• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.8-14
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• 2015

In patients with a language developmental delay, it is necessary to make a differential diagnosis for autism spectrum disorders (ASDs), specific language impairment, and mental retardation. It is important that pediatricians recognize the signs and symptoms of ASDs, as many patients with language developmental delays are ultimately diagnosed with ASDs. Pediatricians play an important role in the early recognition of ASDs, because they are usually the first point of contact for children with ASDs. A revision of the diagnostic criteria of ASDs was proposed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) that was released in May 2013. The autism spectrum describes a range of conditions classified as neurodevelopmental disorders in the fifth edition of the DSM. The new diagnostic criteria encompasses previous elements from the diagnosis of autistic disorder, Asperger disorder, childhood disintegrative disorder, and pervasive developmental disorder-not otherwise specified. An additional change to the DSM includes synthesizing the section on social and communication deficits into one domain. In ASD patients, the appropriate behavioral therapies and rehabilitation treatments significantly affect the prognosis. Therefore, this makes early diagnosis and treatment very important. In conclusion, pediatricians need to be able to recognize the signs and symptoms of ASDs and be attentive to them in order to make an early diagnosis and provide treatment.

• Clinical and Experimental Pediatrics
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• v.54 no.1
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• pp.22-28
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• 2011

Purpose: To investigate the clinical characteristics of late-onset epilepsy combined with autism spectrum disorder (ASD), and the relationship between certain types of electroencephalography (EEG) abnormalities in ASD and associated neuropsychological problems. Methods: Thirty patients diagnosed with ASD in early childhood and later developed clinical seizures were reviewed retrospectively. First, the clinical characteristics, language and behavioral regression, and EEG findings of these late-onset epilepsy patients with ASD were investigated. The patients were then classified into 2 groups according to the severity of the EEG abnormalities in the background rhythm and paroxysmal discharges. In the severe group, EEG showed persistent asymmetry, slow and disorganized background rhythms, and continuous sharp and slow waves during slow sleep (CSWS). Results: Between the two groups, there was no statistically significant difference in mean age (P=0.259), age of epilepsy diagnosis (P=0.237), associated family history (P=0.074), and positive abnormal magnetic resonance image (MRI) findings (P=0.084). The severe EEG group tended to have more neuropsychological problems (P=0.074). The severe group statistically showed more electrographic seizures in EEG (P=0.000). Rett syndrome was correlated with more severe EEG abnormalities (P=0.002). Although formal cognitive function tests were not performed, the parents reported an improvement in neuropsychological function on the follow up checkup according to a parent's questionnaire. Conclusion: Although some ASD patients with late-onset epilepsy showed severe EEG abnormalities, including CSWS, they generally showed an improvement in EEG and clinical symptoms in the longterm follow up. In addition, severe EEG abnormalities tended to be related to the neuropsychological function.

• The Journal of Korean Academy of Sensory Integration
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• v.17 no.1
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• pp.30-42
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• 2019

Objective : The purpose of this study is to analyze non-medication interventions for self-injurious behavior of individuals with autism spectrum disorders, using a systematic review, and to provide evidence of appropriate services for individuals with autism spectrum disorders with self-injury behaviors in the clinical practice of occupational therapy. Methods : Using the electronic databases PubMed, Medline (ProQuest), DBpia, RISS, KISS, and NDSL, we searched for articles published in Korean and international journals from December 2004 to November 2018. The main search term were "Autism OR Autism Spectrum Disorder AND Therapy OR Treatment Or Intervention AND Self Injurious Behavior." Qualitative analysis was performed, and the results are presented in the PICO format. Results : A total of 12 articles were selected. The quality of the evidence was highest in level IV and level V. Single studies with an experimental design were the most common. Behavior therapy was the most common type of intervention. The next most common interventions were behavioral therapy, brain stimulation and control, and sensory integration therapy with behavioral therapy. The self-injury behaviors of individuals autism spectrum disorders were decreased, and was statistically significant. Conclusion : This study investigated the use of non-medication interventions for children with autism spectrum disorders who showed self-injury behavior. Future research should use higher-level designs, and investigate differences between various non-medication interventions.

