ETEÇOM

ETKİLEŞİM TEMELLİ ERKEN ÇOCUKLUKTA
MÜDAHALE PROGRAMI 

 ETEÇOM ilişki-temelli yaklaşıma dayalı bir programdır. Birincil bakıcının (ebeveyn ya da eğitimci) çocuğu ile etkileşiminin niteliğini geliştirmeyi ve çocuğun bilişsel, sosyal-duygusal ve iletişim becerilerini desteklemeyi hedefler.  2006 yılında program haline getirilmiştir ve ABD, Kore ve Türkiye’de sınanmış ve sınanmaya devam etmektedir. ETEÇOM Down Sendromu, Otistik bozukluk (Otizm), Serebral Palsi, Zihinsel Yetersizlik, Gecikmiş Dil ve Konuşma, Nedeni Belli Olmayan Gelişimsel Gerilik, Prematüre/Düşük Doğum Ağırlığı gibi farklı gelişim özellikleri gösteren çocuklar ve ebeveynleri üzerinde etkili olan bir programdır. Merkezimizde ETEÇOM’u 2013 yılından itibaren Otizm Spektrum Bozukluğu ve Zihinsel Yetersizlik tanısı almış çocuklarla uygulanan eğitim programlarına yardımcı eğitim programı olarak kullanmaktayız.

ETEÇOM eğitimci ya da ebeveynin etkileşimsel davranışlarını geliştirerek, çocuğun bilişsel, iletişim ve sosyal duygusal gelişim alanlarında (sosyal oyun oynayabilme, etkileşim başlatabilme, ortak dikkat gibi) 16 temel davranışı kazanması ya da geliştirmesini hedefler. ETEÇOM’da 16 temel davranışı kazandırmaya yönelik 66 öğretimsel strateji ebeveyne öğretilir. Her oturumda 1-2 strateji çalışılır.

Çocuklar gelişimsel ve eğitimsel tanılarına ek olarak geçerliliği, güvenilirliği kabul edilmiş ölçeklerle detaylı olarak değerlendirilir ve çerçeve program oluşturulur. Ebeveynlerin kaygı ve beklentilerini ifade etmeleri için Temel Davranış Seçici Formu kullanılır. Program aile ile ortak hazırlanır. ETEÇOM programında aile eğitim seanslarının izleyicisi, katılımcısı, uygulayıcısı ve takipçisidir. Çocuğun bulunduğu basamak, hedeflenen temel davranış ve uygun stratejiler belirlendikten sonra birincil bakıcının varlığı ve katılımında müdahale oturumlarına başlanır. Eğitimci temel davranışları ve stratejileri bilgi notlarını kullanarak açıklar, model olur. Kısa aralıklarla değerlendirme ve izleme yapar. Planlama ve izleme yapabilmek için ailenin izni alınarak görüntü kaydı yapılır. Görüşmeler, değerlendirme süreçleri, eğitim seansları sadece çocuğun iletişimsel, sosyal, duygusal ya da fiziksel yetersizlik ve güçlükleri ile ilgilidir.

Birlikte seçilen temel davranışlar ve stratejiler eğitimci tarafından ebeveyne okunur, açıklanır. Etkinliklerle uygulanır, ardından ebeveynin uygulaması istenir. Eğitim seansları dışında ebeveynin çocuğun doğal ortamında onu nasıl destekleyebileceği konuşulur ve aileye ev ödevi verilir. Hedef davranışı ve stratejileri gören, dinleyen ve uygulayan aile zamanla yapılandırılmamış ortamlarda da aynı yaklaşım ve öğretim tekniklerini kullanmaya başlar. Ortamda sıcak hiçbir şey yoksa sıcak kavramını öğretmeye çalışmak ya da öğrenmeye zorlanmak yerine çorba içerken öğrenmek ve öğretmek daha kolay, anlamlı ve kalıcıdır. ETEÇOM programında önce daima Sosyal Oyun temel davranışı çalışılır. “Çocuğun dünyasına girme”,“Çocuğun etkileşimde bulunmasını bekleme” stratejileri kullanılır. “Dünyaya çocuğunuzun gözünden bakın. Yüz yüze oyunlar oynayın. Çocuğun liderliğini izleyin. Çocuğun hızına uyun” gibi pratik önerilerle desteklenir.

Yaklaşık 6 ay içerisinde programdaki stratejiler tamamlanır ve programda belirtildiği gibi uygulandığında çocuğun gelişimde anlamlı gelişmeler gözlenebilir. Yakın zamandaki araştırmalar, çocuklarının eğitiminde aktif rol alan ailelerin kaygı düzeyinin azaldığını, çocukların gelişiminin hızlandığını ortaya koymuştur.

 

 

 

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