• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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• pp.213-219
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• 2017

Objectives: Early intensive interventions are very important for children with autism spectrum disorder. We examined the actual conditions of hospital-based early intensive interventions for autism spectrum disorder in Seoul, in order to help develop and implement an evidence-based early intensive intervention model for use in Korea. Methods: Nine hospital-based institutes running an early intensive intervention program for children with autism spectrum disorder responded to a questionnaire in September 2014. They provided a brief introduction to their program, explained its theoretical bases, and reported the number of children, their age, intervention time, duration and so on. Results: In the majority of the institutions, the intervention was provided for over 20 hours every week, and the theoretical bases included various applied behavioral analysis (ABA) methods and other therapies (language and occupational therapy). The therapist-child ratio ranged from 1:1 to 5:3. Various types of therapists were involved, including behavioral analysts, special education teachers and (or) language pathologists. There was only one clinic where the behavioral analyst was the main therapist. Usually, the intervention was terminated just before the child entered elementary school. The main merit of the hospital-based intervention in our survey was the effectiveness of the multi-disciplinary intervention plan and its other merits were the accuracy of the diagnosis, its ability to be combined with medicine, and so on. Conclusion: The current hospital-based early intensive intervention programs provide interventions for over 20 hours per week and employ multidisciplinary approaches. However, there are very few institutes for children with autism and very few intervention specialists and specialist education courses in the country. We need more educational programs for intervention therapists and have to try to develop policies which encourage the implementation of an evidence-based early intensive intervention program nationwide.

• 대한감각통합치료학회지
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• 제21권3호
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• pp.65-78
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• 2023

목적 : 본 연구에서는 체계적 문헌 고찰을 통하여 국내 자폐스펙트럼장애 아동의 보호자를 대상으로 실시한 가족 중심 중재의 효과를 알아보고자 하였다. 연구방법 : 문헌검색은 2011년부터 2021년 사이의 문헌을 RISS, KISS, DBpia를 통하여 검색하였다. 검색어는 '자폐스펙트럼' OR '전반적발달장애' OR '고기능 자폐' OR '아스퍼거' AND '부모 교육' OR '가족중심중재' OR '부모코칭' OR '부모훈련' OR '가족참여' 등을 적용하였다. 선정 기준에 따라 최종적으로 11편의 실험연구를 선정하였다. 결과 : 연구 참가자의 일반적 특성, 중재 전략 및 효과, 중재 프로토콜을 확인한 결과, 연구대상은 영유아기 자폐스펙트럼장애 아동이 가장 많았고, 가족 중심 중재에 어머니들이 주로 참여하였다. 가족 중심 중재의 효과는 아동과 부모에게서 모두 나타났으며, 아동에게서는 상호작용 및 의사소통에 대한 효과가 가장 높은 비중을 차지하였고, 부모에게서는 양육 스트레스 감소 및 양육효능감 향상을 보였다. 중재 전략은 감각통합 중재, 반응적 의사소통 및 상호작용 중심 중재가 가장 많았고, 발달 중심 중재, 긍정적 행동 지원 중재(Positive Behavioral Supports; PBS), 중심축 반응 훈련(Pivotal Response Training; PRT)순으로 나타났다. 결론 : 본 연구의 결과를 통해 가족 중심 중재는 자폐스펙트럼장애 아동의 기능뿐만 아니라 부모의 양육 스트레스 및 양육효능감에 효과가 있음이 확인되었으며 임상 활용의 근거를 제시하였다는 점에서 의의가 있다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권4호
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• pp.187-195
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• 2014

