• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제19권1호
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• pp.28-37
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• 2008

Objectives : This study was conducted in order to examine the reliability and validity of the Children's Color Trails Test (CCTT). The objective of the study was also to provide the Korean normative data for the CCTT. Methods : Normative samples consisted of 766 children and adolescents living in Seoul and aged from 5 to 15 years. Eighty children who were diagnosed with ADHD, based on the DSM-IV criterion, were recruited from Seoul National University Children's Hospital. Among them, 46 ADHD children were receiving medication, while 34 children were drug-free. Results : The scores of the CCTT were significantly correlated with those of the Stroop test. Three factors were extracted through factor analysis-visual tracking and cognitive flexibility, distractibility and susceptibility to interference, and simple attention and impulsivity. The completion time of the CCTT for all children tended to decrease as age increased. There were significant differences in the CCTT scores between the ADHD group receiving medication, the ADHD-drug free group and the normal groups. The CCTT also showed sound test-retest reliability. These results confirmed the reliability and validity of the CCTT. Finally, we provided the Korean normative data for the CCTT. Conclusion : These results suggest that the CCTT is a reliable and valid test, which can be used to assess frontal function related to child psychiatric disorders in Korean children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제30권2호
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• pp.74-82
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• 2019

Objectives: The objective of this study was to investigate clinical and neuropsychological factors associated with treatment response and adverse events of atomoxetine in children with attention-deficit/hyperactivity disorder (ADHD) in Korea. Methods: Children with ADHD were recruited at the Department of Psychiatry of Asan Medical Center from April 2015 to April 2018. Diagnoses of ADHD and comorbid psychiatric disorders were confirmed with the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. The subjects were subsequently treated with atomoxetine for 12 weeks and illness severity was scored using the ADHD Rating Scale, Clinical Global Impression-Severity scale (CGI-S) and/or Improvement scale (CGI-I), at pre- and post-treatment. They also completed the Advanced Test of Attention (ATA), while their caregivers completed the Korean Personality Rating Scale for Children (KPRC) at pre- and post-treatment. Independent t-test, Fisher's exact test, ${\chi}^2$ test, mixed between-within analysis of variance and correlation analysis were used for statistical analysis. Results: Sixty-five children with ADHD (mean age: $7.9{\pm}1.4years$, 57 boys) were enrolled, of which, 33 (50.8%) were treatment responders. Scores on the social dysfunction subscale of the KPRC (p=0.021) and commission errors on the visual ATA (p=0.036) at baseline were higher in treatment non-responders than in responders; however, the statistical significances disappeared after adjusting for multiple comparisons. Mood changes were also observed in 13 subjects (20.0%), and three of them discontinued atomoxetine due to this. Additionally, atomoxetine-emergent mood change was observed more frequently in girls (p=0.006), while the intelligence quotient (p=0.040) was higher in those subjects with mood changes than in those without. Conclusion: The results of our study suggest that clinical and neuropsychological factors could be associated with treatment response or adverse events of atomoxetine in children with ADHD. Further long-term studies with larger samples are needed.

• 대한감각통합치료학회지
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• 제18권3호
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• pp.1-13
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• 2020

