• Title/Summary/Keyword: 장애 아동.청소년

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CHILDHOOD TRAUMA:PSYCHIATRIC OVERVIEW (아동기 외상의 정신과적 개관)

  • Han, Sung-Hee
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.3-14
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    • 2002
  • Childhood psychic trauma appears to be a crucial factor in the development of serious disorders both in childhood and in adulthood. Traumatized children show strong tendency to revisualize or re-feel a traumatic events. Play and behavioral reenactments are frequent manifestations of both the single blow and the long-standing traumas in childhood. Those children who suffer the results of single, intense terror appear to exhibit detailed memory, retrospective reworkings and misperceptions. In long-standing or repetitive trauma, children would show psychic numbing, self-hypnosis, dissociation and rage. Child's brain is undergoing critical and sensitive periods of differentiation. During this time, developing central nervous system is exquisitely sensitive to stress. Stressor-activated neurotransmitters and hormones can play major roles in neurogenesis, migration, synaptogenesis, and neurochemical differentiation. Internal opiate system operates in some trauma and causes the victim to fail to respond, to avoid, to shut off feelings. Evidence is also accumulating in traumatology that dysfuntion of locus coeruleus and ventral tegmental neucleus system leads to catecholamine receptors hypersensitivity. This change result in hypervigilance, increased startle, affective lability, and increased autonomic nervous system hyperreactivity. Another site of action of trauma on the brain is hypothalamic-pituitary-adrenal axis. Individuals with PTSD do not have enough cortisol to halt the alarm reaction. When children are exposed to long-standing extreme events, massive attempts to protect the psyche and to preserve the self are put into gear. These developmental traumas mobilize various kinds of defense mechanisms. Massive denial, dissociation, self anesthesia, identification with aggressor and aggression turned against the self often lead to profound character changes in the youngsters.

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MMPI PROFILE TYPES OF MOTHERS WITH PSYCHIATRIC DISORDERED CHILDREN (정신 장애 아동들의 어머니의 MMPI 유형 분석)

  • Shin, Min-Sup;Oh, Kyung-Ja;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.3 no.1
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    • pp.97-105
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    • 1992
  • Present study investigated the relationship between children's psychiatric disorders and their mothers' psychological problems. Ninety-one psychiatric outpatients from a children's hospital were classified into three diagnostic groups - internalizing symptom group(n=35), externalizing symptom group(n=35), and developmental disorder group(n=21) - based on their psychiatric problems. A normal control group was formed by matching on the age and education of mothers. Mothers' MMPI profiles which were classified into five types - normal, depression, anxiety disorder, somatization disorder, and personality disorder - were examined in relation with children's diagnoses. The profiles of the mothers in the normal control group were mostly normal, while depressive profiles were dominant among those of the clinical groups regardless of the children's diagnoses. Therefore, the data implied association between children's psychiatric problems and their mothers' psychological problems. A possibility of negative reciprocal interactions between children and their mothers was discussed. It was also suggested that further research need to examine the specific effects of children's psychiatric problems on the psychological adjustment of their mothers, as well as the effects of parental psychiatric problems on the adjustment of their offsprings.

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Occupational Therapy for Activity and Participation of Children and Adolescents With Developmental Disability: A Systematic Review (국내 발달장애 아동·청소년의 작업치료 목표에 대한 체계적 고찰: ICF-CY 모델의 활동과 참여를 중심으로)

  • Park, Jihoon;Choi, Jeong-sil;Hong, Eunkyoung
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.2
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    • pp.56-68
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    • 2019
  • Objective : The purpose of this study is to provide evidence for a systematic analysis of occupational therapy interventions for the activity and participation of children and adolescents with developmental disabilities. Methods : The articles used in this study were collected from the RISS, KISS, and DBpia databases. The key words used were "children and occupational therapy" "children and sensory integration," "adolescent and occupational therapy," "adolescent and sensory integration," "developmental disorder and occupational therapy," and "developmental disorder and sensory integration." The research period was limited to January 2008 to August 2018. Seven articles in total were selected for systematic analysis. Results : Most of the included works were single-case studies, and most subjects dealt with the autism spectrum disorder. The majority of the interventions used involved sensory integration. Occupational therapy interventions were self-care (33%), major life area (33%), learning and application (11%), communication (11%), and mobility (11%). Conclusion : This study will help with understanding the current state of occupational therapy interventions for the activity and participation. On the basis of this understanding, various studies on this subject are expected to be conducted in the future.

