• Clinical and Experimental Pediatrics
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• v.45 no.10
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• pp.1199-1203
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• 2002

Purpose : The study aimed to evaluate the efficacy of auditory brainstem response(ABR) as a screening tool in children with speech and language disorders. Methods : Between January 1, 1999 and December 31, 2001, 139 patients with chief complaints of speech and language delay were recruited from the pediatric neurology clinic, Kyungpook National University Hospital, Daegu, Korea. They had ABR on entry and the clinical data were then analyzed. Results : Fifteen out of 139 cases(10.8%) showed abnormal findings; seven had pervasive developmental disorders, four had developmental language disorders, and four were noted to have other conditions. Among them, seven cases were noted to have conductive hearing loss and eight had sensoryneuronal hearing loss. We also evaluated the normal values in children at the ages of 18 months to seven years. The mean latency of wave I and V were $1.40{\pm}0.13$ and $5.57{\pm}0.26$ respectively. Interpeak latency of I-V was $4.18{\pm}0.24$. Conclusion : Based on these findings, ABR has proved to be a highly sensitive and specific index of hearing impairment. It should be used as a screening tool in children with speech and language disorders.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.18 no.1
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• pp.10-15
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• 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
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• v.28 no.2
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• pp.58-69
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• 2017

Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews 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 the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the 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 and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.18 no.4
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• pp.230-237
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• 2015

Purpose: Various gastrointestinal factors may contribute to maladaptive behavior in children with autism spectrum disorders (ASD). To determine the association between maladaptive behavior in children with ASD and gastrointestinal symptoms such as severity, intestinal microbiota, inflammation, enterocyte damage, permeability and absorption of opioid peptides. Methods: This observational cross-sectional study compared children with ASD to healthy controls, aged 2-10 years. Maladaptive behavior was classified using the Approach Withdrawal Problems Composite subtest of the Pervasive Developmental Disorder Behavior Inventory. Dependent variables were gastrointestinal symptom severity index, fecal calprotectin, urinary D-lactate, urinary lactulose/mannitol excretion, urinary intestinal fatty acids binding protein (I-FABP) and urinary opioid peptide excretion. Results: We did not find a significant difference between children with ASD with severe or mild maladaptive behavior and control subjects for gastrointestinal symptoms, fecal calprotectin, urinary D-lactate, and lactulose/mannitol ratio. Urinary opioid peptide excretion was absent in all children. Children with ASD with severe maladaptive behavior showed significantly higher urinary I-FABP levels compared to those with mild maladaptive behavior (p=0.019) and controls (p=0.015). Conclusion: In our series, maladaptive behavior in ASD children was not associated with gastrointestinal symptoms, intestinal inflammation (no difference in calprotectin), microbiota (no difference in urinary D-lactate) and intestinal permeability (no difference in lactulose/manitol ratio). ASD children with severe maladaptive behavior have significantly more enterocyte damage (increased urinary I-FABP) than ASD children with mild maladaptive behavior and normal children.

• The Journal of Korean Medicine
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• v.25 no.4
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• pp.129-138
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• 2004

Objective : Treatments for patients with mental retardation and pervasive developmental disorders are not curative, and are designed to help those with disabilities adjust to their environments and daily demands. As clinicians, the present authors tried to find agents with potentially curative properties. Among the numerous herbal formulations available, we chose and assessed Gami-jiwhang-tang (GJT) in the hope that it would improve cognitive development of children. Methods : Subjects were typically-developing healthy, 7- to 8-year-old boys and girls living in Seoul, Korea. The experimental group took GJT for six weeks and was followed up six weeks after discontinuation of GJT. The control group was assessed at the same intervals but did not receive placebos. To measure the effects of GJT, neuropsychological tests and intelligence test were taken before commencing GJT and twelve weeks later. Resulets and Conclusion : For all of the ANOVAs, the treatment by time interaction terms was not significant. However, the experimental group showed the tendency to be progressed in most subscales compared with the control group, especially on performance intelligence, visual organization, and verbal fluency. Conclusion : Although GJT failed to reveal significant improvement in cognition, we remain hopeful about the compound and believe that it should be evaluated by a double-blind, placebo-controlled trial in the future.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.5 no.1
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• pp.41-53
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• 1994

In 1944 Hans Asperger reported odd bizzare 400 children who showed autism like clinical symptoms but had higher intelligence and relatively intact speech function. He named these child 'autistic psychopathy'. Since them there were many controversial views about this syndrome. Some regards Asperger syndrome as the high functioning autism variant or preschizophrenic childhood condition or childhood form of schizoid personality disorder. Though there were still many controversy, recently ICD-10, DSM-IV accepted Asperger's syndrome as a distinct subtype of pervasive developmental disorder. The authors reviewed the history and conceptual changes of Asperger syndrome and summarized the interesting recent research findings. In addition, the authors argue that this syndrome has some linkage with autism and schizoid personality disorder and proposed that these is disorders do have common defect in social instinctual development.