목적 : 본 연구는 주의력결핍 과잉행동장애(Attention Deficit Hyperactivity Disorder; ADHD) 아동과 일반 아동을 대상으로 감각처리능력과 시지각 기술을 비교하고자 하였다. 연구방법 : 연구대상은 지역적 환경이 동일한 아동으로 선정하였다. 소아정신과에서 ADHD로 진단받은 아동 25명과 초등학교 1, 2학년의 일반 아동 51명을 대상으로 감각처리능력과 시지각 기술을 평가하였다. 아동의 감각처리능력을 측정하기 위해 감각프로파일(Sensory Profile; SP)을 사용하였고 시지각 기술을 측정하기 위해 한국판 시지각 발달검사(Korean Developmental Test of Visual Perception-2; K-DTVP-2)를 사용하였다. 두 군 간의 감각처리능력과 시지각 기술의 차이는 독립표본 t 검정을 사용하여 분석하였다. 결과 : ADHD 아동과 일반 아동의 감각프로파일(SP)의 모든 하위 영역에서 통계적으로 유의한 차이를 보였다. 감각요인을 비교한 결과 감각예민을 제외한 8가지 요인에서 통계적으로 유의한 차이를 보였다. K-DTVP-2의 모든 시지각 지수에서 유의한 차이를 보였다. K-DTVP-2의 하위 항목 표준점수를 비교한 결과 공간위치(p=.031), 도형-배경(p=.001), 시각 통합(p=.005), 눈-손 협응(p=.000), 따라 그리기(p=.044), 공간관계(p=.006)에서 통계적으로 유의한 차이를 보였다. 결론 : 본 연구는 임상에서 ADHD 아동의 행동의 특성을 이해하는데 감각처리능력과 시지각 기술이 중요하다는 근거가 되며 ADHD 아동의 평가, 교육 및 연구에 도움을 제공할 수 있다는 점에서 의미가 있다.

• 디지털융복합연구
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• 제17권10호
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• pp.497-507
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• 2019

본 연구의 목적은 국내에서 ADHD 아동을 대상으로 실시된 음악 중재 프로그램의 효과를 체계적 문헌고찰과 메타분석을 통해 검증하는 것이다. 이를 위해 2000년부터 2019년 6월까지 출판된 논문 1,856편 가운데 선정기준에 부합하고 대조집단이 있는 실험연구 9편을 분석하였다. 일반적 특성, 음악 중재 특성, 연구별 목표 및 평가도구의 네가지 기준으로 체계적 문헌고찰을 실시한 결과, 대부분의 논문이 음악 활동, 목표, 평가도구를 각각 2가지 이상 사용하였으며, 특히 사회성과 주의집중력 향상을 위한 논문의 비중이 높았다. 메타분석 결과, 전체는 중간효과크기로 나타났으며, 주의력결핍과 사회성은 효과크기가 낮은 반면, 문제행동은 중간효과크기로 나타났다. 이는 ADHD 아동을 위한 음악 중재에서 표준화된 평가도구 사용의 중요성을 밝힌 것과, 음악 중재를 개발하는 데에 중요한 기초자료로 활용될 수 있다는 점에서 의의를 갖는다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권1호
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• pp.28-36
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• 2014

Objectives : The goal of this study was to examine the association between zinc and lead level and symptoms of attention-deficit hyperactivity disorder (ADHD) among Korean children. Methods : A total of 89 clinic-referred children participated in the study (ADHD group=45, control group=44). The participants were 5-15 years old, and were mainly from urban areas of Seoul, Korea. ADHD was diagnosed using the Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. We excluded children with a comorbid psychiatric disorder, medical illness requiring medication, or a prior history of taking ADHD medication. In order to evaluate the severity of ADHD symptoms, parents' Korean ADHD Rating Scale (K-ARS) was used. The ADHD diagnostic system (ADS) was used for evaluation of the severity of inattention and impulsivity. All participants completed the intelligence test and hair mineral analysis. Multiple regression analysis was used to examine the effect of hair zinc and lead levels on the K-ARS and ADS. We measured the predictive ability of the zinc and lead levels using logistic regression analysis. Results : The lead level explained the score for omission errors, commission errors, and response time SD in visual ADS in the ADHD group (adjusted $R^2$=.243, p<.01, adjusted $R^2$=.362, p<.01, and adjusted $R^2$=.275, p<.01), the score for omission errors of auditory ADS in ADHD group (adjusted $R^2$=.407, p<.01) and the entire group (adjusted $R^2$=.292, p<.01). Zinc was significantly explanatory for the K-ARS scores for the entire group (adjusted $R^2$=.248, p<.001) and the ADHD group (adjusted $R^2$=.247, p<.05). Conclusion : These findings suggest a possible role of zinc and lead in ADHD. Lead concentration in hair samples affected the ADS scores, and this was more prominent in children with ADHD. Children with ADHD had a lower zinc concentration in their hair, and the zinc concentration in hair showed negative correlation with the K-ARS score.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제17권2호
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• pp.163-169
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• 2006