Effect of Virtual Reality-based Occupational Therapy Interventions for Disabled Children and Adolescents: A Systematic Review (장애 아동 및 청소년에게 가상현실(VR) 기반 작업치료 중재가 미치는 영향: 체계적 고찰)

  • Kim, Man-Je;Gil, Young-Suk;Kang, Set-Byul;Lee, Jae-Shin
    • The Journal of Korean Academy of Sensory Integration
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    • v.21 no.1
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    • pp.34-46
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    • 2023
  • Objective : The purpose of this study was to systematically analyze the methods by which virtual reality (VR)-based occupational therapy interventions are applied to disabled children and adolescents and to assess their effectiveness. Methods : The RISS, DBpia, KCI, Science Direct, and CINAHL MEDLINE databases were searched for relevant literature from January 2012 to August 2022. The main search terms used were "virtual reality," "work therapy," "youth," "virtual reality," "occupational therapy," "child," and "adolescent." A total of 16 documents were selected for analysis by the 4th stage of the PRISMA flowchart. Results : In the 16 selected studies, VR-based occupational therapy when used with children and adolescents with disabilities and was shown to have meaningful effects. Among the types of cerebral palsy covered in the studies, the most common was hemiplegia, and the evaluation tools used for measurement of the VR effect were daily activities, cognition, exercise technology, social-interaction technology, and visual-perception evaluation. Nintendo wii and Microsoft Kinect produced the VR tools most commonly used to improve motor skills and daily life. Conclusion : The results of this study indicate that VR interventions can be used effectively in clinical practice. In the future, they may assist in the diagnosis of disabled children and adolescents, in helping to select VR tools that are suitable for the purposes of intervention, and in the presentation of specific methods.

A STUDY ON THE EVENT-RELATED POTENTIALS BETWEEN THE PATIENTS WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER AND NORMAL CHILDREN (주의력결핍 ${\cdot}$ 과잉운동장애 아동과 정상아동간의 사건관련전위 소견의 비교 연구)

  • Cho, Soo-Churl;Shin, Sung-Woong
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.179-189
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    • 1996
  • Objective : This study was conducted to find out the electrophysiological abnormalities of the patients with attention-deficit/hyperactivity disorder(abbr. ADHD) through identifying the profiles of the event-related potentials. Methods : Through measuring event-related potentials of 20 patients with ADHD and 16 normal control children using Oddball paradigm, we evaluated the latencies and amplitudes of each wave form. Results : In the group older than 9 years old, the latencies that reflect selective attention and discriminative capacity of the patients with ADHD were significantly longer than those of normal controls, which suggests that patients with ADHD be more distractible to non-significant stimuli and that they be in lark of sustained attention and discriminative ability. Conclusions : We concluded that the patients with ADHD are more distractible to trivial stimuli than normal children but they lack discriminative, sustained ability of attention.

