• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.33 no.2
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• pp.35-40
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• 2022

Objectives: Restricted and repetitive behaviors (RRBs) are a core symptom in the diagnosis of autism spectrum disorder (ASD). The complexity of behavioral patterns has called for the creation of phenotypically homogeneous subgroups among individuals with ASD. The purpose of this study was 1) to investigate the different types of RRBs and 2) to explore whether subgroups created by RRBs would show unique levels of functioning in toddlers and young children with ASD. Methods: A total of 313 children with ASD, aged 12-42 months were included in the analysis. The Autism Diagnostic Interview-Revised was used to obtain information on the different types of RRBs by grouping 15 items into six categories. The Vineland Adaptive Behaviors Scale, a parent-reported questionnaire, was used to measure adaptive functioning. A portion of the children were analyzed separately for verbal-related RRBs based on their expressive language level. Two-step cluster analysis using RRB groups as features was used to create subgroups. Analysis of covariance while covarying for age and language was performed to explore the clinical characteristics of each cluster group. Results: Sensory-related RRBs were the most prevalent, followed by circumscribed interests, interest in objects, resistance to change, and repetitive body movements. A subset of the children was analyzed separately to explore verbal-related RRBs. Four cluster groups were created based on reported RRBs, with multiple RRBs demonstrating significant delays in adaptive functioning. Conclusion: Heterogeneity of RRBs emerges at a young age. The different patterns of RRBs can be used as valuable information to determine developmental trajectories with better implications for treatment approaches.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.35 no.1
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• pp.29-38
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• 2024

We conducted a comprehensive review of behavioral and educational interventions for individuals with autism spectrum disorder (ASD). The most prominent type of intervention, Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention (EIBI), has been found to be particularly effective in improving intelligence and adaptive behaviors. The naturalistic developmental behavioral intervention, designed to enhance social and communication abilities, showed effectiveness in improving language, cognitive function, and social initiation. However, more studies are needed to examine its effectiveness. Intensive individualized intervention, which provides a tailored intervention for a specific target behavior, was effective in improving social skills and communication, as well as reducing sleep, eating, and toileting problems. Cognitive behavioral therapy (CBT) is the most effective method for dealing with emotional difficulties, but it has not been widely used because of the shortage of trained experts. Parent-mediated intervention (PMI) involves parents acquiring knowledge and specific skills to improve their child's functioning or reduce challenging behaviors. Speech and language therapy, sensory integration, Treatment and Education of Autistic and related Communications Handicapped Children, developmental approaches, and social stories are frequently used interventions. However, evidence of their effectiveness has yet to be well established. Based on these findings, intervention recommendations for autism include EIBI, Early Start Denver Model, intensive individualized intervention, CBT, and PMI. The choice of intervention should be tailored to the individual's needs and delivered by qualified professionals with expertise in the specific intervention.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.35 no.3
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• pp.197-209
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• 2024

Objectives: In this functional magnetic resonance imaging study, we aimed to investigate the differences in brain activation between individuals with autism spectrum disorder (ASD) and typically developing (TD) individuals during perspective taking. We also examined the association between brain activation and empathic and interoceptive abilities. Methods: During scanning, participants from the ASD (n=17) and TD (n=22) groups were shown pain stimuli and asked to rate the level of the observed pain from both self- and other-perspectives. Empathic abilities, including perspective taking, were measured using an empathic questionnaire, and three dimensions of interoception were assessed: interoceptive accuracy, interoceptive sensibility, and interoceptive trait prediction errors. Results: During self-perspective taking, the ASD group exhibited greater activation in the left precuneus than the TD group. During other-perspective taking, relative hyperactivation extended to areas including the right precuneus, right superior frontal gyrus, left caudate nucleus, and left amygdala. Brain activation levels in the right superior frontal gyrus while taking other-perspective were negatively correlated with interoceptive accuracy, and those in the left caudate were negatively correlated with perspective taking ability in the ASD group. Conclusion: Individuals with ASD show atypical brain activation during perspective taking. Notably, their brain regions associated with stress reactions and escape responses are overactivated when taking other-perspective. This overactivity is related to poor interoceptive accuracy, suggesting that individuals with ASD may experience difficulties with the self-other distinction or atypical embodiment when considering another person's perspective.

• Sleep Medicine and Psychophysiology
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• v.22 no.1
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• pp.5-10
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• 2015

The secretion of melatonin exhibits a circadian rhythm entrained with the sleep-wake cycle. An alteration of this secretory rhythm has been found in various psychiatric disorders. This review summarizes the regulation of melatonin and its relationship to the circadian rhythm, major depressive disorder, bipolar disorder, seasonal affective disorder, Alzheimer's disease and autism. The review also looks at the effect of melatonin and melatonin agonist on sleep and symptoms of depression, bipolar disorder and seasonal affective disorder. In Alzheimer's disease, the circadian rhythm alterations are associated with the change of melatonin levels and melatonin receptors. It has been reported that melatonin and melatonin synthetic enzyme levels decrease in autism spectrum disorder.

