• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.17 no.1
• /
• pp.51-59
• /
• 2006

Objectives : Present study compared the characteristics in Rorschach responses and Sandplay between ADHD and normal children group. Method : ADHD (excluded inattention type & emotional problem) group and normal group was composed of 10 children respectively. All of them were controlled by Intelligence Quotation. Rorschach responses were scored by Exner system and compared by t-test. For sandplay work, the time was measured and photo was taken. Results : 1) ADHD group showed that the reaction time in Rorschach was significantly fast and they easily failed to recall the responses. The statical significances are 3r+ (2)/R, X-%, Xu%, (2), AG, Afr, SCZI, Wsum 6, FD, Zd, Blends, a. 2) ADHD group showed that the reaction time in Sandplay was significantly fast, they used low materials (total numbers of toy, vehicles) and the work was less coordinated. Conclusion : This results suggest that ADHD children are apt to react, think and coordinate impulsively. Also, Sandplay could be used fur diagnostic method as Rorschach test.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.2 no.1
• /
• pp.76-86
• /
• 1991

Plasma $dopamine-{\beta}-hydroxylase(DBH)$ activity was measured in 37 autistic disorders, 26 atypical pervasive developmental disorders and 23 controls, to elucidate the biological etiology in pervasive developmental disorders. The results are summarized as follows : 1) In the autistic group, the mean plasma DBH activity was significantly elevated compared to the atypical and control groups. The mean plasma DBH activity was also significantly elevated in pervasive developmental disorders(autistic disorder+atypical developmental disorder) compared to control group. 2) In the atypical and control groups, the DBH activity significantly increased with age, but in the autistic group, the DBH activity was not significantly correlated with age. 3) No significant correlation was found between the DBH activity and the severity of psychopathology. These findings support the hypothesis of a possible involvement of brain catecholamine dysfunction in the production of autistic symptoms, and this dysfunction might be due to the abnormal ontogenetic process of DBH activity in autistic disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.28 no.4
• /
• pp.244-251
• /
• 2017

Objectives: The objective of this study was to investigate the effect of pharmacological treatments for attention-deficit hyperactivity disorder (ADHD) on motor coordination, using the Developmental Coordination Disorder Questionnaire (DCDQ). Methods: The participants were recruited from April 2015 to November 2016 from the Department of Psychiatry of Asan Medical Center and were treated for 3 months with methylphenidate or atomoxetine. The illness severity at baseline and 3 months were scored using the ADHD Rating Scale (ARS), Clinical Global Impression-Severity Scale (CGI-S) and/or Clinical Global Impression-Improvement Scale (CGI-I). A total of 39 children with ADHD (age $8.0{\pm}1.4years$, 36 boys) completed the Advanced Test of Attention (ATA) and their parents completed the DCDQ at baseline and 3 months. The paired t-test, mixed between-within analysis of variance and correlation analysis were used. Results: The CGI-S (p<0.001), ARS (p<0.001), and fine motor/hand writing (p=0.005) on the DCDQ were significantly changed between pre-treatment and post-treatment. When the participants were divided into those who were suspected of having developmental coordination disorder (DCD) (n=23) and those who probably did not (n=16), the control during movement, fine motor/hand writing and general coordination scores on the DCDQ showed the main effects for group (p<0.001, p<0.001 and p<0.001, respectively). The fine motor/hand writing on the DCDQ has a significant main effect for time [F(1,37)=7.31, p=0.010, ${\eta}^2=0.405$] and the interaction effect between group and time was also significant [F(1,37)=4.63, p=0.038, ${\eta}^2=0.111$]. The baseline visual commission error on the ATA is significantly correlated with the changes in the DCDQ total scores (r=0.330, p=0.040). Conclusion: Our results provide preliminary evidence that pharmacological treatment for ADHD improves not only the core symptoms of ADHD, but also the motor coordination. Further studies are needed to confirm the effect of the pharmacological treatment for ADHD on the motor coordination.

