• Journal of the korean academy of Pediatric Dentistry
• /
• v.46 no.4
• /
• pp.362-368
• /
• 2019

The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018. Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2^nd referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2^nd referral was relatively delayed with increased ratio of 'during treatment'. These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.34 no.4
• /
• pp.258-267
• /
• 2023

Objectives: This study aimed to compare the utility of the Psychoeducational Profile-Revised (PEP-R), Korean Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (K-WPPSI-IV), and Vineland Adaptive Behavior Scale, Second Edition (VABS-II) for evaluating developmental disabilities (DD) in preschool children. Additionally, we examined the correlations between the PEP-R, K-WPPSI-IV, and VABS-II. Methods: A total of 164 children aged 37-84 months were assessed. Children's development was evaluated using the PEP-R, K-WPPSI-IV, VABS-II, Preschool Receptive-Expressive Language Scale, and Korean Childhood Autism Rating Scale, Second Edition. Results: Of the 164 children, 103 had typical development (TD) and 61 had DD. The mean of the PEP-R Developmental Quotient (DQ), K-WPPSI-IV Full-Scale Intelligence Quotient (FSIQ), and VABS-II Adaptive Behavior Composite (ABC) scores were significantly higher in the TD group than in the DD group (p<0.001). The estimated area under the curve of the PEP-R DQ, K-WPPSI-IV FSIQ, and VABS-II ABC scores was 0.953 (95% confidence interval [CI]=0.915-0.992), 0.955 (95% CI=0.914-0.996), and 0.961 (95% CI=0.932-0.991), respectively, which did not indicate a statistically significant difference. The PEP-R DQ scores were positively correlated with the K-WPPSI-IV FSIQ (r=0.90, p<0.001) and VABS-II ABC scores (r=0.84, p<0.001). A strong correlation was observed between the K-WPPSI-IV FSIQ and VABS-II ABC scores (r=0.89, p<0.001). Conclusion: This study found that the PEP-R, K-WPPSI-IV, and VABS-II effectively distinguished DD from TD in preschool children, and no significant differences in utility were observed between them.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.12 no.1
• /
• pp.11-15
• /
• 2016

Angelman syndrome is characterized by a partial deficit of paired autosomal chromosome 15, which contains a subunit of the GABA (Gamma-Amino Butyric Acid) receptor. The main clinical characteristics of this syndrome are delayed neuropsychological development, intellectual disability, and speech impairment. The syndrome has oral manifestations such as diastemas, tongue thrusting, sucking swallowing disorder, and excessive chewing behavior. A 3-year-6-month old girl with Angelman syndrome was scheduled for dental treatment. She had multiple caries, but she was poorly cooperative for treatment due to developmental delay and movement disorder, so general anesthesia was considered. The patient with Angelman syndrome was successfully treated under general anesthesia. There were no postoperative complications related to anesthesia and dental treatment. When treating children with this syndrome, the dentist needs to manage their uncooperative behavior and medical problem.

• Journal of The Korean Society of Integrative Medicine
• /
• v.9 no.2
• /
• pp.131-140
• /
• 2021

Purpose : The purpose of this study was to systematically review the studies on the effects of social story intervention on the individuals with autism spectrum disorders(ASD) to provide the basis for evidence-based practice. Methods : In order to find out the studies on the effect of social story intervention on individuals with ASD, studies published from 2011 to December 2020 were searched on Google Academic Search. The keywords used were "autism spectrum disorder AND social story". A total of 16,900 studies were searched, and from these, 12 studies were selected based on the application of the selection and exclusion criteria. The included studies comprised of 10 single subject design studies and 2 randomized controlled trials design studies. The included studies were analyzed in accordance to population, intervention, outcome measures and results. Results : As a result of analysing the subjects of the included studies, we found out that pre-school children and adolescents were the most common groups of individuals diagnozsed with ASD. In addition to ASD, the diagnosis of the subjects included intellectual disability, Asperger, and Prader-willi. We found out that there were more interventions that were mixed with other interventions, than just the pure social story interventions. In particular, video modeling was found to be the most frequent intervention. This was followed by photo-based social stories. For outcome measure, autism social skills profile was found to be the most often used standardized assessment. For a non-standardized assessment, social desired behavior was found to be the most frequently evaluated behavior, followed by personal problem behavior. Of all the dependent variables, the dependent variable reported as "effective" was the most, followed by "some effective". Conclusion : This study is organized to help the individuals with ASD, families, researchers, and therapists understand the effects of social story intervention on the individuals with ASD in an easy fashion. Further, therapists can use this study as the basic data for evidence-based practice.

