• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.23 no.2
• /
• pp.82-89
• /
• 2012

Objectives : Demands for comprehensive and intensive treatment programs for treatment of children with attention-deficit hyperactivity disorder (ADHD) who suffer from serious impairment in various psychosocial areas are increasing. The aim of this study was to evaluate the possibility of developing new types of camp programs focused on improving social adjustment of children and helping parents effectively manage their children's problem behaviors. Methods : Fifteen children diagnosed as ADHD according to Diagnostic and Statistical Manual of Mental Disorders-IV (mean age 9.5 years) and their parents participated in this program. Eight consecutive camps were held at two-week intervals, from Jun 2007 to Oct 2007 in an adolescent training center located at Chungtaesan, in Korea. Each camp program included social skills training in the classroom and outdoor activities in the forest for children, as well as parent training for mothers. In addition, after the sixth camp, we conducted one parental session for fathers and a three-day booster family camp three months later. Finally, eleven families adhered to the program. Results : All children, parents, and therapists rated questionnaires or checklists at baseline, intra-, and post-treatment. Parenting burden rated using the Parenting Stress Index showed a significant decrease, from 57.89 to 46.22 (p=.019). And, overprotection rated using the Parenting Bonding Instrument showed a significant decrease, from 16.56 to 12.44 (p=.046). However, no significant improvement in children's behavioral and emotional problems was observed. Conclusion : In this study, the consecutive ADHD family camp program was effective for empowerment of parental competency, but not for general improvement of children's behavioral and emotional symptoms.

• Journal of Medicine and Life Science
• /
• v.19 no.1
• /
• pp.1-7
• /
• 2022

Learning disabilities (LD), also known as learning disorders, refers to cases in which an individual experiences lower academic ability as compared to the normal range of intelligence, visual or hearing impairment, or an inability to peform learning. Children and adolescents with learning disabilities often have emotional or behavioral problems or co-existing conditions, including depression, anxiety disorders, difficulties with peer relationships, family conflicts, and low self-esteem. In most cases, attention deficit and hyperactivity disorder coexists. As learning disabilities have the characteristics of a difficult heterogeneous disease group that cannot be attributed to a single root cause, they are diagnosed based on an interdisciplinary approach through medicine and education, such as mental health medicine, education, psychology, special education, and neurology. In addition, for the accurate diagnosis and treatment of learning disabilities, the diagnosis, prescription, treatment, and educational intervention should be conducted in cooperation with doctors, teachers, and psychologists. The treatment of learning disabilities requires a multimodal approach, including medical and educational intervention. It is suggested that educational interventions such as the Individualized Education Plan (IEP) and the Response to Invention (RTI) should be implemented.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.14 no.1
• /
• pp.36-52
• /
• 2003

Attention deficit/hyperactivity disorder is one of the most comminly treated conditions in the child psychiatric units and results in substantial impairment in peer, family and academoc functioning. For 70% to 80% of children with a diagnosis of ADHD, stimulant tratment results in successful improvement of the core ADHD symptoms. However, children with ADHD have high level of comorbidity and may respond differently from children with ADHD without comorbidity. Therefore they may need specific treatment plan. We reviewed efficacy and safety of prescribed medication for treating children with ADHD, the relationship between ADHD and the comorbid conditions and treatment algorithm projects of ADHD with/without comorbid conditions performed Korean and American child psychiatrists. Our main objective is to increase the uniformity of treatment and improve the clinical outcomes of children with comorbid ADHD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.18 no.1
• /
• pp.10-15
• /
• 2007

Probably the three most important components to a comprehensive evaluation of patients with attention-deficit hyperactivity disorder (ADHD) are the clinical interview, the medical examination, and the completion and scoring or behavior rating scales. Teachers and other school personnel are often the first to recognize that a child or adolescent might have ADHD, and often play an important role in the help-seeking/referral process. A diagnostic evaluation for ADHD should include questions about ADHD symptoms, other problems including alcohol and drug use, family history of ADHD, prior evaluation and treatment for ADHD. Screening interview or rating scales as well as interviews should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with objective assessments of the ADHD symptoms, such as psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but they may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. Screening for intellectual ability and academic achievement skills is also important in determining the presence of comorbid developmental delay or loaming disabilities. The number and type of symptoms required for a diagnosis of ADHD vary depending on the specific subtype. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in daily functioning, and must not meet criteria for other mental disorders which might better account for the observed symptoms such as mental retardation, autism or other pervasive developmental disorders, mood disorders, anxiety disorders. This report aims to suggest a practice guideline of assessment and diagnosis for children and adolescents with ADHD in Korea.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.7 no.1
• /
• pp.92-109
• /
• 1996

