• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.29 no.4
• /
• pp.178-184
• /
• 2018

Objectives: The objective of this study was to investigate the concordance of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5) diagnostic criteria for autism spectrum disorder (ASD). Methods: We retrospectively reviewed the medical records of 170 subjects (age range: 3-23, 140 boys) with developmental delay or social deficit from January 2011 to July 2016 at the Department of Psychiatry of Asan Medical Center. The Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS), and intelligence tests were performed for each subject. Diagnosis was reviewed and confirmed for each subject with DSM-IV Pervasive Developmental Disorder (PDD) and DSM-5 ASD criteria, respectively. Results: Fifty-eight of 145 subjects (34.1%) who were previously diagnosed as having PDD in DSM-IV did not meet DSM-5 ASD criteria. Among them, 28 (48.3%) had Asperger's disorder based on DSM-IV. Most algorithm scores on ADOS and all algorithm scores on ADI-R were highest in subjects who met both DSM-IV PDD criteria and DSM-5 ASD criteria (the Convergent group), followed by subjects with a DSM-IV PDD diagnosis who did not have a DSM-5 ASD diagnosis (the Divergent group), and subjects who did not meet either DSM-IV PDD or DSM-5 ASD criteria (the non-PDD group). Intelligence quotient was lower in the Convergent group than in the Divergent group. Conclusion: The results of our study suggest that ASD prevalence estimates could be lower under DSM-5 than DSM-IV diagnostic criteria. Further prospective study on the impact of new DSM-5 ASD diagnoses in Koreans with ASD is needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.35 no.1
• /
• pp.51-56
• /
• 2024

This review explores the complexities of autism spectrum disorder (ASD), primarily focusing on the significant eating challenges faced by children and adolescents with this neurodevelopmental condition. It is common for individuals with ASD to exhibit heightened sensitivity to various sensory aspects of food such as taste, texture, smell, and visual appeal, leading to restricted and less diverse diets. These dietary limitations are believed to contribute to an imbalance in the gut microbiota. This review elaborates on how these eating problems, coupled with the distinctive characteristics of ASD, might be influenced by and, in turn, influence the gut-brain axis, a bidirectional communication system between the gastrointestinal tract and the brain. This discussion aims to shed light on the multifaceted interactions and potential implications of diet, gut health, and neurological development and function in children and adolescents with ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.31 no.3
• /
• pp.105-120
• /
• 2020

Although autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social impairments, patients with ASD frequently manifest atypical sensory behaviors. Recently, atypical sensory perception in ASD has received much attention, yet little is known about its cause or neurobiology. Herein, we review the findings from neuroimaging studies related to visual perception in ASD. Specifically, we examined the neural underpinnings of visual detection, motion perception, and face processing in ASD. Results from neuroimaging studies indicate that atypical visual perception in ASD may be influenced by attention or higher order cognitive mechanisms, and atypical face perception may be affected by disrupted social brain network. However, there is considerable evidence for atypical early visual processing in ASD. It is likely that visual perceptual abnormalities are independent of deficits of social functions or cognition. Importantly, atypical visual perception in ASD may enhance difficulties in dealing with complex and subtle social stimuli, or improve outstanding abilities in certain fields in individuals with Savant syndrome. Thus, future research is required to elucidate the characteristics and neurobiology of autistic visual perception to effectively apply these findings in the interventions of ASD.

• The Journal of Pediatrics of Korean Medicine
• /
• v.31 no.4
• /
• pp.49-60
• /
• 2017

Objectives The purpose of this study is to report the effectiveness of Korean medicine on treating autism spectrum disorder (ASD) in childhood. Methods We treated an 8-years-old patient who was diagnosed with autism (grade II) with herbal medicine, acupuncture and electric moxibustion. Every 11 months, Korean-Childhood Autism Rating Scale (K-CARS) was used to assess the patient's symptom progression. Results After 21 months of Korean medicine treatment, the child's overall health was improved. Moreover, language ability, emotional control, memory and cognitive abilities got better, as well as anxiety, agitation, and aggressive behavior related to ASD were also decreased. K-CARS score at the initial stage of the treatment was 39.5 points, which can be considered as severe autism. After 11 months of the treatment, the K-CARS score was 34.5 points which is mild-moderate autism. Conclusions Korean medicine treatment can be effective in improving symptoms of ASD. However, further studies are needed to demonstrate the treatment benefits to ASD.

• Science of Emotion and Sensibility
• /
• v.21 no.2
• /
• pp.125-136
• /
• 2018

Although atypical sensory processing is a core feature of autism spectrum disorder (ASD), there is considerable heterogeneity among ASD individuals in the modality and symptoms of atypical sensory processing. The present study examined visual processing of children with ASD, focusing on the complexity and orientation of visual information. Age- and -IQ-matched Korean children (14 ASD and 14 typically-developing (TD) children) received an orientation discrimination task involving static spatial gratings varied in complexity (simple versus complex) and orientation (horizontal versus vertical). The results revealed that ASD children had difficulty perceiving complex information regardless of orientation, whereas TD children had more difficulty with vertical gratings than horizontal gratings. Thus, group-level differences between ASD and TD children appeared greater when gratings were presented horizontally. Unlike ASD adult literature, however, ASD children did not show superior performance on simple gratings. Our findings on typical and atypical processing of ASD children have implications for both understanding the characteristics of ASD children and developing diagnostic tools for ASD.