• The Journal of Korean Academy of Sensory Integration
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• v.7 no.2
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• pp.77-90
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• 2009

Objective : The purpose of this study was to provide evidence for the effectiveness of Sensory Integrative Intervention (SII) through a systematic review. Method : The systematic review was executed using MEDLINE/PubMed, PsycINFO, CINAHL, Cochrane Library, OTSeeker. The key words for search was "effects of sensory integration", "sensory integration therapy", and "sensory integration intervention". 11 studies were used for data analysis, and the level of evidence were level I, leve lII and level IV. The substances of review were subject (population), method (intervention type), effect of the intervention, outcome parameter, and outcome measurement. Results : 1. The subjects of SII were autism spectrum disorders (30.7%), pervasive developmental disorder (15.4%) and preterm infants (15.4%). 2. Most frequently used method was the traditional intervention of J. Ayres (36.5%). The outcome parameters of SII were behavioral outcome (40.63%), motor performance outcome (28.13%), sensory-based outcome (25.0%), and academic outcome (6.35%). 3. The effects of SII were improvement of motor performance (66.7%), sensory-based (62.5%), and behavior problems (61.5%). In most studies, however, academic skill such as writing skill was not a positive outcome parameter in terms of effectiveness of SII. Conclusions : The results implied that the sensory integrative intervention is effective on motor performance, sensory-based and behavioral change, but not on the academic skill. It is suggested that the future research need to be done to examine whether and how the effect of sensory integration intervention can be long-lasting and contribute any academic skill and activities of daily living performance.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.2 no.1
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• pp.87-96
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• 1991

A double bhad, placebo controlled study was performed to evaluate the therapeutic effects of Carbamazepine in autistic children, 23 boys with the diagnosis of Pervasive Developmental Disorders according to the DSM-IIIR were selected for study subjects, from Child and Adolescent Psychiatric Outpatient Department of Seoul National University Children Hospital during Oct. $1989{\sim}Nov.$ 1991. Subjects with histories of medical disease or psychiatric diseases were excluded and all study subjects had drug free periods more than 2 Months. Study subjects were randomly assigned to Cabamazepine treatment group(N=12) and placebo group(N=11). After the baseline observation periods, the double blind drug treatment and observation were performed for 12 weeks. Several scales (Ritvo-Freedman Real Life atring Scale. Behavior Checklist) were employed to evaluate the effects of drug treatment during baseline observation periods and the drug treatment periods by two raters blind to the study. Interrater reliability of each scales were .4875~.6613, the socrodemographic variables and the rating scores during baseline observation periods were not significantly different between two groups. Reduction of total scores in Autsm Behavior Checklist scale, i.e.. improvement of global autistic symptoms were noted significantly in Carbamazepine treatment group. Improvement in significant social maturations according to Vineland Social Mataration scale were observed in both patient groups after drug treetment periods.

• The Journal of the Korea Contents Association
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• v.11 no.3
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• pp.327-338
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• 2011

This study was conducted to determine the degree of satisfaction and the demand for the current education service of language therapy. We surveyed a total of fifty two nurturers of children who had been diagnosed as autistic. A three-part questionnaire that covered the environment of the therapy institution (7 questions), the programs provided by the Speech-Language Pathologist (7 questions) and the degree of satisfaction and the demand for therapy education (7 questions) was used. The study results showed, in the area of the institution environment for therapy education, that the degree of satisfaction was highest for Social Welfare Center users due to the therapy costs. The level of satisfaction then decreased in the order of private clinic users and general hospital users. However, in the area of education programs provided by Speech-Language Pathologists, it was highest for the users of general hospitals due to the proper contents of the programs and consulting service. The satisfaction level then decreased in the order of private clinic users and Social Welfare Center users. Regarding the level of satisfaction with therapy education and related demand, the degree of satisfaction with language therapy and all therapy education services was generally satisfactory. After the language therapy, the children showed considerable improvement in their living skills (60% of survey respondents) and psychological stability (stress reduction, 30% of the total survey respondents). Regarding the future demand for therapy education, the degree of demand was high for the individual and group language therapy education service. In summary, the results of this study uncovered a number of problems related to services provided by language therapy education institutions and suggested various implications that Speech-Language Pathologists and relevant professionals should endeavor to use so as to enhance the satisfaction level of therapy education for autistic children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.13 no.1
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• pp.67-75
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• 2002

Objectives：This study was conducted to investigate the degree of psychopathologies of the family members of children with chronic convulsive disorder and evaluate the structures and dynamics of those families. Methods：The participant patients and family members were recruited from the population attending the outpatient clinic of department of pediatric neurology in Seoul National University Hospital in Korea. All the patients had idiopathic chronic convulsive disorder. Any patient with mental retardation, pervasive developmental disorder and gross brain pathology was excluded. As controls, normal students were chosen and their sex, age, achievement, socioeconomic status were matched to patients. The author interviewed the children and their family members twice and obtained informations about patient-parent relationship, patient-sibling relationship and others. For in-depth evaluation, we used family environment scales(FES), symptom Checklist-90-revised(SCL-90-R), self administered dependency questionnaire for mother(SADQ). Results：After interviewing with the parents of epileptic children, overprotection of parents, hostile feeling of siblings toward index children were higher than controls. The parental conflict was also more expressed than control families. According to results from FES, the scores of the subscales of expression, achievement-orientation, intelligence-orientation and active recreation were significantly lower than control group. The epileptic children showed higher dependency to parents especially in affection, communication and traveling areas of SADQ than control group. Maternal psychopathologies evaluated by SCL-90-R were much higher than the mothers of controls. According to T scores of SCL-90-R, about 40% of mothers with epileptic children had the risk of clinically significant depressive or anxiety disorders. Conclusion：These results suggested that the family members of epileptic children had more relationship problems and psychopathologies than control group and some mothers might have clinically significant depressive or anxiety disorders. so, effective psychiatric family interventions are needed for resolution of conflict and psychopathologies of family members.