• 대한통합의학회지
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• 제10권3호
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• pp.95-105
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• 2022

Purpose : This study aims to systematically review the methods of occupational therapy intervention in children with autism spectrum disorders having sleep disorders and evaluate the improvements with intervention effects, based on experimental studies of children with sleep disorders. Methods : Studies published overseas from January 2011 to June 2021 were searched from a total of two databases. Science Direct and OTseeker. The five selected studies were analyzed by dividing them into age, number, intervention period, intervention type, intervention effect, evaluation tool, research design type, and evidence level. Results : The total number of subjects was 182, 95 subjects in ther experimental group, and 87 in the control group. The interventions included weighted blankets, swimming, and sleep education for parents. Ther interventions were found to increase total sleep time, improve mood when waking up, reduce sleep anxiety, reduce sleep time, reduce the number of waking up of during sleep, and reduce sleep resistance behavior. Conclusion : Many people have sleep disorders, with or without disabilities, and the number is gradually increasing. Consequently, research on occupational therapy intervention in children with autism spectrum disorder are actively conducted in foreign countries, and these interventions have a positive effect. Based on the results of this study, it can be concluded that such occupational therapy intervention studies are necessary for children with autism spectrum disorder with sleep disorders in Korea. In addition, further research on the quality of life of parents of children with autism spectrum disorders due to sleep disorders and their methods are required.

• Clinical and Experimental Pediatrics
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• 제64권6호
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• pp.286-292
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• 2021

Background: The effect of exposure to environmental factors on autism spectrum disorders (ASD), especially during pregnancy, is unclear. Purpose: This meta-analysis investigated the association between exposure to pesticides and polychlorinated biphenyls (PCBs) during pregnancy and ASD risk among children. Methods: We searched Scopus, PubMed, Web of Science, and ProQuest for articles published through September 2019. Random-effects models were used to examine the association among studies using pooled odds ratios (ORs) and their 95% confidence intervals (CI). I2 tests were used to measure interstudy heterogeneity. Results: The pooled OR indicated a significant association between PCB and pesticide exposure during pregnancy and ASD risk among children (OR, 1.80; 95% CI, 1.26-2.34; and OR, 1.20; 95% CI, 1.02-1.39), respectively. Conclusion: Findings of the present study indicate that exposure to pesticides and PCBs during pregnancy may affect the risk of ASD among children.

• Clinical and Experimental Pediatrics
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• 제62권11호
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• pp.405-409
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• 2019

A structured review study of drug interventions on sleep disorders in patients with autism spectrum disorders (ASD) has not been published to date. This systematic review aimed to investigate drug interventions for the treatment of sleep disorders in children with ASD. The Web of Science, PubMed, and Scopus databases were searched until March 2019. Study quality was assessed using the Delphi checklist. Due to the heterogeneity of the findings, a meta-analysis was not possible. Drug interventions for the treatment of sleep disorders in patients with ASD included melatonin, atomoxetine, and risperidone. Atomoxetine had no effect on sleep disorders in patients with ASD. A total of 10 studies were reviewed. Melatonin appears to be useful for the treatment of sleep problems in patients with ASD, but further studies are needed to determine the effects of other drugs.

• 한국콘텐츠학회논문지
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• 제11권8호
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• pp.221-230
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• 2011

이 연구는 요인분석을 통해 아동 청소년 행동평가척도(Korean-Child Behavior Checklist: K-CBCL)가 자폐 범주성 장애 아동의 정서와 행동적 문제를 평가하는 도구로 타당한지를 알아보기 위해 실시되었다. 이를 위해 자폐 범주성 장애 아동 248명을 대상으로 K-CBCL을 측정하고 요인분석을 실시하였다. 확인하고자 하는 요인 모델은 2요인 모델로 위축, 신체증상, 불안/우울의 내재화 문제와 비행과 공격성의 외현화 문제였다. 확인적 요인분석 결과, K-CBCL의 2요인 모델의 적합도 지수는 표준화적합지수 .964, 비교 적합지수 .975, 근사오차평균자승이중근은 .091로 나타나 모델의 부합도 기준을 만족하는 것으로 나타났다. 확인적 요인분석을 통해 2요인 모델의 적합성을 확인한 후, 하위 요인들의 문항내적합치도를 알아보았다. 위축, 사회적 미성숙, 비행의 하위 요인의 문항내적합치도는 낮게 나타났으나, 내재화 문제, 외현화 문제, 총 문제행동 척도는 문항내적합치도가 적합한 수준으로 나타났다. K-CBCL은 자폐 범주성 장애 아동의 정서와 행동적 문제를 평가한 도구로 타당한 도구임을 논의하였다.

