• 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.

• International Journal of Computer Science & Network Security
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• 제23권4호
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• pp.179-186
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• 2023

For the future prosperity of any society, the sound growth of children is essential. Autism Spectrum Disorder (ASD) is a neurobehavioral disorder which has an impact on social interaction of autistic child and has an undesirable effect on his learning, speaking, and responding skills. These children have over or under sensitivity issues of touching, smelling, and hearing. Its symptoms usually appear in the child of 4- to 11-year-old but parents did not pay attention to it and could not detect it at early stages. The process to diagnose in recent time is clinical sessions that are very time consuming and expensive. To complement the conventional method, machine learning techniques are being used. In this way, it improves the required time and precision for diagnosis. We have applied TFLite model on image based dataset to predict the autism based on facial features of child. Afterwards, various machine learning techniques were trained that includes Logistic Regression, KNN, Gaussian Naïve Bayes, Random Forest and Multi-Layer Perceptron using Autism Spectrum Quotient (AQ) dataset to improve the accuracy of the ASD detection. On image based dataset, TFLite model shows 80% accuracy and based on AQ dataset, we have achieved 100% accuracy from Logistic Regression and MLP models.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제25권3호
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• pp.156-162
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• 2014

Objectives : The aim of this study was to estimate the prevalences of electroencephalographic (EEG) abnormalities and epilepsy in children and adolescents with autism spectrum disorder (ASD). In addition, we intended to identify demographic and clinical correlates of epilepsy in ASD. Methods : A total of 140 children and adolescents (age $7.3{\pm}4.8yrs$, 106 boys) with ASD underwent EEG from January 2010 to December 2013 at Asan Medical Center. Medical records were reviewed for demographic information, clinical characteristics, psychiatric diagnoses and comorbidities, EEG findings and neurological diagnoses. Results : The prevalences of EEG abnormalities and epilepsy in children and adolescents with ASD was 62.1% and 38.6%, respectively. In subjects with seizure-like movements, EEG abnormalities and epilepsy were more frequent than those without seizure-like movements (EEG abnormalities : 92.5% vs. 43.7%, p<.001 ; epilepsy : 90.6% vs. 5.7%, p<.001). ASD subjects who had epilepsy were older (p=.001), had lower full scale intelligence quotient (p<.001) and took more antipsychotics (p=.006) than those who did not. Conclusion : The prevalences of EEG abnormalities and epilepsy in our sample were similar to those from Western countries. Our results suggested a possible association of older age, lower intelligence quotient, and antipsychotics use with epilepsy in ASD. Conduct of further prospective study in a larger sample is needed.

• 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.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제28권4호
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• pp.228-234
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• 2017

Objectives: The aim of this study was to investigate the clinical characteristics of aggressive behavior problems in children and adolescents with autism spectrum disorder (ASD). Methods: Children and adolescents with ASD, aged 6-18 years, were included in this study. We divided them into two groups according to the presence or absence of aggressive behavior. They were assessed using three scales, the Korean-Child Behavior Checklist (K-CBCL), Behavior Problem Inventory, and Social Communication Questionnaire, which were completed by their parents, who conducted a continuous performance test to evaluate their attention function. The statistical analysis was done using the Mann-Whitney U-test between the two groups at a p-value of 0.05. Results: A total of 17 children participated in this study. Ten children (7 boys, $12.4{\pm}4.27years$) were included in the group with aggressive behavior problems and 7 children (6 boys, $13.8{\pm}3.53years$) in the group without aggressive behavior problems. There were no significant differences in the age, gender or intelligence quotient of the two groups. The children with aggressive behavior problems showed a trend of higher T-scores in the attention problems and anxiety/depressed subscale of the CBLC (p<0.1). Conclusion: The results suggest that aggressive behavior problems in children with ASD may be related to their attention problems, anxiety and depression.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권1호
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• pp.35-40
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• 2021

Objectives: Among the many intervention programs for children with autism spectrum disorder (ASD), the Early Start Denver Model (ESDM) is one of the few approaches that has succeeded in demonstrating clinical efficacy in randomized control trials. Here, we investigate the clinical efficacy of ESDM intervention in young children with ASD in a community setting within Japan. Methods: All subjects were children with ASD who received ESDM intervention during the study period. Each ESDM session lasted 75 min and occurred once per week for at least 12 weeks. The outcome measures consisted of the Kyoto Scale of Psychological Development (K-test), Aberrant Behavior Checklist-Japanese version (ABC-J), and the Clinical Global Impression-Severity scale (CGI-S). Results: Twenty-seven subjects (29.4±6.4 months old) received ESDM intervention that lasted for 8.0±2.6 months on average. The score on Language and Social developmental quotient on the K-test increased significantly after the intervention. The total scores on the ABC-J and CGI-S significantly decreased after completion of the ESDM intervention. Conclusion: Our results suggest that ESDM intervention could reduce the severity of distinct clinical features of ASD, such as impairments in social interaction and communication assessed by the K-test, and maladaptive behavior rated by the ABC-J and CGI-S. We believe that the ESDM adapted to each institution might become one of the standard options for children with ASD in Japan.

