• Biomolecules & Therapeutics
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• v.30 no.4
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• pp.320-327
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• 2022

Neurodevelopmental disorders are complex conditions that pose difficulty in the modulation of proper motor, sensory and cognitive function due to dysregulated neuronal development. Previous studies have reported that an imbalance in the excitation/inhibition (E/I) in the brain regulated by glutamatergic and/or GABAergic neurotransmission can cause neurodevelopmental and neuropsychiatric behavioral deficits such as autism spectrum disorder (ASD). NMDA acts as an agonist at the NMDA receptor and imitates the action of the glutamate on that receptor. NMDA however, unlike glutamate, only binds to and regulates the NMDA receptor subtypes and not the other glutamate receptors. This study seeks to determine whether NMDA administration in mice i.e., over-activation of the NMDA system would result in long-lasting behavioral deficits in the adolescent mice. Both gender mice were treated with NMDA or saline at early postnatal developmental period with significant synaptogenesis and synaptic maturation. On postnatal day 28, various behavioral experiments were conducted to assess and identify behavioral characteristics. NMDA-treated mice show social deficits, and repetitive behavior in both gender mice at adolescent periods. However, only the male mice but not female mice showed increased locomotor activity. This study implies that neonatal exposure to NMDA may illicit behavioral features similar to ASD. This study also confirms the validity of the E/I imbalance theory of ASD and that NMDA injection can be used as a pharmacologic model for ASD. Future studies may explore the mechanism behind the gender difference in locomotor activity as well as the human relevance and therapeutic significance of the present findings.

• The Journal of Korean Academy of Sensory Integration
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• v.19 no.1
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• pp.39-53
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• 2021

Objective : The purpose of this study was to systematically review dysphagia rehabilitation treatment for children with feeding disorders. Methods : The articles evaluated in this study were collected from the PubMed, Medline Complete, and CINAHL databases and subsequently reviewed using the PRISMA flow chart and PICOS approach. A total of 13 papers were analyzed for study quality, disease groups, evaluation tools, interventions, and post-intervention effects. Results : Of the reviewed papers, six (46.15%) related to autism spectrum disorder (ASD) and seven (53.85%) to cerebral palsy (CP) with age ranges of between 2 and 8 years for the ASD studies and between 12 months and 18 years for CP. In evaluating the types of feeding disorder involved, the ASD group exhibited predominantly behavioral conditions while the CP subjects had a larger number of functional oral and swallowing issues. In terms of interventions, behavior modifications were used most frequently with ASD while oral-sensory motor, texture modifications, and electrical stimulation were applied at the same frequency with children with CP. All interventions were found to be effective. Conclusion : In this study, research into children with feeding disorders was reviewed according to condition, evaluation tool, and method of intervention. It is expected that this review can be used as basic data for developing a protocol that will allow clinicians to efficiently apply condition-specific interventions for eating disorders without resorting to trial and error.

• Therapeutic Science for Rehabilitation
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• v.13 no.2
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• pp.9-25
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• 2024

Objective : Children with autism spectrum disorder (ASD) commonly suffer from feeding disorders. Major feeding problems include mealtime behavior problems, picky eating, and a lack of food variety can lead to nutritional problems, developmental and social limitations, and stress for the caregivers. A review of the latest literature was conducted to gain an in-depth understanding of assessment tools for feeding disorders in children with ASD. Method : This study analyzed assessments to identify feeding problems in ASD based on previous studies searched through keywords such as ASD, ASD feeding problem, and ASD feeding evaluation. Results : The ASD feeding disorder assessment was divided into direct and indirect assessments. Indirect assessment, in which caregivers measure a child's situation using questionnaires, is mainly used. The assessment of feeding disorders in children with ASD was divided into 1) mealtime behavior, 2) sensory processing, 3) food consumption, and 4) others. Conclusion : As the main feeding disorder characteristics of children with ASD are very diverse, a comprehensive evaluation is necessary but is still limited. Swallowing rehabilitation experts, such as occupational therapists, should apply comprehensive assessment tools based on a basic understanding of the feeding problems, behaviors, and sensations in ASD.