The objectives of the present study were to provide comprehensive assessment of the impact of epilepsy on the psychological well-being of children with epilepsy and to identify the neurological factors associated with the psychopathology. The participant patients were recruited from the population of children and adolescent aged 7 to 16 attending the OPD of department of pediatric neurology in Seoul National University Hospital in Korea. We exclude mental retardation, pervasive developmental disorder and brain organic pathology. As control group, formal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The first author interviewed the children and their family members and obtained the developmental history and family information. We used the following 10 scales for assessing psychological and behavioral problems in patients and their family member. The scales were standardized and their validity and reliability were confirmed before. Parent rating scales : Yale children's inventory, Disruptive behavior disorder scale, Parent's attitude to epilepsy questionnaire, Family environment scale, Symptom check-list-90 revision, Children behavior check-list. Children's self rating scales : Children's depression inventory, Spielberger's state-trait anxiety anxiety, Piers-Harris self-concept inventory and Self-administered Dependency questionnaire for Mother. The result showed the risk factors associated depression were early onset, complex partial seizure, lateralized temporal focal abnormality on EEG, Drug polypharmacy, high seizure frequency and sick factors associated anxiety were old age of patient, lateralized temporal focal abnormality EEG, Drug polypharmacy, high seizure frequency. Also the result of this present study indicated that risk factors associated oppositional defiant disorder, conduct disorder and attention deficit hyperactivity disorder were young age, male, early onset, lateral temporal EEG abnormality and high seizure frequency. According to these results, common risk factors associated psychological and behavioral problems were lateralized EEG temporal abnormality, high seizure frequency in neurological factors.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.16 no.1
• /
• pp.79-89
• /
• 2005

Objectives : To acquire an improved understanding of oppositional defiant disorder, we evaluated the characteristics of children who have the symptoms of ODD in community sample. Methods : 1200 children from an elementary school in Bucheon (an urban community near Seoul) were recruited by randomized sampling method. By Disruptive Behavior Disorder Scale according to DSM-III-R & DSM-IV, we evaluated the symptoms of ODD and selected subjects with ODD. Psychiatric comorbidity, character trait were compared in subjects with ODD and comparison group. Also we examined the association between prenatal/perinatal risk factors, family functions and the symptoms of ODD. Data were analyzed by appropriate statistical method using SPSS 11.5 window version. Result : Children with oppositional defiant disorder were revealed to have significantly higher rates of psychiatric comorbidity and significantly greater family dysfunction compared to comparison group. Among the prenatal/perinatal risk factors, severe emotional stress during pregnancy, postpartum depression, medication during pregnancy were revealed as risk factors of ODD. In character inventory, ODD group were evaluated to have high score in novelty seeking, harm avoidance, but low in reward dependency. Conclusion : These results support that 1) prenatal/perinatal and psycho-social risk factors could be a important role in the progression of ODD, and 2) children with ODD have diverse comorbid psychiatric symptoms.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.15 no.2
• /
• pp.160-167
• /
• 2004

Objectives : There have been very few studies on the compliance of methylphenidate-immediate releasing form(MPH-IR), which is the most frequently used drug in Korea, in Attention Deficit Hyperactivity Disorder(ADHD). This study was conducted to investigate the compliance rate and the related factors in the one year pharmacotherapy process via OPD for children with ADHD. Method : Total 100 ADHD patients were selected randomly among patients who have been treated with MPH-IR from September in 2002 to December in 2002. All the selected patients were diagnosed with DSM-IV-ADHD criteria and fulfilled the inclusion criteria. In March, 2003(at the time of 6 month treatment), all the patients and parents received the questionnaire for the compliance and satisfaction for MPH-IR treatment. In October 2003(at time of 1 year treatment), we, investigators evaluated the socio-demographic variables, developmental data, medical data, family data, comorbid disorders, treatment variables, and compliance rate. Through these very comprehensive data, The compliance rate at the time of mean 1 year treatment and the related factors were investigated. Result : 1) In the questionnaire for compliance and satisfaction for MPND treatment, the 60% of respondents(parents) reported more than moderate degree of satisfaction in the effectiveness of MPND. Their compliance rate for the morning prescription was 81%, but the rate of afternoon prescription was 43%. 2) In the evaluation at the time of 1 year treatment(October 2003), the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1 year treatment was 62%. the 38% of parents were dropped out from the OPD treatment. The mean compliance rate for the 1year treatment was 62%. 3) Compared with the noncompliant group(drop-out group), compliant group showed higher total, verbal and performance IQ scores. In the treatment variables, higher reposponder rate(clinician rating), higher medication dosage and more compliance rate in afternoon prescription were found in the compliant group compared with the noncompliant group. There were no statistical differences in the demographic variables(age, sex, SES, parental education level), medical data, developmental profiles and academic function. Conclusion : To our knowledge, this is the first report about the compliance rate of the MPH-IR treatment for the children with ADHD. The compliance rate at the time of mean 1year treatment was 62%, which was comparable with other studies performed in foreign countries, especially States. In this study, the compliance related factors were IQ score, clinical treatment response, dosage of MPH-IR, and early compliance for the afternoon prescription. These results suggest that clinician plan the strategies for the promotion of the early compliance for the after prescription and enhancement of overall treatment response.

