• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.29 no.1
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• pp.7-13
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• 2018

Objectives: Problem behaviors pose a great obstacle to daily functioning in children with neurodevelopmental deficits and are an important target for treatment. In this study, we translated the Behavior Problems Inventory (BPI)-01 into Korean language and tested its psychometric properties. Methods: We attained the approval of the BPI author and performed standard translation-back translation. Then, professional caregivers examined appropriateness according to cultural and situational contexts in order to make necessary modifications of the Korean version of the BPI. Results: The BPI-01, Korea-Scales of Independent Behavior-Revised (K-SIB-R), and Child Behavior Checklist were completed for 98 autistic spectrum disorder or intellectual development disorder participants (mean age=28.3, standard deviation=7.3, range=10.1-51.7). The inter-rater reliability of the BPI-01 was found to be high (r=0.992-1.000). As for the results for concurrent validity for subscale items of BPI-01 and scales of SIB, correlations between SIB and BPI-01 subscales were statistically significant (r=0.357-0.672). Discussion: The Korean version of the BPI-01 showed good psychometric properties with high reliability and sufficient convergent validity. Further examination of the validity of BPI-01 should be carried out with inclusion of younger aged children and a closer look at less frequently occurring symptoms.

• Journal of the Korea Convergence Society
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• v.9 no.3
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• pp.153-163
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• 2018

The purpose of this research is to investigate the research trends on the clinical use of robots for children with autistic spectrum disorders. In order to understand research trends in the context of the clinical use of robots for children with ASD, recent studies on the use of robot in the educational and therapeutic intervention were examined. Critical literature review is used as research method. Recent studies of 17 articles are chosen with two filters of 1) publication years since 2009, and 2) two key-words; robot and ASD. Further, literature on research trends is scrutinized and categorized according to the kinds of robots that are used, the types of independent and dependent variables, and research methods. The result of this research indicated that recent years, the clinical use of interactive robots with children with disability has received considerable attention in light of the proven utility of educational and therapeutic intervention. Rapid progress in robotics, especially in the area of ASD, offers tremendous possibilities for innovation in treatment for children with ASD. In conclusion, this study addresses the need of further study on the implementation procedures and protocols of clinical robots that will make the adoption feasible and easy.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.415-421
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• 2018

Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairment in social skills and communication with repetitive behaviors. Etiology is still unclear although it is thought to develop with interaction of genes and environmental factors. Oxytocin has extensive effects on intrauterine brain development. Vitamin D, affects neural development and differentiation and contributes to the regulation of around 900 genes including oxytocin receptor gene. In the present study, the contribution of D vitamin receptor and oxytocin receptor gene polymorphisms in the development of ASD in Turkish community was investigated. To our knowledge, this is the first study examining these two associated genes together in the literature. Methods: Eighty-five patients diagnosed with ASD according to DSM-5 who were referred to outpatient clinics of Child and Adolescent Psychiatry of Başkent University and Mersin University and 52 healthy, age and gender-matched controls were included in the present study. Vitamin D receptor gene rs731236 (Taq1), rs2228570 (Fok1), rs1544410 (Bsm1), rs7975232 (Apa1) polymorphisms and oxytocin receptor gene rs1042778 and rs2268493 polymorphisms were investigated using real time polymerase chain reaction method. Results: No significant difference between groups in terms of distribution of genotype and alleles in each of polymorphisms for these genes could be found. Conclusion: Knowledge of genes and polymorphisms associated with the development of ASD may be beneficial for early diagnosis and future treatment. Further studies with larger populations are required to demonstrate molecular pathways which may play part in the development of ASD in Turkey.

