کمبود مهارتهای بازی در کودکان اوتیسم به شیوههای مختلف خود را نشان میدهد. پذیرش اجتماعی پایین در میان همسالان ، فقدان مهارتهای توجه ، اشکال در تقلید از دیگران اشکال در درک هیجانات دیگران و زلزدنهای نابهنجار از نشانههای بارز کمبود مهارتهای بازی این کودکان است.
مدلهای مداخلاتی متنوعی برای مهارتهای بازی کودکان اوتیسم مورد استفاده قرار گرفته که از جمله میتوان به تعدیل رفتار، آموزش به وسیله همسالان، داستانهای اجتماعی، مدلسازی ویدیوئی، آموزش توجه و آموزش مسئولیت شخصی اشاره کرد. در بین رویکردهای مداخلاتی مختلف، موسیقیدرمانی نیز به عنوان فنی شناخته شده که تاثیر زیادی بر رفتارهای ارتباطی و مهارتهای بازیکودکان اوتیسم دارد به نظر میرسد جنبه غیر کلامی موسیقی تاثیر بسیار زیادی بر ارتباط موسیقایی- هیجانی کودک اوتیسم با دیگران ایفا میکند. اکثر مطالعات انجام شده در حیطه موسیقیدرمانی بر جنبه تحریکی موسیقی برای این کودکان و تمایل کودکان اوتیسم به موسیقی اشاره کردهاند.
موسیقی باعث برانگیخته شدن هیجانات میشود و از طرف دیگر اعتقاد بر این است که گوش دادن به موسیقی واکنشهای هیجانی فرد را نیز به دنبال دارد. مطالعات نشان داده که گوش دادن به موسیقی باعث کاهش انقباض ماهیچههای کودکان و نوجوانان دارای نشانگان اوتیسم میشود مایکل و چسکی نیز در مطالعه خود نشان دادند که موسیقیدرمانی باعث کاهش درد میشود. همچنین مطالعات، تاثیر آموزش موسیقی و موسیقیدرمانی را بر کاهش اضطراب افراد دچار اختلال اوتیسم نشان داده است. اسکیل و ویگرام در مطالعه دیگر نیز دریافتند که موسیقی درمانی بر سیستم عصبی خودمختار و فشارخون این افراد اثر میگذارد
افراد دچار اختلال اوتیسم در مقایسه با افراد عادی از سطح اضطراب بالاتری نیز برخوردارند به نظر میرسد که مشکلات رفتاری میتواند ارتباط نزدیکی با اضطراب تجربه شده در این افراد داشته باشد به علاوه اکثر افراد دچار اختلال اوتیسم علائمی از اختلال در عملکرد فیزیولوژیکی را نشان میدهند و به احتمال فراوان مشکلات رفتاری کودکان و نوجوانان اوتیسم تحت کنترل این اختلال است
شواهدی وجو د دارد که نشان میدهد بین بدکاری نورونهای آیینهای در کودکان دچار اختلالات اوتیسم با ضعف رفتاری آنان رابطه وجود دارد. همچنین یافتههایی که به وسیله تصویرداری از نورونها به دست آمده نشان داده که سیستم حسی- حرکتی نقش عمدهای در پردازش زبان ایفا میکند. پس از تایید نقش مهم نورونهای آیینهای در درک رفتاری و پردازش زبانی و همچنین رابطه نزدیکی که بین ناهنجاریهای نورونهای آیینهای و ضعف در مهارتهای بازیوجود دارد، رویکردهای درمانی متنوعی شکل گرفت که هدفشان درگیر ساختن نورونهای آینهای و به حداکثر رساندن پتانسیل این نورونها بود موسیقیدرمانی یکی از این رویکردهای درمانی است که به دلیل تحریک و تقویت پردازش شنیداری، دیداری و حسی- حرکتی میتواند به درگیر ساختن نورونهای آیینهای بینجامد فرضیهی مطرح شدهی دیگر این است که فعالیتهای موسیقایی از جمله تقلید و هماهنگی حرکتی به بخشهای از مغز مرتبط است که میتواند با نورونهای آیینهای موجود در سیستم عصبی همپوشی داشته باشد