• Clinical and Experimental Pediatrics
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• 제64권10호
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• pp.538-542
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• 2021

Background: The relationship between small for gestational age (SGA) and autism spectrum disorders (ASDs) remains unknown. Purpose: This meta-analysis aimed to investigate the relationship between SGA and the risk of ASD. Methods: We searched PubMed, Web of Science, and Scopus databases from inception to November 2020. The heterogeneity across studies was explored using the I² statistic. The possibility of publication bias was assessed using Begg test. The results were reported using the odds ratio (OR) and 95% confidence interval (CI) using a random-effects model. Results: The literature search yielded 824 articles with 8,752,138 participants. We assessed the association between SGA and the risk of ASD in cohort and case-control studies. Based on the random-effects model, compared with SGA, the estimated OR of the risk of ASD was 1.17 (95% CI, 1.09-1.24). Therefore, there was a significant association between SGA and the risk of ASD. Conclusion: Based on OR reports in epidemiological studies, we showed that SGA is a risk factor for and can increase the risk of ASD. The association between SGA and ASD risk has further relevance to the current public health emphasis on appropriate prepregnancy weight and pregnancy weight gain.

• The Korean Journal of Physiology and Pharmacology
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• 제16권6호
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• pp.369-378
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• 2012

Analysis of synaptic plasticity together with behavioral and molecular studies have become a popular approach to model autism spectrum disorders in order to gain insight into the pathosphysiological mechanisms and to find therapeutic targets. Abnormalities of specific types of synaptic plasticity have been revealed in numerous genetically modified mice that have molecular construct validity to human autism spectrum disorders. Constrained by the feasibility of technique, the common regions analyzed in most studies are hippocampus and visual cortex. The relevance of the synaptic defects in these regions to the behavioral abnormalities of autistic like behaviors is still a subject of debate. Because the exact regions or circuits responsible for the core features of autistic behaviors in humans are still poorly understood, investigation using region-specific conditional mutant mice may help to provide the insight into the neuroanatomical basis of autism in the future.

• Clinical and Experimental Pediatrics
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• 제63권1호
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• pp.8-13
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• 2020

Autism spectrum disorder is a common neurodevelopmental disorder with an unknown etiology. The correlation between neonatal jaundice and the risk of developing autism spectrum disorder was investigated previously. Some studies showed significant associations, whereas others demonstrated no association. In this meta-analysis, we pooled the results of observational studies to examine the association between neonatal jaundice and the risk of autism spectrum disorder among children. We identified all studies published through April 2018 by conducting a literature search using Web of Science, PubMed, and Scopus databases as well as the reference lists of the retrieved studies. The pooled odds ratios (ORs), rate ratio (RR), and their 95% confidence intervals (CIs) were calculated as random effect estimates of association among studies. We conducted a subgroup analysis to explore any potential sources of intergroup heterogeneity. The pooled estimates of OR and RR showed a considerable correlation between neonatal jaundice and ASD among children (OR, 1.35; 95% CI, 1.02-1.68) and (RR, 1.39; 95% CI, 1.05-1.74). A larger effect size was shown in the pooled estimated crude OR than in the adjusted OR (1.75 [0.96-2.54] vs. 1.19 [1.07-1.30]). This study showed that neonatal jaundice may be associated with ASD and may increase the risk of ASD among children.