• Korean Journal of Biological Psychiatry
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• v.19 no.4
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• pp.205-210
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• 2012

Objectives The purpose of this study was to investigate clinical profile, efficacy, and safety of long-term treatment with selective serotonin reuptake inhibitors (SSRIs) in Korean autism spectrum disorders (ASDs) patients. Methods Effectiveness was assessed through a retrospective review of self-reported target symptom improvement at the last follow-up visit. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity (CGI-S) of illness and Clinical Global Impression-Improvement (CGI-I) Scales. Tolerability was assessed through a review of the reason for discontinuation of SSRI and documented adverse events. Results A total of 21 ASDs patients (aged 9 to 19 years) treated with SSRI during July 2010 to July 2011 in department of child and adolescent psychiatry of Seoul National Hospital were identified. The mean duration of SSRI treatment was 47.9 (standard deviation = 36.9) months (range 0.7-114.5), and the mean fluoxetine equivalent dosage of SSRIs was $27.1{\pm}10.8$ mg. Nineteen (90.5%) patients were using concomitant medication. We found that SSRIs were prescribed for symptoms of agitation, stereotyped behavior, aggression, depression, impulsivity and self-injury in ASDs. Ten patients (47.6%) reported improvement in their target symptom after SSRI treatment based on CGI-I scores (CGI-I ${\leq}$ 2). The side effects were reported in 5 patients (23.8%) ; vomiting (n = 2, 9.5%), excessive mood elevation (n = 1, 4.8%), insomnia (n = 1, 4.8%), somnolence (n = 1, 4.8%) and decreased appetite (n = 1, 4.8%). Self-injurious behavior was reported in one patient (4.8%). Conclusions The results of this study suggest that SSRIs may be used effectively in children and adolescents diagnosed with ASDs. However, safety issues need to be considered carefully when choosing SSRIs for treatment. Future controlled trials are needed to confirm these findings.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.28 no.2
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• pp.96-105
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• 2017

Objectives: The purpose of this study is to investigate the professional knowledge and perceptions of the early screening of Autism Spectrum Disorder (ASD) in practitioners who have contact with patients with ASD. Methods: A survey was carried out among 674 practitioners in total, where practitioners are defined as those who work at primary medical centers, public institutions, educational institutions and treatment institutions. The survey was carried out both online and offline, and it mainly focused on 1) knowledge about ASD symptoms, 2) knowledge about the early screening of ASD, 3) measures taken after ASD detection, 4) thoughts on the development of early screening tools for ASD, and 5) the current status of ASD treatment. The data collected were analyzed through descriptive statistics, analysis of frequency and cross tabulation analysis using SPSS WIN 22.0. Results: The results of this study suggest that the practitioners were not aware of the exact symptoms of ASD and their professional knowledge and the environment for early screening were insufficient. Furthermore, very few and inappropriate measures were taken after the detection of ASD. In addition, there was a high demand for early ASD screening tools to be used on site and, regarding treatment, the significance of the implementation of evidence based treatments as well as the continuity of relevant research came to the fore. Conclusion: It seems that there is a lack of knowledge and perception of the early screening of ASD and that education and training among practitioners is urgently required. This issue is discussed in more detail in the paper.

• The Journal of the Korea Contents Association
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• v.17 no.2
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• pp.623-636
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• 2017

The use of virtual reality(VR)-based interventions for students with autism spectrum disorders(ASD) has received special attention as evidence-based practices for its feasiblity, practicality, and appropriateness. However, there is little research to investigate the effects of VR-based intervention for students with ASD in Korea. This study identifies and reviews studies applying VR-based interventions. In total, 13 experimental studies were found that examine the effects of VR interventions published from 1990 to 2016. The selected studies were analyzed by 6 variables including publication year, participants, research design, independent variable, dependent variable, and outcome. The results of this study showed the feasibility of the implementing VR-based interventions in various age group students with ASD. In addition, the utilization of VR techniques was particularly effective in improving a wide range of social communication skills including facial recognition, empathy, joint attention, understanding social context, and resolving issues due to limited cognitive abilities. Several recommendations for the future study on VR-based intervention for students with ASD such as interdisciplinary approach to VR-based interventions, support needs regarding characteristics of ASD, generalization and maintenance of acquired technology, and consideration for participants' cultural background. were discussed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.23 no.3
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• pp.154-160
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• 2012

