• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제4권1호
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• pp.27-38
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• 1993

전반적 발달장애는 가장 심각한 소아정신과 장애중 하나로 발달의 여러가지 영역에 있어 이상 소견을 보인다. 약물치료로 전반적 발달장애를 완치 할 수 없으며 치료효과 역시 비특이적이다. 그러나 일부의 전반적 발달장애 아동에게 약물치료는 매우 중요하기도 하고, 행동치료나 교육에 임하는 데에 있어 휠씬 도움을 줄 수 있다. 지금까지 가장 많이 연구된 항정신병 약물인 halopcridol은 임상적으로나 통계적으로 확실히 위약보다 훌륭한 효과를 보이고 있고, 약물의 부작용을 초래하지 않으면서 변별학습이나 모방적 언어사용등 긍정적인 기능을 촉진하는 것으로 보고되고 있다. 그러나 이러한 halopcridol의 투여는 약물과 관련된 운동장애를 초래할 수 있기 때문에 보다 안전한 다른 약물을 찾고자 하는 이유가 된다. 지금까지의 몇몇 생화학적인 연구들은 전반적 발달장애 아동의 일부에서 대조군에 비하석 혈중내 세로토닌치가 높거나, 내인성 opioid 측정치가 높은 군이 있을 것이라는 보고를 하고 있다. 이러한 소견을 근거로 하여 약물치료가 시도 되기도 하였는데, 예를들면, fenfluramine이나 naltrexone등이 그러하다. 그러나 아직 까지의 결과는 결론적이지 못하다. 이 약물들과 이 밖에도 지금까지 전반적 발달장애 아동에게 사용되어진 약물들과 그들의 효과에 대하여 고찰하고자 한다.

• 한국식품조리과학회지
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• 제10권1호
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• pp.13-17
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• 1994

The purpose of this study was to show the abnormal eating habit in pervasive development disorder (PDD) children. The authors studied retrospectively the features of eating habit in 60 PDD children diagnosed by DSM-III-R who made their first visity to Department of Psychiatry, Dongsan Medical Center Keimyung University, from January 1990 to December 1990. The results were as follows;1. The average was 3 years, onset age of illness was before 3 years of all patients, and the ratio between male and female was 5,7:1, and ratio between autistic disorder and PDDNOS was 4:1. 2. Twenty four of 60 PDD children had one or more abnormal eating habit(autistic disorder; 43.8%, PDDNOS; 25%), and more prevalent to male(43.1%,) than female(22.2%). 3. Milk, biscuit, meat and fluids were the favorate foods, the unfavorate foods were vegetable, rice, frutis. 4. Patients of abnormal eating habit were more symptoms of DSM-III-R on 'lack of awareness', 'preoccupation with parts of objects','distress over change'and 'insistence on routine' than others.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제26권3호
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• pp.209-216
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• 2015

Objectives : The purpose of this study was to investigate the effectiveness of a day-hospital treatment program designed to help development of children with pervasive developmental disorder (PDD) and mental retardation (MR). Methods : Retrospective review of the charts of 32 children (28 with PDD, 4 with MR), who participated in a day-hospital treatment program of Seoul Metropolitan Eunpyeong Hospital, from October 2008 to February 2012, was conducted. Development level of each patient was evaluated according to the Psycho-Educational Profile-Revised (PEP-R), Social Maturity Scale (SMS), and Childhood Autism Rating Scale (CARS). Evaluation was done at two points, before participation and after 1 year participation. Results : Children who participated in the day-hospital treatment program showed significant improvement in all categories of PEP-R, SMS, and CARS. Conclusion : Day-hospital treatment program is effective for helping development of children with PDD and MR.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제23권4호
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• pp.188-195
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• 2012

Objectives:This study was conducted in order to evaluate the effectiveness of a day-center treatment program to promote development of children with pervasive development disorder (PDD) and pervasive development disorder/mental retardation (PDD/MR). Methods:Twenty five children (14 in the PDD group and 11 in the PDD/MR group) participated in a day-center treatment program. They had been enrolled in the whole program for 2-3 years. Their performance was evaluated according to the Preschool Language Scale (PRES), Social Maturity Scale (SMS), and Korean version of the Childhood Autism Rating Scale (CARS). They were grouped by diagnosis at the beginning of the program and the treatment effect was compared. Results:Children who participated in the day-center treatment program showed a significant increase in their PRES and SMS scores and a decrease in their CARS scores. Conclusions:A day-center treatment program is effective for development of children with PDD and PDD/MR.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제18권2호
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• pp.85-87
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• 2007

