The Process of Assisting Behavior Modification in a Child with Attention-Deficit Hyperactivity Disorder

協助一位“注意力缺陷過動症”兒童行為改善的過程

張心馨(Hsin-Hsin Chang) ； 張景盛(Ching-Sheng Chang) ； 石英鈴(Ying-Ling Shih)

《The Journal of Nursing Research》 15卷2期 (2007/06) Pp. 147-155

摘要

「注意力缺陷過動症」(Attention Deficit Hyperactivity Disorder, ADHD)是兒童常見的心理疾患。本研究在於呈現協助一位「注意力缺陷過動症」兒童行為改善的過程。個案曾接受一年之藥物治療，因效果不顯著，改由其他專業人士、老師及護理輔導員，對個案進行一年藥物配合行為改變介入之治療方式，藥物治療配合醫生之處方，而行為治療則由醫生、專家擬定行為契約內容，主要基本技術的運用有增強與處罰技巧。研究者透過訪談取得父母親、老師的觀察資料，了解個案行為狀況改善情形。根據研究結果，研究者提出以下建議：(1)藥物配合行為改變介入之治療方式，確實明顯改善過動兒的日常行為表現；(2)與父母親做好溝通與心理建設，是改善過動兒行為表現的最重要關鍵；(3)社會資源的整合與建立，包括階段性親職教育方案的提供、與學校老師相互配合及良好互動形成整合的團隊工作，也是改善過動兒行為表現的關鍵。

關鍵字

注意力缺陷過動症 ； 行為契約 ； 增強與處罰

並列摘要

Attention Deficit Hyperactivity Disorder (ADHD) is a common psychological disease among children. The purpose of this study was to describe the process of assisting with behavior modification in a child with ADHD. The patient had undergone medical treatment for a year with no obvious effect. With the guidance of other professional people, the child's teachers and nursing instructors, the researchers proceeded with behavioral modification in conjunction with medication for another year. The medication treatment followed doctors' prescriptions, and, as regards the behavioral treatment, doctors and experts drafted and decided the content of the behavioral contract. The main basic techniques were skillful reinforcement and punishment. Then, via interviews with his parents and teachers, information was obtained that provided an understanding of the patient's condition and progress. It was found that the improvements were very significant. On the basis of the research results, the researchers submit that: (1) drug treatment combined with behavioral treatment apparently improves the daily behaviors of hyperactive children; (2) good communication with parents and psychological preparation are the most critical keys to the success of substantial behavioral improvement among hyperactive children; (3) establishment and integration of social resources, including provision of transitional parenting education solutions, and cooperation and sound interaction from school teachers, which fosters consolidated team work, are the critical factors to behavioral improvement among hyperactive children.

並列關鍵字

Attention Deficit Hyperactivity Disorder ADHD ； behavioral contract ； reinforcement and punishment

參考文獻

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