• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.35 no.2
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• pp.136-142
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• 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
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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.

• Clinical and Experimental Pediatrics
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• v.64 no.6
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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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.3
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• pp.122-128
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• 2009

Objectives : Autism is a well-known psychiatric disorder that is presumed to have a neural basis. To investigate the underlying neurofunctional abnormalities of autism, the authors performed single photon emission computed tomography (SPECT) on children with autism. Methods : Fifty-five children with untreated autism (47 boys and 8 girls, mean age=$50.6{\pm}20.28$ months) were selected from among the patients visiting the child and adolescent psychiatric clinic of Seoul National University Hospital. Psychiatrists had diagnosed the participants according to the DSM-IV criteria for autistic disorder and the Childhood Autism Rating Scale (CARS) criteria for a diagnosis of autism. All participants were examined using 99mTC-HMPAO Brain SPECT. Using statistical parametric mapping (SPM) analysis, we compared the participants' SPECT images to standardized SPECT images of normal children, which had been retrospectively selected by the authors, on a voxel by voxel basis. Voxels with a p-value less than .001 were considered to be significantly different. Results : The autistic group showed significant hypoperfusion in the right medial frontal gyrus, right precentral gyrus, and left precuneus gyrus. In addition, they showed no significant hyperperfusion areas when compared to the control group. Conclusion : The findings of hypoperfusion in the medial-frontal lobe and precuneus are accord with hemodynamic abnormalities that have been already reported. Therefore, these findings are compatible with the recently suggested "theory of mind" hypothesis and the disturbances in attention shifting that have been observed in autistic children.

• The Journal of Pediatrics of Korean Medicine
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• v.31 no.1
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• pp.52-62
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• 2017

Objectives The purpose of this study is to review pre-existing clinical practice guidelines for autism spectrum disorders, and refer those in developing a new practice guideline. Methods A total of 9 existing clinical practice guidelines for autism spectrum disorder developed from 2010 to 2016 were searched by Google scholar and Pubmed, and were reviewed those literatures in three parts: general, diagnosis & evaluation, and intervention. Results There were no consistency in the recommendation methods of 9 clinical care guidelines (such as the method of rating and recommendation intensity for diagnosis, evaluation, and treatment). However, in the diagnosis and evaluation section, frequently used evaluation and diagnostic tools are mentioned in most clinical practice guidelines, and the types of pharmacologic and non-pharmacological treatments that are mainly recommended in treatment are equally mentioned in most clinical practice guidelines could confirm. Conclusions 1. Some guideline recommendations are graded according to each criterion. Recommendations presented in various databases were based on systematic reviews or other literatures. The most utilized database were PsycINFO, CINAHL, Cochrane. 2. DSM-5 and ICD-10 were the most common used diagnostic criteria, and DSM-IV was used as a diagnostic standard in the guideline published before 2013. The tools used for diagnosis and evaluation were also varied. However, most recommended ones were ADI-R, ADOS-G, and DISCO. 3. Treatment was largely divided into pharmacological intervention and non-pharmacological intervention. In some guideline, the interventions were divided into pediatric and adult. Most of the pharmacological interventions were not recommended due to lack of evidence, but in cases in which specific symptoms were aimed, they recommended to seek professional help. 4. In addition to interventions, each guideline referred to supportive interventions that may be helpful in the daily life of patients with ASD, which may need to be addressed in future clinical guidelines.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.3
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• pp.65-78
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• 2023

Objective : In this study, we aimed to investigate the effectiveness of family-centered intervention conducted with caregivers of children with autism spectrum disorder (ASD) in South Korea through a systematic literature review. Methods : Previous studies published from 2011 to 2021 were searched through RISS, KISS, and DBpia. The search terms applied included "autism spectrum" OR "general developmental disorder" OR "high-functioning autism" OR "Asperger's" AND "parent education" OR "family-centered intervention" OR "parent coaching" OR "parent training" OR "family participation." A total of 11 experimental studies were chosen based on the selection criteria. Results : According to the findings on the general characteristics of the study participants, intervention strategies, and effects of the intervention, it was observed that the majority of children with ASD who participated in the study were preschool-aged, and the majority of participating caregivers were mothers. The effects of family-centered interventions were evident in both children and parents. In children, the most significant effects were observed in interaction and communication skills. In parents, a reduction in parenting stress and an improvement in parenting efficacy were observed. The intervention strategies employed in the study varied, with sensory integration intervention, responsive communication, and interaction-centered intervention being the most commonly used, followed by developmental-centered intervention, positive behavior support (PBS), and parent-mediated intervention based on pivotal response treatment (PRT). Conclusion : The results of this study are significant in that they confirm that family-centered intervention is effective not only in improving the functioning of children with autism spectrum disorder, but also in reducing parenting stress and enhancing parenting efficacy, and provide evidence for clinical use.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.2
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• pp.157-164
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• 2016

Objectives : The objective of this study was to investigate the characteristics of language profiles according to whether or not Korean children with autism spectrum disorder(ASD) also have ADHD, and to examine the relationship with executive function. Methods : Participants in the study were boys with ADHD aged 6 to 11 years who visited the clinic from January 2012 to December 2013. In this study, 25 boys with ASD were included, and completed scales included the Korean version of Autism Diagnostic Interview-Revised(K-ADI-R), Korean version of Autism Diagnostic Observation Schedule(K-ADOS), Korean ADHD Rating Scale(K-ARS), and Korean-Conners' Parent Rating Scale(K-CPRS). They also completed neuropsychological tests and assessed language profiles. Patients were categorized into two groups(with ADHD and without ADHD). T-test and Multivariate analysis of covariance (MANCOVA) was used for analysis. Results : Statistically, no difference was found in receptive and expressive language ability between the ASD groups with and without ADHD. However, a lower score in Test of Problem solving(TOPS) was observed for ASD with ADHD than for ASD without ADHD, with problem solving and finding cues showing significant differences. Conclusions : These findings suggest that language profiles in the ASD group without ADHD could be similar to those in the ASD group with ADHD, but comorbid ADHD could lead to more difficulty in linguistic ability for problem solving and could be related with executive function of the frontal lobe.

• Environmental Analysis Health and Toxicology
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• v.25 no.4
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• pp.259-262
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• 2010

In this review, we give an overview of psychiatric perspectives on environmental disease. The concept of genetic heritability and its meaning with regard to environmental risk factors will be discussed. Recent ideas of gene-environment interaction and neurodevelopmental disorder in psychiatry will also be introduced. This article discusses the environmental risk factors for attention deficit hyperactivity disorder (ADHD) and autism, the two major environmental diseases and neurodevelopmental disorders in psychiatry. Given that both ADHD and autism are complex conditions, the etiology is likely to involve multiple genes of moderate effect interacting with environmental factors. We will introduce recent environmental issues related to these two disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.1
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• pp.35-40
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• 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.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.4
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• pp.85-95
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• 2014

Objectives The purpose of this review is to investigate the clinical studies of oriental treatment for Autism in China and seek the better methods to study and treat Autism in Korea. Methods We searched for the study at CNKI by keywords, 'Autism', '孤獨症', '自閉症', in the last 5years. Results Selected 14 clinical studies were divided into 6 case reports and 8 control studies. The subjects of clinical study were the average 4-9 years old children. It was described that the symptoms were improved after treatment in 6 case reports. 8 control studies reported that the experimental group were better effective than the comparison group. Frequently used method for treatment was Scalp acupuncture. Conclusions It is promising that we could develop our own treatment and studies for autism in Korea by using Scalp acupuncture, based on these clinical studies.