미술치료가 혼재 수용-표현성 언어장애아동의 의사소통에 미치는 영향

Abstract

본 연구의 목적은 미술치료를 통해 혼재 수용-표현성 언어장애아동의 의사소통향상에 미치는 영향을 알아보고자 하였다.

연구대상은 인천광역시에 소재한 K대 S병원 에서 혼재 수용-표현성 언어장애 진단을 받은 초등학교 4학년 여학생 한 명을 대상으로 하였다. 연구자가 근무하는 인천광역시 서구 R심리치료센터에서 2010년 4월부터 11월 까지 주 1~2회 미술치료프로그램을 실시하여 총 38회기를 진행하였다. 생의 초기에 겪었던 사회적 관계에서의 부적절한 경험들과 또래관계 개선을 위해 본 연구자는 대상아동이 심리적으로 내제화되었을 주요증상인 심한위축, 심한불안, 현실감부족, 울화억제력부족, 자제력부족 등의 부적응 행동특성들을 내담자중심의 주제와 현장중심적인 프로그램으로 연구자와의 관계를 통해 신뢰형성의 경험을 해나감으로서 아동의 부적응 행동을 감소시키고 나아가 의사소통 향상을 도모하고자 하였다. 연구방법은 양적인 방법과 질적인 방법으로 대상아동의 미술치료에서 나타나는 현상과 행동변화 과정을 기술하였고 의사소통의 변화과정을 분석하였다. 의사소통 향상의 효과검증을 위한 측정도구는 양적검사인 벅스의 행동평정척도와 투사검사로는 인물화검사 및 풍경구성법을 평가도구로 사용하였다.

본 연구의 주요 연구결과는 다음과 같다. 첫째, BBRS에서는 19개의 행동관련 하위 영역 중 연구자의 연구목적에 따 라 변수 변인을 보고자한 5개 하위영역인 심한위축, 심한불안, 울화억제력부족, 자제력부족, 현실감부족 등에서 전반적으로 점수가 낮아 졌으며 이는 각 영역별 아동의 부적응행동문제가 개선되어 결과적으로 미술치료가 의사소통향상에 긍정적인 영향을 주었음을 알 수 있다. 둘째, 인물화검사에서는 사전검사에서 위축, 경직되고 무기력한 부적응행동모습에서 사후검사에서는 밝은 모습과 적절한 행동의 활동성이 많아지고 심한위축, 심한불안, 현실감부족, 울화억제력부족, 자제력부족의 부적응행동이 감소된 것으로 나타났다. 풍경구성법 검사에서는 현실감 있는 내용으로 바뀌면서 현실감부족을 극복하고, 구성능력이 향상되고 전체적인 통합이 조화를 이루고 있음으로 의사소통에도 긍정적 변화를 가져온 것으로 볼 수 있다. 셋째, 미술치료과정을 분석함으로서 의사소통의 변화과정 내용을 기술 하였다. 분석 결과 대상아동이 부적응 행동요인이 감소되면서 의사소통 향상에 효과가 있음을 알 수 있다.

결론적으로, 내담자 중심의 자유로운 주제선택과 표현활동을 통해 자신의 관심분야와 흥미를 최대한 적용시킴으로써 부적응행동요인을 감소시키고 연구자의 지지와 수용적 관계형성을 바탕으로 중재적 역할로서의 미술치료프로그램이 부적응행동을 보이는 대상아동의 심한불안, 심한위축, 현실감부족, 울화억제력부족, 자제력부족 등을 감소시킴으로서 의사소통 향상에 긍정적 영향을 준 것으로 볼 수 있다.

