Notable signs observed in the growth process of “siblings" of handicapped children : their cause and mother's care of ""siblings"

本研究の目的は,障害児の母親と障害児の兄弟姉妹(以下「きょうだい」)への面接を行い,①発達の過程で「きょうだい」に見られた気がかりな徴候(以下サイン)とその原因を明らかにすること,②養育者としての母親が「きょうだい」を養育するうえで配慮してきた事柄を明らかにすることである.調査の結果,20名の母親が養育する障害児の「きょうだい」32名中12名にサインが見られた.その内10名のサインの原因が障害を持つ同胞と関係していた.その原因は,「障害児の入院付き添いによる母親不在や家族内の緊張の高まり」,「母親が障害児のことで手一杯で「きょうだい」の育児が手薄になったこと」,「きょうだいが障害児を援助する役割を担い,自分を出しにくいこと」,「友達の障害者への接し方から生じる葛藤」であった.母親が「きょうだい」を育てる上で配慮していることは,「きょうだいに意識して関わる」,「障害児ときょうだいの関係が円滑にいくように配慮する」の大きく2つに分類できた.この具体的な方法として示唆された「きょうだいとだけの時間を持つ」,「障害を持つ同胞のことをきょうだいが理解し尊重できるように配慮する」などの事柄は,障害児ときょうだいを養育する母親へのアドバイスとして有用であると思われる.また,母親が障害児と「きょうだい」を平等に扱うように配慮していても,どうしても障害児の方に母親の注意が向いてしまうこと,母親と「きょうだい」が考える平等の間にはズレが生じやすいなど,同胞が障害を持つことで難しさを伴う事柄も見受けられた。「きょうだい」の順位や障害児の能力を加味した個々の事例に応じたきめ細かな対応の必要性が示唆された.※本研究では,「きょうだい」と記した場合,障害児の兄弟姉妹を表し,同胞とした場合には障害児を表す。The purpose of this study was to elucidate anxiety symptoms (hereafter referred to as “signs") observed in the growth process of brothers and sisters of handicapped children (hereafter referred to as “siblings"), their cause, and the special attention of the mother in bringing up the siblings by interviewing handicapped children's mothers and “siblings". The results of the investigation revealed that 12 of 32 siblings of handicapped children brought up by 20 mothers showed some signs, and 10 of 12 siblings showed certain characteristics, whose causes were related to their handicapped brethren. The causes comprised the following factors : “mother's absence or increased strain in a family due to hospital attendance for the handicapped child" ; “preoccupation of the mother with the handicapped child; as a result of which childcare for the siblings became insufficient" ; “siblings bear the role of helping the handicapped children and cannot easily take an initiative for themselves ", and “conflict produced by how their friends treat the handicapped children." The special attention of the mother in bringing up the siblings is classified roughly into two categories: “communicating consciously with the siblings" and “taking care to maintain a smooth relationship between the handicapped child and the siblings." The following subjects are inferred to be effective as advice to mothers who are bringing up handicapped child and siblings: “allocate time for spending exclusively with the siblings" and “take care that the siblings understand and respect brethren who are handicapped." Moreover, cases of special difficulty were observed in relation to handicapped brethren: even if a mother takes care to treat the handicapped child and siblings equally, the mother's attention inevitably tends toward the handicapped child; alternatively, there is sometimes a gap in the concepts of equality between the mother and the siblings. Delicate care is suggested according to each case considering the order of the siblings and the potential of the handicapped child. In this study, “siblings" denotes handicapped children's sibship, while “brethren" denotes handicapped children

The Age at Diagnosis of Autism Spectrum Disorder in Children in Japan

Background. No large-scale study of the timing of autism spectrum disorder (ASD) diagnosis has been performed in Japan to date. The aim of this study was to examine sex differences and annual trends in age at diagnosis of ASD using clinical data. Methods. Clinical data for children aged less than 18 years diagnosed with ASD between January 1, 2009, and December 31, 2013, and in whom follow-up was possible 1 year after diagnosis, were extracted. Results. The mean age at ASD diagnosis was 7.2 ± 4.2 years and the mode age was 3 years. No sex difference was observed for age at diagnosis (p=0.157). An annual trend of earlier diagnosis was observed when fiscal years were compared (p<0.001). Conclusion. This study highlighted the need to develop and provide appropriate early intervention methods and services for ASD children in Japan

Development of an intervention programme for selective eating in children with autism spectrum disorder

Objective/Background: Most parents of children with autism spectrum disorder (ASD) have difficulties with the selective eating behaviour of their children. This study aimed to develop a newly designed intervention programme on improving selective eating behaviour for parents of children with ASD and evaluate its effectiveness. Methods: The participants were 23 parents of children (aged 3–6 years) with ASD. The education programme included a session that addressed approaches to improve selective eating and attitudes at meal times, with a discussion. The intervention aimed to identify the underlying factors and approaches to improve selective eating in children and the self-efficacy of parents. Results: Significant differences were observed before and after the intervention in the degree of difficulty perceived by parents, their degree of self-efficacy, the number of recommendations conducted by them, their subjective view of the degree of dietary imbalance, and the number of food items consumed by their children. Conclusion: We developed an interventional programme for parents of children with ASD and this programme was found to be useful. It is important for occupational therapists to consider the factors and approaches for selective eating in children with ASD in order to provide early intervention for their parents