• The Journal of Pediatrics of Korean Medicine
• /
• v.29 no.4
• /
• pp.119-126
• /
• 2015

Objectives The purpose of this study is to investigate recent clinical studies on effect of acupuncture for Autism Spectrum Disorder in other countries. We have analyzed the studies on effect of acupuncture for Autism Spectrum Disorder within randomized controlled trail (RCT) for 6years (from 2010 to 2015). Methods The search database includes Medline, Embase, Cochrane library and CNKI (China National Knowledge Infrastructure). To narrow the search, the following key search terms were used: 'autism or ASD or Asperger's Syndrome or pervasive developmental disorder, acupuncture'. The search was limited to the publication date from 2010 to 2015. 7 control studies in Medlin, Embase, Cochrane library and 5 control studies in CNKI were selected for analysis. Results and Conclusions 1. The acupuncture and rehabiliation treatment is more effective than only acupuncture treatment. Especially, Retention of needling is helpful. 2. It is necessary to set up standard scale in assessment of ASD patients and serum arginine-vasopressin (AVP) can be substitution. 3. Head acupuncture and tongue acupuncture is effective for ASD.

• Clinical and Experimental Pediatrics
• /
• v.65 no.3
• /
• pp.131-135
• /
• 2022

Purpose: There is inconsistent evidence about the association between fetal nuchal cord and the risk of autism spectrum disorder (ASD). We performed a meta-analysis to investigate whether fetal nuchal cord is associated with an increased risk of ASD in offspring. Methods: Three main English databases were searched until January 2021. The Newcastle-Ottawa Scale was used to assess study quality. Study heterogeneity was determined using the I 2 statistic, while publication bias was assessed using Begg and Egger tests. Results are presented as odds ratios (ORs) and relative ratios with 95% confidence intervals (CI) and were determined by a random-effects model. Results: Five articles (1 cohort, 4 case-control; 3,088 total children) were included in the present meta-analysis. Fetal nuchal cord was not a risk factor for ASD (OR, 1.11; 95% CI, 0.66-1.57). There was homogeneity among studies that reported a risk of ASD (I²=0.0%). Conclusion: Our results showed that fetal nuchal cord is not a risk factor for ASD. Future large cohort studies should confirm this finding.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.34 no.2
• /
• pp.76-92
• /
• 2023

Objectives: This study aimed to analyze research trends in autism spectrum disorder (ASD) and savant syndrome and their cognitive characteristics through a systematic literature review. The objectives of this study were to establish an overview of research trends in ASD and savant syndrome, analyze the overall characteristics of individuals with ASD and savant syndrome, and examine their cognitive characteristics. Methods: For the systematic literature review, three criteria were used to select review articles: 1) literature from peer-reviewed journals, published in the past 15 years, from 2008 to 2022; 2) subjects with ASD and savant syndrome; 3) study objectives focused on the basic phenomenon and cognitive characteristics of ASD and savant syndrome. Finally, based on the selection criteria, a total of 40 articles were included. Results: Five themes and nine subthemes were derived from the analysis of 40 studies. The five main themes were as follows: 1) What is savant syndrome? 2) Demographic characteristics of savant syndrome; 3) Spectra of savant syndrome; 4) Savant syndrome and ASD; and 5) Cognitive characteristics of ASD with savant syndrome. The subthemes of the cognitive characteristics were weak central coherence, detail-focused cognitive processing, enhanced perceptual functioning, and hyper-systemizing. Conclusion: Several studies have been conducted to understand ASD and savant syndrome; however, no single theory can specify the cognitive characteristics of people with ASD and savant syndrome. Therefore, further systematic and multi-layered research on ASD and savant syndrome are required for more comprehensive results.

• International Journal of Contents
• /
• v.15 no.3
• /
• pp.13-20
• /
• 2019

This systematic review compared Korean and international researches on sensory integration therapy in patients with autism spectrum disorder (ASD). We targeted studies on sensory integration therapy for patients with ASD published from January 2000 through July 2016. Specifically, we analyzed the papers that used the phrase 'sensory integration, autism' as keywords. There were fewer Korean studies of sensory integration therapy, and the diversity of research topics were limited, focusing mainly on case studies. There was no difference between the internal/external validity of Korean and those of international studies targeting the clinical environment and patients. Further study of a variety of aspects of sensory integration therapy is needed to gain high internal/external validity.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.34 no.1
• /
• pp.40-50
• /
• 2023

Objectives: This study examined the validity of the Childhood Autism Rating Scale, Second Edition (CARS-2) compared with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in identifying autism spectrum disorder (ASD). Methods: A total of 237 children were tested using both the CARS-2 and ADOS-2. We examined the correlation using Pearson's correlation analysis. In addition, we used a receiver operating characteristic graph to determine the optimal standard version of the CARS-2 (CARS2-ST) cutoff score for ASD diagnosis using the ADOS-2. Results: The concurrent validity of the CARS2-ST was demonstrated by a significant correlation with the ADOS-2 (r=0.864, p<0.001). The optimal CARS2-ST cutoff scores were 30 and 28.5 for identifying autism and autism spectrum, respectively, based on the ADOS-2. Conclusion: We suggest a newly derived CARS2-ST cutoff score of 28.5 for screening ASD and providing early intervention.