• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권4호
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• pp.150-160
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• 2018

Objectives: This study investigated the effect of social skills training (SST) on facial emotion recognition and discrimination in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Methods: Twenty-three children aged 7 to 10 years participated in our SST. They included 15 children diagnosed with ADHD and 8 with ASD. The participants' parents completed the Korean version of the Child Behavior Checklist (K-CBCL), the ADHD Rating Scale, and Conner's Scale at baseline and post-treatment. The participants completed the Korean Wechsler Intelligence Scale for Children-IV (K-WISC-IV) and the Advanced Test of Attention at baseline and the Penn Emotion Recognition and Discrimination Task at baseline and post-treatment. Results: No significant changes in facial emotion recognition and discrimination occurred in either group before and after SST. However, when controlling for the processing speed of K-WISC and the social subscale of K-CBCL, the ADHD group showed more improvement in total (p=0.049), female (p=0.039), sad (p=0.002), mild (p=0.015), female extreme (p=0.005), male mild (p=0.038), and Caucasian (p=0.004) facial expressions than did the ASD group. Conclusion: SST improved facial expression recognition for children with ADHD more effectively than it did for children with ASD, in whom additional training to help emotion recognition and discrimination is needed.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제31권3호
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• pp.131-145
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• 2020

The microbiota-gut-brain axis, which refers to the bidirectional communication pathway between gut bacteria and the central nervous system, has a profound effect on important brain processes, from the synthesis of neurotransmitters to the modulation of complex behaviors such as sociability and anxiety. Previous studies have revealed that the gut microbiota is potentially related to not only gastrointestinal disturbances, but also social impairment and repetitive behavior-core symptoms of autism spectrum disorder (ASD). Although studies have been conducted to characterize the microbial composition in patients with ASD, the results are heterogeneous. Nevertheless, it is clear that there is a difference in the composition of the gut microbiota between ASD and typically developed individuals, and animal studies have repeatedly suggested that the gut microbiota plays an important role in ASD pathophysiology. This possibility is supported by abnormalities in metabolites produced by the gut microbiota and the association between altered immune responses and the gut microbiota observed in ASD patients. Based on these findings, various attempts have been made to use the microbiota in ASD treatment. The results reported to date suggest that microbiota-based therapies may be effective for ASD, but largescale, well-designed studies are needed to confirm this.

• 대한한방소아과학회지
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• 제35권1호
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• pp.122-138
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• 2021

Objectives The purpose of this study is to widely utilize the clinical practice guideline for autism spectrum disorder (ASD) by investigating parents who have children with ASD about their perception in ASD and their thoughts on Korean medicine treatment to treat ASD. Methods We conducted a survey on 'perception of ASD' and 'perception and preference of Korean medicine treatment for ASD' on the parents of 22 children with ASD (age 4-6) who visited department of pediatrics of Korean medicine at Kyunghee University Korean medicine hospital at Gangdong and Kyunghee University Korean medicine hospital. Results Of the parents, 20 (90.91%) said their children had no experience with Korean medicine treatment. Among them, 11 (35.48%) chose 'I didn't know that Korean medicine treats ASD' for the reason (multiple choice). When questioned what the worries are for Korean medicine treatment, 13 (30.95%) chose 'worries about probability of side effects of herbal medicine' as the most worrisome reason (multiple choice). On the question about the necessity of Korean medicine for the treatment of ASD, most chose 'Korean medicine treatments are necessary for children with ASD' (9, 40.91%). Conclusions It is necessary to develop a clinical practice guideline that reflects comprehensive evidence for side effects as well as the effectiveness of Korean medicine for ASD, and is necessary to promote the effectiveness and evidence-based Korean medicine treatment to patients and their caregivers through various distribution tools.

