• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.34 no.1
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• pp.40-50
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• 2023

Objectives: This study examined the validity of the Childhood Autism Rating Scale, Second Edition (CARS-2) compared with the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) in identifying autism spectrum disorder (ASD). Methods: A total of 237 children were tested using both the CARS-2 and ADOS-2. We examined the correlation using Pearson's correlation analysis. In addition, we used a receiver operating characteristic graph to determine the optimal standard version of the CARS-2 (CARS2-ST) cutoff score for ASD diagnosis using the ADOS-2. Results: The concurrent validity of the CARS2-ST was demonstrated by a significant correlation with the ADOS-2 (r=0.864, p<0.001). The optimal CARS2-ST cutoff scores were 30 and 28.5 for identifying autism and autism spectrum, respectively, based on the ADOS-2. Conclusion: We suggest a newly derived CARS2-ST cutoff score of 28.5 for screening ASD and providing early intervention.

• Clinical and Experimental Pediatrics
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• v.64 no.7
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• pp.341-346
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• 2021

Background: The results differ among published studies regarding exposure to meconium and the risk of developing autism spectrum disorders (ASDs). Purpose: The present study pooled all of the epidemiologic studies retrieved from broader databases on the association between meconium exposure and risk of developing ASD in children. Methods: The Web of Science, PubMed, Scopus, and Google Scholar databases were searched without language restrictions for articles published between their inception to February 20, 2020, using relevant keywords. The pooled odds ratios (ORs) and their 95% confidence intervals (CIs) were calculated as random-effect estimates of the associations among studies. A subgroup analysis was conducted to explore any potential sources of heterogeneity among studies. Results: The pooled estimate of OR reported a weakly significant association between meconium exposure and ASD development in children (OR, 1.13; 95% CI, 1.03-1.24). There was low heterogeneity among the articles reporting risk for ASD among children (I²=19.3%; P=0.259). The results of subgroup analysis based on meconium exposure showed a significant association between a meconium-stained neonate and ASD development (OR, 1.18; 95% CI, 1.11-1.24). Couclusion: Meconium exposure was weakly associated with an increased risk of ASD. However, more evidence based on large prospective cohort studies is required to provide conclusive evidence about whether meconium exposure is associated with an increased risk of ASD development.

• Journal of Korean Academy of Nursing
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• v.44 no.5
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• pp.563-572
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• 2014

Purpose: The study was done to identify the construct validity and reliability of the life transition scale (LTS) for parents who have children with autism. Methods: Exploratory factor analysis (EFA) and confirmative factor analysis (CFA) were conducted to identify the most adequate measurement model for structural validity. Convergent validity and discriminant validity were also conducted for structural validity. Data were collected from 208 parents through self-reported questionnaires and analyzed with SPSS/WIN 15.0 and AMOS 20.0 version. Results: A four factor-structure was validated (${\chi}^2$=541.23, p<.001, GFI=.82, RMSEA=.07, IFI=.89, CFI=.89, PNFI=.73, Q (${\chi}^2/df$)=2.20) at the 3rd order of EFA and CFA, and factors were named as denying, wandering, despairing, and accepting. Both convergent and determinant validity for LTS were 100%. Cronbach's alphas for the reliability of each structure were .77-.90 and .83 for total structure. Conclusion: The four structures, 24-item instrument showed satisfactory reliability and validity. LTS has the potential to be appropriate for assessing the transition process of life for parents who have children with autism and provides basic directions for differentiated support and care at each stage.

• The Journal of Korean Academy of Sensory Integration
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• v.20 no.3
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• pp.14-26
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• 2022

Objective : This study investigated the effect of a remote sensory integrated family program on the visual seeking and stereotyped behavior of children with autism spectrum disorder. Methods : This study was conducted as a single-subject study, a mid-baseline design for three children with autism spectrum disorder, and the intervention was conducted 4 times a week for 4 weeks. All three children confirmed the changes in visual seeking and stereotyped behavior after the intervention. Results : After the intervention, visual seeking and stereotyped behavior decreased compared with the baseline period. Visual seeking decreased on average after 7.59% at intervention, and stereotyped behavior decreased by 6.81 on average. Conclusion : Through this study, it was confirmed that the remote sensory integration home program is effective in visual seeking and stereotyped behavior of children with autism spectrum disorder. Addionally it is useful as a new intervention method a program that allows parents to participate in the intervention process. and it is emphasized that occupational therapists should create and promote cooperative relationships for children intervention.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.3
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• pp.112-117
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• 2021

