• Therapeutic Science for Rehabilitation
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• v.13 no.2
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• pp.9-25
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• 2024

Objective : Children with autism spectrum disorder (ASD) commonly suffer from feeding disorders. Major feeding problems include mealtime behavior problems, picky eating, and a lack of food variety can lead to nutritional problems, developmental and social limitations, and stress for the caregivers. A review of the latest literature was conducted to gain an in-depth understanding of assessment tools for feeding disorders in children with ASD. Method : This study analyzed assessments to identify feeding problems in ASD based on previous studies searched through keywords such as ASD, ASD feeding problem, and ASD feeding evaluation. Results : The ASD feeding disorder assessment was divided into direct and indirect assessments. Indirect assessment, in which caregivers measure a child's situation using questionnaires, is mainly used. The assessment of feeding disorders in children with ASD was divided into 1) mealtime behavior, 2) sensory processing, 3) food consumption, and 4) others. Conclusion : As the main feeding disorder characteristics of children with ASD are very diverse, a comprehensive evaluation is necessary but is still limited. Swallowing rehabilitation experts, such as occupational therapists, should apply comprehensive assessment tools based on a basic understanding of the feeding problems, behaviors, and sensations in ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.3
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• pp.154-160
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• 2012

Objectives : The purpose of this study was to investigate clinical characteristics of children and adolescents with autism spectrum disorders (ASDs) using methylphenidate (MPH). Methods : Retrospective review of the charts of 79 children and adolescents with ASDs, who visited the Department of Child and Adolescent Psychiatry of Seoul National Hospital, from July 2010 to July 2011, was conducted. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity of illness (CGI-S) and Clinical Global Impression-Improvement (CGI-I) Scales. Results : We found that MPH was prescribed in 23 (29.1%) children and adolescents. Of the 23 patients on MPH, 4 patients (17.4%) were on MPH monotherapy and 18 patients (78.3%) were using risperidone concomitantly. MPH was prescribed primarily for symptoms of hyperactivity and impulsivity in ASDs patients. The mean dosage of MPH was $26.2{\pm}11.1$mg/day and mean duration of treatment was $31.9{\pm}28.7$ months. Mean CGI-S score improved significantly from baseline to endpoint (from $5.4{\pm}0.6$ to $4.1{\pm}0.9$ ; p<.01). MPH was reported to be effective in 17 patients (17/23, 73.9%), and 10 patients (10/23, 43.5%) reported side effects. Side effects included decreased appetite (4/23, 17.4%), tic (2/23, 8.6%), sleep disturbances (2/23, 8.6%), headache (1/23, 4.3%) and irritability (1/23, 4.3%). Conclusion : The results of this study demonstrate that MPH may be used effectively and safely in children and adolescents with ASDs with hyperactivity and impulsivity. Future controlled trials are needed to confirm these findings.

• Clinical and Experimental Pediatrics
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• v.49 no.4
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• pp.341-353
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• 2006

Learning disorders are diagnosed when the individual's achievement on standardized tests in reading, mathematics, or written expression is substantially below that expected for age, schooling, and level of intelligence. Subtypes of learning disorders may be classified into two groups, language-based type learning disorders including reading and writing disorder, and nonverbal type learning disorder (NLD) such as those relating to mathematics & visuospatial skills, and those in the autism spectrum. Converging evidence indicates that reading disorder represents a disorder within the language system and more specifically within a particular subcomponent of that system, phonological processing. Recent advances in neuroimaging technology, particularly the development of fMRI, provide evidences of a neurobiological basis for reading disorder, specifically a disruption of two left hemisphere posterior brain systems, one parieto-temporal, the other occipito-temporal. The former is the reading system for beginner reading, the latter for skilled reading. Compensatory engagement of anterior systems around the inferior frontal gyrus(Broca's area) and a posterior(right occipito-temporal) system is noted in persistent poor readers in long-term follow up study. The theoretical model proposed to explain NLD's source is not right hemisphere damage, but rather the white matter model. The working hypothesis of the white matter model is that the underdevelopment of, damage to, or dysfunction of cerebral white matter(long myelinated fibers) is the source of this disorder. The role of an evidence-based effective intervention in the remediation of children with learning disorder is discussed.

