A BEHAVIOR THERAPEUTIC APPROACH TO ELECTIVELY MUTISTIC RESPONSES IN A MILDLY MENTALLY RETARDED CHILD : EFFECTS OF A STIMULUS FADING PROCEDURE AND SOCIAL SKILLS TRAINING

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  • 軽度精神遅滞児の選択性緘黙反応への行動療法的アプローチ : 刺激フェイディング法と社会的スキルトレーニングの併用による効果
  • ケイド セイシン チタイジ ノ センタクセイ カンモク ハンノウ エ ノ コウ

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Abstract

A 6-years-old elementary school girl, electively mute, was treated by a stimulus fading procedure and social speech skills training. Mutistic responses appeared in all social settings, especially in school. In her home, furthermore, the girl also showed some difficulty in fluent speech interaction at home with her family and others in her home seemingly due to mild speech retardation. The goal of the treatment was to get her to respond verbally using training in speech skills with the homeroom teacher and classmates in school. The treatment procedures were as follows: 1) Making her verbal interactions with the therapists at her home. 2) Making her the social speech skills which are needed in social settings and school life through the training at her home by means of operant procedures. 3) After achieving fundamental speech skills at home, introducing these skills gradually from the home area to the school setting by means of a stimulus fading procedure. 4) Measuring her tention levels (using the check list for measuring tentions of her speech, action, and face; KATOH et al. 1981) in various areas of her school. 5) Arranging a hierarchy of her mutistic responses on the basis of situation, person, and time factors. 6) Dividing the fading steps into 20 by means of the hierarchy. 7) Desensitizing of her tension and making verbal responses with the social speech skills training, according to the fading steps. 24 sessions were needed up to arrive at items of verbal interaction with the homeroom teacher in her classroom. It was shown on the one month later follow-up that the girl has not only continued to perform well on training items, but has also become more active on other verbal responses in her regular classroom. The results mentioned above suggest that the shaping of verbal responses and reducing tensions in the school situation are achieved not only by a stimulus fading procedure, but also by operant training of social speech skills.

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