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BIO-PSYCHOSOCIAL STUDY OF EMOTIONAL BEHAVIORAL PROBLEMS IN KOREAN ELEMENTARY SCHOOL CHILDREN(II) -Quantitated Various EEG Elements of Basic Activity in ADHD and Emotional Behavioral Problem Children by Computerized Wave Form Recognition Method - (국민학교 아동의 정서행동문제에 대한 생물 ${\cdot}$ 정신사회학적 연구(II) -뇌파자동해석장치에 의한 주의력 결핍과잉운동장애 아동과 정서행동문제아동의 뇌파조사-)

  • Lee, Chung-Kyoon;Jang, Kyung-June;Park, Seong-Ho;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.40-54
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    • 1990
  • The author studied EEG differences among normal, children, children with emotional behavioral problems determined by Rutter's questionnaire and children with attention-deficit hyperactivity disorder according to DSM-III-R. The results are as follows ; There were no differences in incidence and pattern of abnormal EEG between normal control children and children with emotional behavioral problems. But children with attention-deficit hyperactivity disorder tend to show lower average amplitude, and less wave percentage time of alpha wave in occipital area than normal did, furdermore wave percentage time of alpha wave appeared more in left occipital area than in right occipital area, These results demonstrated that emotional behavioral problems in elementary school children may not be related to EEG abnormality, Where as children with attention deficit hyperactivity disorder showed underdeveloped alpha waves as compared with normal control children.

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TREATMENT OF REACTIVE ATTACHMENT DISORDER (반응성 애착 장애의 치료)

  • Lee, He-Len
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.15 no.2
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    • pp.132-142
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    • 2004
  • Most articles of Reactive Attachment Disorder reported Disinhibited Type children adopted from other countries. Reports from only Turkey and Korea focused on Inhibited Type of Reactive Attachment Disorder children whom raised by their own parents and whose symptoms are very similar to Autistic Disorder. Since articles of treatment of Reactive Attachment Disorder, especially for Inhibited Type are very rare, this article informed the author's experiences of treatment for Korean Reactive Attachment Disorder children since 1987. To treat Reactive Attachment Disorder patients and their parents, three important areas must be included : 1) to make a therapeutic environment for a Reactive Attachment Disorder child, 2) to make an attachment between Reactive Attachment Disorder child and his/her mother through individual play therapy, filial therapy, and group therapy with sibling or peer, 3) to catch up developmental delay by speech therapy, cognitive therapy and therapeutic education. This treatment methods can be more easily and more effectively applied to Korean patients than other methods from western countries including USA or England.

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CLINICAL STUDY OF THE ABUSE IN PSYCHIATRICALLY HOSPITALIZED CHILDREN AND ADOLESCENTS (소아청소년 정신과병동 입원아동의 학대에 대한 임상 연구)

  • Lee, Soo-Kyung;Hong, Kang-E
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.2
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    • pp.145-157
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    • 1999
  • This study was performed by the children and adolescents who were abused or neglected physically, emotionally that were selected in child & adolescents psychiatric ward. We investigated the number of these case in admitted children & adolescents, and also observed characteristics of symptoms, developmental history, characteristics of abuse style, characteristics of abusers, family dynamics and psychopathology. We hypothesized that all kinds of abuse will influnced to emotional, behavioral problems, developmental courses on victims, interactive effects on family dynamics and psychopathology. That subjects were 22 persons of victims who be determined by clinical observation and clinical note. The results of the study were as follows:1) Demographic characteristics of victims:ratio of sex was 1:6.3(male:female), mean age was $11.1{\pm}2.5$. According to birth order, lst was 12(54.5%), 2nd was 5(23%), 3rd was 2(9%) and only child was 3(13.5%). 2) Characteristics of family:According to socioeconomic status, middle to high class was 3(13.5%), middle one was 9(41.% ), middle to low one was 9(41%), low one was 1(0.5%). according to number of family, under the 3 person was 3(13.5%), 4-5 was 17(77.5%), 6-7 was 2(9%). according to marital status of parents, divorce or seperation were 5(23%), remarriage 2(9%), severe marital discord was 19(86.5%). In father, antisocial behavior was 7(32%), alcohol dependence was 10(45.5%). In mother, alcohol abuse was 5(23%), depression was 17(77.3%), history of psychiatric management was 6(27%). 3) Characteristics of abuse:Physical abuse was 18(81.8%), physical and emotional abuse and neglect were 4(18.2%). according to onset of abuse, before 3 years was 15(54.5%), 3-6 years was 5(27.5%), schooler was 1(15%). Only father offender was 2(19%), only mother offender was 8(35.4%), both offender was 8(35.4%), accompaning with spouse abuse was 7(27%), and accompaning with other sibling abuse was 4(18.2%). 4) General characteristics and developmental history of victims:Unwanted baby was 12(54.5%), developmental delay before abuse was9(41%), comorbid developmental disorder was 15(68%). there were 6(27.5%) who didn‘t show definite sign of developmental delay before abuse. 5) Main diagnosis and comorbid diagnosis:According to main diagnosis, conduct disorder 6(27.3%), borderline child 5(23%), depression4(18%), attention deficit hyperactivity disorder(ADHD) 4(18%), pervasive developmental disorder not otherwise specified 2(9%), selective mutism 1(5%). According to comorbid diagnosis, ADHD, borderline intelligence, mental retardation, learning disorder, developmental language disorder, oppositional defiant disorder, chronic tic disorder, functional enuresis and encoporesis, anxiety disorder, dissociative disorder, personality disorder due to medical condition. 5) Course of treatment:A mean duration of admission was $2.4{\pm}1.5$ months. 11(15%) showed improvement of symtoms, however 11(50%) was not changed of symtoms.