| This study is conducted to look into the effect of art therapy on communication of a child with mixed receptive-expressive language disorder. The study subject was a fourth-grade of elementary school girl with mixed receptive-expressive language disorder diagnosed at S hospital of K University in Incheon. A total of 38 art therapy programs were conducted from April to November, 2010 once or twice a week in this researcher's office, R Psychical Cure Center in Seo-gu, Incheon. To improve inappropriate social experiences that she encountered early in life and relationship with peers, this researcher experienced the creation of trust through maladjusted behavior characteristics such as excessive withdrawal, excessive anxiety, poor reality contact, poor anger control, and poor impulse control, which are main symptoms that the subject might feel psychologically, through client-oriented topics and actual field-oriented programs in order to reduce the child's maladjusted behaviors and further promote communication improvement. For the study methods, quantitative and qualitative methods were used to describe the child's symptoms in art therapy and behavioral changes and analyze transitions in her communication. For measurement tools to verify the effect of communication improvement, BBRS : Burks' Behavior Rating Scales as a quantitative method and drawing a person test and LMT: Landscape Montage Technique as a projective test were used. The major findings are as follows. First, BBRS showed lower score of excessive withdrawal, excessive anxiety, poor anger control, and poor impulse control, and poor reality contact that are five sub-areas in which this researcher aims to look into variables under the purpose of the study among 19 behavior-related sub-areas. This has found that a child's maladjusted behavior problems about each item are improved and finally art therapy has an positive effect on communication improvement. Second, drawing a person test showed that the girl was withdrawn, stiffen and fecklessly maladjusted in the pre-test while she was bright and expressed active proper behaviors in the post-test. In addition, maladjusted behaviors such as excessive withdrawal, excessive anxiety, poor reality contact, poor anger control, and poor impulse control were improved through the art therapy program so that her improper behaviors were decreased and she was changed to be bright. LMT: Landscape Montage Technique showed that she overcame the lack of reality and improved the construction ability by changing the contents realistically so overall integration was harmonized and positive changes in communication were brought. Third, the study described transitions in communication by analyzing the art therapy process. According to the analysis results, the subject child's maladjusted behavior factors were decreased and her communication was improved. In conclusion, the art therapy program reduced maladjusted behavior factors by applying interests and attentions as much as possible through client-oriented free topic selection and expression activities. In addition, it had a positive effect on her communication by reducing excessive anxiety, excessive withdrawal, poor reality contact, poor anger control, and poor impulse control.

Korean studies on maladjusted behaviors of children with the communication disability are insufficient and therefore the studies are urgently required. In particular, this study is so meaningful that it is the first art therapy case study on a child with mixed receptive-expressive language disorder, and it aims to provide the basic data for the follow-up study. In addition, it needs to develope more art therapy programs to improve communication skills and the comparative studies on the effects should be conducted actively.; This study is conducted to look into the effect of art therapy on communication of a child with mixed receptive-expressive language disorder. The study subject was a fourth-grade of elementary school girl with mixed receptive-expressive language disorder diagnosed at S hospital of K University in Incheon. A total of 38 art therapy programs were conducted from April to November, 2010 once or twice a week in this researcher's office, R Psychical Cure Center in Seo-gu, Incheon. To improve inappropriate social experiences that she encountered early in life and relationship with peers, this researcher experienced the creation of trust through maladjusted behavior characteristics such as excessive withdrawal, excessive anxiety, poor reality contact, poor anger control, and poor impulse control, which are main symptoms that the subject might feel psychologically, through client-oriented topics and actual field-oriented programs in order to reduce the child's maladjusted behaviors and further promote communication improvement. For the study methods, quantitative and qualitative methods were used to describe the child's symptoms in art therapy and behavioral changes and analyze transitions in her communication. For measurement tools to verify the effect of communication improvement, BBRS : Burks' Behavior Rating Scales as a quantitative method and drawing a person test and LMT: Landscape Montage Technique as a projective test were used. The major findings are as follows. First, BBRS showed lower score of excessive withdrawal, excessive anxiety, poor anger control, and poor impulse control, and poor reality contact that are five sub-areas in which this researcher aims to look into variables under the purpose of the study among 19 behavior-related sub-areas. This has found that a child's maladjusted behavior problems about each item are improved and finally art therapy has an positive effect on communication improvement. Second, drawing a person test showed that the girl was withdrawn, stiffen and fecklessly maladjusted in the pre-test while she was bright and expressed active proper behaviors in the post-test. In addition, maladjusted behaviors such as excessive withdrawal, excessive anxiety, poor reality contact, poor anger control, and poor impulse control were improved through the art therapy program so that her improper behaviors were decreased and she was changed to be bright. LMT: Landscape Montage Technique showed that she overcame the lack of reality and improved the construction ability by changing the contents realistically so overall integration was harmonized and positive changes in communication were brought. Third, the study described transitions in communication by analyzing the art therapy process. According to the analysis results, the subject child's maladjusted behavior factors were decreased and her communication was improved. In conclusion, the art therapy program reduced maladjusted behavior factors by applying interests and attentions as much as possible through client-oriented free topic selection and expression activities. In addition, it had a positive effect on her communication by reducing excessive anxiety, excessive withdrawal, poor reality contact, poor anger control, and poor impulse control.

Korean studies on maladjusted behaviors of children with the communication disability are insufficient and therefore the studies are urgently required. In particular, this study is so meaningful that it is the first art therapy case study on a child with mixed receptive-expressive language disorder, and it aims to provide the basic data for the follow-up study. In addition, it needs to develope more art therapy programs to improve communication skills and the comparative studies on the effects should be conducted actively.