• Journal of Music and Human Behavior
• /
• v.3 no.1
• /
• pp.13-28
• /
• 2006

Autistic children have difficulties in communication. They tend to have more difficulties in general expression than in understanding sentences. This thesis tested the effect of music activities on children who have difficulties in language expression. As a research method, a group of autistic middle school students was selected who were attending normal schools. Three male students were selected for the test of K-ABC and CARS. Music treatments on the selected students were applied fifteen times, twice a week, for thirty minutes every time. The total treatment process could be divided into two stages. The stage one included the first twelve treatments and the stage two included following three treatments. In the stage one, the selected autistic students learned twenty four musics under real-world-like social circumstances. In the stage two, the students repeatedly learned the twenty four musics. A week before beginning the music treatment, the students were tested by PRES and a test developed by the author of this thesis. And a week after all treatments were completed, the students were tested again with the same test method to check if the students' expressive language ability got improved. The results of the research were as the following: First, the music treatment helped improve the autistic student's ability of expressing themselves such as 'requesting', 'rejecting', 'applying social customs' and 'providing information'. Second, the author of this thesis first had a hypothesis that the tested students might show different levels of achievements according to their intellectual ability or expressive language ability in K-ABC test, PRES and CARS. But it was not true. The student's level of achievement by music activities was proved not to have a significant correlation with their intellectual or expressive language abilities in the tests. Third, it was found that, through pre- and post-test of PRES, the music treatments could improve the receptive language ability as well as the expressive language ability. It saw great effect that musical data that utilize in specially this research investigator according to children's ability, autistic children write lyrics setting in social circumstance that is revealed much routinely and composes. To front, expect that suitable a lot of musics are developed in function and ability of subject person for elevation of expressive language ability.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.12 no.1
• /
• pp.125-137
• /
• 2001

We investigated the self-concept, subjective depression, and state-trait anxiety of the school boys with learning disabilities(abbr. LD, n=86) and compared them with normal boys(n=52) using Piers-Harris Self-Concept Inventory, Child Depression Inventory(abbr. CDI), and State-Trait Anxiety Inventory(abbr. STAI). With regard to Piers-Harris Self-Concept Inventory total scores, there was no significant difference between two groups, but normal boys showed higher scores in intellectual and school status, physical appearance, and happiness-satisfaction subscales than patients with LD. The male patients with LD showed significantly higher ratings in CDI total scores, and CDI subscales - ineffectiveness, anhedonia, negative self-esteem than normal children. The patients with LD reported significantly higher state anxiety, but not trait anxiety. Correlation analyses revealed that self-concept decreased over time, and depression-anxiety increased across grades in the patients with LD, but not in normal children. Especially, negative mood, anhedonia, negative self-esteem subscales of CDI, and state-trait anxiety showed significant positive correlation with grades. In both groups, CDI scores were inversely correlated with Piers-Harris Self-Concept and positively with State-Trait anxiety. In conclusion, self-concept problems which were related with school achievement and self-esteem were more abundant in the patients with LD than normal children, self-image problem, depression and anxiety increased across grades. According to regression analysis, age, behavior subscale, intellectual-school status, anxiety, popularity, happiness-satisfaction, CDI-ineffectiveness, interpersonal problem, negative self-esteem, and state anxiety could explain the self-concept in the patients with LD, not in normal children. So, the self-concept of the patients with LD were found to be related to the school achievement and stress when comparing with peers. In conclusion, elementary school boys with LD showed lower self-concept, higher depression and anxiety, and these differences increased across grades. Since the patients with LD have concomitant depression and anxiety disorders, it is important that comorbidity with emotional problems should be explored and managed properly.

• The Journal of Pediatrics of Korean Medicine
• /
• v.36 no.1
• /
• pp.38-56
• /
• 2022

Objectives The purpose of this study was to analyze the trend of recent randomized controlled trials (RCTs) that used herbal medicine for the treatment of tic disorders in China and to evaluate the efficacy and safety of the treatment. Methods RCTs published from January 2017 to December 2021 were searched for using the China National Knowledge Infrastructure (CNKI). These were then analyzed using herbal medicine treatment methods and their results. Results A total of 35 randomized controlled trials were selected and analyzed. In most studies, evaluation indicators such as the Yale tic symptom scale and total effective rate were significantly improved in the herbal medicine treatment group compared to the control group. The most commonly used herb for tic disorder was Uncaria Rhynchophylla (釣鉤藤), followed by Glycyrrhizae Radix (甘草), Gastrodiae Rhizoma (天麻), Paeoniae Radix Alba (白芍藥), Batryticatus (白殭蠶), Poria (茯笭), and Bupleuri Radix (柴胡). In all studies that reported adverse events, herbal medicine was identified as a relatively safe treatment with fewer adverse reactions or no significant difference compared with the control group. Conclusions Based on the results of RCTs, herbal medicine has been shown to be safe and effective for the treatment of intellectual disability. However, additional well-designed large-scale clinical trials are needed to confirm these findings.

