발달장애인의 도전적 행동(Challenging Behavior) 완화를 위한 작업치료 중재에 대한 체계적 고찰

Abstract

Objective: This study aimed to find the effects of occupational therapy (OT) as a way to alleviate challenging behaviors for persons with developmental disabilities. Methods: Literature published from January 2000 to July 2022 was searched in Pubmed, CINAHL, ERIC, Cochrane Library, EMBASE, and RISS. The search terms were “Behavioral disturbance” OR “Problem behavior” OR “Maladaptive behavior” OR “Aberrant behavior” OR “Behavioral abnormalities” OR “Challenging behavior” AND “Occupational therapy” AND “Developmental disability” OR “Autism” OR “Intellectual disability.” Both Korean and English were used. The searched literature was systematically analyzed according to the PICO format. Results: A total of 14 papers were selected for review. Sensory therapy, play therapy, and therapeutic mediation therapy approaches were shown to be effective in alleviating challenging behaviors, but demonstrated no improvements in other functions. A cognitive learning approach and a positive behavior support approach were effective in alleviating challenging behaviors and improving the school performance. In addition, parental education was effective in alleviating the challenging behaviors in children, although there was a limit in extending the therapeutic effects on improving their daily life functions. Conclusions: It was found that various OT approaches have been used to mediate challenging behaviors. Future research should highlight the generalized effects in daily life and school performance rather than emphasizing only the mitigation of challenging behaviors.