Objectives : The study was conducted to investigate the effect of intelligence ability on attention using Continuous Performance Test (CPT). Methods : 56 children with ADHD (52 boys, 4 girls) and 41 children in normal (28 boys, 13 girls) were sampled, their age range was 7 to 15. They performed IQ test and ADHD Diagnostic System (ADS) in order to examine intelligence and attention. Participants were divided into normal group and ADHD group, average IQ level children and superior IQ level children. Then ADS variables (omission error, commission error, reaction time, reaction time deviation, response sensitivity, and response criterion) were analyzed. Results : There was no significant interaction effect between group (normal, ADHD) and intelligence (average, superior). But there was significant difference between normal group and ADHD group in omission error, commission error, reaction time deviation, and response sensitivity. Also average level IQ group had significantly showed more omission, greater reaction time deviation, and lower response sensitivity than superior level IQ group. Conclusion : ADHD group has attention deficit than normal group, and CPT is available tool to detect attention problems. These findings indicate that intelligence can contaminate inattention and cognitive impulsivity thus it compensates for attention deficit. And it suggests that intelligence effect is considered in analyzing CPT in ADHD children.

• Child Health Nursing Research
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• 제17권2호
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• pp.136-144
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• 2011

Purpose: The purpose of this study was to analyze teaching status and knowledge about children with Attention Deficit Hyperactivity Disorder (ADHD) in elementary school teachers. Methods: The participants of this study were 204 elementary school teachers in Busan. From July to September 2010, the researchers collected data by using self-report questionnaires consisted of questions about their teachers' characteristics and teaching status and KADDS (36 items) developed by Sciutto, Terjesen and Frank. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data using SPSS WIN 16.0 program. Results: Less than 50% of the participants had previous education on ADHD. According to this experience, there were significant differences in participants' knowledge about children with ADHD (t=4.703, p<.001). For the 36 items, participants had an average of $19.19{\pm}4.58$ points out of a possible 36. Moreover, lack of knowledge about teaching children with ADHD and communication problems with the parents of these children were considered to be the most disturbing factors. Conclusion: These results suggest that networks among teachers, parents and medical care professionals should be established. The results also indicate that educational programs for elementary school teachers should be developed in order to identify and teach children with ADHD appropriately.

• 대한한의학회지
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• 제31권1호
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• pp.47-56
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• 2010

Objective: Many drug or non-drug therapies are reported to be effective in reducing the severity of attention deficit/hyperactivity disorder (ADHD). The aim of this study was to assess the effect of color and pattern on the severity of ADHD in young ADHD patients. Method: We randomly assigned 30 children into two groups and had them participate in 15-minute block play sessions once in a week. The experimental group used blocks with green (3G, Munsell color system) circle patterns on them, while the control group played with plain white blocks. We also provided a set of playing cards with the corresponding patterns. This trial continued for 4 weeks and 29 children (96.7%) completed. The primary outcome measurement was the ADHD rating scale-IV and was evaluated on every visit. Results: After the trial, ADHD score decreased in both groups but not significantly ($34.4{\pm}8.0$ to $30.0{\pm}4.3$; $34.0{\pm}6.0$ to $30.3{\pm}3.2$). However, there were significant differences in 4 items of ADHD rating scale between the two groups. These consisted of 3 inattention (Q3, Q7, Q15) and 1 hyperactivity-impulsivity (Q12) items and the reduction between the first and final visits was significant (p=0.0240, p=0.0498, p=0.0237 and p=0.0012 respectively). Conclusion: Repeated exposure to a green circle pattern might not influence the total score of ADHD rating scale but reduced 3 inattention items and 1 hyperactivity-impulsivity significantly in children with ADHD. Proper visual stimuli are partially helpful for pediatric ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제22권4호
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• pp.307-313
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• 2011

