• Title/Summary/Keyword: 정신지체 아동

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소아의 조음장애

  • 김영태
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.7 no.1
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    • pp.106-112
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    • 1996
  • 조음장애(articulation disorders)란 조음기관(예 : 혀, 입술. 치아, 입천장)을 통하여 말소리가 만들어지는 과정에서의 결함을 나타내는데, 이러한 조음장애를 보이는 아동은 '불명료한' 구어를 사용하게 되므로 해서 결국 의사소통의 어려움을 나타내게 된다. 음소를 생략하거나, 다른 음소로 대치하거나, 또는 같은 음소내에서 소리를 왜곡시키는 조음 장애 현상들은 순수 조음 장애 아동들 뿐 아니라, 정신지체, 청각장애, 구개파열, 뇌성마비 등의 장애자들에게서 중복적인 결함으로 나타나기도 한다. 본고에서는 소아의 조음장애를 다루는 임상가가 알아두어야 할 관련 요인들, 조음 오류 평가. 그리고 치료방법에 대하여 고찰하고자 한다.

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A CASE OF SEVERELY SELF-INJURED CHILD ASSOCIATED WITH PHYSICAL ILLNESS (신체 질환과 연관된 심한 자해로 입원한 아동 보고 1례)

  • Hong, Kang-E;Jeon, Seong-Ill
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.7 no.2
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    • pp.258-266
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    • 1996
  • Self-injurious behaviors are commoly founded in the case of the developmentally impaired, such as mental retardation and autistic disorder. These behaviors are primary serious sources of distress for both child and their parents, another obstacle to overcome within the family and society. The author has a case that a child, had never before shown self-injurious behaviors. He abruptly started to injury his face and heel. The beginnings of these harmful behaviors are associated with symptoms of physical illness, such as fever, chills and general aches. The self-injured wounds were very severe. After the patient was treated with haloperidol and improved his physical conditions, self-injurious behaviors disappeared. The author reports the child's clinical process, characteristics of self-injurious behaviors, and discuss the treatment factors, along with a literature review.

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EFFECTS OF INTERPERSONAL COGNITIVE PROBLEM SOLVING SKILLS TRAINING ON ADOLESCENTS WITH MILD MENTAL RETARDATION (대인관계 인지 문제해결 기술훈련의 효과 - 교육가능 정신지체 청소년을 대상으로 -)

  • Oh, Kyung-Ja;Lee, Mi-Seon
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.6 no.1
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    • pp.100-108
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    • 1995
  • The purpose of the present study was to examine whether Interpersonal Cognitive Problem Solving(ICPS) skill training would enhance interpersonal solving skills and behavioral adjustment of mildly mentally retarded adolescents in the junior and high school. The program used in the present study was shortened and adapted for mildly retarded adolescents from Shure and Spivack(1982) program which was developed to improve the adjustment of children in the intermediate grades 5-6. The subjects were 22 mildly retarded adolescents, and they were assigned to either the experimental(11) or the control group(11). The experimental group were given ICPS training 4 times a week over a period of 8 weeks with a total of 32 sessions in all. The results showed a significant improvement of alternative thinking and consequential thinking in the experimental group compared with the control group. With regard to behavioral ratings by the parents and teachers, there were no significant differences between the groups. The results indicated that the training was effective in increasing the ability to generate alternative solutions and to predict consequences, but the significant improvement of interpersonal cognitive problem solving skills did not lead to noticeable improvement in behavioral adjustment. It was suggested that a longer training period for over-learning, concomitant parent education program, and more behaviorally oriented social skill training combined with the cognitive approach would yield significant training effects, maintenance and transfer.

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COMPARISON OF DEVELOPMENTAL AND PSYCHOPATHOLOGlCAL CHARACTERISTICS FOR RAD AND PDD CHILDREN (반응성 애착장애 아동과 전반적 발달장애 아동의 발달 및 정신병리학적 특징의 비교연구)

  • Yoon, Hyun-Sook;Choi, Jin-Sook;Kim, Tae-Ryeon;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.3-13
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    • 1992
  • For the purpose of better understanding of RAD children, comparisons were performed about the developmental and psychopathological characteristics between RAD and PDD children. Study subjects were the children between the ages 2 and 6. who visitied SNUCH Child and Adolescent Psychiatry OPD or treated in Day Treatment Center during May, 1989 and Sep., 1991, diagnosed by the child psychiatrist as RAD or PDD according to DSM-III-R diagnostic criteria. A total of 40 children were included in the study. 20 were RAD(18 boys, 2 girls). 20 were PDD(20 boys). PEP was performed to all study subjects, by the raters blind to psychiatric diagnosis of each. And analysis was done about the level of developmental functioning score and psychopathological scores between RAD and PDD children. The results are as follows 'There were retardation on the general developmental functioning in RAD children, and the severity of retardation were lined up as perceptual ability>imitation>gross motor>cogitive language>eye-hand coordination>fine motor. Characteristics of psychopathology in RAD children were lined up by severity as language>play>relationship>affection >sensory. Group differences of the two shows on PDD group rejection score was significantly higher on the perception item. while RAD was superior on the perception emerging response. Differences of the psychopathology between two groups were on such areas as ; Affection, which was significantly higher on 'Absent' in RAD, while significantly higher on 'severe' in PDD children. On the interest for the play and materials. sensory and language areas, RAD children were significantly higher ratings on 'Absent' than PDD children.

