認知行為遊戲治療對ADHD 兒童干擾行為之成效研究

A Study of The Effects of Cognitive-Behavioral Play Therapy for ADHD Child with Disruptive Behaviors

本研究旨在探討認知行為遊戲治療（CBPT）對改善ADHD 兒童干擾行為之介入與維持效果。研究設計採單一受試A-B 實驗設計之跨行為多基準線設計，自變項為認知行為遊戲治療，依變項為干擾行為問題（包括：B1 與他人說話玩耍、B2 自己玩東玩西、B3 大聲頂嘴與插嘴），以一位10 歲被診斷為ADHD 之男童為研究對象，接受每週2 次，每次40 分鐘之CBPT 介入，共進行9 週。研究期間並透過客觀與主觀的方式於基線期、介入期和維持期蒐集資料。並依觀察所得資料採視覺分析、C 統計及效果量考驗其成效，並訪談教師及重要他人作為社會效度，以探討實驗處理效果。研究結果發現：（一）CBPT 對於改善與他人說話玩耍行為具有介入（f 2 = .507），和維持效果（f 2=1.943）。（二）CBPT 對於改善自己玩東玩西行為具有介入（f 2=2.003）和維持效果（f 2 = .578）。（三）CBPT 對於改善大聲頂嘴和插嘴行為具有介入（f 2 =2.011）和維持效果（f 2= .793）。總之受試者能藉CBPT 學習到自我控制技巧和適當的替代行為，並能改善其干擾行為。

The purpose of this study was to investigate the effects of the CBPT on ADHD Children and to improve the disruptive behaviors, including talking and playing with other students (B1), self-playing (B2), loudly retort and interrupt in class (B3). A multiple-baseline design across behaviors of a single-subject A-B research design was used in this study to a 10 yrs boy during 3 stages (baseline, treatment and maintenance) in 9 weeks (40 minutes one time and twice a week). The researcher collected the objective and subjective data during the baseline, treatment and follow-up periods, then analyzing them by using visual analysis, C statistics and effect size. At the end of treatment, teachers and significant other were interviewed to examine social validity of effects.The results of this study are as follows:(1)CBPT had immediate effects ( f 2 = .507) and had maintenance effects ( f 2 =1.943) on the behavior of talking and playing with others.(2)CBPT had immediate effects ( f 2 =2.003) and had maintenance effects ( f 2 = .578) on the behavior of self-playing.(3)CBPT had immediate effects ( f 2 =2.011) and had maintenance effects ( f 2 = .793) on behavior of loudly retort and interrupt.Subject learned self-control and proper coping behaviors with CBPT, and improve disruptive behaviors.