• Title/Summary/Keyword: Developmental disability

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Limitations of neurobiological approach convergent to neuropsychiatry: DCD and two visual systems theory (신경정신학에 융복합되는 신경생물학적 접근법의 한계점: 발달성 협응장애와 두 시각 이론에 관한 종설)

  • Lee, Young-Lim
    • Journal of Digital Convergence
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    • v.13 no.6
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    • pp.225-234
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    • 2015
  • Neurobiological approach helps to resolve the mind-body dualism and develop new assessment and treatment approaches in psychiatry. However, it could be a problem to place too much emphasis on certain aspects of neurobiology, specifically structural neuroanatomy, because of the complexity or comorbidity of neuropsychiatric disorders. Developmental Coordination Disorder (DCD), for instance, is generally related to problems in motor skills and this movement disability is often related to perception. One account, two visual systems theory, relied on functional distinction in brain; ventral stream is responsible for visual recognition, and dorsal stream is responsible for the guidance of actions. However, Studies are now showing that shape perception is relevant to visually guided action, such as reaching-to-grasp an object. In this article, I reviewed fundamental findings of two-visual system theory and suggested problems of visually guided action to consider what shape perception implies for the two visual systems. Questions raised highlight possible limitations of adopting a structural neuroanatomical approach to account for perception and action effects, and by extent related psychiatric conditions such as DCD. In conclusion, neurobiological approach converging to neuropsychiatry, while useful, would be limited if it focuses too much on anatomical distinction.

Clinical Features and Genetic Analysis of Homocystinuria Patients in Korea (전형적 호모시스틴뇨증 환자들의 임상적 특성과 유전자분석)

  • Lee, Yena;Lee, Jeongho;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.15 no.2
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    • pp.78-86
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    • 2015
  • Purpose: Homocystinuria (OMIM#236200) is a metabolic disease caused by mutation in the CBS gene. This study was conducted to identify the clinical features and prognosis of homocystinuria as well as to find out the CBS gene mutations of the six homocystinuria patients who were receiving treatment in the Pediatric Department at Soonchunhyang University Hospital. Methods: From January 1992 to March 2015, clinical, biochemical, and genetic analyses were performed retrospectively on the six patients diagnosed with classic homocystinuria at Soonchunhyang University Hospital. Results: A total of six patients were included in this study, including three who were diagnosed with homocystinuria at the mean age of $50{\pm}22.5$ days based on their abnormal newborn screening test results. The other three were diagnosed at the mean age of 7, when they visited the hospital for evaluation of developmental delay and lens dislocation. The group diagnosed at early infancy had normal cognitive function, but the other group had varying degrees of mental retardation. Major complications were found only in the group diagnosed after infancy. CBS gene mutation was found in all the patients, and they were all non-responsive to vitamin B6 treatment. At present, all patients' diets are controlled following a methionine-free formula and they are on medication with folic acid, betaine, pyridoxine, and methylcobalamin. Conclusion: Six homocystinuria patients were monitored for up to 23 years. The group diagnosed at early infancy exhibited no major complications. Therefore, early diagnosis is crucial in the prognosis, and homocystinuria must be included in the newborn screening program.

Perspective on Population Characteristics and Health Problems of Koreans in 21st Century (21세기 초 한국의 인구구조 및 질병양상)

  • Kim, Joung-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.175-185
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    • 1994
  • In order to anticipate disease pattern and health problems of Koreans in the 1st part of 21st century (by the year 2020), transition of population characteristics, mortality and morbidity data during the last 30 years Koreans have experienced were reviewed. On the actual basis of epidemiologic transition process that has undergone during last 30 years since 1960 along with socioeconomic development and successful implementation of selective national health policies (family planning, medical insurance and etc.), following changes can be expected in the 21st century in Korea, under the assumption that the current rate of progress is maintained. The population of South Korea alone will be doubled the population of 1960 by the year 2013 : aged Population older than 65 years will be increased from 3.3% in 1960 to 11.4% in 2020 with increased average age of the population from 23.6 year in 1970 to 39.2 year in 2020; urban population from 28% in 1960 to 83% in 2005. GNP/capita has increased tremendously from U.S. $120 in 1970 to $6,749 in 1992, and the government estimated it would be 519,350 in 2010 and $29,460 in 2020. Growth and developmental indices of children, educational achievement and social status of women also showed a remarkable improvement and anticipated to make futher progress. Leading causes of mortality and morbidity have shown a striking change during the last 30 years, from infectious diseases to chronic degenerative diseases and man-made injuries. Occurrence of communicable diseases may become minimal although viral hepatitis, venereal diseases Including AIDS, and well adapted herpes virus infections will maintain their endemic level. Newly evolving infectious agents, however, should be carefully monitored because of rapidly changing environments and human behaviours. Tuberculosis may increase up to the epidemic level when AIDS prevails. Ischemic heart diseases may increase steadily with increasing occurrence of hypertension and diabetes mellitus whereas cerebrovascular diseases may be decreased slowly. Musculaskeletal diseases which contribute a lot to the disability of aged people may be a major health problems due to increased aged population. Mental diseases, particularly that caused by alcohol and drug abuse, and senile dementia may become a prominent health problem. On the other hand injuries caused by traffic and industrial accidents that have shown most striking increase till now may be decreased considerably by intensive intervention. The health policies in the 21st century will be oriented to the health promotion for good quality life rather than life-savings.

