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

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.1
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• pp.51-56
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• 2023

Objectives: Regression, while not a core symptom of autism spectrum disorder (ASD), has been suggested to be a distinct subtype by previous studies. Therefore, this study aimed to explore the prevalence and clinical differences between those with and without regression in children with ASD. Methods: This study includes data from toddlers and young children aged 2-7 years acquired from other projects at Seoul National University Bundang Hospital. The presence and characteristics of regression were explored using question items #11-28 from the Autism Diagnostic Interview-Revised. Chi-square and independent t-tests were used to compare various clinical measurements such as autistic symptoms, adaptative behavior, intelligence, and perinatal factors. Results: Data from 1438 young children (1020 with ASD) were analyzed. The overall prevalence rate of regression, which was mainly related to language-related skills, was 10.2% in the ASD group, with an onset age of 24 months. Regarding clinical characteristics, patients with ASD and regression experienced ASD symptoms, especially restricted and repetitive interests and behaviors, with greater severity than those without regression. Furthermore, there were significant associations between regression and hypertension/placenta previa. Conclusion: In-depth surveillance and proactive interventions targeted at young children with ASD and regression should focus on autistic symptoms and other areas of functioning.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.4
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• pp.187-195
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• 2014

Objectives : The objective of this study was to investigate the relationship between restricted, repetitive behaviors and interests (RRBI) and autistic symptoms in Korean high functioning autism spectrum disorder (ASD) children and to examine the structure of RRBI. Methods : Participants included 147 high functioning ASD subjects and 181 unaffected siblings. ASD subjects were divided into two groups based on the presence of RRBI. The domain scores of the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R), Korean version of Asperger Syndrome Diagnostic Scale and total scores of Korean translated version of Social Responsiveness Scale, Korean version of Social Communication Scale were used for comparison of ASD symptoms between the groups. Eleven items from the RRBI domain of the K-ADI-R were used in principal axis factor analysis (PAF). Results : A statistically lower nonverbal IQ score was observed for ASD with RRBI than for ASD without RRBIs, and more social deficit, communication deficit, and behavioral and emotional problems were observed for ASD with RRBI compared to ASD without RRBI. Using PAF, two distinct factors were identified. 'Resistance to trivial changes in environment', 'Difficulty with minor changes in personal routine & environment', and 'Compulsion/ritual' were included as one factor. Conclusion : Analysis of the data suggests that the presence of RRBI in high functioning ASD is associated with a more severe presentation of autistic disorder. In addition, there appears to be heterogeneity within RRBI in autism except insistence on sameness.

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

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

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

• Sleep Medicine and Psychophysiology
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• v.20 no.2
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• pp.53-58
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• 2013

Autism Spectrum Disorder (ASD) is characterized by persistent deficits in social communication and restricted, repetitive patterns of behavior and interest. Sleep problems are not uncommon in children with autism spectrum disorders. Symptoms of insomnia are the most frequent sleep problems in individuals with ASD. Sleep problems can cause significant difficulties in the daily life of children with ASD and their families. Genetic factor, deregulations of melatonin synthesis, extraneous environmental stimuli and psychiatric and medical conditions may cause sleep problems. The first line treatment of sleep problems in ASD includes managements for potential contributing factors and parent education about sleep hygiene care for child and behavioral therapy. Supplementation with melatonin may be effective before considering other medications, such as risperidone, clonidine, and mirtazapine.

• 대한상한금궤의학회지
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• v.12 no.1
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• pp.183-198
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• 2020

Objective: The purpose of this study was to report improvement in patients with autism spectrum disorder (ASD) treated with herbal medication described in Shanghanlun. Methods: The patient was diagnosed with Lesser Yin disease based on the 315^th provision of Shanghanlun, and Baektonggajeodamjup-tang was used for treatment. The result was evaluated using the Korean-Childhood Autism Rating Scale (K-CARS). Results: The K-CARS score decreased from 32 to 15 after 7 months of treatment. Conclusions: Lesser Yin disease 315^th provision of Shanghanlun may be a provision describing ASD; in addition, Baektonggajeodamjup-tang may be an effective treatment for ASD.

• The Journal of Pediatrics of Korean Medicine
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• v.35 no.3
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• pp.28-42
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• 2021

Objectives The purpose of this study is to investigate the effect of Tuina treatment for children with Autism Spectrum Disorder (ASD), and to propose guidance to future studies or application in clinical setting. Methods The articles published from year 2000 to May 2021 by China National Knowledge Infrastructure (CNKI) were searched by setting up field as '中醫學', '中藥', '中西醫結合' and by setting up keyword as '小儿自閉症', '儿童自閉症', '自閉症譜系障碍', 'Autism', 'Autism spectrum disorder' that corresponds to participant and '推拿', '導引', '按摩', 'Tuina', 'massage'. Results Nine selected articles were analyzed and summarized by authors and year published, characteristics, diagnostic criteria, treatment methods and contents, treatment duration, evaluation criteria and results of the study. The articles were also reviewed by reported side effects, and evaluated the quality of the study according to Cochrane Handbook's Risk of Bias 2 (RoB 2) assessment of the Randomized Control Trial (RCT) articles. All studies used Tuina treatment to achieve effective results for pediatric autism spectrum disorder. Conclusion Pediatric Tuina treatment (TM) is a non-invasive treatment that does not stimulate patients with unstable ASD but increase patient adherence, and can be safely and simply operated. Therefore, pediatric Tuina treatment is worth utilizing as a clinical basis for further development of ASD treatment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.30 no.1
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• pp.9-16
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• 2019

Objectives: The purpose of this study was to analyze the discriminant validity and the clinical cut off scores of the Child Behavior Checklist 1.5-5 (CBCL 1.5-5) in the diagnosis of autism spectrum disorder (ASD) and non-ASD. Methods: In total, 104 ASD and 441 non-ASD infants were included in the study. T-test, discriminant analysis, receiver operating characteristic (ROC) curve analysis, and odds ratio analysis were performed on the data. Results: The discriminant validity was confirmed by mean differences and discriminant analysis on the subscales of Emotionally reactive, Somatic complaints, Withdrawn, Sleep problems, Attention problems, Aggressive behavior, Internalizing problems, Externalizing problems, and Total problems, along with the Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales between the two groups. ROC analysis showed that the following subscales significantly separated ASD from normal infants: Emotionally reactive, Somatic complaints, Withdrawn, Sleep problems, Attention problems, Aggressive behavior, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems. Moreover, the clinical cut off score criteria adopted in the Korean-CBCL 1.5-5 were shown to be valid for the subscales Withdrawn, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems. Conclusion: The subscales of Withdrawn, Internalizing problems, Externalizing problems, Total problems, and DSM pervasive developmental problems significantly discriminated infants with ASD.