Objectives : The objective of this study was to investigate the relationship between restricted, repetitive behaviors and interests (RRBI) and autistic symptoms in Korean high functioning autism spectrum disorder (ASD) children and to examine the structure of RRBI. Methods : Participants included 147 high functioning ASD subjects and 181 unaffected siblings. ASD subjects were divided into two groups based on the presence of RRBI. The domain scores of the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R), Korean version of Asperger Syndrome Diagnostic Scale and total scores of Korean translated version of Social Responsiveness Scale, Korean version of Social Communication Scale were used for comparison of ASD symptoms between the groups. Eleven items from the RRBI domain of the K-ADI-R were used in principal axis factor analysis (PAF). Results : A statistically lower nonverbal IQ score was observed for ASD with RRBI than for ASD without RRBIs, and more social deficit, communication deficit, and behavioral and emotional problems were observed for ASD with RRBI compared to ASD without RRBI. Using PAF, two distinct factors were identified. 'Resistance to trivial changes in environment', 'Difficulty with minor changes in personal routine & environment', and 'Compulsion/ritual' were included as one factor. Conclusion : Analysis of the data suggests that the presence of RRBI in high functioning ASD is associated with a more severe presentation of autistic disorder. In addition, there appears to be heterogeneity within RRBI in autism except insistence on sameness.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권4호
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• pp.178-184
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• 2018

Objectives: The objective of this study was to investigate the concordance of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV and DSM-5) diagnostic criteria for autism spectrum disorder (ASD). Methods: We retrospectively reviewed the medical records of 170 subjects (age range: 3-23, 140 boys) with developmental delay or social deficit from January 2011 to July 2016 at the Department of Psychiatry of Asan Medical Center. The Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS), and intelligence tests were performed for each subject. Diagnosis was reviewed and confirmed for each subject with DSM-IV Pervasive Developmental Disorder (PDD) and DSM-5 ASD criteria, respectively. Results: Fifty-eight of 145 subjects (34.1%) who were previously diagnosed as having PDD in DSM-IV did not meet DSM-5 ASD criteria. Among them, 28 (48.3%) had Asperger's disorder based on DSM-IV. Most algorithm scores on ADOS and all algorithm scores on ADI-R were highest in subjects who met both DSM-IV PDD criteria and DSM-5 ASD criteria (the Convergent group), followed by subjects with a DSM-IV PDD diagnosis who did not have a DSM-5 ASD diagnosis (the Divergent group), and subjects who did not meet either DSM-IV PDD or DSM-5 ASD criteria (the non-PDD group). Intelligence quotient was lower in the Convergent group than in the Divergent group. Conclusion: The results of our study suggest that ASD prevalence estimates could be lower under DSM-5 than DSM-IV diagnostic criteria. Further prospective study on the impact of new DSM-5 ASD diagnoses in Koreans with ASD is needed.

• 융복합기술연구소 논문집
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• 제1권2호
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• pp.1-5
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• 2011

It is known that as many as 15-20 in 10,000 children are diagnosed with autistic spectrum disorder. A framework of the treatment system for children with autism using affective computing technologies was proposed by Chung and Yoon. In this paper, a prototype for the framework is proposed. It consists of emotion stimulating module, multi-modal bio-signal sensing module, treatment module using virtual reality, and emotion recognition module. Primitive experiments on emotion recognition show the usefulness of the proposed system.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권3호
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• pp.97-104
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• 2020

Deep learning (DL) is a kind of machine learning technique that uses artificial intelligence to identify the characteristics of given data and efficiently analyze large amounts of information to perform tasks such as classification and prediction. In the field of neuroimaging of neurodevelopmental disorders, various biomarkers for diagnosis, classification, prognosis prediction, and treatment response prediction have been examined; however, they have not been efficiently combined to produce meaningful results. DL can be applied to overcome these limitations and produce clinically helpful results. Here, we review studies that combine neurodevelopmental disorder neuroimaging and DL techniques to explore the strengths, limitations, and future directions of this research area.

• International Journal of Advanced Culture Technology
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• 제6권4호
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• pp.80-86
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• 2018

The intervention of Autism Spectrum Disorder (ASD) is limited research focus on the effect of occupational-based intervention. This study sought to determine the effect of occupational-based intervention of chopstick skills for children with ASD. This study included a total of 3 children with ASD.Using single-subject study design, a changing criterion design and ABC design were implemented. The participants' behavior was observed and recorded throughout each session. In this study, the results were analyzed through visual graphs. The amount of food that was moved using the chopsticks was gradually increased. The results show that all participants significantly improved in their ability to use chopsticks in each intervention session. In addition, Assessment of Motor and Process Skills (AMPS) improved the generalization. According to the AMPS, both the overall motor and process skills increased from baseline an average of 0.7 logit. The results of this study showed occupational-based intervention on chopsticks skill to be effective in acquisition and generalization of chopstick skill in children with ASD.

