• Clinical and Experimental Pediatrics
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• v.57 no.8
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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.

• Phonetics and Speech Sciences
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• v.12 no.2
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• pp.39-49
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• 2020

The prosody of children with autism spectrum disorders (ASD) has several abnormal features, including monotonous speech. The purpose of this study was to compare acoustic features between an ASD group and a typically developing (TD) group and within the ASD group. The study also examined audience perceptions of the lengthening effect of increasing the number of syllables. 50 participants were divided into two groups (20 with ASD and 30 TD), and they were asked to imitate a total of 28 sentences. In the auditory-perceptual evaluation, seven participants chose sentence types in 115 sentences. Pitch, intensity, speech rate, and pitch slope were used to analyze the significant differences. In conclusion, the ASD group showed higher pitch and intensity and a lower overall speaking rate than the TD group. Moreover, there were significant differences in s2 slope of interrogative sentences. Finally, based on the auditory-perceptual evaluation, only 4.3% of interrogative sentences produced by participants with ASD were perceived as declarative sentences. The cause of this abnormal prosody has not been clearly identified; however, pragmatic ability and other characteristics of autism are related to ASD prosody. This study identified prosodic ASD patterns and suggested the need to develop treatments to improve prosody.

• Clinical and Experimental Pediatrics
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• v.62 no.10
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• pp.374-379
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• 2019

Background: Attention deficit hyperactivity disorder (ADHD) symptoms have a major impact on individuals, families, and society. Therefore identification risk factors of ADHD are a public health priority. Purpose: This is meta-analysis evaluated the association between maternal prepregnancy body mass index and the risk of ADHD among the resulting offspring. Methods: The search identified studies published through December 2018 in the PubMed, Web of Science, and Scopus databases. The odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CI) extracted from eligible studies were used as the common measure of association among studies. Results: A significant association was found between overweight women and the risk of ADHD among children with the pooled HR and OR estimates (HR, 1.27 and 95% CI, 1.17-1.37; OR, 1.28 and 95% CI, 1.15-1.40, respectively). This association was significant between obese women and the risk of ADHD among children and adolescents with the pooled estimates of HR and OR (HR, 1.65 and 95% CI, 1.55-1.76; OR, 1.42 and 95% CI, 1.23-1.61). Conclusion: The current epidemiological studies present sufficient evidence that prepregnancy overweight and obesity are significantly associated with an increased risk of ADHD among children and adolescents. These findings provide a new approach to preventing ADHD by controlling weight gain in the prenatal period, which should be considered by policymakers.

• The Journal of Korean Academy of Sensory Integration
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• v.21 no.2
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• pp.69-83
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• 2023

Objective : This study sought to systematically examine the intervention effect of social stories when applied in relation to children with sleep disorders. Methods : Studies available in the SCOPUS, ScienceDirect, PsycArticles, and PubMed databases that were published from 2001 to 2022 were searched. The keywords used for the search were as follows: ("social story" OR "social stories") AND ("sleep" OR "sleep disorders" OR "sleep wake disorder bedtimes" OR "sleep initiation and maintenance disorders" OR "sleep wake disorder" OR "sleep arousal disorders"). Based on the selection criteria, six experimental studies were selected and analyzed. Results : The selected studies were two randomized controlled trials, three individual trials, and one case study. The subjects were mostly children diagnosed with autism spectrum disorder who were school-aged or adolescent. The intervention types were often complex interventions, including social stories and other interventions, while the durations of the interventions varied from one day to more than 40 days. The interventions had a positive effect on the subjects' sleep quality, with night wakings, sleep onset delay, and sleep anxiety all being improved. As standardized assessment tools to evaluate the effectiveness of social stories, the Child Sleep Habits Questionnaire and the Child Behavior Checklist were used in two papers each, and were the most commonly used. As non-standardized assessment tools, each of the four papers used turbulence and sleep diaries as assessment tools. Conclusion : The effect of social story mediation can be divided into sleep quality and sleep-related behavior. In terms of sleep quality, studies showing improvements in night wakings, sleep onset delay, and sleep anxiety accounted for a large proportion of the sample. The detailed effect area of sleep quality showed a significant improvement after the interventions in most studies, and in all six studies analyzed in the present study, the continuation of the effect after the intervention was confirmed via follow-up tests. Thus, the findings of this study are expected to be helpful when applying social stories in children with sleep disorders in clinical practice due to presenting the intervention effects, outcome evaluation tools, and intervention periods in children with sleep disorders in prior investigations involving social stories.

