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Originalarbeit

Frankfurter Gruppentraining sozialer Fertigkeiten für Kinder und Jugendliche mit autistischen Störungen

Published Online:https://doi.org/10.1024/1422-4917.35.1.33

Zusammenfassung:Fragestellung: Trotz des hohen Bedarfs an gruppentherapeutischen Interventionen bei Kindern und Jugendlichen mit autistischen Störungen stehen bisher kaum spezifische deutschsprachige Therapieprogramme zur Verfügung. Seit 2003 wird an unserer Klinik ein strukturiertes Gruppentraining sozialer Fertigkeiten primär für Kinder und Jugendliche mit High-Functioning-Autismus und Asperger-Syndrom entwickelt und durchgeführt. Das Training adressiert die Hauptproblembereiche dieser Störungsbilder, Hauptziele sind die Verbesserung der sozialen Kommunikations- und Interaktionsfertigkeiten. Methodik: Die Teilnehmer sind Kinder und Jugendliche mit ausreichenden kognitiven Fähigkeiten und funktionaler Sprache. Prinzipien der Intervention sind die Strukturierung der Abläufe, Kombination von theoretischen und praktischen Elementen, verbindliche Gruppenregeln, Berücksichtigung individueller Problembereiche, schrittweises Vorgehen und sukzessive Steigerung des Schwierigkeitsgrades der Therapiebausteine. Die Therapiebausteine umfassen strukturierte Gruppenspiele, Training der Emotionserkennung, gemeinsame Gruppenaktivitäten, Rollenspiele, Gruppendiskussionen, Feedback und Hausaufgaben. Verwendet wird ein an unserer Klinik entwickeltes Gruppentrainingsprogramm sozialer Fertigkeiten in Form eines strukturierten Trainingsmanuals. Das Training umfasst aktuell drei Gruppen (5-7 Teilnehmer) unterschiedlicher Altersbereiche (Kinder und Jugendliche) und findet wöchentlich/14-tägig für 1-1,5 Stunden außerhalb der Schulferien statt. Jeweils zwei Gruppenleiter leiten die Trainingsstunden und wechseln sich im Verlauf des Programms ab. Es finden in regelmäßigen Abständen Gruppengesprächsrunden mit den Eltern zum gegenseitigen Erfahrungsaustausch und zur Information über Einzelheiten des Programms statt. Ergebnisse: Sowohl die Akzeptanz und Zufriedenheit mit dem Training als auch die Toleranz für die jeweiligen individuellen Probleme sind unter den Teilnehmern hoch. Rückmeldung der Eltern und die klinischen Beobachtungen der Gruppenleiter weisen auf eine klare Verbesserung der Verbalisations- und Kontaktfähigkeit hin. Die Teilnehmer scheinen dabei insbesondere von den Rollenspielen zu profitieren. Schlussfolgerungen: Qualitative Daten (Angaben der Teilnehmer, Eltern und der Gruppenleiter zu Veränderungen der sozialen Fertigkeiten) legen verbesserte Interaktions-, Kommunikations- und Problemlösefertigkeiten im Verlauf des Gruppentrainings nahe. Eine laufende Pilotevaluation des Gruppentrainings beinhaltet auch die Erfassung von Effekten in Alltagssituationen. In Abhängigkeit der Ergebnisse könnte das Training nachfolgend in gemischten Gruppen mit anderen psychiatrischen Störungsbildern angewendet und überprüft werden.


Frankfurt group social communication and interaction skillstraining for children and adolescents with autism spectrum disorders

Summary:Objective: Despite the recognition of the need for group-based training programmes for children and adolescents with autistic disorders, there are only very few specific German-speaking training programmes available. Since 2003, a structured group training programme on social skills for children and adolescents with high-functioning autism or Asperger syndrome has been developed and conducted at our department. The training programme focuses on the main deficits of those disorders. Thus, the primary goal is to improve communication and interaction skills. Method: Participants are children and adolescents without significant cognitive and language delays. Principles of intervention include structured formats, combination of theoretical and practical elements, predictable rules, consideration of individual difficulties, and sequential and progressive learning. Techniques range from structured games, the training of affect recognition, group activities, role play, team discussions, and feedback to homework using a newly designed manual on our group-based social skill training programme and curriculum. Generally, three groups of 5-7 participants each and of different age range (children, adolescents) meet weekly / biweekly for 1-1.5 hours (excluding the holidays). Two trainers - who change during the programme - carry out each of the sessions. Trainers meet regularly with the parents to discuss experiences and to provide details of the programme. Results: Acceptance by and satisfaction with the programme are high among participants, as is the mutual recognition of and tolerance of their respective problems. Both feedback from parents and trainers’ clinical impressions indicate distinct improvement of verbalization and contact abilities. Participants seem to benefit particularly from role play. Conclusions: Qualtitative measures (impressions of the participants, their parents and their trainers with regard to change in behaviour skills) suggest mounting interaction, communication, and problem-solving skills during the group treatment. An ongoing pilot evaluation also includes measurements of effects in everyday settings. Depending on the results, the training subsequently could be conducted and evaluated in groups with both pervasive developmental, as well as other psychiatric disorders.