• Clinical and Experimental Pediatrics
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• v.65 no.3
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• pp.131-135
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• 2022

Purpose: There is inconsistent evidence about the association between fetal nuchal cord and the risk of autism spectrum disorder (ASD). We performed a meta-analysis to investigate whether fetal nuchal cord is associated with an increased risk of ASD in offspring. Methods: Three main English databases were searched until January 2021. The Newcastle-Ottawa Scale was used to assess study quality. Study heterogeneity was determined using the I 2 statistic, while publication bias was assessed using Begg and Egger tests. Results are presented as odds ratios (ORs) and relative ratios with 95% confidence intervals (CI) and were determined by a random-effects model. Results: Five articles (1 cohort, 4 case-control; 3,088 total children) were included in the present meta-analysis. Fetal nuchal cord was not a risk factor for ASD (OR, 1.11; 95% CI, 0.66-1.57). There was homogeneity among studies that reported a risk of ASD (I²=0.0%). Conclusion: Our results showed that fetal nuchal cord is not a risk factor for ASD. Future large cohort studies should confirm this finding.

• Genomics & Informatics
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• v.19 no.4
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• pp.44.1-44.9
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• 2021

Autism is a complex neurodevelopmental disorder, the prevalence of which has increased drastically in India in recent years. Neuroligin is a type I transmembrane protein that plays a crucial role in synaptogenesis. Alterations in synaptic genes are most commonly implicated in autism and other cognitive disorders. The present study investigated the neuroligin 3 gene in the Indian autistic population by sequencing and in silico pathogenicity prediction of molecular changes. In total, 108 clinically described individuals with autism were included from the North Karnataka region of India, along with 150 age-, sex-, and ethnicity-matched healthy controls. Genomic DNA was extracted from peripheral blood, and exonic regions were sequenced. The functional and structural effects of variants of the neuroligin 3 protein were predicted. One coding sequence variant (a missense variant) and four non-coding variants (two 5'-untranslated region [UTR] variants and two 3'-UTR variants) were recorded. The novel missense variant was found in 25% of the autistic population. The C/C genotype of c.551T>C was significantly more common in autistic children than in controls (p = 0.001), and a significantly increased risk of autism (24.7-fold) was associated with this genotype (p = 0.001). The missense variant showed pathogenic effects and high evolutionary conservation over the functions of the neuroligin 3 protein. In the present study, we reported a novel missense variant, V184A, which causes abnormal neuroligin 3 and was found with high frequency in the Indian autistic population. Therefore, neuroligin is a candidate gene for future molecular investigations and functional analysis in the Indian autistic population.

• Journal of The Korean Dental Society of Anesthesiology
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• v.5 no.1 s.8
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• pp.15-21
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• 2005

Autism is characterized with an abnormality of reciprocal social relatedness and of communication development. Also, autistic children show repetitive and stereotypical behavior pattern and deficiency of endurance against change. Dental problems related to autism are self-injury and trauma from accidents. Sometimes self-injury is due to discomfort resulting from restoration and local anesthesia. Also, gingivitis and multiple caries are common because of poor oral hygiene. Autistic children are anxious about visual and auditory stimuli because they don't understand the dental procedure. If the face of any changes in their daily life, their behavior becomes uncontrollable. In a setting such as the outpatient office, an autistic child's uncontrollable behavior makes it difficult to carry out proper treatment. If they need treatment under general anesthesia, it is very difficult to manage them in a ward as they are severly anxious about being admitted to a hospital. Therefore it is necessary to treat these children according to a specific management program under general anesthesia in an outpatient office. This case study reports of a 14 year old autistic teenager who although became uncontrollable because of the pain from multiple caries and from anxiety of the dental treatment eventually received treatment under general anesthesia and under conscious sedation in an outpatient office.