تاکنون مطالعات متعددی درباره تاثیرات موسیقیدرمانی بر جنبههای مختلف روانشناختی، اجتماعی، ارتباطی، و مهارتی افراد دچار اختلال اوتیسم صورت گرفته است. کاپلان و استیل طی یک مطالعه دقیق دو ساله به بررسی تاثیر موسیقیدرمانی بر جنبههای مختلف زندگی افراد اوتیسم پرداختند. طی این مطالعه آنها یک برنامه موسیقیدرمانی منظم را بر روی ۴۰ فرد دچار اختلال اوتسیم در دامنه سنی ۴۹-۲ سال اجرا کردند. نتایج حاکی از آن بود که موسیقیدرمانی به ترتیب بیشترین تاثیر را بر مهارتهای زبانی، ارتباطی (۴۱%)، بازی (۳۹%)، شناختی (۸%)، موسیقایی (۷%) و اداراکی، حرکتی (۵%) داشته است
بوسو و همکارانش نیز در مطالعهای مشابه به بررسی تاثیر موسیقیدرمانی تعاملی بلندمدت بر بازی و مهارتهای موسیقایی افراد جوان دچار اختلال اوتیسم پرداختند. برنامه مداخلهای طی ۵۲ هفته بر روی ۸ نفر فرد دچار اختلال اوتیسم انجام شد. نتایج بیانگر تفاوت معنادار نمرات بازی و مهارتهای موسیقایی افراد گروه کنترل و گروه آزمایش در پیشآزمون و پسآزمون بود. این بدین معناست که در این مطالعه نیز موسیقی بر نیمرخ رفتاری بازی و مهارتهای موسیقایی این افراد تاثیر گذاشته است.
ریتمن نیز طی مطالعهای به بررسی تاثیر مداخلات موسیقیدرمانی بر مهارتهای توجه مشترک کودکان اوتیسم پرداخت. این مطالعه طی دو سال و بر روی کودکان ۱۰-۴ سال انجام شد. نتایج این مطالعه نیز بیانگر تاثیر موسیقیدرمانی و آموزش موسیقی بر مهارتهای توجه و بازی کودکان اوتیسم است
جینا کیم و همکارانش در مطالعهای شبیه به مطالعه ریتمن به مقایسه تاثیر موسیقیدرمانی و بازی درمانی بر افزایش توجه در کودکان اوتیستیک پیشدبستانی پرداختند. در این مطالعه، ۱۴ کودک اوتیستیک ۵-۳ سال را به طور تصادفی در دو گروه قرار داده و با یک گروه طی ۱۲ جلسه ۳۰ دقیقهای به موسقیدرمانی پرداختند و با گروه دیگر نیز ۱۲ جلسه ۳۰ دقیقهای بازیدرمانی صورت گرفت. نتایج کلی این مطالعه نشان داد که موسیقیدرمانی در مقایسه با بازیدرمانی تاثیر کمتری بر افزایش توجه کودکان اوتیستیک دارد. همچنین نتایج آنان بیانگر تاثیر موسیقیدرمانی بر ارتباطات اجتماعی غیرکلامی بوده است.
لانکویست نیز در مطالعهای به بررسی تاثیربازی بر رفتارهای چالشی افراد اوتیستیک و دچار اختلالات رشدی پرداخت. در مطالعه وی تعداد ۲۰ نفر از افراد مبتلا به اختلال اوتیسم و اختلالات رشدی طی ۵ هفته در جلسات ۲۰-۱۰ دقیقه ای به موسیقی آرام بخش گوش میدادند و بازی تعاملی انجام میدادند. نتایج بیانگر این بوده که گوش دادن به موسیقی آرام بخش و بازی باعث کاهش هر سه طیف رفتار کلیشهای، رفتار پرخاشگرانه و رفتار خودآزاری شده است
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