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Yıl:2009; Cilt: 20; Sayı: 2>> Özet
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Türk Psikiyatri Dergisi; 2009;20(2):105-117
Otistik Bozukluk ve Gelişim Geriliğinde Bağlanmaya Yönelik Sosyal Davranışların Karşılaştırılması
D Akdemir, B Pehlivantürk, F Ünal, Ş Özusta
Hacettepe Ü. Tıp Fak. Çocuk Psikiyatrisi ABD
Amaç: Bu araştırmada otistik bozukluk tanısı konan çocuklarda bağlanma ile ilişkili sosyal davranışların olup olmadığı ve bu davranışların gelişim geriliği olan çocuklara göre farklılık gösterip göstermediği incelenmiştir. Bu davranışlar ile yaş, bilişsel gelişim, otizmin şiddeti, dil gelişimi ve annenin kendi bağlanma stili gibi klinik değişkenler arasındaki ilişkinin de değerlendirilmesi amaçlanmıştır. Yöntem: Araştırma grubu otistik bozukluk tanısı konan, yaş ortalaması 37.9 ± 6.8 ay olan 19 çocuktan; kontrol grubu ise otistik bozukluk tanısı konmayan, yaş, cinsiyet ve zeka düzeyi açısından araştırma grubu ile eşleştirilmiş, gelişim geriliği bulunan 18 çocuktan oluşmuştur. Çalışmaya katılan tüm çocuklara iki çocuk psikiyatristi tarafından Çocukluk Otizmi Derecelendirme Ölçeği (ÇODÖ) uygulanmıştır. Anneler İlişki Ölçekleri Anketi (İÖA) doldurmuşlardır. Çocukların bilişsel gelişimi Stanford-Binet zeka ölçeği ile değerlendirilmiştir. Araştırmaya katılan tüm çocuklarda bağlanma davranışları Yabancı Durum Testi'nin (YDT) uyarlanmış şekli ile belirlenmiştir. Bulgular: Otistik bozukluğu olan çocukların gelişim geriliği olan çocuklara benzer şekilde bağlanma davranışları gösterdikleri, gelişim geriliği olan çocuklardan farklı olarak yabancıya göre annelerine daha yakın durdukları saptanmıştır. Otistik bozukluk grubunda bağlanma davranışları yaş, zeka puanı ve annenin kendi bağlanma stili ile ilişki göstermezken, otizmin şiddeti ve dil gelişimi ile anlamlı ilişki göstermektedir. Sonuç: Otistik bozukluğu olan çocuklardaki bağlanma gereksiniminin ve bağlanma davranışlarının, hastalığın erken döneminde anne babaları tarafından doğru bir şekilde yorumlanması, bu çocukların güvenli bağlanma ilişkileri kurmalarını arttırarak sosyal gelişimlerine katkıda bulunabilir.
Comparison of Attachment-Related Social Behaviors in Autistic Disorder and Developmental Disability
Objective: This study examined social behaviors related to attachment in children with autistic disorder and the differences in these behaviors from those observed in developmentally disabled children. Additionally, we aimed to investigate the relationship between attachment behaviors and clinical variables, such as age, cognitive development, severity of autism, [language] development, and mothers' attachment styles. Method: The study group consisted of 19 children with autistic disorder (mean age: 37.9 ± 6.8 [month]s) and the control group consisted of 18 developmentally disabled children without autistic disorder that were matched with respect to age, gender, and cognitive development. The Childhood Autism Rating Scale (CARS) was administered to all the children by two child psychiatrists. Mothers completed the Relationships Scale Questionnaire (RSQ). Cognitive development of the children was assessed with the Stanford-Binet intelligence scale. Attachment behaviors of the children were evaluated with a modified Strange Situation Procedure (SSP). Results: Attachment behaviors in the children with autistic disorder and in the children with developmental disabilities were similar. In contrast to the developmentally disabled group, the children with autistic disorder stayed closer toward their mothers compared with their responses to strangers. In the autistic disorder group, attachment behaviors were not associated with age, intelligence quotient, or mothers' attachment styles; however, a significant relationship between the severity of autism and the presence of speech was observed. Conclusion: Parents' understanding of the attachment needs and the attachment behaviors of their autistic children in the early stages of the disorder may lead to more secure attachment relationships and improved social development.

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