• 대한감각통합치료학회지
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• 제21권3호
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• pp.65-78
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• 2023

목적 : 본 연구에서는 체계적 문헌 고찰을 통하여 국내 자폐스펙트럼장애 아동의 보호자를 대상으로 실시한 가족 중심 중재의 효과를 알아보고자 하였다. 연구방법 : 문헌검색은 2011년부터 2021년 사이의 문헌을 RISS, KISS, DBpia를 통하여 검색하였다. 검색어는 '자폐스펙트럼' OR '전반적발달장애' OR '고기능 자폐' OR '아스퍼거' AND '부모 교육' OR '가족중심중재' OR '부모코칭' OR '부모훈련' OR '가족참여' 등을 적용하였다. 선정 기준에 따라 최종적으로 11편의 실험연구를 선정하였다. 결과 : 연구 참가자의 일반적 특성, 중재 전략 및 효과, 중재 프로토콜을 확인한 결과, 연구대상은 영유아기 자폐스펙트럼장애 아동이 가장 많았고, 가족 중심 중재에 어머니들이 주로 참여하였다. 가족 중심 중재의 효과는 아동과 부모에게서 모두 나타났으며, 아동에게서는 상호작용 및 의사소통에 대한 효과가 가장 높은 비중을 차지하였고, 부모에게서는 양육 스트레스 감소 및 양육효능감 향상을 보였다. 중재 전략은 감각통합 중재, 반응적 의사소통 및 상호작용 중심 중재가 가장 많았고, 발달 중심 중재, 긍정적 행동 지원 중재(Positive Behavioral Supports; PBS), 중심축 반응 훈련(Pivotal Response Training; PRT)순으로 나타났다. 결론 : 본 연구의 결과를 통해 가족 중심 중재는 자폐스펙트럼장애 아동의 기능뿐만 아니라 부모의 양육 스트레스 및 양육효능감에 효과가 있음이 확인되었으며 임상 활용의 근거를 제시하였다는 점에서 의의가 있다.

• 대한치과마취과학회지
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• 제12권3호
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• pp.165-171
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• 2012

Background: The aim of this study was to investigate and compare the oral health conditions of Autism Spectrum Disease (ASD) and cerebral palsy(CP) patients visiting the Kyung Hee University Dental Hospital from January 2003 to december 2010. Methods: This study analyzed the data (patient's chart and radiograph) of fifty-eight ASD patients and fifty-seven CP patients. The oral health conditions of patients were surveyed by DMFT (dmft) and periodontal condition at the first visit. The performed dental procedure, behavior management methods and follow-up check were analyzed. Results: The average age of patients having ASD and CP was 12 year 2 month (ASD; 11 year 9 month and CP; 12 year 4 month). Within the limit of this study, the rate of dental caries was higher in CP patients than autism patients. Both of diseases showed the periodontal problem. Autistic patients showed more difficult management problems according to the rate of general anesthesia experiences. Conclusions: This article would contribute for dental practitioners to provide appropriate and specialized treatment to ASD patients and CP patients.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권2호
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• pp.117-122
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• 2007

Practice parameters for non-pharmacological treatment of children and adolescents with pervasive developmental disorders are based on the scientific literature for evidence-based practices. Appropriate educational and behavioral interventions are important in improving the long-term outcome in pervasive developmental disorders. Early and sustained intervention appears to be particularly important. The goal for interventions is to gain pragmatic skills for verbal communication, playing with peers, daily living routines, self-management, and social adaptation. Appropriate involvement and collaboration with parents and family are essential for well-functioning intervention programs. The life-long nature of autism implies that the clinician should maintain an active role in long-term treatment planning and family support. Vocational training and training for more independent living are important for adolescents with autism. Professionals should be knowledgeable about local and national resources and opportunities for family support as well as support of the individual.