Literatur

  • Aldred, C. , Green, J. , Adams, C. (2004). A new social communication intervention for children with autism: pilot randomized controlled treatment study suggesting effectiveness. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 45, 1420– 1430 First citation in articleCrossref MedlineGoogle Scholar

  • Baron-Cohen, S. , Tager-Flusberg, H. , Cohen, D. J. (2000). Understanding other minds. Oxford: Oxford University Press First citation in articleGoogle Scholar

  • Barry, T. , Klinger, L. G. , Lee, J. M. , Palardy, N. , Gilmore, T. , Bodin, S. D. (2003). Examining the Effectiveness of an Outpatient Clinic-Based Social Skills Group for High-Functioning Children with Autism. Journal of Autism and Developmental Disorders, 33, 685– 701 First citation in articleCrossref MedlineGoogle Scholar

  • Bölte, S. , Feineis-Matthews, S. , Leber, S. , Dierks, T. , Hubl, D. , Poustka, F. (2002). The development and evaluation of a computer-based program to test and to teach the recognition of facial affect. International Journal of Circumpolar Health, 61, 61– 68 First citation in articleCrossref MedlineGoogle Scholar

  • Bölte, S. , Rühl, D. , Schmötzer, G. , Poustka, F. (2006). Diagnostisches Interview für Autismus - Revidiert (ADI-R). Bern: Huber First citation in articleGoogle Scholar

  • Bondy, A. , Frost, L. (1994). The Picture Exchange Communication System. Behavior Modification, 25, 725– 744 First citation in articleCrossrefGoogle Scholar

  • Drew, A. , Baird, G. , Baron-Cohen, S. , Cox, A. , Slonims, V. , Wheelwright, S. , Swettenham, J. , Berry, B. , Charman, T. (2002). A pilot randomized control trial of a parent training intervention for pre-school children with autism. Preliminary findings and methodological challenges. European Child and Adolescent Psychiatry, 11, 266– 272 First citation in articleCrossref MedlineGoogle Scholar

  • Eikeseth, S. , Smith, T. , Jahr, E. , Eldevik, S. (2002). Intensive behavioral treatment at school for 4- to 7-year old children with autism. A 1-year comparison controlled study. Behavior Modification, 26, 49– 68 First citation in articleCrossref MedlineGoogle Scholar

  • Goldstein, H. (2002). Communication intervention for children with autism: a review of treatment efficacy. Journal of Autism and Developmental Disorders, 32, 373– 396 First citation in articleCrossref MedlineGoogle Scholar

  • Gray, C. (2000). The new social story book. Arlington, TX.: Future Horizon First citation in articleGoogle Scholar

  • Häußler, A. , Happel, C. , Tuckermann, A. , Altgassen, M. , Adl-Amini, K. (2003). SOKO Autismus. Gruppenangebote zur Förderung sozialer Kompetenzen bei Menschen mit Autismus - Erfahrungsbericht und Praxishilfen. Dortmund: Verlag modernes Lernen First citation in articleGoogle Scholar

  • Howlin, P. , Baron-Cohen, S. , Hadwin, J. (1998). Teaching children with autism to mind-read: A practical guide for teachers and parents. New York: Wiley First citation in articleGoogle Scholar

  • Koegel, R. L. , Koegel, L. K. , McNerney, E. K. (2001). Pivotal areas in intervention for autism. Journal of Clinical Child Psychology, 30, 19– 32 First citation in articleCrossref MedlineGoogle Scholar

  • Krasny, L. , Williams, B. , Provencal, S. , Ozonoff, S. (2003). Social skills interventions for the autism spectrum: essential ingredients and a model curriculum. Child and Adolescent Psychiatric Clinics of North America, 12, 107– 122 First citation in articleCrossref MedlineGoogle Scholar