• The Journal of Korea Assosiation for Disability and Oral Health
• /
• v.9 no.1
• /
• pp.51-55
• /
• 2013

Lennox-Gastaut syndrome (LGS) is a severe form of childhood epilepsy that is defined by generalized multiple type seizures, slowness of intellectual growth, and a specific EEG disturbance. Children affected might previously have infantile spasms or underlying brain disorder but etiology can be idiopathic. LGS seizures are often treatment resistant and the long term prognosis is poor. A 14-year-3-month old, 20.5 kg girl with LGS was scheduled for dental treatment under general anesthesia. The patient presented with multiple caries and heavy calculus. General anesthesia was induced and maintained with inhalation agent, Sevoflurane. And caries treatment, scaling, subgingival curretage were performed. LGS patients usually have poor oral hygiene due to mental retardation and have high risk of seizure during dental treatment. In dental treatment under general anesthesia for LGS, it must be considered of seizure control during peri-operative period. Also periodic recall check, instruction of oral hygiene must be performed.

• Journal of The Korean Society of Inherited Metabolic disease
• /
• v.21 no.1
• /
• pp.7-14
• /
• 2021

Purpose: Pseudohypoparathyroidism (PHP) is caused by genetic and epigenetic alteration in the GNAS locus, and characterized by the resistance to multiple hormones and the Albright's hereditary osteodystrophy (AHO) phenotype. This study investigated the phenotypic characteristics and molecular features of PHP. Methods: Eight patients who diagnosed as PHP were enrolled at Pusan National University Children's hospital and clinical features, biochemical and genetic findings were retrospectively reviewed. Results: Of a total of 8 patients, 5 were diagnosed with PHP1a, and 3 were diagnosed with PHP1b. Patients with PHP1a had three different mutations in the GNAS gene, and patients with PHPIb had imprinting defect in differentially methylated regions (DMRs) of the GNAS locus. Two novel GNAS variants were identified in patients with PHP1a, including c.313-2A>T and c.1094G>A. All patients with PHP1a displayed AHO features; short stature (80%), brachydactyly (80%), a round face (80%), obesity (40%), heterotopic ossification (60%), and intellectual disability (60%), whereas only one patient (33.3%) with PHP1b showed AHO feature such as a round face. When phenotypic features between PHP1a and PHP1b patients were compared, patients with PHP1b showed a tendency of higher current height standard deviation scores (SDS) compared to patients with PHP1a, (-3.2±2.1 vs.-1.1±0.8; P=0.06) Conclusions: This study summarizes the phenotypic and genetic features of the PHP patients. Although we found considerable clinical overlap between PHP1a and PHP1b, further long-term follow-up is needed to evaluate the growth and development of children with PHP, as well as the effects of end-organ resistances to endocrine hormones.

• Pediatric Infection and Vaccine
• /
• v.25 no.3
• /
• pp.113-122
• /
• 2018

Purpose: The aim of this study was to evaluate the clinical characteristics of children diagnosed as cryopyrin-associated periodic syndrome (CAPS) in Korea. Methods: Diagnosis was made based on clinical features and confirmed by a mutation in the cold-induced autoinflammatory syndrome 1 (CIAS1) gene. Especially, osteocartilaginous overgrowth in the patella or distal femur was so characteristic that its presence warranted a diagnosis of chronic infantile neurologic cutaneous and articular/NOMID. Results: We observed the clinical features of 9 Korean CAPS patients. All the patients suffered from an urticarial rash with recurrent fever. Among the 9 patients, 6 presented with rash and 4 with fever on the 1st or 2nd days of birth. Eight patients showed myalgia, and 7 patients showed arthralgia in the joints, and 6 patients showed radiologic findings of arthropathy including cupping of the metaphysis, excessive growth of the epiphysis, osteopenia or overgrowth of the cartilage. Four patients showed brain atrophy, enlarged ventricles or leptomeningeal enhancement on magnetic resonance imaging. Intellectual disability was observed in 1 patient. Five patients had eye involvement as conjunctivitis, uveitis, chorioretinitis, avascular area or papillary edema, and 3 patients showed progressive hearing loss. All 9 patients showed increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Conclusions: All the patients carried a mutation on exon 3 of the CIAS1 gene. After the anakinra (interleukin-1 receptor antagonist) therapy, the fever and rash immediately disappeared, and CRP and ESR were improved.