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ΠΡΟΓΡΑΜΜΑ ΧΡΗΜΑΤΟΔΟΤΟΥΜΕΝΟ ΑΠΟ ΤΗΝ ΕΥΡΩΠΑΪΚΗ ΕΝΩΣΗ & ΤΟ ΥΠΟΥΡΓΕΙΟ ΥΓΕΙΑΣ ΚΑΙ ΚΟΙΝΩΝΙΚΗΣ ΑΛΛΗΛΕΓΓΥΗΣ The application of systemic practice in the enhancement of adaptive behavior for people with pervasive developmental disorders: A repeated measures study. Georgia Gkantona 1 & Nicholas Paritsis² 1. Psychologist, Ph. D in School & Developmental Psychology. E-mail: gkantona@yahoo. gr 2. Professor of Psychiatry, President of Society for Systems Therapy and Intervention. E-mail: epakmosesythepas@yahoo. com
The present systemic intervention is based on the following principles of living systems development: 1. The law of experience (Ashby, 1958). The lack of stimulation leads to functioning decrease. 2. The law of over-load of information stress (Miller, 1978). Each living system has a certain ability to process information. If the environmental information is much more than the ability to process them, then there is an overload of information stress, while if the environmental information is less than the ability to process them, then there is an under-load of information stress. 3. Development through order increase (Prigogine & Stengers, 1984). The development in living systems contains order increase.
4. The law of optimal variety (Paritsis, 1992). The increase of the development rate is succeeded when the variety of environmental components is high enough so as not to cause overload of information stress. 5. The combination of variety and order in the development (Paritsis, 1993, 1999). The increase of variety and at the same time the increase of order contribute to speeding up the rate of development. This happens as the increase of order reduces the overload of information stress. Target of the study According to the above mentioned principles it is concluded that the gradual (optimal) increase of the amount and variety of stimulation in parallel with the gradual (optimal) increase of organization and order in the environment contributes to the maximization of functioning bettering. In this context, the hypothesis of the present study was the following one: An intervention based on the above principles that is applied in individuals with profound mental retardation will result in adaptive behavior improvement in a period of 6 months.
METHOD EXPERIMENTAL DESIGN Research type: Action research Repeated Measures: n Measure Α: 6 months before participants leave the institution for the boarding house n Measure Β: 1 months after moving to the boarding house n Measure C: 6 months after moving to the boarding house PARTICIPANTS Sex: 9 men and 4 women with profound/mild mental retardation and behavior problems Age: 19 – 44 years old (mean= 29, 6 years) Mean institutional care: 18, 3 years in the Child Psychiatric Hospital of Athens.
ASSESSMENT MATERIALS Vineland Adaptive Behavior Scales (Sparrow, Balla & Cicchetti, 1984) Since adaptive behavior is a composite of various dimensions, the test measures 4 domains: n The Communication Domain: It evaluates the receptive, expressive, and written communication skills. n The Daily Living Skills Domain: It measures personal behavior as well as domestic and community interaction skills. n The Socialization Domain : It assesses play and leisure time, interpersonal relationships, and various coping skills. n The Motor Skills Domain: It measures both gross and fine motor skills. (not used in this study as it is only for children) Demographic questionnaire It has 10 items that assess: sex, age, physical condition, mental state etc. PROCEDURE All assessments were conducted by the same trained psychologist who interviewed direct care staff.
RESULTS Table 1. Medians, inter-quartile ranges and Z - scores of Wilcoxon’s Signed Ranks Test in the comparison of differences between measurement A and B Domain Measurement Median Interquartile Ζ -score range Communication 16 -29 19 12 - 23 A 35 21, 5 - 44 B 25 21 -35 A 16, 5 10 - 26 B Socialization 24 B Daily Living Skills A 25 21 -35 Note: * P<0, 05, ** P<0, 01, *** P<0, 001 -0, 98 -1, 33 - 0, 98
Table 2. Medians, inter-quartile ranges and Z - scores of Wilcoxon’s Signed Ranks Test in the comparison of differences between measurement B and C Measurement Median Inter-quartile range Ζ - score 2η 19 12 - 23 1, 73 3η 25 20, 5 – 29, 5 Daily Living Skills 2η 25 21 -35 3η 36 29 - 43 Socialization 2η 25 21 -35 3η 36 29 -43 Domain Communication Note: * P<0, 05, ** P<0, 01, *** P<0, 001 -2, 41* -2, 76**
DISCUSSION n n Comparison between measurements Α and Β: Non significant differences Comparison between measurements B and C: Statistically significant differences in the domains of: Communication (receptive), Daily living skills (personal and domestic) and Socialization (community interaction skills) The above results may be due to: n n n The participants lived for a long period in an environment with small stimulation The intervention helped the participants to activate the possibilities they had. The systemic method applied was based on General Systems Theory principles and it seems that it results in adaptive functioning improvement, as was theoretically supposed (Paritsis, 1993).
Bibliography n n n n Ashby, R. (1958). An introduction to Cybernetics. Chapman and Hall, London. Miller, J. (1978). Living systems. Chapman and Hall, London. Paritsis, N. (1992). Towards a law of optimum variety. In R. Trappl (ed. ), Cybernetics and Systems Research "92", Vol. I. , World Scientific, London, pp. 35 - 40. Paritsis, N. (1993). Evolution, learning and progress of science: Αn increase in variety and order. Systems Research, 10, 4, 73 -79. Paritsis, N. (1999). The balance of variety with order: A necessity for the developing sustainable systems. International Conference of the Research Committee of Socio-cybernetics: “Problems of complexity and emergence in sustainable systems”, May 26 -31 1999, Kolimbari, Crete, Greece. Prigogine, I. & Stengers, I. (1984). Order out of chaos. Fontana Paperbacks, London. Sparrow, S. S. , Balla, D. A. , & Cicchetti, D. V. (1984). Vineland adaptive behaviour scales, interview edition, survey form manual. Circle Pines: American Guidance Service.