• Title/Summary/Keyword: 장애 아동.청소년

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Prevalence of Orthostatic Dysregulation in Elementary School Students and Frequency of Individual Symptoms (학동기 아동의 Orthostatic Dysregulation의 유병률과 임상증상의 빈도에 대한 연구)

  • Yang, Eun Seok;Kim, Eun-Young;Moon, Kyoung-Rae;Park, Sang Kee;Park, Young Bong;Rho, Young Il
    • Clinical and Experimental Pediatrics
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    • v.48 no.2
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    • pp.138-142
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    • 2005
  • Purpose : The purpose of the present study was to access the prevalence of orthostatic dysregulation(OD) and the frequency of each category for major and minor criteria among elementary school students using the OD questionnaire. Methods : We carried out inquiry by questionnaire as to the frequency of OD among two elementary schools with 725 students, 10 to 12 years of age, residing in Gwangju, Korea. The questionnaire was made according to criteria proposed by the Japan OD Study Group. Results : Of the 725 students(male 390; female 335) questioned, the OD was found in 338 students (53.5 percent). Prevalence of OD in males(59.2 percent) was significantly higher than in females(46.8 percent)(P<0.05). Palpitation with slight exercise(95.9 percent) was the most frequent major symptom. Headaches(85.8 percent) were the most frequent minor symptom among cases of OD. Conclusion : The prevalence of OD in elementary school students in this study(53.5 percent) was higher than in other studies. Contrary to studies from other countries, the male to female ratio was reversed. Because the diagnostic criteria seem to be dependent on subjective reporting of the symptoms, a newer diagnostic system based on more objective findings should be established.

A case of restless legs syndrome in a child presenting with growing pains (성장통으로 발견된 하지 불안 증후군 1예)

  • Kim, Dong Soon;Shin, Hong Beom;Ahn, Young Min
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1222-1227
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    • 2008
  • Restless legs syndrome (RLS) is a common neurological sleep disorder in adults characterized by the following diagnostic criteria: an urge to move that is usually associated with unpleasant sensations and symptoms that are worse at rest, relieved by movement, and most severe at night. The definite diagnosis of RLS in children is stricter and consists of self-description of leg discomfort or the presence of 2 of 3 supportive criteria combined with 4 essential criteria for diagnosis in adults. RLS in childhood has often been misdiagnosed as growing pains or a part of normal development. As a result, physicians have often missed the chance for proper management. We diagnosed a case of RLS in a 5-year-old boy presenting with growing pains, whose mother was found to have had RLS since childhood. We confirmed RLS by using a polysomnograph, in which the indices of periodic limb movement syndrome (PLMS) and periodic limb movement during wakefulness (PLMW) were recorded to be compatible with RLS criteria. The patient's ferritin level was low normal, and his symptoms improved after taking iron supplements.

Research Trends of Music for People with Visual Impairments: A Review of Journals Published Domestically and Internationally from 1998 to 2017 (시각장애인을 대상으로 한 음악 연구의 동향: 1998-2017년 국내·국제 학술지 논문 비교)

  • Park, Hye Young;Cho, Mi Ran;Yoon, Eun Jeong
    • The Journal of the Korea Contents Association
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    • v.18 no.6
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    • pp.243-256
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    • 2018
  • The purpose of this study was to perform a content analysis on 62 domestic and international journals from 1998 to 2017, in order to review research trends in music and people with visual impairments. The framework of the content analysis was based on the year of publication, field of journal, research method, type of research, research subject, participants' age, and factors of impairment. The results showed that both domestic and international journals have rapidly increased in the last 10 years, and have expanded into the fields of education and therapy. In the research method, survey research was conducted much more frequently in domestic journals, while both qualitative and experimental research were employed on a roughly even basis in international journals. With respect to the type and subject of research, music perception and recent trends on the subject of musical interest and aptitude took up the majority of domestic journals, while international journals focused on music intervention, music perception and cognition with musical influences and experiences. The participants in both domestic and international journals were children, adolescents and adults, while the elderly were not observed. In the factors of impairment, research on people with total blindness or low vision were conducted frequently, but those with adventitious vision loss or multiple impairments were rarely performed. This study could be meaningful to suggest the direction of further studies, through the investigation of research trends in music and people with visual impairments.