Objectives : The purpose of this study was to investigate clinical characteristics of children and adolescents with autism spectrum disorders (ASDs) using methylphenidate (MPH). Methods : Retrospective review of the charts of 79 children and adolescents with ASDs, who visited the Department of Child and Adolescent Psychiatry of Seoul National Hospital, from July 2010 to July 2011, was conducted. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity of illness (CGI-S) and Clinical Global Impression-Improvement (CGI-I) Scales. Results : We found that MPH was prescribed in 23 (29.1%) children and adolescents. Of the 23 patients on MPH, 4 patients (17.4%) were on MPH monotherapy and 18 patients (78.3%) were using risperidone concomitantly. MPH was prescribed primarily for symptoms of hyperactivity and impulsivity in ASDs patients. The mean dosage of MPH was $26.2{\pm}11.1$mg/day and mean duration of treatment was $31.9{\pm}28.7$ months. Mean CGI-S score improved significantly from baseline to endpoint (from $5.4{\pm}0.6$ to $4.1{\pm}0.9$ ; p<.01). MPH was reported to be effective in 17 patients (17/23, 73.9%), and 10 patients (10/23, 43.5%) reported side effects. Side effects included decreased appetite (4/23, 17.4%), tic (2/23, 8.6%), sleep disturbances (2/23, 8.6%), headache (1/23, 4.3%) and irritability (1/23, 4.3%). Conclusion : The results of this study demonstrate that MPH may be used effectively and safely in children and adolescents with ASDs with hyperactivity and impulsivity. Future controlled trials are needed to confirm these findings.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.24 no.3
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• pp.109-123
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• 2013

The discovery of the mirror neuron system (MNS) is one of the most important neuroscientific achievements in the 20th century. Some researchers had reported that MNS dysfunction was discovered in autism spectrum disorders (ASD). Finally, the 'broken mirror' theory of ASD was announced in the mid 2000's. According to this theory, ASD cannot simulate the mind and behavior of others due to MNS dysfunction; therefore, they cannot imitate the behaviors and empathized with the mind of others. However, ASD does not always show imitation problems. The researchers who have criticized the 'broken mirror' theory proposed the 'social top-down response modulation (STORM)' theory. On STORM theory, the medial prefrontal cortex or temporo-parietal junction, brain areas related with mentalising, might modulate MNS according to social context. We compared the strengths and weaknesses of each theory.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.27 no.3
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• pp.196-206
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• 2016

Objectives: Individuals with autism spectrum disorder (ASD) are considered to have problems with empathy. It has recently been suggested that there are two systems for empathy; cognitive and emotional. We aimed to investigate the neural response to cognitive and emotional empathy and elucidate the neurobiological aspects of empathy in patients with ASD. Methods: We recruited patients with ASD (N=17, ASD group) and healthy controls (HC) (N=22, HC group) for an functional magnetic resonance imaging study. All of the subjects were scanned while performing cognitive and emotional empathy tasks. The differences in brain activation between the groups were assessed by contrasting their neural activity during the tasks. Results: During both tasks, the ASD group showed greater neural activities in the bilateral occipital area compared to the HC group. The ASD group showed more activation in the bilateral precunei only during the emotional empathy task. No brain regions were more activated in the HC group than in the ASD group during the cognitive empathy task. While performing the emotional empathy task, the HC group exhibited greater neural activities in the left middle frontal gyrus and right anterior cingulate gyrus than the ASD group. Conclusion: This study showed that the brain regions associated with cognitive and emotional empathy in ASD patients differed from those in healthy individuals. The results of this study suggest that individuals with ASD might have defects both in cognitive empathy and in emotional empathy.

• Journal of Music and Human Behavior
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• v.17 no.1
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• pp.97-125
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• 2020

This case study examined the effects of synchronization-based group music therapy for improving peer interaction of children with autism spectrum disorder (ASD). The participants were five children between the ages of 6 and 10 with ASD. A total of eight 30-minute music therapy sessions were conducted two times a week. During sessions, target behaviors (i.e., engagement in joint action, synchronized movements, eye contact, and initiation of social interaction) were observed and analyzed. Also, the PIPPS-P was completed by parents to identify behavioral changes in real-life environments from pretest to posttest. Following the intervention, all of the participants showed increases in synchronized movements with peers and attempts to initiate social interaction. In addition, parents rated their children's play behavior as being improved in their everyday living environment. These results support that synchronous movements between children with ASD, which were facilitated with rhythmic cueing, led to enhanced engagement in joint action. Considering that those movements are the basis for further social skills (e.g., play behavior), this study also indicates that synchronization-based group music therapy could be an effective therapeutic approach for improving the peer interaction of this population.