorimotor deficits characterize children with ADD/WO? Archives of Clinical Neuropsychology, 7, 77-83. Iwanaga, R., Ozawa, H., Kawasaki, C., & Tsuchida, R. (2006). Characteristics of the sensory-motor, verbal and cognitive abilities of preschool boys with attention deficit/hyperactivity disorder combined type. Psychiatry and Clinical Neurosciences, 60, 37-45. Jensen, P. S., Mrazek, D., Knapp, P. (1997). Evolution and revolution in child psychiatry: ADHD as a disorder of adaptation. Journal of American Academy of Child and Adolescent Psychiatry, 36, 1672-1679. Kapczinski, F., Curran, H. V., Przemioslo, R., Williams, R., Fluck, E., Fernandes, C., & File, S. E. (1996). Cognitive impairments of alcoholic cirrhotic patients: Correlation with endogenous benzodiazepine receptor ligands and increased affinity of platelet receptors. Journal of Neurology, Neurosurgery and Psychiatry, 60, 676-680. Kranowitz, C. (1998). The out-of-sync child: recognizing and coping with sensory integrative dysfunction. New York: The Berkley Publishing Group. - 125 -
- 24. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) Lauer, C. J., Gorzewski, B., Gerlinghoff, M., Backmund, H., & Zihl, J. (1999). Neuropsychological assessment before and after treatment in patients with anorexia nervosa and bulimia nervosa. Journal of Psychiatric Research, 33, 129-138. Leung, A. C., Robson, L. M., Fagan, J. E., Lim, S. N. (1994). Attention-deficit hyperactivity disorder: Getting control of impulsive behavior. Postgraduate Medicine, 95(2), 153-160. Lezak, M. D. (1995). Neuropsychological Assessment (3rd edn.). New York: Oxford University Press. Linderman, T. M., & Stewart, K. B. (1999). Sensory integrative based occupational therapy and functional outcomes in young children with pervasive developmental disorders: A single-subject study. American Journal of Occupational Therapy, 53, 207-213. Mangeot, S. D., Miller, L. J., McIntosh, D. N., McGrath-Clarke, J., Simon, J., & Hagerman, R. J., et al. (2001). Sensory modulation dysfunction in children with attention deficit hyperactivity disorder. Developmental Medicine & Child Neurology, 43, 399-406. McIntosh, D. N., Miller, L. J., Shyu, V., & Hagerman, R. J. (1999). Sensory modulation disruption, electrodermal responses, and functional behaviors. Developmental Medicine & Child Neurology, 41, 608-615. McKenzie, A. L., Nagarajan, S. S., Roberts, T. P. et al. (2003). Somatosensory representation of the digits and clinical performance in patients with focal hand dystonia. American Journal of Physical Medicine Rehabilitation, 82, 737-749. Mulligan, S. (1996). An analysis of score patterns of children with attention disorders on the Sensory Integration and Praxis Tests. American Journal of Occupational Therapy, 50, 647-654. Nikharge, T., Mulgaonkar, K. P. (2002). Attention deficit hyperactive disorder: a sensory perspective. The Indian Journal of Occupational Therapy, XXXIV(2). Ottenbacher, K. (1986). Evaluating clinical change: Strategies for occupational and physical therapists. Baltimore: Williams and Wilkins. - 126 -
- 25. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? Piek, J. P., Pitcher, T. M., & Hay, D. A. (1999). Motor coordination and kinaesthesis in boys with attention deficit hyperactivity disorder. Developmental Medicine & Child Neurology, 41, 159-165. Piek, J. P., Dyck, M. J. (2004). Sensory-motor deficits in children with developmental coordination disorder, attention deficit hyperactivity disorder and autistic disorder. Human Movement Science, 23, 465-488. Pitcher, T. M. (2001). Motor performance and motor control in children with subtypes of attention deficit hyperactivity disorder. Unpublished Doctoral Dissertation, Curtin University of Technology. Prudhomme White, B., & Mulligan, S. E. (2005). Behavioral and physiologic response measures of occupational task performance: A preliminary comparison between typical children and children with attention disorder. American Journal of Occupational Therapy, 59, 