• Clinical and Experimental Pediatrics
• /
• v.52 no.11
• /
• pp.1221-1227
• /
• 2009

Purpose:To identify the risk factors for poor neurodevelopmental outcomes in high-risk neonates. Methods:We studied 94 infants admitted to the neonatal intensive care unit at the Sanggye Paik Hospital between January 2002 and November 2005 and evaluated the follow-up data. The following events were considered as risk factors: ${\leq}32$ weeks of gestation, very low birth weight, Apgar scores of less than 5, neonatal resuscitation, neonatal seizure, congenital infection, and abnormalities in cranial ultrasound or magnetic resonance imaging (MRI). The infants who had any one of these risk factors were included. They were evaluated at their mean corrected age of 13.84${\pm}$8.03 months. Mental and Psychomotor Developmental Indices (MDI, PDI) were determined by a clinical psychologist using the Bayley Scales of Infant Development II. Results:The mean MDI and PDI of all the patients were 96.28${\pm}$26.70 and 94.00${\pm}$22.80, respectively. Abnormalities on cranial ultrasound or MRI were significant predictors of both low MDI (P<0.05) and low PDI (P<0.001). These abnormalities showed a stronger association with low PDI than with low MDI. The infants with periventricular leukomalacia had the lowest MDI and PDI ($70.10{\pm}28.68$ and $69.70{\pm}24.91$, respectively). Apgar score at 1 minute and very low birth weight were also significant predictors for low PDI (P<0.05, P<0.05, respectively). Conclusion:Image findings with cranial ultrasound or MRI were the strongest predictors of neurodevelopmental outcome. Periventricular leukomalacia was the best predictive factor for mental and psychomotor development.

• Clinical and Experimental Pediatrics
• /
• v.52 no.3
• /
• pp.289-294
• /
• 2009

Purpose : To assess the usefulness of magnetic resonance imaging (MRI), karyotyping, brainstem auditory evoked potential (BAEP), electroencephalogram (EEG), tandem mass screening test, and newborn metabolic screening test in children with language delay for diagnosing underlying diseases. Methods : From January 2000 to June 2007, a retrospective chart review was performed for 122 children with language delay who visited the Child Neurology Clinic at Yeungnam University Hospital and who underwent neuropsychologic tests and other diagnostic evaluations for underlying diseases. They were grouped into phenomenological diagnostic categories, and test results were analyzed according to the underlying diseases. Results : Of 122 patients, 47 (38.5%) had mental retardation, 40 (32.8%) had developmental language disorders, 23 (18.9 %) had borderline IQ, and 12 (9.8%) had autism spectrum disorder. In 26 (21.3%) cases, the causes or relevant clinical findings to explain language delay were found. Eight (10.4%) of 77 MRIs, 6 (8.0%) of 75 EEGs, and 4 (5%) of 80 BAEPs showed abnormal results. Results directly attributed to diagnosing underlying diseases were 2 hearing defects in BAEPs and 1 bilateral perisylvian cortical dysplasia in MRIs. No abnormal results were found in karyotyping, tandem mass screening tests, and new-born screening tests. Conclusion : Commonly used tests to diagnose the cause of language delay are not very effective and should only be used selectively, according to patient characteristics. However, despite the low diagnostic yields from these tests, because many patients show abnormal results, these tests are useful when conducted in complete evaluation.

• Clinical and Experimental Pediatrics
• /
• v.49 no.10
• /
• pp.1056-1060
• /
• 2006

Purpose : As hearing ability affects language and cognitive development, early detection and intervention of congenital hearing defects is very important. We analyzed the result of newborn hearing screening using automated auditory brainstem response and estimated the incidence of congenital hearing defects in newborn infants in Korea. Methods : Hearing screening tests were done on 7,218 newborn infants who were delivered at Cheil General Hospital from July 1, 2004 to June 30, 2005. The first screening test was done on the second day of life with automated auditory brainstem response(AABR) using $ALGO{\bigcirc}^{(3)}$ Newborn hearing screener($Natus^{(R)}$ Medical Incorporated, San Carlos, USA) with 35 dB sound level. The newborn infants who did not pass the initial screening test took the second screening AABR test before discharge from the nursery. Infants who did not pass these screenings at the nursery were followed up at the Department of Otorhinolaryngology, Samsung Seoul Hospital. Results : Total 7,218 infants(83.3 percent of total 8,664 live births of the Cheil General Hospital) were screened in the nursery, and 55 of them failed to pass the newborn screening. Among 55 infants who were referred, six were lost during follow-up, and 14 were confirmed as hearing impaired. Six of them(42.8 percent) do not have any risk factors for hearing impairment. We can estimate that the incidence of hearing defects is about 1.9-2.8 per 1,000 live births. Conclusion : Automated auditory brainstem response is an effective tool to screen the hearing of newborn infants. Congenital hearing loss is more frequent than metabolic diseases on which screening tests are available in the newborn period. About 40 percent of infants who have hearing defects do not have any risk factors for hearing impairment. Therefore, universal newborn hearing screening must be recommended to all neonates.

