2024년 작업치료 개념서 03-아동 CHAPTER 1 아동작업치료의 개관 _9 1.1 개요 ························································································ 11 1.2 임상적 추론 ············································································ 12 1.3 아동 평가 ··············································································· 15 1.4 치료계획 ················································································· 17 1.5 목표 및 전략·········································································· 18 1.6 근거 있는 치료 ······································································· 24 Summary ······················································································ 25 CHAPTER 2 팀 구성 및 기초 이론 _27 2.1 개요 ························································································ 29 2.2 함께 하는 전문가들 ································································29 2.3 팀 역동 모델 ·········································································· 30 2.4 아동작업치료의 이론 ······························································ 33 2.5 기초이론 ················································································· 35 2.6 작업치료사가 사용하는 중재 모델 ········································· 47 Summary ······················································································ 53 CHAPTER 3 아동을 위한 평가 _55 3.1 개요 ························································································ 57 3.2 아동 평가도구 : 측정 및 평가 참조 ······································ 58 Summary ······················································································ 72 CHAPTER 4 자세 조절의 발달 _73 4.1 운동 발달 ··············································································· 75 4.2 자세 반응의 발달 ··································································· 80 4.3 자세 조절 평가 ······································································· 82 4.4 치료적 중재 ············································································ 83 4.5 운동발달 ················································································· 87 4.6 자세발달 ················································································· 89 4.7 영유아의 반사 ········································································· 91 4.8 중추신경계 반사 ····································································· 92 Summary ···················································································· 110 CHAPTER 5 손 기술의 발달 _113 5.1 손 기술 ················································································· 115 5.2 감각기능 ··············································································· 115 5.3 신경/근육/골격 ······································································ 116 5.4 손 기술 발달 ········································································ 116 5.5 잡기 패턴의 발달순서 ·························································· 120 5.6 In-Hand Manipulation 기술 ················································· 121 5.7 손 기술의 문제 ····································································· 123 5.8 아동의 작업과 손 기술과의 관계 ········································· 124 5.9 평가 ······················································································ 126 5.10 치료적 중재 ········································································ 127 5.11 스플린트의 사용 ································································· 142 Summary ···················································································· 143 CHAPTER 6 감각통합 _145 6.1 개요 ······················································································ 147 6.2 아동의 감각통합 ··································································· 147 6.3 신경생리학을 기초로 하는 개념들 ······································· 148 6.4 아동의 작업과 감각통합의 발달 ··········································· 150 6.5 감각통합의 문제 ··································································· 152 6.6 감각통합의 장애 ··································································· 153 6.7 감각통합 장애의 치료 ·························································· 157 6.8 감각분별 및 지각의 문제 ····················································· 160 6.9 전정감각 및 고유수용성 감각 ·············································· 161 6.10 평가 ···················································································· 162 Summary ···················································································· 164 CHAPTER 7 식사를 위한 중재 _165 7.1 개요 ······················································································ 167 7.2 식사 발달 ·············································································· 167 7.3 전형적인 구강구조의 발달 ···················································· 169 7.4 먹기 기술과 관련된 전형적인 