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FACTORS OF MENTALLY HANDICAPPED CHILDREN AND THEIR FAMILY ASSOCIATED WITH THE QUALITY OF LIFE AND THE EMOTIONAL WELLBEING OF THEIR MOTHERS (장애 아동의 행동 특성과 가족환경이 어머니의 정서적 안녕감과 삶의 질에 미치는 영향)

  • Lee, Yong-Ho;Chung, Yong-Kyoon;Cho, Soo-Churl;Koo, Young-Jin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.10 no.1
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    • pp.100-112
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    • 1999
  • Objective:In life-long disabilities like autism and mental retardation, the authors thought that it is important for clinician to consider the quality of life of a primary caregiver for long-term management and prognosis. This study was to investigate the factors of children and family environment affecting the quality of life and depression in mothers with autistic and/or mentally retarded children. Methods:41 autistic and/or mentally retarded children aged 5-12 years with their mothers were surveyed from September, 1998 to January, 1999, with K-CBCL, K-BDI, K-FES, and K-SBQOL scale and compared with data from 35 normal control subjects. Results:1) Total K-BDI and K-SBQOL scores of mothers with mentally handicapped children were significantly poorer than the scores of normal control group. Independence, intellectual/cultural orientation and active recreation subscales of K-FES in mentally handicapped children were significantly decreased than those in normal control group. 2) Total K-BDI score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially internalizing and thought symptoms, and with family cohesion, expressiveness, conflict and independence. 3) Totol K-SB quality of life score of mothers with mentally handicapped children was correlated with their children’s behavioral problems, especially attention problem, and with family cohesion, conflict, independence, intellectual/cultural orientation, and moral-religional emphasis. 4) The quality of life of mothers with mentally handicapped children was predicted by attention problem($R^2$=.36, p=.000) and social competence($R^2$=.07, p=.038) in children and family cohesion ($R^2$=.16, p=.001). 5) Depression of mothers with mentally handicapped children was predicted by internalizing symptom ($R^2$=.21, p=.003) and thought disorder($R^2$=.06, p=.048) in children and family cohesion($R^2$=.14, p=.008). Conclusion:Reducing behavioral problems and family therapeutic intervention in autistic and mentally retarded children can improve the quality of life of primary caregivers and long-term prognosis of the children, although those are not curative.

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Hair Heavy Metal Contents in Mentally Retarded Children III - In Association with Mercury - (정신지체아 두발 중 중금속 함량 III - 수은과의 관련성 -)

  • Han, Ki-Hwan;Jang, Bong-Ki;Park, Soon-Woo;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.3 s.27
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    • pp.368-379
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    • 1989
  • The relationship between mercury level of hair and mental retardation was investigated. The 297 subjects with mental retardation were drawn from two schools providing special educational services, one, consisted of children living in an orphan home, another, children with parents. The 117 centre] subjects were drawn from whom had got average or above average academic achivement in a regular elementary school. Hair sample were taken from the nape of the neck and the mercury analysis was carried out on an atomic absorption spectrophotometer(IL 551). There was no relationship between mercury contents and age, and there was a statistically significant difference in mercury contents between male and female in the mentally retarded children living with parents. Children in the retarded group had significantly higher mercury contents compared with control group except the female group with parents. Also, the mercury levels in the retarded group living in an orphan home were significantly higher than that of the retarded group with parents. The concomitant diseases were Down's syndrome, epilepsy, cerebral palsy and autism. There were statistically significant differences in hair mercury levels in the cases of accompanying Down's syndrome and cerebral palsy in male and Down's syndrome and autism in female compared with the control group of the same sex. The most accompanying handicap was speech disturbance(40.7%) and the others were crippled, emotional disturbance etc. The percentages of double handicap were 66.7% among 6 persons exceeding 6ppm of their hair mercury contents. 10.4% among $3{\sim}6$ ppm and 15.7% among the group of 3ppm or less. The findings of this study suggest that the more opportunities of exposure to mercury in mentally retarded children may have occurred, so it can not be excluded the possibility of mercury as a contributing factor to mental retardation. Therefore, the causal relationship between mercury levels and mental retardation should be established through the examinations about their living environments, dietary pattern, eating habit etc.

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Hair Heavy Metal Contents in Mentally Retarded Children II - In Association with Cadmium and Zinc - (정신지체아 두발 중 중금속 함량 II - 카드뮴 및 아연과의 관련성 -)

  • Park, Soon-Woo;Lee, Jong-Young;Kim, Doo-Hie
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.215-222
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    • 1989
  • The relationship between cadmium level and mental retardation was investigated. The 297 subjects with mental retardation were drawn from two schools providing special educational services, one, consisted of children living in an orphan home, another, children with parents. The 117 control subjects were drawn from whom had got average or above average academic achivement in a general elementary school. Hair sample was taken from the nape of the neck and the cadmium and zinc analysis were carried out on an atomic absorption spectrophotometer (IL 551). Children in the retarded group had significantly higher cadmium levels compared with control but not in zinc levels. There was no relationship between metal concentrations and age except control male group, which showed significant positive linear relationship in zinc, and there was no difference between sex in both metal except the male orphan group in cadmium. In the orphan group, there was relationship between severity of retardation and cadmium concentration in both sex but not in retarded children with parents. No difference in cadmium levels between the group with Down's syndrome, one of causes of mental retardation, and the control group suggested the cadmium as a possible cause of mental retardation. In the case of accompanying autism, zinc level was significantly lower than that of other accompanying diseases. Although not establishing an etiologic relationship, findings of this study suggest that there are some influeces of cadmium on mental retardation, and call for a continuing study.

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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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