• Journal of Preventive Medicine and Public Health
• /
• v.26 no.4 s.44
• /
• pp.628-649
• /
• 1993

This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile (poor performers) and 97 children whose school performance were within high 5 percentile (good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry (body weight, height, head circumference), intelligence (Kodae Stanford-Binet test), test anxiety (TAI-K), neurologic examination by a developmental pediatrician and heavy metal content (Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and prenatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic & language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder (ADHD), poor physical growth (weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order (odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD (odds ratio=9.67), I.Q. score (odds ratio=0.85) and height less than Korean standard mean-1S.D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(P<0.05) and zinc was positively correlated with grade (P<0.05). among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.14 no.1
• /
• pp.3-11
• /
• 2003

Attention-deficit/Hyperactivity disorder(ADHD) is the most common psychiatric disorder of childhood and among the most prevalent chronic health conditions affecting school-aged children. Children with ADHD experience significant functional problems, such as school difficulties, academic underachievement, troublesome interpersonal relationships with family members and peers, and low self-esteem. The most widely used pharmacological treatments for ADHD are psychostimulants, such as methylphenidate and amphetamine salts. These medications provide clinical efficacy by increasing the availability of catecholamines, primarily dopamine, in the frontal lobe of the brain. immediate-release(IR) formulations of sychostimulants were among the most effective psychotrophic medications in the psychopharmacological treatment. However, there are some limitations of IR formulations：the short half-life and duration of efficacy, which result in the need for multiple daily dosing and the poor compliance. These limitations have led to the development of once-daily, extended-release(ER) formulations of methylphenidate and amphetamine salts. However, these ER formulations may not be as immediately helpful to ADHD children due to delayed onset of action and the acute tolerance which is the failure to sustain the efficacy with the same concentration of drug as the initial stage of medication. OROS-methylphenidate(Concerta$^{\circledR}$) given once a day produces an ascending-pattern plasma drug level generated by the osmotically released, timed drug-delivery system. These new formulations of the psychostimulants have been shown to be a useful alternative to old stimulant medications through the evidence by the clinical trials.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
• /
• v.7 no.2
• /
• pp.203-212
• /
• 1996

In this thesis, we investigate the psychosocial variables within the family environments of Attention Deficit Hyperactivity Disorder with (ADHD+CD/ODD) or without (ADHD) externalizing symptoms. The subjects in this research were 86 boys and girls(aged range 6 to 14 years) consisted of 20 ADHD, 22 comorbid ADHD(ADHD+CD/ODD) and 44 normal control group(NC). We have collected data on children and their mothers. The psychosocial variables included in the analysis are socioeconomic status, parent's educational level, life stress event, and the rate of psychiatric disorders in relatives. The self-reported questionnaires marital discord(MAS), parenting stress(PSI), and parenting attitute(MBRI) completed by mothers. The results indicated that ADHD+CD/ODD is supposed to have higher level of family adversity suggested by the lower SES, lower parental educational level, higher life stress events, and more psychic disorders in relatives compared with ADHD or normal control group. In MAS, ADHD+CD/ODD group has significantly the lowest scores on each factor of the measure of marital adjustment. Parents of ADHD+CD/ODD are much more likely to have positive parenting stress when compared with the parents of ADHD. Especially, mothers of ADHD+CD/ODD have the lowest tendency in the mean score on affective, accepted attitudd. In an inapropriate parenting attitude perceived by children, father of ADHD+CD/ODD have the most negative, contradictory attitude and mothers of ADHD+CD/ODD have the most restrictive, negative and contradictory attitude.