• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제35권2호
• /
• pp.136-142
• /
• 2024

Objectives: The purpose of this study was to examine the patterns of use of oral aripiprazole treatment in children and adolescents diagnosed with autism spectrum disorder (ASD) at a university medical center in Korea. Methods: We retrospectively reviewed the medical records of 164 outpatient children and adolescents diagnosed with ASD by child and adolescent psychiatrists. Patient demographic characteristics, clinical features, age and dose of aripiprazole treatment, associated adverse events, and concomitant medications, etc. were evaluated. Results: Aripiprazole treatment was initiated at a mean age of 7.64 years, at a mean initial dose of 1.15 mg. Methylphenidate was often co-administered with aripiprazole. The most commonly reported adverse effects were increased appetite and weight gain, which in some cases led to discontinuation of medication. Conclusion: A follow-up study is warranted to evaluate the efficacy and safety of aripiprazole treatment in Korean children and adolescents diagnosed with ASD, and it is crucial to consider their clinical characteristics and response to treatment in the evaluation.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제35권1호
• /
• pp.57-65
• /
• 2024

Autism spectrum disorder (ASD) can be associated with eating problems. However, currently, there is a lack of established guidelines for assessing and addressing eating behaviors in individuals with ASD. This gap in research exists due to the challenges associated with using traditional assessment methods, which may lead to discrepancies in responses and unintentional potential biases from caregivers. In this review, we provided a comprehensive overview of various eating behaviors commonly observed in individuals with ASD. These behaviors include 1) food neophobia, 2) selective eating, 3) binge eating, 4) food avoidance, 5) chewing and swallowing problems, 6) pica, 7) rumination, 8) rituals, and 9) problematic behaviors. Furthermore, we provide a perspective of utilizing digital tools: 1) augmentative and alternative communication; 2) ecological momentary assessment; and 3) video analysis, behavioral analysis, and facial expression analysis. This review explores existing assessment methods and suggests novel assessment aiding together.

• Biomolecules & Therapeutics
• /
• 제24권3호
• /
• pp.207-243
• /
• 2016

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social and communication impairments, as well as repetitive and restrictive behaviors. The phenotypic heterogeneity of ASD has made it overwhelmingly difficult to determine the exact etiology and pathophysiology underlying the core symptoms, which are often accompanied by comorbidities such as hyperactivity, seizures, and sensorimotor abnormalities. To our benefit, the advent of animal models has allowed us to assess and test diverse risk factors of ASD, both genetic and environmental, and measure their contribution to the manifestation of autistic symptoms. At a broader scale, rodent models have helped consolidate molecular pathways and unify the neurophysiological mechanisms underlying each one of the various etiologies. This approach will potentially enable the stratification of ASD into clinical, molecular, and neurophenotypic subgroups, further proving their translational utility. It is henceforth paramount to establish a common ground of mechanistic theories from complementing results in preclinical research. In this review, we cluster the ASD animal models into lesion and genetic models and further classify them based on the corresponding environmental, epigenetic and genetic factors. Finally, we summarize the symptoms and neuropathological highlights for each model and make critical comparisons that elucidate their clinical and neurobiological relevance.

• Clinical and Experimental Pediatrics
• /
• 제54권1호
• /
• pp.22-28
• /
• 2011

Purpose: To investigate the clinical characteristics of late-onset epilepsy combined with autism spectrum disorder (ASD), and the relationship between certain types of electroencephalography (EEG) abnormalities in ASD and associated neuropsychological problems. Methods: Thirty patients diagnosed with ASD in early childhood and later developed clinical seizures were reviewed retrospectively. First, the clinical characteristics, language and behavioral regression, and EEG findings of these late-onset epilepsy patients with ASD were investigated. The patients were then classified into 2 groups according to the severity of the EEG abnormalities in the background rhythm and paroxysmal discharges. In the severe group, EEG showed persistent asymmetry, slow and disorganized background rhythms, and continuous sharp and slow waves during slow sleep (CSWS). Results: Between the two groups, there was no statistically significant difference in mean age (P=0.259), age of epilepsy diagnosis (P=0.237), associated family history (P=0.074), and positive abnormal magnetic resonance image (MRI) findings (P=0.084). The severe EEG group tended to have more neuropsychological problems (P=0.074). The severe group statistically showed more electrographic seizures in EEG (P=0.000). Rett syndrome was correlated with more severe EEG abnormalities (P=0.002). Although formal cognitive function tests were not performed, the parents reported an improvement in neuropsychological function on the follow up checkup according to a parent's questionnaire. Conclusion: Although some ASD patients with late-onset epilepsy showed severe EEG abnormalities, including CSWS, they generally showed an improvement in EEG and clinical symptoms in the longterm follow up. In addition, severe EEG abnormalities tended to be related to the neuropsychological function.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제26권1호
• /
• pp.30-37
• /
• 2015

Objectives: The purpose of this study was to verify the validity and clinical cutoff score of the Child Behavior Checklist for ages 1.5-5 (CBCL 1.5-5) for diagnosis of autism spectrum disorder (ASD). Methods: 44 ASD infants and 100 normal infants participated. T-test, discriminant analysis, receiver operating characteristic (ROC) curve analysis, and odds ratio analysis were performed on the data. Results: Discriminant validity was confirmed by mean differences and discriminant analysis on the subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, and all Diagnostic and Statistical Manual of Mental Disorders (DSM)-oriented scales between the two groups. ROC curve analysis showed that Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems significantly predicted ASD infants compared to normal infants. In addition, the clinical cutoff score criteria adopted in the Korean CBCL 1.5-5 for subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems were shown to be valid. Conclusion: The subscales of Withdrawn, Attention problems, Internalizing problems, Externalizing problems, Total problems, DSM pervasive developmental problems, DSM attention deficit/hyperactivity problems, and DSM oppositional defiant problems significantly discriminated for the diagnosis of ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제32권1호
• /
• pp.35-40
• /
• 2021