• The Journal of Korean Academy of Sensory Integration
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• v.19 no.1
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• pp.39-53
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• 2021

Objective : The purpose of this study was to systematically review dysphagia rehabilitation treatment for children with feeding disorders. Methods : The articles evaluated in this study were collected from the PubMed, Medline Complete, and CINAHL databases and subsequently reviewed using the PRISMA flow chart and PICOS approach. A total of 13 papers were analyzed for study quality, disease groups, evaluation tools, interventions, and post-intervention effects. Results : Of the reviewed papers, six (46.15%) related to autism spectrum disorder (ASD) and seven (53.85%) to cerebral palsy (CP) with age ranges of between 2 and 8 years for the ASD studies and between 12 months and 18 years for CP. In evaluating the types of feeding disorder involved, the ASD group exhibited predominantly behavioral conditions while the CP subjects had a larger number of functional oral and swallowing issues. In terms of interventions, behavior modifications were used most frequently with ASD while oral-sensory motor, texture modifications, and electrical stimulation were applied at the same frequency with children with CP. All interventions were found to be effective. Conclusion : In this study, research into children with feeding disorders was reviewed according to condition, evaluation tool, and method of intervention. It is expected that this review can be used as basic data for developing a protocol that will allow clinicians to efficiently apply condition-specific interventions for eating disorders without resorting to trial and error.

• Journal of Music and Human Behavior
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• v.13 no.1
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• pp.61-87
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• 2016

With broad individual variability in social communication skills of children with autism spectrum disorders and increasing focus on interventions targeting social communication of this population, there is a need for systematic analysis of how social communication outcomes are measured. This study aimed to systematically analyze the measurement tools used in the music therapy interventions for improving social communication of children with ASD. Electronic databases and music therapy journals were searched for controlled studies published between 1980 and 2015. A total of 21 studies were included for the analysis. The results demonstrated that direct observation of behaviors was the most frequently used and the combination of targeted social communication areas and specific measurements used for a specific skill varied among the studies. In addition, 90.4% of studies reported interrater reliability. These results indicate that there has been a diversity in approaches to measure social communication skills despite increasing attempts for systematic measurements. In consideration of the nature of social communication development in children with ASD, multifaceted strategy to understand and assess the target skills in terms of specific behavior acquisition, social functioning in general, and social cognition was recommended.

• Journal of Korean Society of Neurocognitive Rehabilitation
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• v.10 no.2
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• pp.35-44
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• 2018

This study was conducted to explore the effects of semi-structured $DIRFloortime^{(R)}$ treatment on the enhancement of language comprehension and information processing of children with high-performance autistic spectrum disabilities. We measured the general characteristics of the test subjects, which are level of autism, total intelligence, language comprehension and information processing indicators. The intervention method used was a semi-structured $DIRFloortime^{(R)}$ therapy using board game intervention program after revising and supplementing the expert content validity. A pre/post-test for a group was designed as a similar experiment and the pre/post test was initiated with the t certification at .05 of significance level. After initiating the program, the post test has shown that the language comprehension indicators showed statistically significant levels of difference (p<.001) and the information processing indicator also had a statistically significant effect (p<.001). There was a statistically significant difference (p<.001) in the level of verbal comprehension index after the program implementation, and statistically significant differences in the information processing index (p<.001). The semi-structured $DIRFloortime^{(R)}$ treatment using boardgames for enhancing the language comprehension and information processing indicators of children with high performance autistic spectrum disorder had a significant effect.