• 디지털콘텐츠학회 논문지
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• 제18권1호
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• pp.35-46
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• 2017

본 연구는 자폐 스펙트럼 장애 학생을 대상으로 하는 증강현실기반 교육 콘텐츠 연구들을 고찰해 보면서 연구동향과 시사점을 탐색하는 것을 목적으로 하였다. 이를 위해 학술 데이터베이스를 활용하여 2006년에서 2016년까지 발표된 논문들을 수집한 후, 선정기준에 적합한 12편의 국외 연구들을 분석 대상으로 선정하였다. 연구결과, 선행연구들은 초등학생들을 대상으로한 연구가 많았으며, 연구설계는 단일대상연구가 가장 많았다. 연구도구로는 증강현실을 위한 모바일 기기가 다수를 차지하고 있었으며, 측정방법으로는 행동관찰방법을 많이 사용하였다. 증강현실기반 교육콘텐츠 유형은 사물조작형, 자기모델링 관찰조작형, 현장문제해결형, 위치기반 학습안내형으로 구분되었다. 교육적 효과는 사회적 행동, 놀이 및 모방행동, 타인에 대한 감정인식의 향상이 주로 나타났다. 마지막으로, 자폐 스펙트럼 장애 학생을 위한 증강현실기반 교육 콘텐츠 개발과 적용을 위한 고려사항을 도출하여 제시하였다.

• 대한통합의학회지
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• 제8권3호
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• pp.133-142
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• 2020

Purpose : The purpose of this study was to investigate the differences in social quotient and sensory processing function between completed-toileting and incomplete-toileting children with autism spectrum disorder (ASD). We aims to provide a basis for the training of children with autism spectrum disorders. Methods : The subjects of this research were children with ASD, aged from 4 to 7, receiving sensory integration therapy at the H-Child Development Research Center in Busan, South Korea. After recruiting 30 parents who had children with ASD, we interviewed them and we divided their children into completed-toileting group and incomplete-toileting group based on the past researches. We assessed them using the Social Maturity Scale and Sensory Profile. Spearman correlation was used to analyze between the sensory processing score and social quotient. Mann-Whitney U test was used to compare the Sensory Profile scores of the two groups. Results : The social quotient was correlated with the sensory processing score in the most of component as for auditory processing, vestibular processing, touch processing, multisensory processing, orosensory processing, except for visual processing. The groups of completed-toileting and incomplete-toileting group showed statistically significant intergroup difference in sensory seeking, emotional reactive, oral-sensory sensitivity, and inattention/distractibility in the sensory factor region. No statistically significant difference from intergroup was observed in any modulation areas, nor in behavioral & emotional response domains. Conclusion : A significant intergroup difference was observed in the most of sensory processing areas, except for modulation areas and behavioral & emotional response domains. The result revealed that toileting is significantly correlated with sensory processing. Therefore, this study suggests that the sensory processing function should be considered in the toilet training of children with ASD.

• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.341-346
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• 2021

Background: The results differ among published studies regarding exposure to meconium and the risk of developing autism spectrum disorders (ASDs). Purpose: The present study pooled all of the epidemiologic studies retrieved from broader databases on the association between meconium exposure and risk of developing ASD in children. Methods: The Web of Science, PubMed, Scopus, and Google Scholar databases were searched without language restrictions for articles published between their inception to February 20, 2020, using relevant keywords. The pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated as random-effect estimates of the associations among studies. A subgroup analysis was conducted to explore any potential sources of heterogeneity among studies. Results: The pooled estimate of OR reported a weakly significant association between meconium exposure and ASD development in children (OR, 1.13; 95% CI, 1.03-1.24). There was low heterogeneity among the articles reporting risk for ASD among children (I²=19.3%; P=0.259). The results of subgroup analysis based on meconium exposure showed a significant association between a meconium-stained neonate and ASD development (OR, 1.18; 95% CI, 1.11-1.24). Couclusion: Meconium exposure was weakly associated with an increased risk of ASD. However, more evidence based on large prospective cohort studies is required to provide conclusive evidence about whether meconium exposure is associated with an increased risk of ASD development.