• Science of Emotion and Sensibility
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• v.26 no.3
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• pp.115-128
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• 2023

This study examines the effects of a new app-based intervention program for conversational skills of children with high-functioning autism spectrum disorder (ASD). Participants in this study comprised 26 children diagnosed with autism, Asperger's syndrome, or pervasive developmental disorder-not otherwise specified (PDD-NOS). Participants were randomly assigned into a treatment group or a control group according to their ages, IQ, SCQ, and ASSQ scores. The treatment group met with teachers once a week for a single non-face-to-face class for nine weeks, along with conversation training at home using an app. The control group did not participate in any specific programs for conversational skills. Conversation data of all participants were collected before and after the intervention to compare the two groups based on changes in the conversational turn-taking and topic manipulation skills. When analyzed with respect to a Group X Period analysis of variance (ANOVA), the data indicated maintenance on the rate of appropriate listener's verbal responses in the treatment group, whereas the rate of inappropriate listener's verbal response significantly declined in the control group. In addition, the rate of conversation initiation and maintenance and the rate of appropriate initiation improved in the treatment group, whereas the rate of inappropriate initiation declined in this group. Overall, the study demonstrates promising effects of the novel App-based digital intervention on verbal conversational skills in children with high function ASD.

• Journal of Music and Human Behavior
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• v.19 no.2
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• pp.27-53
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• 2022

The purpose of this case study was to construct a social context-based musical play program for children with high-functioning Autism Spectrum disorder (ASD) and to examine its applicability in improving the social skills of the children. The participants were a group of three children with high-functioning ASD with an average age of 9 years. The children participated as a group in 40-minute sessions that were implemented twice a week for 8 weeks. The children's social communication behaviors were observed during the sessions and analyzed in terms of sharing and exchanging their ideas and voluntarily interacting with peers and an adult (i.e., the researcher). The Social Skills Rating System (SSRS) was completed by the teachers of participants before and after the intervention. For all three participants, the occurrence of behaviors to exchange their ideas with peers and voluntarily interacting with an adult increased following the intervention. However, there were individual differences between the participants in terms of changes in each target behavior depending on their level of language and social skill development. These results suggest that social context-based musical play program may produce positive changes in voluntary communication with peers and play a significant role in expanding the scope of interventions that target the social communication of children with ASD.

• Journal of Music and Human Behavior
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• v.16 no.1
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• pp.47-72
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• 2019

This study reviewed and analyzed English-written studies using a rhythmic tapping task for motor control of children with autism spectrum disorder (ASD). Inclusion criteria for the participants were children with ASD and typically developing (TD) children. The keywords used for the outcome variables included rhythmic tapping, timed movement, and synchronization. Ten studies were included in the final analysis. The included studies were analyzed in terms of target variables, auditory stimuli, and measurements. A meta-analysis was also conducted to examine how children with ASD performed rhythmic tapping tasks compared to children with TD. In the identified studies, five variables were used: timed movement control, timing reproduction, bimanual coordination, synchronization, and interpersonal synchronization. It was found that rhythmic tapping performance was analyzed in terms of accuracy and precision of the movement and reported as significantly correlated to social skills measures. The meta-analysis results showed that there were no significant differences between the ASD and TD groups in continuing rhythmic movements when the presented auditory stimuli ended, whereas there were significant group differences in their ability to maintain their motor performance consistently and to synchronize with auditory cue or with others. These results support the rhythmic tapping task as an effective measure for not only motor control but also social skills development in children with ASD.

• The Journal of the Convergence on Culture Technology
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• v.9 no.1
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• pp.581-586
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• 2023

Recently a drama that features a lawyer with autism spectrum disorder has attracted a lot of attention, raising interest in the difficulties faced by people with autism spectrum disorders. If the Autism spectrum gets detected early and proper education and treatment, the prognosis can be improved, so the development of the treatment is urgently needed. Drugs currently used to treat autism spectrum often have side effects, so Digital Therapeutics that have no side effects and can be supplied in large quantities are drawing attention. In this paper, we introduce 'AEmotion', an application and a Digital Therapeutic that provides emotion and facial expression learning for toddlers with an autism spectrum disorder. This system is developed as an application for smartphones to increase interest in training autistic children and to test easily. Using machine learning, this system consists of three main stages: an 'emotion learning' step to learn emotions with facial expression cards, an 'emotion identification' step to check if the user understood emotions and facial expressions properly, and an 'expression training' step to make appropriate facial expressions. Through this system, it is expected that it will help autistic toddlers who have difficulties with social interactions by having problems recognizing facial expressions and emotions.