• The Journal of Korean Academy of Sensory Integration
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• v.16 no.1
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• pp.14-24
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• 2018

Objective : The purpose of this study was to identify the effect of Interactive Metronome (IM) training on postural control and hand writing performance of children with Attention Deficit Hyperactivity Disorder (ADHD). Methods : Participant was a third grade elementary school student diagnosed with ADHD. ABA design was used and a total of 30 sessions were held for 3 sessions every week for a total of 10 weeks. In the intervention period, IM training was conducted for 40~50 minutes before intervention for writing, and the writing task was carried out. We evaluated the handwriting legibility and speed. Before baseline A and within a month after A' phase, Clinical Observation of Motor and Postural Skills (COMPS) was evaluated to examine the changes in postural control of the student. Results : After the IM intervention, the postural control of the student improved in the score of slow movement, finger-nose touching, and asymmetrical tonic neck reflex. The handwriting legibility and speed has also tended to increase during the intervention period, but it has not significantly changed. Conclusion : This study could be used as an evidence that the IM training aimed at postural control and handwriting ability could enhance the ability to improve postural control and thereby provide fundamental knowledge for future studies.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.4
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• pp.213-219
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• 2013

Objectives : It is known that adolescents with autism spectrum disorder (ASD) often concurrently exhibit attention-deficit hyperactivity disorder (ADHD). The objective of this study is to investigate how ADHD symptoms modify clinical characteristics in adolescents with ASD. Methods : Subjects were recruited from the Program for the Education Enrichment of Relational Skills program, which is a program for adolescents with ASD to promote and train social skills. The study participants and their parents completed the study questionnaires, such as the ADHD rating scale, Autism Diagnostic Observation Schedule, and Korean version of Child Behavior Checklist. Results : Adolescents with ASD and ADHD (N=19) were found to have more impaired sociality, less open communication with their parents, and more behavioral and emotional problems compared with adolescents with ASD, and without ADHD (N=28). Conclusion : Although further research is needed, the results of our study suggest that adolescents with ASD present different clinical characteristics when comorbid with ADHD.

• The Journal of the Korea Contents Association
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• v.14 no.12
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• pp.854-862
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• 2014

Attention deficit hyperactivity disorder (ADHD) students' intellctual defects, learning problems, and poor academic achievements seem to be due to significantly lower intelligence compared to the normal students, but rather the characteristic of inability to pay attention at a given time can be seen as the more attributing reason. In this study, a comparison between the ADHD students and the normal students will be performed using a fMRI analysis in order to differentiate the brain function between the two groups during a working memory task performance and to assess the difference in the activated regions of the brain. Clinical survey examinations and fMRI measurements were performed for a group of 26 elementary students from the Incheon area. The stimulus of fMRI was a working memory. Cartography statistically analyzed parameters and the Statistical Package of Social Sciences using single-sample t-test, two-sample t-test, were analyzed by multiple regression analysis, the statistical significance level was p<0.05 in, respectively. The disproportionate developments could be seen in the ADHD students group such as the frontal cortex, parietal cortex, thalamus, and caudate nucleus, among others. In addition, as some students felt the increase in the difficulty of working memory task performance, the orbitofrontal cortex and the hippocampus were activated, which seems to be the result of an effort for looking for an answer. More types of ADHD students needs to be secured as research subjects, and more stimulations for fMRI experiments should be considered as it would be useful in the overall evaluation of brain function.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.7 no.2
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• pp.190-202
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• 1996

This study assessed psychiatrically referred 5-to 13-year-old children who presented inattention or hyperactivity as chief complaints. Demographic characteristics, primary diagnosis, and comorbid psychiatric conditions of them were identified, and they were assessed using questionnaires and neuropsychological tests. Primary diagnoses included ADHD, anxiety disorder, mental retardation, depression, oppositional defiant disorder, developmental language disorder and others. functional enuresis, conduct disorder, and developmental language disorder were among the secondarily diagnosed disorders. In patients diagnosed as ADHD, overall comorbidity rate was 55.3%. The disorders that frequently co-occured with ADHD were specific developmental disorder, conduct disorder, oppositional defiant disorder, anxiety disorder and other. ADHD groups with or without comorbidity differed in performance IQ and CPT scores. ADHD group differed from externalizing disorders group in the information subscore of IQ, MFFT, and CPT scores, and differed in teachers rating scales, the uncommunication factor of CBCL, and CPT card error compared with internalizing disorders group. The authors concluded that inattentive or hyperactive children should be assessed using various instruments to differentiate other disorders and to identify possible presence of comorbid conditions.

• Journal of Korean Academy of Nursing
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• v.47 no.3
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• pp.305-318
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• 2017

Purpose: The aim of this study was to identify the effects of a newly developed instructional coaching program regarding Attention Deficit Hyperactivity Disorder (ADHD) for teachers. Methods: Seventy teachers participated in this study involving a nonequivalent control group and a pretest-posttest design. The instructional coaching program consisted of eight 60-minute sessions. The program was developed through a theoretical development program involving six steps. To evaluate the effects of the program, data were collected through self-report questionnaires including the Knowledge Scale of Attention Deficit Disorder, Attitude Scale of Primary School Teachers Experiencing Students with ADHD, Practice Scale of Educational Intervention Activity, and the Korean ADHD Rating Scale. Data were analyzed with an independent t test, a chi-square test, and an ANCOVA using SPSS WIN version 20. Results: The intervention program consisted of 3 sectors, 8 subjects, and 24 content items. The experimental group showed a significant improvement in attitudes toward ADHD (F=22.83, p<.001). In addition, teacher's knowledge regarding ADHD (F=7.16, p=.010) and the implementation of instructional interventions (F=4.29, p=.043) improved. Further, teachers reported a reduction in children's ADHD-related behavior (F=4.34, p=.041). Results showed that the coaching program made a positive contribution to teaching skills and understanding of school-age children with ADHD. Conclusion: The instructional coaching program was well structured and significantly improved not only teachers'attitudes, knowledge, and teaching skills but also the behavior of children with ADHD in class. Therefore, the program is recommended as a means of facilitating teaching and managing children with ADHD in class.