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The Effects of Music Therapy by Self-Selected Music Listening on Terminal Cancer Patients' Affect and Stress by Pain Level (선호 음악 감상의 음악치료가 말기암환자의 통증 정도에 따른 정서 및 스트레스에 미치는 효과)

  • Lee, Eun-Hai;Choi, Sung-Eun
    • Journal of Hospice and Palliative Care
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    • v.15 no.2
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    • pp.77-87
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    • 2012
  • Purpose: This study investigated the effects that music therapy by self-selected music listening has on the affect and stress relief in adult patients who have been diagnosed with terminal cancer by pain level. Methods: Participants were 20 terminally ill cancer patients who were over 18 years old and were admitted to the hospice and palliative care unit of a local hospital. At the beginning of each session, participants selected music of their choice. Each participant had a total of six 30-minute music listening sessions. Participants were grouped into two according to their self-rated perceived pain scores on the visual analogue scale and numeric rated score: 5 and above and less than 5. Each participant completed a questionnaire on their affect state before and after each session and a questionnaire on their stress level before the first session and after the last session. Further analysis was performed to compare differences between the two groups according to pain level. Results: There were significant differences in patients' affect before and after each session (P<0.001) and stress level before and after the therapy (P=0.001). Conclusion: In this study, self-selected music listening had positive effects on terminal cancer patients' affect and stress regardless of perceived pain level. Therefore, self-selected music listening can be used as an appropriate intervention to improve affect and reduce stress in terminal cancer patients in the hospice and palliative care unit.

A multidisciplinary approach for the treatment of child abuse in Korea (병원 기반 학대아동보호팀의 20년간의 활동 경험)

  • Song, Bong Kyu;Kim, Do Kyun;Park, Hye Young;Hwang, Jun Won;Kwak, Young Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1207-1215
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    • 2009
  • Purpose:To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. Methods:We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. Results:Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was $54.3{\pm}49.2$ months, and the current mean age of the children was $8.3{\pm}6.4$ years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. Conclusion:A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.

COMPARATIVE STUDY UPON THE CHARACTERISTICS OF WRITING BETWEEN THE PATIENTS WITH WRITING DISABILITIES AND NORMAL ELEMENTARY SCHOOL STUDENTS (쓰기 장애 환자와 정상 초등학교 학생의 쓰기 특성 비교)

  • Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.51-70
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    • 2001
  • Characteristics of handwriting were investigated and compared between the patients with writing disabilities and normal elementary school pupils. Generally, the heights of the letters of the patients were significantly larger than those of normal children, and letters of the patients were more sparsely distributed than those of controls. The distance between the words were significantly reduced in the patients’ writings, which indicated that patients had much more problems of space-leaving than normal pupils. Letter heights differences were significant across all grades in the patients and normal controls. The heights of the letters decreased as they grew older, and the slope of the decrements were more steeper in normal girls(r=-0.45) than girls with writing disabilities(r=-0.16). Sex differences were found in the letter spacings in low grades(grades 1, 2), that is, the distances between the letters were significantly narrower in the male patients than normal boys in these grades, and the differences were almost indiscriminating in grades 3 through 5, and finally, in sixth grade, letter spacings were signifycantly broader in normal boys than male dysgraphics. In girls, letter spacings were significantly broader in the patients across all grades. These findings supports the hypothesis that male and female writings were qualitatively different and that distinct mechanisms served in boys and girls dysgraphics. Across all grades and sexes, spaces between the words of the patients were significantly broader than normal pupils, which suggested that space-leaving between the words was important in Korean writings. There was trend that letter spacings and word spacings decreased across grades, but in girls, no correlations between the letter spacings and grades were found. Correlation analyses revealed that letter heights and letter spacings had mild correlation(r=0.11-0.15), and that letter spacings and word spacings had robust correlation(r=0.99). Phonological errors were mostly found in last phoneme(Jong-seong), especially double-phoneme(ㄳ, ㄵ, ㄶ, ㄺ, ㄻ, ㄼ, ㄾ, ㄿ, ㅀ, ㅄ), and in the case the sound values changed due to assimilations of phonemes. Semantic errors were rare in both groups. Space-leaving errors were correlated with phonological errors, and more frequent in boys than girls. In conclusion, significant differences existed in the letter heights, letter spacings, word spacings, and frequencies of phonological errors and spaceleaving errors between the patients with writing disabilities and normal pupils. The characteristics of writings changed across grades and the developmental profiles were somewhat quantitatively different between the groups. The differences became obvious from the second-third grades.

