• The Journal of Korean Academy of Sensory Integration
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• v.21 no.3
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• pp.79-102
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• 2023

Objective : Autistic Spectrum Disorders(ASD) is a developmental disorder characterized by atypical sensory adaptation, communication problem, stereotyped behavior, and feeding disorders. The reasons for ASD feeding disorders are oral sensory motor, cognitive, behavioral, and social problems. Major symptoms include picky eating, selective eating, food refusal, food neophobia, limited food variety, and food aversion. ASD feeding disorders could be accompanied by various problems such as health and nutrition intake problems, feeding development, eating-related sociability, and family and caregiver stress. Feeding problems and disorders in ASD can present from birth. However, ASD is diagnosed by the age of 3, and there might be an appropriate treatment gap. Usually, symptoms of feeding disorders tend to decrease with age. However, the symptoms often remain, so early evaluation, intervention, and periodic checking are necessary. In this study, the general information about the feeding disorder characteristics of ASD, influencing factors, and intervention were described through a literature review. Conclusion : Sensory-based therapy and behavior-based therapies are generally used for feeding disorders in ASD. Sensory-based therapy is effective for food sensitivity and behavior-based therapy for food selection. As the symptoms of feeding disorders in ASD are diverse, a comprehensive approach includes play and participation, oral motor exercise, diet, and daily life. However, appropriate evaluation, intervention protocol, and guidelines for the treatment of feeding disorders in ASD are limited. Therefore, a complex approach based on a more systematic understanding is needed. Feeding rehabilitation specialists, such as occupational therapists, should provide appropriate evaluation and intervention.

• Perspectives in Nursing Science
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• v.18 no.1
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• pp.1-9
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• 2021

Purpose: This study was undertaken for developing a cognitive behavioral therapy (CBT) program for adolescents with eating disorders. Methods: The specific process for the development of this program involved establishing a program goal, analyzing existing CBT programs, and constructing a CBT program. Results: The program consisted of 12 sessions, which is shorter than typical programs conducted for people with eating disorders, in order to reduce the dropout rate. Each session was 40~60 minutes long, and included the use of the psychoeducation, Dysfunctional Thought Record, and activity planning. The participants attended 5 sessions individually and 7 with their family members. Conclusion: This study presented a 12-session CBT program for adolescents with eating disorders. These results will provide valuable data for developing effective programs to improve the quality of life of these adolescents.

• The Journal of Korean Academy of Sensory Integration
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• v.9 no.2
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• pp.41-49
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• 2011

Objective : This study aims to compare children with and without pervasive developmental disorders in terms of the sensory processing ability and behavioral characteristic of oral feeding. This study also aims to identify correlation between sensory processing and characteristics of eating. Methods : The subjects of this research were normal children and those who have diagnosis of a pervasive developmental disorder, aged from 4 to 6. The research instruments were composed of Short Sensory Profile (SSP), Brief Autism Mealtime Behavior Inventory (BAMBI) and Food Items of the Sensory Checklist. Data collection was done by a professional survey institute located in 10 cities including Busan, South Korea. The survey questionnaires were distributed to 455 parents of children with and without pervasive developmental disabilities through the survey institutes. Total 263 answers were collected out of 455 questionnaires (62%) and 154 answers were used in data analysis. Out of 154 answers, 45 were for children with pervasive developmental disabilities and 109 were for normal children. Data analysis was done to identify correlations between sensory processing and characteristics of eating such as eating behavior and oral feeding. Results : 1. There was a significant difference between children with and without pervasive developmental disorders in all area of sensory processing ability (p<.05). 2. There was no difference between children with and without pervasive developmental disorders in eating behavior (p=0.881) and oral feeding (p=0.324). 3. In the group of children with a pervasive developmental disorders, it is found that there is negative correlation between sensory processing, eating behavior and oral feeding (r=-0.384, p<.01). 4. A remarkable significant correlation was found between sensory processing and eating behavior especially in taste/smell sensitivity (r=-0.6, p<.01) and auditory filtering (r=-0.326, p<.05). The correlation between sensory processing and oral feeding was most significant in under responsiveness/seeking sensation (r=-0.372, p<.05) and auditory filtering (r=-0.382, p<.05). Conclusion : This study found that there are significant correlations between sensory processing ability and some characteristics of eating behaviors for children with pervasive developmental disorders. This information can be useful to develop a program to intervene eating behavior problems of children with pervasive developmental disorders.