• Genomics & Informatics
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• v.15 no.3
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• pp.82-86
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• 2017

Chromosomal microarray (CMA) is a high-resolution, high-throughput method of identifying submicroscopic genomic copy number variations (CNVs). CMA has been established as the first-line diagnostic test for individuals with developmental delay (DD), intellectual disability (ID), autism spectrum disorders (ASDs), and multiple congenital anomalies (MCAs). CMA analysis was performed in 42 Korean patients who had been diagnosed with unexplained DD, ID, ASDs, and MCAs. Clinically relevant CNVs were discovered in 28 patients. Variants of unknown significance were detected in 13 patients. The diagnostic yield was high (66.7%). CMA is a superior diagnostic tool compared with conventional karyotyping and fluorescent in situ hybridization.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.2
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• pp.86-93
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• 2015

Autism spectrum disorder (ASD) is a neurodevelopmental disorder marked by impaired social communication and repetitive, restricted behaviors and activities. The prevalence of ASD has been increasing for the past 2 decades, but evidence-based therapeutic approaches are lacking for patients with ASD. To date, there is no cure for the core symptoms of ASD, and the existing treatments focus on improving the patient's function and adaptation by using behavioral intervention methods. Behavioral interventions have been proven to show the greatest effect when applied before the age of 2 years, for at least 40-60 hours per week. Many clinicians and ASD families are unfamiliar with the treatment methods, and consequently, may seek unproven and potentially hazardous methods. The purpose of this article was to present an extensive and updated review on evidence-based ASD behavioral interventions that are commonly used in clinical settings.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.4
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• pp.192-196
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• 2017

Social (pragmatic) communication disorder (SCD) is a new diagnosis included under communication disorders in the neurodevelopmental disorders section of Diagnostic and Statistical Manual of Mental Disorders-5. SCD is defined as a primary deficit in the social use of nonverbal and verbal communication. SCD has very much in common with pragmatic language impairment, which is characterized by difficulties in understanding and using language in context and following the social rules of language, despite relative strengths in word knowledge and grammar. SCD and Autism Spectrum Disorder (ASD) are similar in that they both involve deficits in social communication skills, however individuals with SCD do not demonstrate restricted interests, repetitive behaviors, insistence on sameness, or sensory abnormalities. It is essential to rule out a diagnosis of ASD by verifying the lack of these additional symptoms, current or past. The criteria for SCD are qualitatively different from those of ASD and are not equivalent to those of mild ASD. It is clinically important that SCD should be differentiated from high-functioning ASD (such as Asperger syndrome) and nonverbal learning disabilities. The ultimate goals are the refinement of the conceptualization, development and validation of assessment tools and interventions, and obtaining a comprehensive understanding of the shared and unique etiologic factors for SCD in relation to those of other neurodevelopmental disorders.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.2
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• pp.101-110
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• 2024

Purpose : The purpose of this study provided an overview of the general status and recent intervention approaches in overseas research related to feeding problems in children with autism spectrum disorder (ASD). This review aims to explore interventions for feeding problems in order to provide higher quality follow-up research directions and implications, particularly focusing on providing recommendations for future research in the context of domestic studies. Methods : Analyzing studies published in international journals from 2017 to 2023. This review involved six selected articles, through Embase, Pubmed, RISS, KISS database search engine. A literature analysis that includes inclusion and exclusion criteria, six selected articles were examined. The literature analysis categorized the general status of the research and intervention approaches and treatment components into intervention, treatment settings and therapists, and dependent variables, respectively. Results : Among feeding intervention approaches, parent education interventions based on behavioral therapy had the highest proportion, followed by multidisciplinary interventions. To maintain the effectiveness of interventions over the long term and to generalize them to the home environment, parent education that utilizes parents as mediators is considered a crucial factor. The most commonly observed effects as dependent variables were changes in the consumption of disliked foods, health foods and alterations in feeding behavior. Conclusion : This study introduces various intervention approaches for addressing feeding problems in children with autism spectrum disorder (ASD), focusing on the positive effects demonstrated by active intervention research in abroad. Furthermore, it underscores the need for additional research in Korea to validate the efficacy of these feeding intervention methods. Lastly, the study outlines future research directions aimed at developing feeding programs to support children with ASD and their families coping with feeding issues.

• 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.

• Proceedings of the Korean Society of Computer Information Conference
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• 2021.07a
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• pp.529-530
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• 2021

본 논문에서는 MindWave와 AR 헤드셋 기기를 연동하여 자폐 스펙트럼 장애 아동이 불안감을 느낄 때 발산되는 뇌파 신호를 실시간으로 감지한다. 또한 실시간 객체 검출을 위한 YOLOv5 알고리즘을 통해 시각적 정보를 수집하여 해당 아동이 불안감을 느끼는 원인을 파악하고 이에 맞는 해결책을 AR 형태로 제시하며 자폐 스펙트럼 장애 아동이 불안감을 느끼면 보호자에게 알림을 전송하는 앱을 구현한다. 이를 통해 자폐 스펙트럼 장애 아동의 뇌파 안정과 정서 회복을 돕고 실생활에서 발생할 수 있는 돌발 상황을 방지할 수 있는 시스템을 제안한다.