一自閉症児に対する治療教育の試み

言語訓練を中心として

抄録

Behavior therapy techniques were applied to the therapeutic education of an 8-year-old mute autistic boy from January 1969 to June 1970 by the author. This paper intends to describe the process of verbal behavior formation training for the child. At the first step, playing at seesaw with the child contingently after his spontaneous meaningless vocalizations, the author succeeded in strengthen his vocalizations. Subsequently the author tried to shape those vocalizations into a word yaritai (wanna do), using successive approximation method. It took 13 sessions (almost 2 months) for him to speak yaritai clearly. Contrary to the author's expectation, he did not show much progress in using the word which he had acquired ; also another speech training through conditioning generalized imitation proved to be very difficult for him. On the other hand, the author found that the child's behavior system, which might support the verbal behavior, had not been well formed and he stayed on the sensory-motor intelligence level. Then, as a second step, author devised teaching sequence based on sensory-motor training. At first, the child was trained to fit the form-boards, and the problems were gradually made more and more difficult ; i. e., he was required to discriminate forms or sizes between several form-boards presented simultaneously before him. Through that training, he modified his stiff manipulatory responses and acquired a well-coordinated sensory-motor system. Furthermore, with modified WGTA, extensive discrimination learning training of forms, colors, and sizes between vavious visual stimuli was also given and the child showed significant progress and acquired the discrimination learning set. After the formboards training, the child got the set to lay the objects on their appropriate pictures through systematic picture-picture matching training. As a final goal, the letters-objects matching training was introduced. The training consisted of fading in he letters as final cues and fading out the pictures as prompts. As a result, letters-objects matching behavior was almost errorlessly established, and the child was able to use letters as the signs of corresponding objects.
The behavior characteristics of autistic children were also discussed. A hypothesis, that stereotypic behaviors and the tendencies to keep the sameness were caused by the spontaneous fear to excessively novel or complex stimuli, was proposed. For, some disorders in the orienting response system (including orienting reflexes and voluntary investigatory activities) prevented the assimilation and accommodation processes of autistic children. Consequently, adaptation level formed through prior experience did not reach as high as those of normal children. Therefore, even interesting and approach-investigation provoking stimuli which were optimally discrepant from adaptation level for normal children might extraordinarily be discrepant for autistic children and make them avoid those stimuli and cause the peculiar withdrawal syndrome. In this discussion an attempt was mabe to show the importance of sensory-motor training for severely retarded autistic children.