• Korean Journal of Biological Psychiatry
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• v.19 no.4
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• pp.205-210
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• 2012

Objectives The purpose of this study was to investigate clinical profile, efficacy, and safety of long-term treatment with selective serotonin reuptake inhibitors (SSRIs) in Korean autism spectrum disorders (ASDs) patients. Methods Effectiveness was assessed through a retrospective review of self-reported target symptom improvement at the last follow-up visit. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity (CGI-S) of illness and Clinical Global Impression-Improvement (CGI-I) Scales. Tolerability was assessed through a review of the reason for discontinuation of SSRI and documented adverse events. Results A total of 21 ASDs patients (aged 9 to 19 years) treated with SSRI during July 2010 to July 2011 in department of child and adolescent psychiatry of Seoul National Hospital were identified. The mean duration of SSRI treatment was 47.9 (standard deviation = 36.9) months (range 0.7-114.5), and the mean fluoxetine equivalent dosage of SSRIs was $27.1{\pm}10.8$ mg. Nineteen (90.5%) patients were using concomitant medication. We found that SSRIs were prescribed for symptoms of agitation, stereotyped behavior, aggression, depression, impulsivity and self-injury in ASDs. Ten patients (47.6%) reported improvement in their target symptom after SSRI treatment based on CGI-I scores (CGI-I ${\leq}$ 2). The side effects were reported in 5 patients (23.8%) ; vomiting (n = 2, 9.5%), excessive mood elevation (n = 1, 4.8%), insomnia (n = 1, 4.8%), somnolence (n = 1, 4.8%) and decreased appetite (n = 1, 4.8%). Self-injurious behavior was reported in one patient (4.8%). Conclusions The results of this study suggest that SSRIs may be used effectively in children and adolescents diagnosed with ASDs. However, safety issues need to be considered carefully when choosing SSRIs for treatment. Future controlled trials are needed to confirm these findings.

• Science of Emotion and Sensibility
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• v.13 no.3
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• pp.429-440
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• 2010

It is known that as many as 1 in 91 children are diagnosed with an autistic spectrum disorder, and the incidence rate of the autistic spectrum disorder is much higher than that of cancer in Korea. It is necessary to develop a novel technology to sense their emotional status and give proper psychological diagnosis and therapy, since the children with autistic spectrum disorder usually do not express their own emotional status. This article presents the state-of-the-arts on the affective computing technologies that include recognition of emotional status through bio-sensing and virtual affective agent modeling, and then proposes a novel system architecture for diagnosis and therapy of autistic spectrum disorder. The diagnosis and therapy system of autistic spectrum disorder is composed of bio-sensing module, virtual environment module with affective agents, and haptic interface module. The architecture proposed in this paper will enhance the objectivity to diagnose autism spectrum disorders, and enable continuous treatment in daily life.

• Clinical and Experimental Pediatrics
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• v.57 no.8
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• pp.363-369
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• 2014

Purpose: This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. Methods: We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results: At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. Conclusion: Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.

• Phonetics and Speech Sciences
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• v.12 no.2
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• pp.39-49
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• 2020

The prosody of children with autism spectrum disorders (ASD) has several abnormal features, including monotonous speech. The purpose of this study was to compare acoustic features between an ASD group and a typically developing (TD) group and within the ASD group. The study also examined audience perceptions of the lengthening effect of increasing the number of syllables. 50 participants were divided into two groups (20 with ASD and 30 TD), and they were asked to imitate a total of 28 sentences. In the auditory-perceptual evaluation, seven participants chose sentence types in 115 sentences. Pitch, intensity, speech rate, and pitch slope were used to analyze the significant differences. In conclusion, the ASD group showed higher pitch and intensity and a lower overall speaking rate than the TD group. Moreover, there were significant differences in s2 slope of interrogative sentences. Finally, based on the auditory-perceptual evaluation, only 4.3% of interrogative sentences produced by participants with ASD were perceived as declarative sentences. The cause of this abnormal prosody has not been clearly identified; however, pragmatic ability and other characteristics of autism are related to ASD prosody. This study identified prosodic ASD patterns and suggested the need to develop treatments to improve prosody.