• 사상체질의학회지
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• 제17권1호
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• pp.120-129
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• 2005

1. Objectives This study was conducted to establish a standard and classify suitability in the treatment of speech impediment and limb impediment among the children with development disabilities using Oriental Medicine treatment on the ground of Sasang Constitutional Medicine. 2. Methods 43 patients with pediatric development disabilities with speech impediment and 10 patients with pediatric development disabilities with limb impediment as the main symptoms had been chosen in this study. Oriental Medicine treatments on the ground of Sasang Constitutional Medicine were rendered and evaluated responses as well as pursuing most proper treatment methods. 3. Results & Conclusions 1) For pediatric development disabilities with speech impediment, Oriental Medicine treatment showed a significant effect on similarity of Autism and Cerebral Palsy, but insignificant effect on innate Autism. 2) For pediatric development disabilities with limb impediment, Bee venom was effective for severe limb impediment and limb asthenia, while as eight principles herbal acupuncture effective for mild limb impediment and spasticity. 3) Sasang Constitutional Medicine for treating speech impediment and limb impediment among the children with development disabilities showed general improvement as a fundamental healing through coordinating inner organ activities.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권4호
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• pp.217-226
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• 2019

Background: We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. Methods: We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). Results: For all groups, the duration of dental treatments was $43{\pm}18$ minutes, total sedation time was $73{\pm}23$ minutes, and total BIS values was $57{\pm}12$. The propofol maintenance dosage values for each group were: mental retardation, $3{\pm}0.5(2-4){\mu}g/ml$; autism, $3.1{\pm}0.7(2-5){\mu}g/ml;$; brain lesion, $2.8{\pm}0.7(1.5-5){\mu}g/ml;$; genetic disease, $2.9{\pm}0.9(1-4){\mu}g/ml;$ and dementia $2.3{\pm}0.7(1-3.4){\mu}g/ml;$. Conclusions: The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients.

• 대한소아치과학회지
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• 제23권3호
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• pp.593-600
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• 1996

본 증례의 혈우병 및 자폐증 환아의 치료를 통해 다음과 같은 결론을 얻었다. 1. 혈우병 환자의 내원시 내과의사나 소아과의사 및 혈액학자에게 의뢰를하여 출혈찬도 및 부족인자 보충 퉁에 관한 자문을 얻어야 한다. 2. 매우심한중증의 혈우병 환자이거나 외과적 수술등으로 인해 많은 출혈이 예상될 경우에는 포괄적인 환자 관리를위해 입원 치료를 해주어야 한다. 3. 자폐중으로인한 행동조절이 어렵거나 그외 다른 요인에 의해 행동조절이 불가능한 혈우병 환자의 경우 입원치료가 필요하다. 4. 치과 시술을 행할때에는 최소의 관혈적인 치과치료 행하도록 노력해야 하며, 응급 상황을 대비해서 국소적인 지혈방법을 습득해야 한다. 5. 치과 시술시 환자의 동통 완화 및 소염작용을 위한 약물 처치시에도 주의를 요한다. Non-steroidal anti-inflammatory drugs는 혈소판응집을 방해하기 때문에 동통완화를 위해서는 aspirin 대신에 acetaminophen을 사용하며, 소염효과를 위해서는 steroid 계통의 약물을 사용하며 ibuprofen, indomethacin, phenylbutazone 등의 약제 사용은 금한다. 6. 혈우병 환자라고해서 두려워하거나 치과 치료의 질을 변경해서는 안된다.

• 대한장애인치과학회지
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• 제6권2호
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• pp.84-93
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• 2010

The developmental disorder(intellectual disorder(ID) and autism spectrum disorder(ASD)) can severely impair a patient's ability to communicate and socialize. So they require physical management techniques, pharmacologic agents, and general anesthesia more than the normal at the dental clinic. The behavior therapy is a kind of the psychotherapy and is applied to the patient with behavioral problems. Seoul Dental Hospital for Disabled(SDHD) set up the Dental Behavior Clinic for the patients with developmental disorder and treated 32 patients with ID or ASD, blind. 18 patients were treated according to the ordinary plans, 14 patients stopped the treatment by different reasons. The various results of the treatment were produced by the kind or severity of the diseases, age and cooperation of the patients and the caregivers. Especially, the behavior therapist helped to figure out the characteristics of the patients and to make individualized treatment plans. In the future, it will be necessary to treat more patients and to make the dental behavior therapy objectify. And through the dental behavior therapy, it will be expected that the patients will become more cooperative to the dental clinic and can receive regular check-up peacefully, reducing the frequency of the general anesthesia.