تأثير آموزش تمرين‌هاي جسمي و حركتي ازطريق شبكه‌هاي اجتماعي تلفن همراه به مادران كودكان مبتلا به اختلال طيف اوتيسم بر بهبود رفتارهاي قالبي كودكان

The Effects of Physical and Motor Exercise Training by Mobile Social Networks to the Mothers of Children With Autism Spectrum Disorder on Improving Children's Patterned Behaviors

زمينه و هدف: علم تغيير رفتار را مي توان پدر درمان هاي اختلال طيف اوتيسم ناميد؛ زيرا استفاده از اين شيوهٔ درماني بسياري از رفتارهايي را بهبود مي دهد كه به طور مشخص با فعاليت ها و تمايلات تكراري، همراه با تعصبات يا گرايش هاي غيرعادي در كودكان با اختلال اوتيسم مرتبط اند. هدف از پژوهش حاضر مطالعهٔ تأثير آموزش تمرين هاي جسمي و حركتي از طريق شبكه هاي اجتماعي تلفن همراه به مادران كودكان مبتلا به اختلال طيف اوتيسم بر بهبود رفتارهاي قالبي اين كودكان بود. روش بررسي: روش پژوهش نيمه آزمايشي با طرح پيش آزمون-پس آزمون و گروه گواه بود. جامعهٔ آماري پژوهش را تمامي مادران كودكان مبتلا به اختلال طيف اوتيسم شهرهاي رباط كريم و پرند در سال 1397 تشكيل دادند. نمونهٔ آماري پژوهش 30 مادر داراي كودك با اختلال طيف اوتيسم بودند كه به شيوهٔ نمونه گيري دردسترس برحسب شرايط ورود به پژوهش انتخاب شدند و به شكل تصادفي در گروه هاي آزمايش و گواه قرار گرفتند. پيش آزمون به كمك مقياس تجديد نظر شدهٔ رفتارهاي تكراري (بودفيش و همكاران، 2000 )انجام پذيرفت. سپس به مادران گروه آزمايش ازطريق شبكهٔ اجتماعي واتس آپ و با استفاده از فيلم ها و تصاوير مرتبط با تمرين هاي جسمي و فعاليت هاي حركتي منظم، در يك دورهٔ زماني 6 ماهه آموزش داده شد؛ درحالي كه گروه گواه هيچ مداخله اي دريافت نكرد. براي تحليل داده ها از آزمون تحليل كوواريانس چندمتغيره با سطح معناداري 0/05 به كمك نرم افزار SPSS نسخهٔ 24 استفاده شد . يافته ها: نتايج تحليل كوواريانس چندمتغيره نشان داد كه مداخلات مبتني بر تمرين هاي حركتي بر بهبود رفتارهاي كليشه اي( p=0/002) خودآزاري ( p=0/002) وسواسي ( p=0/002) محدود ( p=0/002) آييني ( p=0/004) و يكنواختي ( p=0/001 ) اثربخش است. نتيجه گيري: آموزش ازطريق تلفن همراه ميتواند به خانوادهٔ كودكان با اختلال طيف اوتيسم درجهت كاهش برخي از رفتارهاي قالبي كودك مانند رفتارهاي خودآزاري، وسواسي، آييني و يكنواختي كمك كند و سبب كاهش مشكلات مربوط به رفتارهاي قالبي در اين كودكان شود.

Background & Objectives: Autism Spectrum Disorder (ASD) is among the most prevalent disorders in the group of developmental conditions. ASD causes disabilities in various aspects, including the occurrence of patterned behaviors. In many cases, children with ASDs, for several reasons, such as distance travel to medical centers, employing family members, including the mother, with other family responsibilities, job, or taking care of other children, treatment costs, improper timing of treatment courses, etc., refrain from participating in medical activities; subsequently, they fail to receive the necessary interventions in time to improve themselves. Accordingly, information and communication technology, i.e., affected all aspects of human life, can be accessed by children. Besides, their families can be effective in providing timely interventions. Therefore, the present study aimed to investigate the effects of physical and motor exercise training by mobile social networks to the mothers of children with ASD on improving children's patterned behaviors. Methods: This was a quasi–experimental study with a pretest–posttest and a control group design. The statistical population of this study consisted of all mothers of children with ASD in Robat Karim and Parand Cities, Iran, in 2018 (N=35). The research sample consisted of 30 mothers of children with ASD who were eligible candidates and selected by convenience sampling approach according to the inclusion criteria. The study samples were randomly assigned to the experimental and control groups. The inclusion criteria were having a child with ASD with the ability to perform movement and instruction to perform motor activities, having a child in the age range of 4 to 7 years, having a mobile phone with the possibility to connect to the social networks by the mothers, the absence of other diseases, and conscious satisfaction for contributing to the research. Besides, the exclusion criteria of the study included mothers' dissatisfaction with attending the study, the inability of a child with ASD to perform movement and orderliness, and the lack of having a child in the considered age range of the study. Next, performing the pretest with the Revised Scale of Repetitive Behaviors (Budfish et al., 2000). Then, the experimental group was trained through the WhatsApp social network using videos and images related to physical activity and regular motor activity over 6 months; the videos were designed by an ASD treatment center, became short–lived files of about 3 to 5 minutes, and along with the photos of physical exercises and regular movement activities and related explanations. Accordingly, it was provided to the investigated mothers through WhatsApp and they were requested to practice with their children at home after observing how they move; however, the control group received no intervention. To analyze the obtained data, the Kolmogorov–Smirnov, Levene's, Box's M, and Wilks Lambda tests, as well as Multivariate Analysis of Covariance (MANCOVA) were used at a significance level of 0.05 in SPSS. Results: The present research results revealed that most of the mothers in both groups aged between 28 and 38 years, were married, had a diploma, and were housewives. Furthermore, a small number of them aged between 17 and 27 years, were single and employed, and their education level was between the ninth grade and less than a diploma. The MANCOVA results indicated that interventions based on motor training were effective in improving stereotypy behaviors (p=0.002), self–harm behaviors (p=0.002), obsessive behaviors (p=0.002), restricted behaviors (p=0.002), ritualistic behaviors (p=0.004), and sameness behaviors (p=0.001). The effect size for the stereotype behavior variable was equal to 0.31; the effect size for the self–harming behavior variable was calculated as 0.293; the effect size for the obsessive behavior was obtained as 0.307; the effect size for the ritual behavior equaled 0.313; the effect size for the uniformity behavior was obtained equal to 0.305; finally, the effect size for finite behavior was equal to 0.303. Conclusion: It seems that educating the family of children with ASD is effective in reducing some of the child's patterned behaviors, such as self–harm, obsessive, ritualistic, and sameness.