• Neonatal Medicine
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• v.25 no.1
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• pp.7-15
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• 2018

We need to understand the outcomes into adulthood for survivors born either extremely low birthweight (ELBW; <1,000 g) or extremely preterm (EP; <28 weeks' gestational age), particularly their blood pressure and cardiovascular metabolic status,respiratory function, growth, psychological and mental health performance, and functional outcomes. Blood pressure is higher in late adolescence and early adulthood in ELBW/EP survivors compared with controls. In some studies, expreterm survivors have higher insulin and blood lipid concentrations than controls, which may also increase their risk for later cardiovascular disease. ELBW/EP survivors have more expiratory airflow obstruction than do controls. Those who had bronchopulmonary dysplasia (BPD) in the newborn period have even worse lung function than those who did not have BPD. As a group, they are unlikely to achieve their full lung growth potential, which means that more of them are likely to develop chronic obstructive airway disease in later life. Although they are smaller than term born controls, their weight gradually rises and ultimately reaches a mean z-score close to zero in late adolescence, and they ultimately attain a height z-score close to their mid-parental height z-score. On average, ex-preterm survivors have intelligence quotient (IQ) scores and performance on tests of academic achievement approximately 2/3 SD lower than do controls, and they also perform less well on tests of attention and executive function. They have similar high rates of anxiety and depression symptoms in late adolescence as do controls. They are, however, over-represented in population registries for rarer disorders such as schizophrenia and Autism Spectrum Disorder. In cohort studies, ex-preterm survivors mostly report good quality of life and participation in daily activities, and they report good levels of self-esteem. In population studies, they require higher levels of economic assistance, such as disability pensions, they do not achieve education levels as high as controls, fewer are married, and their rates of reproduction are lower, at least in early adulthood. Survivors born ELBW/EP will present more and more to health carers in adulthood, as they survive in larger numbers.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.16 no.2
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• pp.239-250
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• 2005

Objective : The purpose of this study was obtaining data on the efficacy and safety of risperidone in child and adolescent psychiatric patients. Method : Thirty one children and adolescents (males n=18, females n=13, age ranged from 5.4 to 17.3 years) treated with risperidone were selected among child and adolescent psychiatric inpatients of Seoul National University Hospital from January, 2001 to June, 2002, and charts for them were reviewed retrospectively. Results : The primary psychiatric disorders treated with risperidone were schizophrenia and other psychosis, bipolar I disorder with psychotic features, Tourette's disorder, autism spectrum disorders, mixed receptive and expressive language disorder, attention deficit-hyperactivity disorder, conduct disorder and obsessive-compulsive disorder. twelve of these had comorbid mental retardation. Primary target symptoms of risperidone were psychotic symptoms (n=13 or $41.9\%$), behavioral symptoms (n=10 or $32.3\%$) including aggression, impulsivity, hyperactivity, stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics (n=8, $25.8\%$). The efficacy of risperidone was measured by clinical global improvement (CGI) for target symptoms, $67.7\%$ of subjects showed moderate or marked improvements and its therapeutic effect appeared to be maintained during at least 7.5 months. Mean daily dosage of risperidone was $0.05{\pm}0.01mg/kg$, the group with psychotic symptoms had significantly higher mean daily dosage (0.07mg/kg) compared with other two groups (0.04mg/kg) with behavioral symptoms or tics. A variety of adverse events were reported in this study : weight gain (n=23) most commonly reported, extrapyramidal symptoms (n=15), autonomic symptoms (n=6), sedation (n=5) and symptoms related to hyperprolactinemia (n=2) etc. Although there was no drug change related to the adverse events of risperidone, and $90\%$ of subjects at their last visits were maintained on it, thus its tolerability appeared good. Conclusions Results suggest that risperidone may be relatively safe and effective drug in managing a wide variety of child and adolescent psychopathologies such as psychotic symptoms, behavioral symptoms including aggression, impulsivity, hyperactivity and stereotypy nonresponsive to other psychiatric treatments, and chronic and severe tics. Controlled and long-term studies of efficacy and safety of risperidone treatment for children and adolescents are recommended in the future.

• Clinical and Experimental Pediatrics
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• v.52 no.3
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• pp.289-294
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• 2009

Purpose : To assess the usefulness of magnetic resonance imaging (MRI), karyotyping, brainstem auditory evoked potential (BAEP), electroencephalogram (EEG), tandem mass screening test, and newborn metabolic screening test in children with language delay for diagnosing underlying diseases. Methods : From January 2000 to June 2007, a retrospective chart review was performed for 122 children with language delay who visited the Child Neurology Clinic at Yeungnam University Hospital and who underwent neuropsychologic tests and other diagnostic evaluations for underlying diseases. They were grouped into phenomenological diagnostic categories, and test results were analyzed according to the underlying diseases. Results : Of 122 patients, 47 (38.5%) had mental retardation, 40 (32.8%) had developmental language disorders, 23 (18.9 %) had borderline IQ, and 12 (9.8%) had autism spectrum disorder. In 26 (21.3%) cases, the causes or relevant clinical findings to explain language delay were found. Eight (10.4%) of 77 MRIs, 6 (8.0%) of 75 EEGs, and 4 (5%) of 80 BAEPs showed abnormal results. Results directly attributed to diagnosing underlying diseases were 2 hearing defects in BAEPs and 1 bilateral perisylvian cortical dysplasia in MRIs. No abnormal results were found in karyotyping, tandem mass screening tests, and new-born screening tests. Conclusion : Commonly used tests to diagnose the cause of language delay are not very effective and should only be used selectively, according to patient characteristics. However, despite the low diagnostic yields from these tests, because many patients show abnormal results, these tests are useful when conducted in complete evaluation.