구강운동 발달 ······················ 170 7.5 평가 ······················································································ 177 7.6 감각의 문제를 지닌 아동에 대한 중재 ································ 179 7.7 구강운동 수행증진을 위한 중재 ··········································· 181 7.8 삼키기 문제에 대한 중재 ····················································· 189 Summary ···················································································· 190 CHAPTER 8 일상생활동작 _191 8.1 ADL 및 IADL 활동 ···························································· 193 8.2 수행에 영양을 주는 요소 ····················································· 193 8.3 치료 전략 및 접근 ······························································· 194 8.4 치료 테크닉 ·········································································· 199 Summary ···················································································· 208 CHAPTER 9 일반적인 아동의 질환 _209 9.1 심폐질환 ··············································································· 211 9.2 혈액의 장애 ·········································································· 213 9.3 근골격의 장애 ······································································· 214 9.4 신경근육 질환 ······································································· 215 9.5 소아 정신의학 기타(염색체) 질환 ········································ 224 CHAPTER 10 시지각 _225 10.1 정의 ···················································································· 227 10.2 눈의 해부학적 구조 ···························································· 227 10.3 시각 인지 기능 ··································································· 228 10.4 시지각 발달 ········································································ 231 10.5 시지각 문제 ········································································ 232 10.6 평가 ···················································································· 233 10.7 보상적 접근법 ····································································· 234 10.8 다양한 중재 전략 ······························································· 235 CHAPTER 11 신생아 집중치료실 _237 11.1 신생아 집중치료의 진화 ····················································· 239 11.2 신생아 작업치료의 진화 ····················································· 240 11.3 의학적 기초 ········································································ 241 11.4 NICU의 환경 ······································································ 244 11.5 NICU의 영아 ······································································ 249 11.6 스트레스와 안정 상태 비교 ················································ 256 11.7 미숙아의 자세 ····································································· 256 11.8 기타 ···················································································· 259 CHAPTER 12 쓰기 전 기술 및 쓰기 기술 _263 12.1 개요 ···················································································· 265 12.2 쓰기 과정 ············································································ 266 12.3 쓰기 평가 ············································································ 268 12.4 쓰기 수행 평가 ··································································· 269 12.5 쓰기 평가 ············································································ 270 12.6 수기 중재 ············································································ 271 CHAPTER 13 수단적 일상생활 활동과 지역사회 참여 _275 13.1 IADL 발달 ········································································· 277 13.2 지역사회 참여와 관련된 개인적/환경적 영향 ····················· 282 13.3 IADL 및 지역사회 참여에 관한 평가 ································ 284 13.4 중재 계획 및 실행 ······························································ 286 13.5 중재 모델과 전략 ······························································· 287 CHAPTER 14 기 타 _291 14.1 아동의 놀이 ········································································ 293 14.2 행동치료(행동수정) 기법 ····················································· 295

머리말 작업치료 분야는 그 어떤 영역보다 광범위하고 다차원적인 분야이다. 의학, 심리학, 사회학 등 인간 관련 다영역적 학문으로 매우 다양하고 복합적 성격을 지닌 학문이다. 국내 작업치료 역사는 한국전쟁을 시작으로 이미 반세기가 지났으며, 매우 다양한 분야로 진출하고 있다. 반면, 국내 작업치료의 교육 현실은 예전보다 많이 발전하였으나 전공 교육과정에 필요한 교재는 여전히 부족한 상태이며, 이로 인해 국가시험을 준비해야 하는 재학생들에게 큰 부담이 되고 있다. 이에 본 교재는 부족한 교육과정을 보충하고 중요한 내용들을 요약정리하므로 보다 쉽게 작업치료사 국가고시를 준비할 수 있도록 구성하였다. 최근 국가시험은 보다 전문적이고, 과학적이며, 다양한 문제들이 출제되는 경향을 보이고 있다. 과거 출간된 서적들 대부분이 암기형 문제 풀이식으로 구성되어 있어 국가시험을 준비하는 학생들에게 큰 도움을 주지 못했던 반면, 본 서적은 다양한 분야의 실기형ㆍ 사례형 문제들을 탑재하는 동시에 풍부한 해설을 통해 체계적이고, 논리적 학습이 가능하도록 편집하였다. 본 교재는 학생들의 이해도를 높이기 위해 구체적이고, 보다 체계적인 해설과 매뉴얼을 제공하고 있으며, 실전 문제와 같은 문제들을 통해 국시 및 임상대비 능력을 극대화하고자 하였다. 국시에 필요한 전공과목의 체계적인 정리는 학생들 스스로 학습이 가능하도록 하였으며, 출제 비중이 높은 이론과 실기, 그에 따른 해설을 통해 학생들의 학습효과를 극대화하여 국가시험에 대한 자신감을 높여주고자 한다. 작업치료사 국가시험을 준비하는 모든 학생들에게 등대와 같은 교재가 되기를 희망하며… 2024년 4월 작업치료 국시연구회