Objectives: This study identified changes in social communication and interaction among children with autism spectrum disorder (ASD) through Theraplay. Methods: This study included 20 children who were diagnosed with ASD by a child and adolescent psychiatrist and were recommended to undergo Theraplay in 2012-2017. The Marschak interaction method was used to identify and analyze the interactions between parents and their children. The Korean version of the Social Communication Questionnaire (K-SCQ) was used to evaluate symptoms of ASD. The Wilcoxon signed-rank test was used to compare the differences before and after Theraplay. Results: Upon comparing the differences in total K-SCQ scores, there were statistically significant changes (z=-3.269, p=0.001) in children with ASD. Changes were also confirmed in each category, namely social interaction, communication, and limited and repetitive behavior patterns (p=0.011, p=0.025, p=0.039, respectively). Conclusion: This study found that Theraplay may cause significant changes in social communication in children with ASD. Further studies are needed to establish the effectiveness of Theraplay in children with ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.20 no.3
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• pp.122-128
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• 2009

Objectives : Autism is a well-known psychiatric disorder that is presumed to have a neural basis. To investigate the underlying neurofunctional abnormalities of autism, the authors performed single photon emission computed tomography (SPECT) on children with autism. Methods : Fifty-five children with untreated autism (47 boys and 8 girls, mean age=$50.6{\pm}20.28$ months) were selected from among the patients visiting the child and adolescent psychiatric clinic of Seoul National University Hospital. Psychiatrists had diagnosed the participants according to the DSM-IV criteria for autistic disorder and the Childhood Autism Rating Scale (CARS) criteria for a diagnosis of autism. All participants were examined using 99mTC-HMPAO Brain SPECT. Using statistical parametric mapping (SPM) analysis, we compared the participants' SPECT images to standardized SPECT images of normal children, which had been retrospectively selected by the authors, on a voxel by voxel basis. Voxels with a p-value less than .001 were considered to be significantly different. Results : The autistic group showed significant hypoperfusion in the right medial frontal gyrus, right precentral gyrus, and left precuneus gyrus. In addition, they showed no significant hyperperfusion areas when compared to the control group. Conclusion : The findings of hypoperfusion in the medial-frontal lobe and precuneus are accord with hemodynamic abnormalities that have been already reported. Therefore, these findings are compatible with the recently suggested "theory of mind" hypothesis and the disturbances in attention shifting that have been observed in autistic children.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.26 no.1
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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.

• Child Studies in Asia-Pacific Contexts
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• v.2 no.1
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• pp.11-27
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• 2012

We examined play interactions between siblings when one child has autism in a Vietnamese American and a European American family. Analysis was based on video recorded free play sessions with each set of siblings at their home. Interviews with the typically developing sibling and parents also provided supplemental data to aid our knowledge about their play behavior. This study describes the role of the typically developing sibling in play and the types of play engaged in by siblings. Findings indicate that the two sets of siblings differed in their play behavior. Specifically, significant differences were noted in the role of the typically developing sibling in play, and the types of play engaged in by the siblings. The perceptions of the typically developing siblings and parents regarding autism also differed across families, significantly affecting their play behavior. Implications for research are described.

• Journal of the Korean Home Economics Association
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• v.40 no.6
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• pp.117-131
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• 2002

The purpose of this study was to analyze coping behavior types of mothers of autistic children. Through the use of Q methodology using a sample of 23 pairs of mothers and therapists, four factors were derived that account for the coping strategies of mothers of children with autism. The mothers of the first type have either accepted their child's disability and their own situation. For the second type, the mothers engaged in therapeutic work for their child with a positive attitude. These mothers accepted their child as a family member. The third type shared ambivalent feelings and responses regarding their child's disability. And the last type expressed concerns and difficulties related to the situation. They tried to get social support to deal with the stressful situation. The agreement of mothers'psychological adjustment from the exports'and mothers'perceptive was found to be 52%.

• The Journal of Korean Academy of Sensory Integration
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• v.18 no.3
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• pp.39-52
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• 2020

Objective : The purpose of this study was to investigate the effect of parent education on feeding problems in children with autism spectrum disorder. Method : Articles published between 2000 and May 2019 were identified through a database search of Cochrane Library, Embase, Ovid-Medline, and PubMed as well as through additional manual searches. A total of six articles were selected and qualitatively analyzed according to the level of evidence of the study and arranged according to PICO (Patient, Intervention, Comparison, Outcome). Results : Six articles were used for the data analysis; four articles were at evidence level 1 and two articles were at evidence level 3. Behavioral therapy was the most common interventional approach to parent education, and all of the articles based on behavioral therapy had evidence level 1. Conclusion : This study examines the various ways of parenting to help families with autism spectrum children with feeding problems in order to find directions for parent education that can be applied in clinical practice.