• 한국심리학회지 : 문화 및 사회문제
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• 제25권2호
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• pp.137-155
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• 2019

본 연구는 한국 성인을 대상으로 자폐 기질이 사회도덕적 판단과 어떠한 관련성을 가지고 있는지 탐색하였다. 연구 결과, 자폐 기질이 높을수록 타인의 행동의 도덕성을 평가할 때에 행동의 의도를 고려하는 것에 있어 어려움을 보였다. 특히, 자폐 기질이 높을수록 시나리오 속 주인공이 타인을 해하려는 의도는 있었지만, 결과적으로 실패한 행동에 대해 더 허용적으로 판단하였다. 또한, 자폐 기질이 높을수록 다수의 이익을 위해 소수를 적극적으로 희생시키는 공리주의적 선택의 적절성은 더 높게 판단하였다. 더불어, 도덕적 판단에서 어떠한 기본 원리를 얼마나 중요하게 여기는가에 관한 도덕적 기반 측정의 경우, 자폐 기질이 높을수록 위해 금지에 대한 민감성이 낮은 것으로 나타났다. 이러한 상관관계는 자폐 기질을 높은 집단(AQ >= 26)과 낮은 집단(AQ < 26)으로 나누었을 때, 집단 간 차이로도 확인되었다. 이러한 결과는 자폐 기질이 높을수록 사회도덕적 판단에서 타인의 의도를 고려하는 것에 더 어려움을 겪을 수 있으며, 또한 도덕적 판단에서 타인을 해하여서는 안된다는 위해 금지 원리에 대한 민감성을 더 낮게 보일 수 있음을 시사한다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권1호
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• pp.22-29
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• 2015

Objectives : Repetitive and stereotyped behaviors are core symptoms in children with autism spectrum disorders (ASD). The purpose of our study was to investigate the frequency of motor stereotypes in ASD children and their clinical features. Methods : Among 171 ASD children (age range, 3-15), the ASD group with motor stereotypes was defined according to two items in the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R). We compared the clinical features, behavior problems and severity of other domains in the K-ADI-R and executive functions between the ASD group with motor stereotypes and the ASD group without motor stereotypes. Results : Ninety (52.6%) of 171 ASD children had motor stereotypes. The ASD group with motor stereotypes had a lower intelligence quotient score (62.23 vs. 84.94, p<.001) compared to the ASD group without motor stereotypes. The ASD group with motor stereotypes had more impairments in the social interaction domain [adjusted odds ratio (AOR) 1.11, p=.001] and communication domain (AOR 1.15, p=.008). Thought problems and lethargy were more frequent in the ASD group with motor stereotypes than the ASD group without motor stereotypes (AOR 2.059, p=.034 ; adjusted OR 1.045, p=.046). However, no significant differences in executive function were observed between the ASD group with motor stereotypes and the ASD group without motor stereotypes. Conclusion : The ASD group with motor stereotypes showed more impairment in social interaction and communication domains, which are core symptoms of autism. Motor stereotypes may indicate greater severity of ASD.

• 생물정신의학
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• 제13권4호
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• pp.289-298
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• 2006

