The Effect of Milieu Therapy on Aggressive Behaviors Of Severe Autistic Children

Abstract

Purpose: 1) to compare aggressive behaviors of severely autistic children before and after using the milieu therapy program, and 2) to compare aggressive behaviors of severely autistic children using the milieu therapy program and those who received usual nursing care.

Design: Quasi-experimental research

Methods: The research sample consisted of thirty-six severe autistic children, aged 6-12 and caregivers receiving services in the inpatient department of Rajanukul Institute selected by inclusion criteria, were matched pair by sex and age of severely autistic children, then, equally randomly assigned to an experimental group and a control group with 18 subjects in each group.  The experimental group received the 4 weeks milieu therapy program. The control group received usual nursing care. Research instruments were: 1) A personal data questionnaire, 2) An aggressive behaviors assessment scale, 3) A clinical nursing practice guideline of the milieu therapy for severely autistic children, 4) A nurses teaching manual for parents on aggressive behavior management, 5) A checklist of caregivers’ ability to manage children’s aggressive behavior at home. All instruments were content validated by a panel of 5 experts. The reliability of the aggressive behavior scale was 0.87. Data analysis was done by t-test.

Results: 1) Aggressive behaviors of severely autistic children after using the milieu therapy program was significantly lower than those before, at the .05 level; and 2) Aggressive behaviors of severely autistic children who received the milieu therapy program was significantly lower than those who received usual nursing care, at the .05 level.

Conclusion: The result of this study support that the milieu therapy program can reduce the aggressive behaviors of severe autistic children.