The Effect of Milieu Therapy on Aggressive Behaviors Of Severe Autistic Children
Main Article Content
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.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
ลิขสิทธิ์ของบทความที่ตีพิมพ์เป็นของวารสารพยาบาลศาสตร์ จุฬาลงกรณ์มหาวิทยาลัย ทั้งฉบับตีพิมพ์เป็นรูปเล่มและเอกสารออนไลน์
References
Barbaresi WJ, Katusic SK, Voigt RG. Autism: a
review of the state of the science for
pediatric primary health care clinicians.
Archives of Pediatric and Adolescent
Medicine 2006; 160(11): 1167-75.
Ruangtrakul S. Textbook Children and
Adolescent. 2nd ed. Bangkok: Ruen Kaew
Printing House; 2008.
Carter AS, Black DO, Tewani S, Connolly CE,
Kadlec MB, Tager-Flusberg H. Sex
differences in toddlers with autism
spectrum disorders. Journal of autism
and developmental disorders 2007;
(1): 86-97.
Trangkasombat U. Helping an autistic child.
nd ed. Bangkok: Research and
Development Center Family; 2008
Rimland B, Edelson SM. Autism Treatment
Evaluation Checklist (ATEC) [internet].
[Cited 2020 June 22]. Available
from: https://psycnet.apa.org/doi
Landing? doi=10.1037%2Ft03995-000
Medical Statistics of Rajanukul Institute.
Annual Report. Bangkok: Rajanukul
Institute, 2018.
Yudofsky SC, Silver JM, Jackson W, Endicott J,
Williams D. The Overt Aggression Scale
for the objective rating of verbal and
physical aggression. The American
journal of psychiatry 1986; 143(1): 35-9.
Doi: 10.1176/ajp.143.1.35
Kloosterman PH, Kelley EA, Parker JD, Craig
WM. Executive functioning as a predictor
of peer victimization in adolescents with
and without an Autism Spectrum
Disorder. Research in autism spectrum
disorders 2014; 8(3): 244-54.
Kanne SM, Mazurek MO. Aggression in children
and adolescents with ASD: Prevalence
and risk factors. Journal of Autism and
Developmental Disorders 2011; 41(7):
-37.
Hill AP, Zuckerman KE, Hagen AD, Kriz DJ,
Duvall SW, Van Santen J, et al. Aggressive
behavior problems in children with
autism spectrum disorders: Prevalence
and correlates in a large clinical sample.
Research in Autism Spectrum Disorders
; 8(9): 1121-33.
Isaranarug S. Emotional and social development
of children aged 6-12 years.
Journal of Public Health and Development
; 4(2): 89-100. (in Thai).
Borge L, Rossberg JI, Sverdrup S. Cognitive
milieu therapy and physical activity:
experiences of mastery and learning
among patients with dual diagnosis.
Journal of Psychiatric and Mental Health
Nursing 2013; 20(10): 932-42.
Mancil GR, Conroy MA, Haydon TF. Effects
of a modified milieu therapy intervention
on the social communicative behaviors
of young children with autism spectrum
disorders. Journal of Autism and
Developmental Disorders 2009; 39(1):
-63.
Yungsantia C, Yunibhan J. A study of nursing
care emphasizing milieu therapy on
aggressive behaviors of mentally
retarded children, Rajanukul Institute
[Master’s thesis in Nursing Program].
Bangkok: Chulalongkorn University;
Pangpromma N, Yunibhan J, Upasaen R.
The effect of behavior therapy with
family involvement on aggressive
behaviors of autistic children [Master’s
thesis in Nursing Program]. Bangkok:
Chulalongkorn University; 2015.
Leelanuntakit T. Management of aggressive
and violent patients with the safety of
patients and care takers. Bangkok:
Thammasat Printing House; 1998. p. 167.
Nightingale F. Notes on Nursing. Philadelphia:
J.B. Lippincott; 1992.
Skinner BF. Science and human behavior.
New York: The Free Press; 1953.
Thongpetch A, Yunibhan J. The effect
of behavior therapy on aggressive
behaviors of autistic children, out
patient department [Master’s thesis in
Nursing Program]. Bangkok: Chulalongkorn
University; 2011.