• Therapeutic Science for Rehabilitation
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• v.10 no.2
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• pp.129-140
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• 2021

Objective : The purpose of this study was to examine differences in social maturity and behavioral problems according to the level of sleep problems in children with ASD. Methods : The participants were 102 mothers of infants with ASD aged 1-5 years. The Social Maturity Scales (SMS) and Child Behavior Checklist 1.5-5 were used as the measuring tools. Results : The level of sleep problems in infants with ASD was 56.58T on the sleep problems scale. The participants were grouped based on scores on the sleep problems scale: those with scores <65 (good sleepers) or scores ≥65 (poor sleepers). Sleep problems significantly correlated with all the scales on the CBCL. However, no association was found between sleep problems and social quotients. Poor sleepers achieved significantly lower scores on the social quotient scale of the SMS than good sleepers. Poor sleepers achieved significantly higher scores in internalizing problems, externalizing problems, and DSM-oriented scales on the CBCL compared to those in the good sleepers. Conclusion : The significance of this study is that it has verified the severity of sleep problems in infants with ASD and has examined the differences in social maturity and behavioral problems between poor sleepers and good sleepers.

• Phonetics and Speech Sciences
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• v.13 no.2
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• pp.91-101
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• 2021

The purpose of this study was to investigate laryngeal characteristics in children with autism spectrum disorders (ASD). A total of 50 children participated, including eight children aged 2 to 4 years old diagnosed with ASD and 42 normal controls at the same age. All children recorded X-ray images of the midsagittal plane of the cervical spine and larynx, and compared the laryngeal positions of ASD and control. In addition, samples of children with vowel prolongation were collected and analyzed for acoustic parameters. X-rays showed that the height of the hyoid bone in the normal group was the lowest at 3 years of age, and ascended at 4 years of age. Nevertheless, the distance from the external acoustic meatus to the hyoid bone was longest at age 4. 4-year-olds with explosive language development showed laryngeal height elevation and anteriorization. In contrast, the hyoid height of the ASD group of all ages was lower than that of the control group, and there was no difference in the hyoid position between the ages. As a result of acoustic evaluation, PFR, vFo, and vAm were significantly higher ASD than control. Low laryngeal height of ASD children may be associated with delayed language development. PFR, vFo, and vAm seem to be voice markers showing the difference between normal and ASD children.

• Korean Journal of Child Studies
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• v.36 no.5
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• pp.189-208
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• 2015

The purposes of this study were twofold. Firstly, we sought to examine the effects of the severity of behavior problems of children with autism spectrum disorders and maternal stress coping styles on maternal parenting stress. Secondly, we investigated whether maternal stress coping styles moderate the relationship between the severity of children's behavior problems on parenting stress. The participants of this study comprised 106 mothers of children with ASD who were aged 6 to 18. In order to measure the research variables, the Parenting Stress Scale(Hwang, 2002), the Korean version of Child Behavior Checklist for Ages 6-18(Oh, Kim, Ha, Lee, & Hong, 2010), the Ways of Coping Checklist(Kim, 1987) were used. The data were analyzed by means of descriptive statistics and hierarchical multiple regression analyses. The results indicated that both the severity of externalizing behavior problems and the emotion-focused stress coping styles had significant and positive effects on parenting stress. Second, the stress coping styles had no moderating effect on the relationship between the severity of behavior problems(externalizing behavior problems, internalizing behavior problems) and maternal parenting stress.

• Journal of Music and Human Behavior
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• v.11 no.1
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• pp.21-37
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• 2014

The significant role of joint attention in the development of children with autism spectrum disorder (ASD) has highlighted the importance of early intervention. With the emphasis on the effective cueing and reinforcer for orienting to social stimuli in improving responding to joint attention (RJA) of children with ASD, the use of musical cue was hypothesized. This study aimed to examine the occurrence of RJA behaviors depending on the attentional cue, which differed in the level of information and type of auditory modality. Nine children with ASD participated in this study. The use of eight different joint attention cues were analyzed in terms of the frequency and accuracy of RJA behaviors elicited. The results of the study showed that RJA behaviors occurred more frequently with musical cues than with verbal cues and the mean accuracy rate of RJA was higher with musical cues (p = .047). Musically delivered eliciting and directing cues accompanied with pointing elicited the highest attentional shift and RJA accuracy. The significant increases in RJA with the use of musical cues indicated that incorporating musical elements into an attentional cue may provide more accurate cue information, enough to improve RJA behaviors of children with autism.