• 대한감각통합치료학회지
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• 제17권1호
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• pp.30-42
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• 2019

목적 : 본 연구는 자해행동을 보이는 자폐스펙트럼장애의 비약물적 치료 중심으로 실시한 연구를 대상으로 체계적으로 분석하여 작업치료 임상현장에서 동일한 문제를 보이는 자폐스펙트럼장애 아동에게 적절한 서비스를 제공하기 위한 근거를 마련하고자 한다. 연구방법 : 전자데이터 베이스인 PubMed, Medline, DBpia, RISS, KISS, NDSL을 사용하여 2008년 10월부터 2018년 11월까지 국내외 학회지에 게재된 연구를 대상으로 검색하였다. 주요 용어는"(Autism OR Autism Spectrum Disorder) AND (Therapy OR Treatment OR Intervention) AND (Self Injurious Behavior)"으로 검색하였고, PICO형식과 근거수준을 사용해 분석하였다. 연구결과 : 총 12편의 논문이 선정되었고, 근거의 질적 수준은 대상연구 논문 12편 중 수준 IV와 수준 V가 가장 많았으며, 실험설계는 단일대상연구가 많았다. 중재의 종류는 행동치료가 가장 많았다. 분석결과 자폐스펙트럼장애의 자해행동은 행동치료와 뇌자극 및 조절기법, 행동치료와 병행한 감각통합치료로 자해행동을 감소시켰으며 통계적으로도 유의한 결과를 보였다. 결론 : 자해행동을 보이는 자폐스펙트럼 장애 아동에게 적용한 비약물적 중재에 대한 근거자료를 제시하였다. 앞으로 자폐스펙트럼 장애 아동의 자해행동에 대한 중재효과성을 증명하기 위하여 근거수준이 높은 연구 설계와 다양한 비약물적 중재간의 차이점을 밝히는 연구가 지속적으로 이루어져야 할 것이다.

• Clinical and Experimental Pediatrics
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• 제62권4호
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• pp.126-130
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• 2019

Purpose: In this meta-analysis, relevant case-control and cohort studies were pooled to evaluate the association between preeclampsia and the risk of autism spectrum disorders (ASDs) in children. Methods: A search for relevant studies in major databases, including Web of Science, PubMed, and Scopus, was performed up to May 2018. The odds ratios (ORs) or rate ratios (RRs) with 95% confidence intervals (CIs) were extracted from eligible studies to determine the association among studies. Results: The pooled estimates of ORs and RRs indicated a significant association between preeclampsia and ASD [(OR, 1.36; 95% CI, 1.12-1.60) and (RR, 1.30; 95% CI, 1.20-1.41)]. Conclusions: Despite existing controversy, our findings indicated that preeclampsia was associated with an increased risk of ASD among children.

• Clinical and Experimental Pediatrics
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• 제63권9호
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• pp.368-372
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• 2020

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by impairments in social interaction and verbal and nonverbal communication. Purpose: Determine the association between use of assisted reproduction technology (ART) and the risk of ASD among children. Methods: This case-control study included 300 participants (100 cases, 200 controls). The control group included women with a child aged 2-10 years without ASD, while the cases were women with a child aged 2-10 years with ASD. We used a researcher-made questionnaire. Data were analyzed using Stata ver. 14 at the 0.05 significance level. Results: In the univariate analysis, there was significant association between child sex, delivery mode, history of preterm delivery, history of using ART, and maternal age at child's birth and the risk of ASD. After the adjustment for other variables, this association was significant for male sex (2.66; 95% confidence interval [CI], 1.11-4.31; P=0.001) and history of using ART (4.03; 95% CI, 1.76-9.21; P=0.001). Therefore, after the adjustment for confounder variables, there was no significant association between ART and the risk of ASD among children (4.98; 95% CI, 0.91-27.30; P=0.065). Conclusion: After the adjustment for other variables, risk factors for ASD were male sex and history preterm delivery. Thus, there was no significant association between ART and the risk of ASD among children.