The Cognitive Performance, Emotional and Behavioral Problems of the Children with ADHD Showing the Difference between Visual and Auditory Attention (시각 주의력과 청각 주의력의 차이를 보이는 주의력 결핍.과잉활동장애 아동의 인지기능과 정서 및 행동 문제)

  • Son, Jung Woo
    • Korean Journal of Biological Psychiatry
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    • v.13 no.2
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    • pp.70-81
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    • 2006
  • Objective : The purpose of this study was to investigate the differences of the cognitive performance, emotional and behavioral problems among the attention-deficit/hyperactivity disorder(ADHD) groups that show the difference between visual and auditory attention. Method : Using 'ADHD Diagnostic System(ADS)', visual attention and auditory attention of 98 children diagnosed as ADHD were measured. According to the omission and commission error of ADS, they were divided into three groups ; 1) the group whose each visual omission and commission error scores were higher than each auditory omission and commission error scores(VV group), 2) the group whose each auditory omission and commission error scores were higher than each visual omission and commission error scores(AA group), 3) the group that was the rest of VV and AA group(M group). And the results of both the subscales of Korean Educational Development Institute-Wechsler Intelligence Scale for Children(KEDI-WISC) and the subscales of Korean Child Behavior Checklist(K-CBCL) among three groups were compared. Finally, the correlation between the visual omission, visual commission, auditory omission, auditory commission error and the results of KEDI-WISC, K-CBCL were investigated. Results : The results were as follows ; 1) In 98 ADHD children, the number of VV group(N=56) was higher than that of AA (N=10) and M group (N=32). 2) All mean scores of the subscales of KEDI-WISC of VV group were higher than those of M and AA group. The score of verbal IQ(p=.039) of VV group was significantly higher than that of AA group and the scores of block design(p=.015), Kaufman's factor 2(p=.045), performance IQ(p=.004) were significantly higher than those of M group. The score of full IQ(p=.004) were significantly higher than that of M and AA group. 3) The mean scores of all K-CBCL subscales of VV group were higher than those of M and AA group, except the score of Somatic complaint subscale. The score of Social subscale(p=.041) of VV group was significantly higher than that of AA group. The score of Withdrawn subscale(p=.021) of AA group was significantly higher than that of VV group. 4) There were no significant correlation between the scores of visual omission/commission error and those of each subscale of KEDI-WISC. But, there were many significant correlations between the scores of auditory omission/commission error and those of each subscale of KEDI-WISC. 5) There were significant correlation between the score of the visual omission error and that of Thought problem subscale(r=.205, p=.043) of K-CBCL. There were significant correlation between the scores of the auditory omission error and those of Social subscale(r=-.319, p=.001), Social problems subscale(r=.206, p=.042), Thought problem subscale(r=.235, p=.021). Finally, there were significant correlation between the scores of auditory commission error and those of Social subscale(r=-.241, p=.017), Thought problem subscale(r=.235, p=.020). Conclusion : The ADHD children whose auditory attention ability were higher than visual attention ability had relatively better cognitive performance and less emotional/behavioral problems than the others. The more comprehensive experiment will be needed about the cognitive performance, emotion and behavior problems of the ADHD children showing the difference between visual and auditory attention.

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STUDY ON THE RELATIONSHIP BETWEEN SEROTONIN SYSTEM AND PSYCHOPATHOLOGY IN TOURETTE'S DISORDER (Tourette씨병의 Serotonin계와 정신병리와의 상호관계에 관한 연구)

  • Cho, Soo-Churl;Shin, Yun-O;Suh, Yoo-Hun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.1
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    • pp.77-91
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    • 1996
  • In order to elucidate the biological etiology and the effects of comorbidity on biological variables in tic disorders, plasma serotonin (5-hydroxlfryptamine, 5-HT) and 5-hydroxy- indoleacetic acid (5-HIAA) we.e measured in 87 tic disorders and 30 control subjects. The 87 tic disorder were composed of 45 Tourette's disorder(TS), 22 chronic motor tic disorders (CMT) and 20 transient tic disorders (TTD). Among these patients,43 patients were pure tic disorder (PT), 28 subject also had attention deficit hyperactivity disorder (T+ADHD) and 16 subjects had obsessive compulsive disorders (T+ OCD) as comorbid disorders. The results are summarized as follows : 1) Plasma 5-HT levels showed significant positive correlations with plasma 5-HIAA levels (Pennon r=0.77, p<0.05). 2) Plasma 5-HT and 5-HIAA levels showed no significant correlation with age in tic disorders. 3) Plasma 5-HIAA and 5-HT levels showed no significant correlations with age in control subjects. 4) There was significant difference in plasma 5-HT levels among TS, CMT, TTD and control groups (ANOVA F=34.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and ITD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TTD groups. 5) There was significant difference in plasma 5-HIAA levels among TS, CMT, TTD and control groups (ANOVA F=26.48, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed significant differences between control and TS, control and CMT, control and TTD groups. But, post-hoc test showed no significant differences between TS and CMT, TS and TTD, CMT and TID groups.f) There was significant difference in plasma 5-HT and 5-HIAA levels among PT, T+ADHD, T+OCD and contol groups (ANOVA 5-HT, F=37.59, df=3, 113, p<0.01, 5-HIAA, F=27.37, df=3, 113, p<0.01), and post-hoc test using Scheffe method showed signiscant differences between control and PT, control and T+ADHD and control and T+OCB. But, post-hoc test showed no significant differences between PT and T+ADHD, PT and T+ OCD and T+ADHD and T+ OCD. These results show that decreased 5-HT and 5-HIAA levels may play a role in the genesis of tic disorders, but these findings have no significant correlations with the severity of tic disorders. And the comorbid disorders of tics may have minimal effects on the biochemical abnormalities. Future studies must be focused on the effects of serotonin agonists and antagonists on tic disorders and molecular biological methodology may enhance to elucidate the mechanisms of these abnormal findings.