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COMPARISON OF MEMORY FUNCTION BETWEEN ATTENTION DEFICIT/HYPERACTIVITY DISORDER AND LEARNING DISORDER CHILDREN (주의력 결핍/과잉운동 장애와 학습 장애 아동의 기억 기능 비교)

  • Kim, Yong-Hee;Cho, Soo-Churl;Shin, Min-Sup
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.85-92
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    • 2002
  • Objectives:This study was conducted to compare the memory function among the attention deficit/hyperactivity disorder(ADHD), the learning disorder(LD) and the comorbidity disorder(ADHD+LD) groups. Methods:Thirty-four children(11 ADHD, 5 LD, 9 ADHD+LD, and 8 Psychiatric control) were individually assessed using the KEDI-WISC and Memoty Assessment Scale(MAS), and then the results of those test were analyzed. Results:In memory test, all of three group showed lower performances than control group. The comorbidity, the LD and the ADHD group showed lower scores in almost subtests of MAS respectively. The good performance in memory test was significantly correlated with the types of memory strategy and error response children used during testing. Discussion:The clinical utility of the memory test like MAS was discussed in terms of differential diagnosis for ADHD, LD and ADHD+LD children.

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Parents' Perceptions on Their Experiences and Roles in a Synchronous Videoconferencing Music Therapy Intervention for Their Children With Developmental Disabilities (발달장애 아동·청소년 대상 실시간 비대면 음악치료에서의 보호자 역할에 대한 인식 조사)

  • Ryu, Jinsun
    • Journal of Music and Human Behavior
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    • v.20 no.1
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    • pp.99-115
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    • 2023
  • Given the ongoing discussion regarding remote music therapy following the COVID-19 pandemic and the pivotal role of parental involvement in it, this study investigated parents' perceptions on their roles in a synchronous videoconferencing music therapy for their children with developmental disabilities. A total of 32 participants participated in an online survey comprising 68 questions. Descriptive statistics summarized the collected responses, and Pearson's correlation was conducted to examine the relationship between perceived parental roles, psychological burden, and willingness to participate in future remote music therapy. The findings showed that parents of children with developmental disabilities acknowledged the benefits of tele-music therapy and possessed substantial information about its implementation. Furthermore, they reported their roles of providing physical, participatory, and mediating support. As parents exhibited greater satisfaction with their role in supporting their children's participation or managing their off-task behaviors, they perceived reduced psychological burden. These findings hold significant implications for expansion of tele-music therapy strategies to address the unique needs of children with developmental disabilities and support their parents as immediate mediators for their children.