426-436. Roley, S. S., Blanche, E. I., & Schaaf, R. C. (2001). Understanding the nature of sensory integration with diverse populations. Austin: pro?ed. Schaaf, R. C., Miller, L. J. (2005). Occupational therapy using a sensory integrative approach for children with developmental disabilities. Mental Retardation Development Disability Research Review, 11, 143-148. Schaaf, R. C., Miller, L. J., Seawell, D., & O¡¯Keefe, S. (2003). Children with disturbances in sensory processing: A pilot study examining the role of the parasympathetic nervous system. American Journal of Occupational Therapy, 57, 442-449. Sheda, C. H., Ralston, P. R. (1997). Sensorimotor processing activity plans. San Antonio: Therapy skill builders. Stonefelt, L. L., Stein, F. (1998). Sensory integrative techniques applied to children with learning disabilities: an outcome study. Occupational Therapy International, 5(4), 252-272. Stratton, J., Galifus, D. (1998). A new approach to substance abuse treatment: Adolescents and adults with ADHD. Journal of Substance Abuse Treatment, 15(2), 89-94 Teicher, M. H., Anderson, C. M., Polcari, A. et al. (2000). Functional deficits in basal ganglia of children with attention-deficit/hyperactivity - 127 -
- 26. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) disorder shown with functional magnetic resonance imaging relaxometry. National Medicine, 6, 470-473. Whitmont, S., & Clark, C. (1996). Kinaesthetic acuity and fine motor skills in children with attention deficit hyperactivity disorder: A preliminary report. Developmental Medicine & Child Neurology, 38, 1091-1098. Zang, Y., Bomei, G., Qian, Q., & Wang, Y. (2002). Objective measurement of the balance dysfunction in Attention Deficit Hyperactivity Disorder in Children. Chinese Journal of Clinical Rehabilitation, 6, 1372-1374. - 128 -
- 27. ??????? ????? ? ?????? ??? ?? ? ???? ??? ?? - 129 - <Abstract> The Effects of Sensory Integrative Intervention on the Balance and Attention of Children with Attention Deficit Hyperactivity Disorder: Single-Subject Research Design Kim, Kyeong Mi?Kim, Jin Mi The purpose of this study is to verify the effects of Sensory integrative intervention on the balance and attention of children with Attention Deficit Hyperactivity Disorder(ADHD). The subject is a boy diagnosed with ADHD, who is 7 years and 6 months old and a second grader in an elementary school in P city. A single subject ABAB design was used for this study. The procedure consisted of 3 times of baseline 1 phase(A), 3 times of treatment 1 phase(B), 5 times of baseline 2 phase(A') and 6 times of treatment 2 phase(B'). The baseline phases involved no treatment, but during the treatment phases sensory integrative intervention was conducted. The balance ability was measured by Tetrax and the attention by Mesulam and Weintraub Cancellation Test(MWCT). According to this study, the subject¡¯s balance ability was improved in the phases of treatment 1 and 2 better than in the phases of baseline 1 and 2. The attention of subject was constantly increased throughout the whole phases. But compared with that in the baseline 2 phase, the attention in the treatment 2 phase was boosted strikingly. Therefore, this study showed that sensory integrative intervention provided positive treatment effects on the improvement of the balance and attention of the subject with ADHD. Furthermore, this study supported the effectiveness of sensory integrative intervention by dealing with the attention problem and the motor aspects at the same time and helped the caregiver to increase awareness of the child with ADHD. But this study has some limitations in that it is somewhat difficult to generalize owing to the insufficient number of the subject and the short period of
- 28. ÌØÊ├ÓýÔÙ»î¿ÆŒW³x¾¿(µÚ46¾íµÚ4Ì–) the experiment. Therefore, the future research should be done more extensively with the consideration of these aspects. Key Words : sensory integrative intervention, ADHD, balance, attention ???? : 2007. 11. 3 / ??? ?? : 2007. 12. 7 / ?? ?? : 2007. 12. 14 - 130 -