Objectives: Among the many intervention programs for children with autism spectrum disorder (ASD), the Early Start Denver Model (ESDM) is one of the few approaches that has succeeded in demonstrating clinical efficacy in randomized control trials. Here, we investigate the clinical efficacy of ESDM intervention in young children with ASD in a community setting within Japan. Methods: All subjects were children with ASD who received ESDM intervention during the study period. Each ESDM session lasted 75 min and occurred once per week for at least 12 weeks. The outcome measures consisted of the Kyoto Scale of Psychological Development (K-test), Aberrant Behavior Checklist-Japanese version (ABC-J), and the Clinical Global Impression-Severity scale (CGI-S). Results: Twenty-seven subjects (29.4±6.4 months old) received ESDM intervention that lasted for 8.0±2.6 months on average. The score on Language and Social developmental quotient on the K-test increased significantly after the intervention. The total scores on the ABC-J and CGI-S significantly decreased after completion of the ESDM intervention. Conclusion: Our results suggest that ESDM intervention could reduce the severity of distinct clinical features of ASD, such as impairments in social interaction and communication assessed by the K-test, and maladaptive behavior rated by the ABC-J and CGI-S. We believe that the ESDM adapted to each institution might become one of the standard options for children with ASD in Japan.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제29권3호
• /
• pp.101-113
• /
• 2018

Objectives: The purpose of this study was to investigate whether the neural activity of autism spectrum disorder (ASD) patients is different from that of normal individuals when performing aesthetic judgments. Methods: We recruited typical ASD patients without savant skills (ASD group, n=17) and healthy controls (HC group, n=19) for an functional magnetic resonance imaging study. All subjects were scanned while performing aesthetic judgment tasks on two kinds of artwork (magnificent landscape images and fractal images). Differences in brain activation between the two groups were assessed by contrasting neural activity during the tasks. Results: The aesthetic judgment score for all images was significantly lower in the ASD group than in the HC group. During the aesthetic judgment tasks, the ASD group showed less activation than the HC group in the anterior region of the superior frontal gyrus, and more activation in the temporoparietal area and insula, regardless of the type of images being judged. In addition, during the aesthetic judgment task for the fractal images, the ASD group exhibited greater neural activity in the amygdala and the posterior region of the middle/inferior temporal gyrus (Brodmann area 37) than the HC group. Conclusion: The results of this study suggest that the brain activation patterns associated with aesthetic experiences in ASD patients may differ from those of normal individuals.

• International Journal of Internet, Broadcasting and Communication
• /
• 제14권3호
• /
• pp.108-114
• /
• 2022

Autism (ASD) is a mental disorder characterized by a pronounced deficit in personal, social, speech, and other aspects of development and communication skills. Since autism is a complex developmental disorder that requires a lot of effort to recognize, this research was conducted to develop an interactive data Acquisition System and detect the first signs of ASD in children. The proposed system presents several variants of the tasks in an entertaining form, using hand tracking. Hand tracking is used to attract children's attention and interest them more to achieve more accurate results. The creation of the system is based on such libraries as OpenCV, PyGame, TensorFlow, and Mediapipe. The ultimate goal of the paper is to obtain data on the disease of autism in children for use in further diagnosis by medical experts.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제35권1호
• /
• pp.15-21
• /
• 2024

Autism spectrum disorder (ASD) is diagnosed by the clinical decision of a trained professional based on the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition or International Classification of Diseases 11th Revision diagnostic criteria. To obtain information for diagnostic formulation, professionals should explore detailed developmental history, and can use structured or semi-structured assessment tools to observe interaction between the child and parents or strangers. Diagnostic assessment should include a profile of the strength and weaknesses of the individual and should be conducted using an optimal approach by a multidisciplinary team with appropriate techniques and experience. Assessment of language, cognitive, neuropsychological, and adaptive functioning should be conducted in ASD individuals prior to establishing an individualized treatment plan. Genetic testing, brain magnetic resonance imaging or electroencephalogram testing can be considered for identification of underlying causes.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• 제27권3호
• /
• pp.196-206
• /
• 2016

Objectives: Individuals with autism spectrum disorder (ASD) are considered to have problems with empathy. It has recently been suggested that there are two systems for empathy; cognitive and emotional. We aimed to investigate the neural response to cognitive and emotional empathy and elucidate the neurobiological aspects of empathy in patients with ASD. Methods: We recruited patients with ASD (N=17, ASD group) and healthy controls (HC) (N=22, HC group) for an functional magnetic resonance imaging study. All of the subjects were scanned while performing cognitive and emotional empathy tasks. The differences in brain activation between the groups were assessed by contrasting their neural activity during the tasks. Results: During both tasks, the ASD group showed greater neural activities in the bilateral occipital area compared to the HC group. The ASD group showed more activation in the bilateral precunei only during the emotional empathy task. No brain regions were more activated in the HC group than in the ASD group during the cognitive empathy task. While performing the emotional empathy task, the HC group exhibited greater neural activities in the left middle frontal gyrus and right anterior cingulate gyrus than the ASD group. Conclusion: This study showed that the brain regions associated with cognitive and emotional empathy in ASD patients differed from those in healthy individuals. The results of this study suggest that individuals with ASD might have defects both in cognitive empathy and in emotional empathy.