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A multidisciplinary approach for the treatment of child abuse in Korea (병원 기반 학대아동보호팀의 20년간의 활동 경험)

  • Song, Bong Kyu;Kim, Do Kyun;Park, Hye Young;Hwang, Jun Won;Kwak, Young Ho
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1207-1215
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    • 2009
  • Purpose:To review and determine the complications in 76 child abuse cases recorded by a multidisciplinary hospital-based child protection team between 1987 and 2007. Methods:We retrospectively reviewed the reports and medical records of child abuse cases maintained by a university hospital-based child protection team. We devised a questionnaire for standardized interviews with the victims' guardians to determine the current physical and mental status of the children; questionnaires were answered by social workers of the child protection team who interviewed the present fosterers of 24 (35.8%) children. Results:Of the 76 children, 6 were infants, 10 were 1-3 years old, were 3-10 years old, and 19 were over 10 years old. Seven children (9.2%) were neglected and 27 (35.5%) and 44 (57.9%) were sexually and physically abused, respectively. In more than half of the cases, the perpetrators were the father or mother of the children. Most children (41 cases, 53.9%) were abused at their homes. The mean follow-up duration from the time of abuse infliction was $54.3{\pm}49.2$ months, and the current mean age of the children was $8.3{\pm}6.4$ years. Moderate and severe developmental delay and physical disability were observed in 6 (25.0%) and 3 (12.5%) cases, respectively. In 13 children (54.2%), the Global Assessment of Functioning Scale (GAF) score was less than 60, which indicates mild mental disability. Conclusion:A hospital-based child protection team may witness the different proportion of abuse types and patterns by conducting a nation-wide survey of child abuse cases.

CLINICAL AND NEUROPSYCHOLOGICAL CHARACTERISTICS OF DSM-IV SUBTYPES OF ATTENTION DEFICIT HYPERACTIVITY DISORDER (주의력결핍 과잉행동장애의 아형별 신경심리학적 특성 비교)

  • Cheung, Seung-Deuk;Lee, Jong-Bum;Kim, Jin-Sung;Seo, Wan-Seok;Bai, Dai-Seg;Chun, Eun-Jin;Suh, Hae-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.13 no.1
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    • pp.139-152
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    • 2002
  • Objectives:This study was conducted to compare the clinical and neuropsychological characteristics by DSM-IV subtypes of attention deficit hyperactivity disorder(ADHD) patients who did not have comorbid psychiatric disorders. Methods:5-15 year old children with ADHD were recruited at psychiatric outpatient clinic of Yeungnam University hospital and the patients with comorbidity or neurological abnormalities were excluded. Finally, total 404 children with ADHD were selected for this study. There were 234 subjects of ADHD-C(57.9%), 156 subjects of ADHD-I(38.6%) and 14 subjects of ADHD-HI(3.5%), who fulfilled the DSM-IV diagnostic criteria. The mean age of the total subjects was 9.63±2.49 years old. The psychopathology, IQ, behavioral problems, neuropsychological executive function were evaluated before pharmacological treatment. The measures were Korean Personality Inventory of Child(K-PIC) for psychopathology, 4 behavioral check lists(ADDES-HV, ACTeRS, CAP, SNAP) for behavioral symptoms of ADHD, K-ABC and KEDI-WISC for IQ and Conner's CPT, WCST, SST for neuropsychological executive functions. Results:1) The prevalence of subtypes was ADHD-C, ADHD-I, ADHD-HI in decreasing order. There was no sex difference of prevalence among three subtypes. The mean age of ADHD-I was older than other subtypes. 2) There was significant differences of psychopathology among subtypes, the ADHD-C and ADHD-HI had higher than the ADHD-I in the scores of delinquent, hyperactivity and psychosis;the ADHD-C had higher than the ADHD-I in the scores of family relation and autism, the scores of ego resilience were lower than the ADHD-I. However, there was no difference in anxiety, depression and somatization scores among them. 3) The results of behavioral symptom check lists, the ADHD-C had higher the score of inattention, hyperactivity and impulsivity than the ADHD-I. Meanwhile the results of ACTeRs, which rated by the teachers, were different. 4) There were significant differences of sequential processing scale and arithmetics among subtypes in IQ using K-ABC, but there was no significant difference between the ADHD-C and the ADHD-I after excluding the ADHD-HI due to small numbers. 5) There was numerical difference among subtypes but did not reach statistical significance in three neuropsychological executive function tests. Conclusion:In conclusion, our results revealed that there was significant difference in clinical features among three subtypes but, no significant difference in executive functions.