• Journal of the Korean Society of School Health
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• v.34 no.2
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• pp.107-114
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• 2021

Purpose: The aim of this study was to investigate the factors influencing eating attitudes in female nursing students. Methods: A cross-sectional study was conducted on 121 university students in 2016. Data was collected using self reported questionnaires asking about circadian rhythm (Morningness-Eveningness Questionnaire), daytime sleepiness (Epworth Sleepiness Scale), sleep quality (Pittsburgh Sleep Quality Index), and eating attitudes (Eating Attitudes Test-26). Stress resistance was measured with a brain quotient test. The data were analyzed with a t-test, ANOVA, Pearson's correlation analysis and linear regression using SPSS 22.0. Results: Eating attitudes were associated with daytime sleepiness, sleep quality, and stress resistance of the right hemisphere. Among these, daytime sleepiness and sleep quality had a significant effect on eating attitudes. Conclusion: The results of this study suggest that sleep should be taken into account when developing interventions for preventing eating disorders in female nursing students.

• Journal of Convergence for Information Technology
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• v.11 no.8
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• pp.168-175
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• 2021

Goal of this study is to perform the correlation about Gross motor function, eating-drinking function, and oral motor function, to identify necessity for invervention of feeding disorders on severity of the function of children with cerebral palsy. Subjects were 61 children diagnosed with cerebral palsy. The subject were evaluated for oral motor function, feeding function by GMFCS, EDACS, OMAS. The results of this study showed a significant correlation between gross motor function, eating and drinking functions, and oral motor functions. That is, the more severe the deterioration of the motor function, the lower the functional level of eating and drinking and oral motor function deterioration. In evaluating and treating the eating activity of children with cerebral palsy through this study, it seems necessary to check the eating and drinking function and oral motor function according to the gross motor function.

• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.25 no.5
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• pp.432-440
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• 2022

Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m². Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m² vs. 16.06± 4.55 kg/m², p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

• 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 Korean Academy of Oral Health
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• v.42 no.4
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• pp.238-241
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• 2018

Williams syndrome is a rare congenital disorder with various physical abnormalities and characterized by facial, oral, and dental features. Individuals with Williams syndrome typically have eating disorders in the early childhood, which lead to prolonged night feeding. Prolonged night feeding is a risk factor for rampant dental caries. Williams syndrome is caused by the microdeletion of chromosome 7, resulting in elastin deficiency. Elastin is integral to cardiovascular health. Many patients with Williams syndrome have complex cardiovascular abnormalities that must be considered a part of dental management. Complications related to cardiovascular diseases may induce adverse effects such as dangerously elevated blood pressure. This may occur in patients during stressful dental treatment. In addition, characteristics of auditory hyperalgesia and anxiety disorders among patients with William syndrome, complicate receiving routine dental management. Therefore, dental treatment under sedation or general anesthesia may be preferable for patients with Williams syndrome; in particular, patients who are very uncooperative and/or needs extensive dental treatment. A thorough evaluation of each patient's physical condition is required before making decisions regarding dental treatment. Careful monitoring and preparation for emergencies are very important during and shortly after dental treatment under general anesthesia or sedation. Monitoring is critical until vital signs have stabilized and return to normal. A 28-month-old man diagnosed as having Williams syndrome, visited the Dental Hospital of ${\bigcirc}{\bigcirc}$ University for the management of rampant dental caries. We reported on the management of this patient who had peripheral pulmonic stenosis, and received dental treatment under general anesthesia. We also reviewed the characteristics of Williams syndrome and discussed considerations for dental treatment under general anesthesia.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.25 no.1
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• pp.20-27
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• 2014

Objectives : The aim of this study was to determine whether intervention using a multidisciplinary approach affects maternal mental health, parenting stress, and sense of parenting competence in children with feeding disorder and failure to thrive (FTT). Methods : Children with feeding disorder and FTT were randomized to the intervention group (N=11) or control group (N=8). We administered the Korean standardization of Parent Temperament Questionnaire for Children (K-PTQ) in both groups before intervention, and the Korean version of the Parenting Stress Index-Short Form (K-PSI-SF), Korean version of the Parenting Sense of Competence (K-PSOC), Korean version of the Beck's Depression Inventory (K-BDI), Korean version of the Beck Anxiety Inventory (K-BAI), and Korean version of the Mood Disorder Questionnaire (K-MDQ) in both groups before and after the intervention. Results : In the intervention group, the K-BDI (p=.068), K-BAI (p=.068), and K-MDQ (p=.066) scores tended to show a decline, the K-PSI-SF scores for stress related to child learning showed a significant decline, and the K-PSOC scores for sense of parenting competence showed significant improvement. However, no significant changes were observed in the control group. Conclusion : Use of a multidisciplinary approach improved maternal mental health, parenting stress, and sense of competence. Comparison of these results with those of normal control will be necessary in a future study.