• Child Health Nursing Research
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• v.23 no.3
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• pp.279-291
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• 2017

Purpose: The aim of this study was to explore how characteristics of ADHD children affect social support for mothers, parenting stress, parenting sense of competence, coping, and quality of life. The conceptual model was based on the Lazarus and Folkman's stress-evaluation-coping theory. Methods: Data were collected 208 mothers of children with ADHD. Data were analysed using SPSS 18.0 and AMOS 18.0 programs. Results: The proposed model was good fit for the data based on the model fit indices. Parenting stress, parenting sense of competence and coping directly affected quality of life but characteristics of the children and social support had only an indirect effect. The explanatory power of these variables was 52.1%. Conclusion: The results of this study indicate that nursing strategies to increase social support for mothers with ADHD children, lowers parenting stress, improves parenting sense of competence, and guides the parents to choose appropriate coping. In particular, as social support has the strongest influence on the quality of life, it is necessary to develop nursing intervention programs that utilize social support for parents with ADHD children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.36-52
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• 2003

Attention deficit/hyperactivity disorder is one of the most comminly treated conditions in the child psychiatric units and results in substantial impairment in peer, family and academoc functioning. For 70% to 80% of children with a diagnosis of ADHD, stimulant tratment results in successful improvement of the core ADHD symptoms. However, children with ADHD have high level of comorbidity and may respond differently from children with ADHD without comorbidity. Therefore they may need specific treatment plan. We reviewed efficacy and safety of prescribed medication for treating children with ADHD, the relationship between ADHD and the comorbid conditions and treatment algorithm projects of ADHD with/without comorbid conditions performed Korean and American child psychiatrists. Our main objective is to increase the uniformity of treatment and improve the clinical outcomes of children with comorbid ADHD.

• Journal of Korean Academy of Nursing
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• v.45 no.2
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• pp.169-182
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• 2015

Purpose: This study was a meta-analysis designed to identify effects of Cognitive Behavioral Therapy (CBT) interventions in alleviating main symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among school-aged children in Korea. Methods: Examination of several databases including Research Information Sharing Service, Korean Studies Information Service System, Data Base Periodical Information Academic and hand-searched article references, resulted in identification of 1,298 studies done between 2000 and 2013 of which 21 met the inclusion criteria. Comprehensive Meta-Analysis version 2.0 was used to analyze effect sizes, explore possible causes of heterogeneity, and check publication bias with a funnel plot and its trim-and-fill analysis. Results: Overall effect size of CBT intervention was large (g=1.08) along with each outcome of self-control (g=1.26), lack of attention (g=1.02), social skills (g=0.92), and hyperactivity (g=0.92). For heterogeneity, moderator analysis was performed, but no significant differences were found between the RCT (Randomized Controlled Trials) group and the NRCT (Non RCT) group. Also, meta-regression was performed using sample size, number of sessions, and length of session as predictors, but no statistically significant moderators were found. Finally, a funnel plot along with trim-and-fill analysis was produced to check for publication bias, but no significant bias was detected. Conclusion: Based on these findings, there is clear evidence that CBT intervention has significant positive effects on the main symptoms of school-aged children suffering ADHD. Further research is needed to target diverse age groups with ADHD along with more RCT studies to improve the effectiveness of the CBT intervention.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.14 no.1
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• pp.3-11
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• 2003

Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations：the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.22 no.4
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• pp.246-252
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• 2011

Background : The objective of this study was to evaluate the diagnostic efficiency of the Comprehensive Attention Test (CAT) by comparing the results of the continuous performance test (CPT) and the CAT in children and adolescents with attention-deficit hyperactivity disorder (ADHD). Method : A total of 110 children and adolescents with ADHD (mean age : 11.2${\pm}$2.9 years, 76 boys) and 36 children and adolescents without ADHD (mean age : 12.0${\pm}$2.7 years, 25 boys) completed the CAT. We compared the specificity and sensitivity of the CPT and CAT at two different cut-off points via the McNemar test. The areas under the receiver operating characteristic curves (AUC) between the two groups were compared using Medcalc software. Results : The sensitivity and specificity of the CPT were .419 and .806, respectively. The sensitivity of the CAT was .827, which was significantly higher than that of the CPT (p<.001), and the specificity of CAT is .444, which was significantly lower than that of CPT (p<.001). The AUC of the CPT and CAT was .664 and .692, respectively, and there were no significant difference between the two groups on the paired comparison (p=.513). Conclusions : The results of this study suggest that the CAT has moderate specificity and high sensitivity. The CAT can be used as a useful tool to evaluate the neuropsychological function of children and adolescents with ADHD.