• Biomolecules & Therapeutics
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• v.25 no.4
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• pp.374-382
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• 2017

Autism spectrum disorder (ASD) remains unexplained and untreated despite the high attention of research in recent years. Aside from its various characteristics is the baffling male preponderance over the female population. Using a validated animal model of ASD which is the telomerase reverse transcriptase overexpressing mice (TERT-tg), we conducted ASD-related behavioral assessments and protein expression experiments to mark the difference between male and females of this animal model. After statistically analyzing the results, we found significant effects of TERT overexpression in sociability, social novelty preference, anxiety, nest building, and electroseizure threshold in the males but not their female littermates. Along these differences are the male-specific increased expressions of postsynaptic proteins which are the NMDA and AMPA receptors in the prefrontal cortex. The vGluT1 presynaptic proteins, but not GAD, were upregulated in both sexes of TERT-tg mice, although it is more significantly pronounced in the male group. Here, we confirmed that the behavioral effect of TERT overexpression in mice was male-specific, suggesting that the aberration of this gene and its downstream pathways preferentially affect the functional development of the male brain, consistent with the male preponderance in ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.4
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• pp.273-278
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• 2015

Objectives : We retrospectively investigated the efficacy and tolerability of risperidone monotherapy in subjects with autism spectrum disorder (ASD). In addition, we did mixed effect model analysis of the effects of risperidone in patients with ASDs naturalistically treated in a routine clinical setting to determine whether the clinical effects were maintained and the side effects were tolerable. Methods : This retrospective study assessed children and adolescents with ASD, who were on risperidone monotherapy from July 2010 to July 2011 at the Child and Adolescent ASD Clinic at Seoul National Hospital. Outcome measures included the Clinical Global Impression-Severity of Illness (CGI-S) and the CGI-Improvement (CGI-I) scales along with other clinical indices: dosage, target symptoms, and side effects. Results : The mean dose of risperidone in 47 children and adolescents with ASD (40 males, 7 females; age range 5-19 years) who were on risperidone monotherapy was $1.6{\pm}0.8mg/day$, and the mean duration of the treatment period was $20.2{\pm}17.3months$. Aggressive behavior, stereotypic behavior, irritability, and self-injurious behavior were the most frequent target symptoms of risperidone. The most common side effects were weight gain followed by somnolence and extrapyramidal symptoms. In a mixed effects model analysis of CGI-I scores, the mean CGI-I score at the 1 month follow-up was significantly different from the mean CGI-I score of the 3-month follow-up (p=.046), and the CGI-I scores were equally maintained over 3 to 48 months [F(6, 28.9)=4.393, p=.003]. Of the 47 patients, 33 patients (70.2%) were identified as the response group, showing an end point CGI-I rating of 3 or under and having continued risperidone treatment for at least 6 months. The baseline CGI-S score showed significant association with clinical response to risperidone (p=.005), the mean baseline CGI-S was higher in the response group compared to the non-response group. Conclusion : In this study, clinical improvement of risperidone stabilized around 3 months and was equally maintained up to 48 months with tolerable side effects, supporting maintenance of risperidone treatment in children and adolescents with ASDs.

• Journal of Music and Human Behavior
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• v.13 no.1
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• pp.89-110
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• 2016

This study examined the effect of an interactive instrument playing program on the social interaction of adults with autism spectrum disorder (ASD). A single subject design with multiple baselines across participants was applied, and three adults with severe ASD in their late 20s living at a group home participated in this study. Participants received a total of 25 group sessions. During the intervention, participants engaged in structured instrument playing in which initiation and response to socially interactive behaviors were musically cued, and target behaviors were reinforced in the musical environment. At pre- and posttest, the frequency of initiation of and responding to social interaction behaviors were recorded and analyzed. The results of this study showed that the frequency of both initiation of, and response to, social interaction increased for all participants during the intervention phase, compared to the baseline phase. This result demonstrates that interactive instrument playing increased social behaviors of adults with ASD. It also shows that musically delivered social information can facilitate adults with ASD understanding the intention of social partners in social contexts and motivate this population to engage in social interaction.