목 적: 본 연구의 목적은 자폐스펙트럼장애를 가진 아동들과 그 부모로 이루어진 trio를 대상으로 이 장애와 NMDA 수용체 유전자, 그 가운데 GRIN2B 유전자와의 관련성을 규명하고자 하는 것이다. 방 법: 발달지연을 주소로 가천의대 길병원과 경상대학교병원 소아정신과 외래를 내원한 아동을 선별 대상으로 하였다. DSM-IV 진단체계를 이용하여 2명의 소아정신과 의사가 자폐 스펙트럼 장애로 진단한 아동이 일차적인 연구 대상으로 선별되었다. 선별된 아동과 부모들에게는 한국판 자폐증 진단 관찰 스케줄(Autism Diagnostic Observation Schedule, 이하 ADOS) 및 자폐증 진단 면담-개정판(Autism Diagnostic Interview-Revised, 이하 ADI-R)를 실시하였다. PCR-RFLP법을 이용, GRIN2B 유전자에서 모두 4개의 단일 염기 다형성을 분석하였다(rs7301328, rs1806201, rs1805247, rs1805502). 각각의 SNPs에 대한 allelic association 을 평가하기 위하여 TDT 방법이 시행되었으며, 이를 통해 자폐장애 아동이 부모로부터 후보유전자의 특정 alleles들을 유의하게 더 많이 전달받았는지의 여부를 관찰한 뒤 McNemar chi-square test(df=1)에 의거하여 분석하였다. 결 과: 1) 연구 대상군의 특성 : 총 126명의 자폐 스펙트럼장애 아동과 그들의 생물학적 부모가 최종 분석 대상에 포함되었다. 전체 대상자 중 109명(86.5%)이 남아였으며 여아는 17명(13.5%)으로, 남아 대 여아의 비율은 6.41:1이었다. 대상군의 진단 분포는 자폐장애 107명(85.1%), 달리 분류되지 않는 전반적 발달장애(PDD, NOS) 17명(13.5%), 아스퍼거 씨 장애(Asperger's disorder) 2명(1.6%)이었다. 대상군 아동의 평균 연령은 $71.9{\pm}31.6$개월(range : 26~185개월)이었으며 한국판 사회성숙도 검사로 측정된 평균 사회지수(Social Quotient)는 $61.2{\pm}20.6$(range : 23.1~126), 측정 가능한 아동들의 평균 지능은 $65.0{\pm}27.7$(range : 25~126)이었다. K-CARS 점수는 $31.5{\pm}5.4$(range 18.5~46)로 나타났다. 2) 유전자 분석 : 분석한 GRIN2B 유전자의 4개 SNPs 가운데 하나의 SNP(rs1805247)에서 의미 있는 allelic transmission의 차이를 보였다. 이 SNP에서 transmission ratio(transmitted alleles/non-transmitted alleles)는 A allele과 G allele에서 각각 2.03과 .49로, A allele이 G allele에 비해 부모로부터 환자군에게 더 빈번하게 전달(preferential transmission) 되었음이 확인되었다(TDT ${\chi}^2$=12.89, p=.0003). 이는 Bonferroni correction 후에도 여전히 유의미한 수준을 유지하였다(p=.0009). 기타 3개의 SNP(rs7301328, rs1806201, rs1805502) 들에서는 의미 있는 transmission의 차이가 나타나지 않았다(p<.05). 결 론: 본 연구에서 GRIN2B 유전자의 단일유전자 다형성과 자폐스펙트럼장애 사이에 유의한 연관성을 보였다. 이는 glutamate NMDA 2B수용체 유전자가 이 질환의 발생에 관여할 가능성을 시사하는 것이라 생각된다.

• Clinical and Experimental Pediatrics
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• 제57권8호
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• pp.363-369
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• 2014

Purpose: This study examines changes in developmental profiles of children with language delay over time and the clinical significance of assessment conducted at age 2-3 years. Methods: We retrospectively reviewed the medical records of 70 children (62 male, 8 female), who had visited the hospital because of delayed language development at 2-3 years, and were reassessed at ages 5-6. Language and cognitive abilities were assessed using multiple scales at the initial and follow-up visits. Results: At the initial test, 62 of the 70 children had mental development index (MDI) below 70 of Bayley Scales of Infant Development Test II. Of the 62 children in the follow-up assessment, 30 children (48.4%) remained within the same cognitive range (full-scale intelligence quotient, FSIQ<70 of Wechsler preschool and primary scale of intelligence), 12 had borderline intellectual functioning (FSIQ, 70-85), 6 improved to average intellectual functioning (FSIQ>85), and 5 had specific language impairment, 9 had autism spectrum disorders. At the initial test, 38 of the 70 children had cognitive developmental quotients (C-DQ) below 70. Of the 38 children in the follow-up assessment, 23 children (60.5%) remained within the same cognitive range (FSIQ<70). The correlation coefficient for MDI and FSIQ was 0.530 (P<0.0001) and that for C-DQ and FSIQ was 0.727 (P<0.0001). There was a strong correlation between C-DQ and FSIQ, and a moderate correlation between MDI and FSIQ. Conclusion: Low MDI scores reflect a specific delay in cognitive abilities, communication skills, or both. The C-DQ, receptive language development quotient, and social maturity quotient also help to distinguish between children with isolated language delay and children with cooccurring cognitive impairment. Moreover, changes in the developmental profile during preschool years are not unusual in children with language delay. Follow-up reassessments prior to the start of school are required for a more accurate diagnosis and intervention.