• Journal of Fisheries and Marine Sciences Education
• /
• v.6 no.2
• /
• pp.183-189
• /
• 1994

1970년 이후 우리나라는 산업화로 인하여 사회구조와 가정구조가 크게 변화 되었다. 도시집중화로 인한 각종 공해 발생, 교통난, 인구이동의 문제를 비롯하여 그리고 핵가족화로 인한 가부장적 권위상실 및 가정교육부재, 청소년 비행등 수 많은 문제가 야기되었다. 특히 핵가족화로 발생된 심각한 사회문제는 전통윤리의 붕괴와 가정교육의 부재현상을 발생 시켰다. 이와같은 문제발생에 관한 선행연구를 종합해보면 첫째, 핵가족화로 인해 발생한 가족규모의 축소현상으로 자녀들의 다면적 인격형성에 결손을 초래하여 성장후 독립심과 의지가 약하고 고집이 세며 이기적이고 자기중심적인 성향이 되어 사회생활에 부적응 현상을 초래하게 되었다고 한다. 그 이유는 다면적 인간관계의 결여로 상호 협조하고 사랑을 교환한 경험 부족과 외동자녀에 대한 부모의 관심이 자녀의 욕구에만 집중되어 자녀종속적인 태도가 크게 적용하였기 때문이다. 둘째는 산업화 사회에서의 부부동시 사회참여가 자녀양육에 어머니와의 애착형성이 결여되어 모성실조를 겪게 된 문제를 들 수 있다. 어머니와 자녀간의 애착형성이 결여 됨으로 발생되는 문제는 지적 정체현상과 정서발달의 장애가 주 원인이 되어 감정 통제력이 약해서 공격적 행동이나 반 사회적 행동으로 확대되어 청소년문제 발생의 원이 되고 있음을 시사하고있다. 세째로 산업화사회와 경쟁력 조장을 들 수 있다. 산업사회를 개방사회, 경재력사회 혹은 능력사회라하여 고학력위주의 선발형태가 입시경쟁을 부추기고 있으며 그에 따라 많은 청소년들과 학부모들이 상위 지향적인 심리가 작용하여 자녀들의 입시경쟁에만 집중하게 되었다. 이러한 원인으로 인하여 인간교육 즉 가정교육을 외면하여 반도덕적, 반사회적 문제를 야기하게 하였다. 특히 전통적 가정윤리가 붕괴되어 부모에 대한 효관의 약화, 부부간의 애정약화 및 물질지향적인 사고가 이혼률을 증가시켜 가정붕괴를 가져왔다. 이상에서 논의된 자녀교육의 부재가 자녀들의 지적 정서적 문제로 확대되어 산업화사회의 모순점을 노출시키고 있음을 알 수 있다. 이와같은 문제를 해결하기 위한 대안으로 연구자가 제시하는 방안은 훌륭한 가정교육을 위해서 우선되어야 하는것은 부모자신의 인격적 개인완성을 제안하였다. 인격의 완성은 양심과 행동이 일체하는 사람을 지칭한다. 다음은 서로 위하여 사는 삶을 영위하는 인격체가 되어 양심의 법에 따르는 삶, 타인을 위하여 사는 삶을 자녀들에게 보여줌으로서 반두라의 모델링 교육을 제안하였다. 마지막으로 오늘날과 같은 암기위주의 경쟁교육이 아니라 타고난 잠재성 개발에 주력하는 교육으로, 적성과 소질을 개발하는 창조적 산 교육장을 마련하여 주고 또한 그것을 뒷바침하는 가정윤리교육의 회복이 무엇보다도 이 시대가 절실히 요구하는 바람직한 교육이라 하겠다.