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Smart phone dependence Intervention Program meta-analysis for elementary school students (스마트폰 중독 초등학생을 위한 개입프로그램 메타분석)

  • Zheng, Song-Hua;Lee, Keung-Eun;Kim, Mi-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.144-152
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    • 2019
  • Reckless use of the Internet by children is a barrier to daily life and has a negative impact on children's physical, psychological and relational aspects. But more and more children depend on the Internet. Thus, the study conducted a meta-analysis to examine the effectiveness of group programs that involve Internet addiction among elementary school students. The study analyzed 18 studies of a local Internet group counseling program. First, the overall effectiveness of Internet-dependent group programs that cause Internet addiction reduction in elementary school students is shown to be g=0.90, indicating that group counseling programs are effective in reducing Internet addiction and changing related variables. Second, as a result of verifying differences between groups, there were differences in effectiveness in voluntary participation motivations. Therefore, intervention by elementary school students requires preventive training for smart phones so that voluntary participation can occur, and education for parents to develop autonomy for children to use smartphones properly. And rather than making these efforts limited to smart phones, IT retriever education needs to be organized.

A Study about Long-Term Effects of Attention-Deficit Hyperactivity Disorder Medication on Height and Weight in the Korean School-Aged Boys with Attention-Deficit Hyperactivity Disorder Based on Observation of Natural Course (자연경과 관찰에 의한 주의력결핍 과잉행동장애 아동에서 장기간의 약물치료가 성장에 미치는 영향)

  • Yeom, Chan-Woo;Eun, Tae-Kyung;Park, Hoon-Sub;Lee, Kyu-Young;Kim, Eui-Joong;Joo, Eun-Jeong;Koo, Young-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.2
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    • pp.89-94
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    • 2014
  • Objectives : This study was conducted naturalistically in order to observe the long-term effects of attention-deficit hyperactivity disorder (ADHD) medications on growth rates among Korean school-aged boys with ADHD. Methods : Participants in the study were boys with ADHD aged 6 to 11 years who have taken ADHD medication, methylphenidate (extended release) or atomoxetine. They attended scheduled visits monthly or bimonthly for clinical assessment with measurement of height and weight. In this study, 35 boys with ADHD (mean age at baseline=$7.90{\pm}1.77$ years ; mean age at endpoint= $12.54{\pm}1.91$ years) were included, with a mean follow-up period of 4.64 years (${\pm}1.62$ years), ranging from 2 to 9.7 years. Height, weight, and body mass index (BMI) measurements were converted to "age-corrected Z-scores" using data from Growth Charts provided by the Korean Center for Disease Control and Prevention from 2007. Results : Age-corrected endpoint growth parameters (height, weight, BMI Z-scores) did not differ significantly from the baseline values (height t=0.027 ; weight t=-0.61 ; BMI t=-1.86, in paired t-test). Especially high correlation was observed between the baseline and endpoint height Z-scores (r=0.876, p<.001), for which the coefficient of determination $r^2$ was 0.767, meaning that the amount of variability in endpoint height Z-scores explained by the baseline height Z-scores was 76.7%. Conclusion : Our results suggested that the long-term effects of ADHD medications on growth parameters to be tolerable in Korean school-aged boys with ADHD.

Treatment Adherence of Osmotic-Controlled Release Oral Delivery System Methylphenidate in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder (주의력결핍 과잉행동장애 아동에서 Osmotic-Controlled Release Oral Delivery System Methylphenidate의 치료순응도)

  • Kim, Bongseog;Lee, Jeong-Seop;Kim, Eui-Jung;Sung, Hyung-Mo;Shin, Yun Mi;Hwang, Seong-Hye;Yoo, Hanik K.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.25 no.2
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    • pp.65-72
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    • 2014
  • Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.