Objectives : This study explored the clinical differences in attention-deficit hyperactivity disorder (ADHD) patients with and without developmental coordination disorder (DCD). Methods : Participants were 49 children and adolescents with ages between 6 and 18 years. These subjects were placed into 2 groups: ADHD without DCD (24) and ADHD with DCD (25). We used several evaluation tools on both groups: the Affective Disorders and Schizophrenia-Present and Lifetime Version- Korean Version (K-SADS-PL), Wechsler Intelligence Scale for Children-III (WISC-IIII), Child Behavior Check List (CBCL), Korean Personality Rating Scale for Children (K-PRC), and Bruininks-Osretsky Test of Motor (BOT-2). Results : Patients with both ADHD and DCD had a lower performance intelligence quotient and more internal and external behavioral symptoms than patients with ADHD but not DCD. It is possible that patients with ADHD and motor coordination problems should be noticed earlier and given intensive treatment.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제9권2호
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• pp.154-164
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• 1998

주의력결핍 과잉운동장애(ADHD)아동에서 약물치료가 주의력결핍이나 과잉운동성, 충동성과 비순응적이고 공격적인 행동을 감소시키는데 효과적이나 여러 가지 습관화된 충동적인 행동패턴이나 문제해결 방식을 변화시키고 바람직한 행동과 자기조절능력을 학습시키는데 효과적이지 못하다는 제한점이 있어 왔다. 따라서 본 연구에서는 주의력결핍 과잉운동장애 아동을 위해 고안된 사회기술훈련 프로그램을 실시한후 사회기술 및 증상의 변화를 알아보고자 한다. 본원 외래 및 입원환자중 주 진단을 ADHD로 받은 $6{\sim}13$세 연령의 아동 16명을 대상으로, 순수한 ADHD 아동군, 품행장애가 동반된 ADHD 아동군, 지능저하 등 다른 질환군이 동반된 ADHD 아동군으로 동반증상에 따라 3집단으로 나누어 10주간의 사회기술훈련 프로그램을 실시하였다. 증상의 변화 및 사회기술의 변화를 보기위해 아동행동조사표(Child Behavior Checklist, CBCL), 주의력결핍 과잉운동장애 포괄적 교사평정척도(The ADD-H Comprehensive Teacher's Rating Scale：ACTeRS), 사회기술 평가척도(Social Skills Rating Scale：SSRS), Matson의 아동 사회기술 평가척도(Matson Evaluation of Social Skills for Youth：MESSY)를 치료전후에 실시하였다. 각 집단에서 치료전후의 효과에 대한 비교는 비모수검증인 Wilcoxon Signed Ranks test로 검증하였고, 치료전후의 변화의 정도에 대한 각 집단사이의 비교는 Kruskal-Wallis test로 검증하였다. 각 집단에서 치료전후의 효과에 대해 비교했을 때 품행장애가 공존된 집단에서 치료전에 비해서 아동행동조사표의 문제행동목록 중 공격성 요인에서 유의한 감소(p<.05)가 보였으며, 사회적 능력 항목중 활동성과 사회성에서 유의한 차이(p<.0001)를 보였다. 지능저하등 다른질환군이 동반된 군에서는 사회기술 평가 척도의 사회기술 항목에서 유의한 증가(p<.05)를 보였다. 그러나 각 집단간의 치료효과에 대해서는 세 집단사이에서 유의한 차이는 보이지 않았다. 위 결과로 보아 주의력결핍 과잉운동장애 아동에서 사회기술훈련 치료프로그램은 통계적으로 유의미할 만한 사회기술 향상은 보이지 않았다. 반면 품행장애가 동반된 군에서 공격적 행동의 감소를 가져오고 인지능력이 떨어진 군에서 사회기술 호전을 보이는 등 아동의 특성 및 동반증상에 따라 사회기술의 호전 및 증상의 변화에 도움이 됨을 확인할 수 있었다.