• Clinical and Experimental Pediatrics
• /
• v.51 no.1
• /
• pp.62-66
• /
• 2008

Purpose : In addition to epileptic seizures (ES), a variety of physiologic, organic and psychogenic disorders can manifest as paroxysmal behavioral events. Paroxysmal nonepileptic events (PNEs) are quite encountered in infants, young children, and adolescents. In a substantial proportion of cases, a careful history and examination will elucidate their nature. However, in other cases, it is necessary to differentiate PNEs from ES by video-electroencephalographic (EEG) monitoring. We report our experiences with PNEs in a group of children and adolescents who underwent video-EEG monitoring. Methods : From September, 2004 to June, 2006, one hundred thirty patients were monitored in the Pediatric Epilepsy Monitoring Units of Korea University Guro and Ansan hospitals. Their hospital charts were reviewed and video records of these events were analyzed. We observed all patients after video-EEG monitoring for more than 3 months. Results : Typical spells occurred during monitoring in 33 patients, not associated with a seizure pattern on EEG recordings. Two patients were diagnosed as frontal lobe epilepsy on basis of typical semiology and clinical characteristics, so 31 patients were documented to have PNEs finally. The mean age of patients was $7.2{\pm}5.8\;years$. The male to female ratio was 15 (48.4%) to 16 (51.6%). Among 31 patients, fifteen patients had associated disorders such as epilepsy, developmental delay, cerebral palsy, gastric ulcer, attention deficit hyperactivity disorder or depressive disorder. Somatoform disorder and factitious disorder was frequently seen in children more than 5 years old (P<0.05). Psychogenic disorder was more frequent in female (n=6) than in male (n=2) but there was no statistical significance (P>0.05). Conclusion : Our study suggests that video-EEG monitoring is an important diagnostic tool in the evaluation of paroxysmal behavioral events. With correct diagnosis of the PNEs, several unnecessary treatment could be avoided.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.10 no.1
• /
• pp.50-63
• /
• 1999

Introduction：Test anxiety is a pervasive problem among high school students in Korea. While anxiety in test situations may actually facilitate the performance of some students, more often it is disruptive and leads to performance decrements. Over the past years, many child psychiatrists have become concerned with understanding the nature of test anxiety, but it is not clearly understood yet. In order to understand the nature of test anxiety, the relationship between test anxiety and depression, state anxiety, trait anxiety, temperament and family environment were examined. Methods：The Test Anxiety Inventory, Chidlren's Depression Inventory, State-Trait Anxiety Inventory, Temperamnet and Family Environment Scale Scale were administered to 576 high school students in Seoul. The relationships between test anxiety and other measures were tested using Pearson correlation coefficients and to test the causal relationship among the variables, regression analysis was performed. Results：The correlation coefficients between test anxiety and depression, state anxiety, trait anxiety, temperament and family environment scale were 0.42(p<0.01), 0.34(p<0.05), 0.38(p<0.05), 0.36(p<0.05) and -0.23(p<0.01), respectively. Regression analysis showed that only state and trait anxiety had direct causal relationship with test anxiety. Depression, temperament and family environment were indirecly related with test anxiety. Conclusions：This study indicates that the level of state and trait anxiety are directly related with test anxiety, and other variables such as temperament, family environment and depression are indirectly related with test anxiety. Thus, in order to develop the effective methods for treatment, these psychopathological characteristics should be kept in mind and the most important factors are the levels of state and trait anxiety.

• Clinical and Experimental Pediatrics
• /
• v.48 no.9
• /
• pp.924-928
• /
• 2005

Purpose : Treatment efficacy for children with speech and language delay has been the subject of considerable debate in recent years. We evaluated the clinical features of children with delayed speech and language and their prognoses according to their etiologies after 6 months of speech and language therapy. Methods : From January, 2000 to March, 2004, we retrospectively reviewed 56 children with speech and language delay who were administered speech and language therapy for 6 months in Uijongbu St. Mary's Hospital. Results : Of 56 cases, the proportion of developmental language disorder was 66.1 percent, structural malformation 19.6 percent, mental retardation 12.5 percent, hearing defect 1.8 percent. The ratio of male to female was 4.6 : 1 and the most frequent age group was over 47 months. The mean age of first spontaneous words with useful meaning was 15.9 months. The mean gestational age of the subjects was 39.8 weeks. The proportion of full-term infants was 96.4 percent and of premature infants was 3.6 percent. As for the birth order, the proportion of the first baby was 51.8 percent, the one of second babies it was 42.9 percent, and percent of third babies it was 7.1 percent. After 6 months of language intervention, 32.4 percent of patients with developmental language disorder showed normal linguistic development. All the patients with mental retardation showed sustained language and speech delay. As for the patients with structural malformations, five out of 11 patients showed normal linguistic development. Conclusion : The relatively advanced old age of majority of participants in this study suggests the necessity of screening test for language delay in this local community.