  • Lord, C. , Wagner, A. , Rogers, S. , Szatmari, P. , Aman, M. , Charman, T. , Dawson, G. , Durand, V. M. , Grossman, L. , Guthrie, D. , Harris, S. , Kasari, C. , Marcus, L. , Murphy, S. , Odom, S. , Pickles, A. , Scahill, L. , Shaw, E. , Siegel, B. , Sigman, M. , Stone, W. , Smith, T. , Yoder, P. (2005). Challenges in evaluating psychosocial interventions for Autistic Spectrum Disorders. Journal of Autism and Developmental Disorders, 35, 695– 711 First citation in articleCrossref MedlineGoogle Scholar

  • Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual function in young autistic children. Journal of Consulting and Clinical Psychology, 55, 3– 9 First citation in articleCrossref MedlineGoogle Scholar

  • Mc Connell, S. R. (2002). Interventions to Facilitate Social Interaction for Young Children with Autism: Review of Available Research and Recommendations for Educational Intervention and Future Research. Journal of Autism and Developmental Disorders, 32, 351– 372 First citation in articleCrossref MedlineGoogle Scholar

  • Mesibov, G. B. , Division TEACCH, (1996). A collaborative model program for service delivery, training, and research for people with autism and related communication handicaps. In M.C. Roberts (Ed.), Model programs in child and family mental health, (pp. 215-230). Hillsdale: Erlbaum First citation in articleGoogle Scholar

  • Mesibov, G. B. (1984). Social skills training with verbal autistic adolescents and adults: a program model. Journal of Autism and Developmental Disorders, 14, 395– 404 First citation in articleCrossref MedlineGoogle Scholar

  • Ozonoff, S. , Cathcart, K. (1998). Effectiveness of a home program intervention for young children with autism. Journal of Autism and Developmental Disorders, 28, 25– 32 First citation in articleCrossref MedlineGoogle Scholar

  • Ozonoff, S. , Miller, J. N. (1995). Teaching theory of mind: a new approach to social skills training for individuals with autism. Journal of Autism and Developmental Disorders, 25, 415– 33 First citation in articleCrossref MedlineGoogle Scholar

  • Panerai, S. , Ferrante, L. , Zingale, M. (2002). Benefits of the Treatment and Education of Autistic and Communication Handicapped Children (TEACCH) programme as compared with a non-specific approach. Journal of Intellectual Disability Research, 46, 318– 327 First citation in articleCrossref MedlineGoogle Scholar

  • Paul, R. (2003). Promoting social communication in high functioning individuals with autistic spectrum disorders. Child and Adolescent Psychiatric Clinics of North America, 12, 87– 106 First citation in articleCrossref MedlineGoogle Scholar

  • Poustka, F. , Bölte, S. , Feineis-Matthews, S. , Schmötzer, G. (2004). Autistische Störungen. Göttingen: Hogrefe First citation in articleGoogle Scholar

  • Probst, P. (2003). Development and evaluation of a psychoeducational parent group training program for families with autistic children. Praxis der Kinderpsychologie und Kinderpsychiatrie, 52, 473– 490 First citation in articleMedlineGoogle Scholar

  • Quill, K. A. (2000). Do-Watch-Listen-Say: social and communication intervention for children with autism. Baltimore: Paul H. Brooks First citation in articleGoogle Scholar

  • Rühl, D. , Bölte, S. , Feineis-Matthews, S. , Poustka, F. (2004). Diagnostische Beobachtungsskala für Autistische Störungen (ADOS). Bern: Huber First citation in articleGoogle Scholar

  • Stone, W. L. , Coonrod, E. E. , Pozdol, S. L. , Turner, L. M. (2003). The Parent Interview for Autism-Clinical Version (PIA-CV): A Measure of Behavioral Change for Young Children with Autism. Autism, 7, 9– 30 First citation in articleCrossref MedlineGoogle Scholar

  • Weiss, M. J. , Harris, S. L. (2001). Teaching social skills to people with autism. Behavior Modification, 25, 785– 802 First citation in articleCrossref MedlineGoogle Scholar

  • Williams, T. I. (1989). A social skills group for autistic children. Journal of Autism and Developmental Disorders, 19, 143– 155 First citation in articleCrossref MedlineGoogle Scholar

  • World Health Organization, (1992). The ICD-10 classification of mental and behavioural disorders. Clinical descriptions and guidelines. Genf: WHO First citation in articleGoogle Scholar