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The Significance of the Early Electroencephalographic Findings in Severely Asphyxiated Newborn Infants (중증 주산기 가사 환아에서 시행한 초기 뇌파 검사의 임상적 의의)

  • Lee, Jong Uk;Choi, Won Joung;Kim, Chun Soo;Lee, Sang Lak;Kim, Jun Sik
    • Clinical and Experimental Pediatrics
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    • v.46 no.8
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    • pp.784-788
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    • 2003
  • Purpose : Perinatal asphyxia occurring in newborn is one of the major causes of acute mortality and chronic neurological disability in survivors. We have studied the relationship between early electroencephalography(EEG) findings and clinical course and neurologic outcome in severe asphyxiated neonates. Methods : Between the period of July 1999 and June 2002, 25 neonates who were diagnosed with severe perinatal asphyxia(1-minute Apgar score of ${\leq}3$ and initial pH is less than 7.2) at NICU in Dongsan Medical Center were enrolled. An EEG was recorded and analyzed within three days of life and divided into two groups - group 1(normal or focal change on EEG) and group 2(generalized abnormal EEG). Between the two groups, clinical courses and neurologic outcomes were compared. Results : Fifteen infants(60%) were group 1 and ten infants(40%) were group 2(polyspikes, burst-suppression, generalized low voltage). Associated maternal disease, days of hospitalization, need for ventilator support, delay of oral feeding and convulsion duration are significantly higher and longer in group 2. Also, poor neurologic outcome(expire, developmental delay) was significantly higher in group 2(60%) than group 1(13.3%). Conclusion : Thus, the early neonatal EEG in asphyxiated newborn can be a predictable diagnostic tool in assessment of neurologic outcome.

The Effect of Teacher Support Program for the Integration of Handicapped Children on Teaching Efficacy of Daycare Center Teachers (장애 유아 통합보육을 위한 교사 지원이 어린이집 교사의 교사 효능감에 미치는 영향)

  • Park, Na Ri
    • Korean Journal of Child Education & Care
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    • v.18 no.4
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    • pp.247-265
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    • 2018
  • Objective: The purpose of this study was to investigate the effect of teacher support program for integration of handicapped children on teaching efficacy of daycare center teachers. Methods: In the study, 12 day care teachers in 4 day care centers in Seoul and Gyeonggi area were selected as experimental groups and 12 teachers in 5 day care centers were selected as control group. Teacher education is carried out through group education, such as understanding of developmental area, curriculum modification, activity-based embedded intervention, cooperative learning, direct teaching, disability understanding education, behavior support, family support. Individual teacher education provided counseling on the reality of child care for children with disabilities that reflects the needs of teachers for integrated child care for handicapped children. Teacher's Efficacy in Inclusive Practices (TEIP) was used as a pre post test to measure teacher's efficacy change. In order to analyze the results of the study, two independent sample t tests were conducted on the difference between pre-post test of teacher efficacy between the two groups. Results: As a result, There was a significant difference in the pre-post change of teacher efficacy between the two groups. Conclusion/Implications: The results of this study are as follows, teacher support program provided immediate feedback in integrated child daycare center for the handicapped children, child care teachers improved their integrated handicapped children care expertise, provided responsive teacher support program to the actual needs of the site, teacher support program reflected various variables related to integration, and emphasized the cooperative relationship between researcher and child daycare center teacher. The results of this study can be used as actual data of field where lack of support for the integration of handicapped children is lacking.

A Study on the Accessibility Requirements Analysis Model for the Preventive Safety and Disaster Service Information System - Focusing on the Communication Ability (정보시스템을 통한 생활안전 위험의 예방·대응을 위한 안전약자 요구사항 분석모델 연구 : 의사소통기능을 중심으로)

  • Lee, Yong-Jick;Ji, Seok-yeon;Kim, Sang-hwa
    • The Journal of Korean society of community based occupational therapy
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    • v.10 no.3
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    • pp.1-13
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    • 2020
  • Objective : The purpose of this study is to present an analysis model in developing an inclusive response for safety hazards and disaster preventive information system for vulnerable people to the disaster including persons with disabilities, and those with specific needs. Methods : In this study, the persona analysis method is used to analyze fictitious characters that correspond to various characteristics such as age, disability, environment, occupation, etc. in terms of the scenario of some particular disaster subjects. Based on the user's communication problems derived from the persona analysis, focused group interview and ICF based analysis were implemented to identify needs and arbitration methods. Results : The needs from persona analysis and ICF-based communication items analysis identifies the factors that make each fictitious character difficult in terms of communication in obtaining the benefits consistent with the purpose of the service. The study derives service requirements that can provide arbitration or facilitation methods to increase communication ability of the users. Conclusion : Through the persona analysis method, difficulties that could occur when receiving disaster information using communication devices were identified and analyzed in conjunction with communication problems described in the ICF. In building information services for the prevention of safety hazards and disasters, this study presented a model that uses the persona analysis method and the ICF classification system to derive user requirements for accessible information system.