The new research data and rapid development of psychotropic drugs over the past few years have warranted the development of clinical practice guidelines for managing pervasive developmental disorder(PDD). These guidelines are urgently needed due to the recent changes in social circumstances and clinical situations in Korea. Despite the many limitations and problems surrounding the development of these guidelines, the Korean Academy of Child and Adolescent Psychiatry(KACAP) has decided to develop the Korean Practice Parameters for the Treatment of PDD. The goal, basic principles, organization, and implications of this development project are introduced in this special paper. We expect these practice parameters to be a useful reference not only for child psychiatrists and other healthcare professionals in clinical practice, but also for the autistic patients themselves and their caregivers. The practice parameters shall be revised and improved in the near future.

• 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.

• 재활복지
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• 제20권4호
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• pp.135-156
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• 2016

이 연구의 목적은 아동기 자폐증 평정척도(CARS)에 대한 평정자의 타당한 평가가 가능토록, Rasch 평정척도모형을 적용하여 문항의 적합성과 난이도를 검증하는 데에 있다. 이를 위해 CARS 평정이 신뢰롭다고 판단된 발달장애인 238명의 자료를 분석하였고, 이때 CARS의 평정은 장애인복지관 치료사에게 교육을 받은 부모가 기입하도록 하였다. 이 연구에서 설정한 연구문제를 검증하기 위해 Rasch 평정척도모형을 적용하였고, Rasch 모형 적용을 위한 일차원성 가정은 PCAR 검증을 통해서, 문항의 적합성과 난이도는 jMetrik 4.03 프로그램을 통하여 추정하였다. 그 결과, 첫째, CARS의 문항 응답범주는 문제가 있는 것으로 나타나, 기존 7점 범주 대신 5점 범주로 수정이 필요하다. 둘째, CARS의 문항 적합도를 살펴본 결과, 집단에 따라 부적합 혹은 과적합한 문항이 존재하였다. 특히 자폐증 진단 대상자 통합 집단에서 Q11 문항만이 부적합하게 나타나, CARS 평정을 위한 교육을 보다 체계적으로 수행할 필요가 있다. 셋째, CARS 문항에 대한 개인 속성점수와 난이도를 비교한 결과, Q2, Q3, Q10, Q11 문항에 대한 개념적 정의를 보다 세부적으로 구분할 필요성이 있다. 넷째, CARS 문항에 대한 난이도를 살펴본 결과, 평정자인 부모가 지각하는 자폐증 집단의 가장 심대한 문제는 언어적 의사소통으로 나타났다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제5권1호
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• pp.41-53
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• 1994

1944년 Hans Asperger는 아동기에 사회적인 고립과 특이한 행동 양식을 보이는 400명의 증례를 보고하고 자폐적 병질(autistic psychopathy)이라 명명하였는데 이 아동들은 1943년 Kanner에 의하여 기술된 자폐 아동들과 여러 가지면에서 유사하였으나 임상적인 관찰에서 몇몇 현저한 차이를 나타냈다. 가장 주목할 만한 것은 정상 언어 발달과 지능 수준의 차이를 들 수 있다. 이후에 이들은 Asperger's syndrome([CD-10) 혹은 Asperger's disorder(DSM-IV)로 명명되었는데 이들은 자폐증과 연속선상에 있는 높은 기능 수행을 보이는 경한 형태의 발달장애로 보는 시각, 아동기 인격 장애의 특수한 형태로 보는 시각, 혹은 성인 정신분열증의 초기 아동기 행태로 보는 시각등이 있는데, 모두 그들 나름대로 연구 방법의 타당성과 결과 해석의 문제점을 안고 있다. ICD-10(1992)과 DSM-IV(1994)에서 전반적 발달 장애의 영역내에 새로이 독립된 진단 체계로써 확고히 자리한 지금에 와서도 이들 질환과 완전히 분리된 개념으로 간주하기에는 미흡한 실정이다. 저자는 이 질환의 현재 개념에 이르기까지의 역사적 고찰과 더불어 독립된 질환이냐의 논의점과 최근 연구 경향에 대해 문헌 고찰을 하였으며 이 증후군이 큰 맥락에서 사회적 본능(social instinct)에 결함이 있는 장애라는 견지에서 연계 질환들과의 관계를 도식적으로 요약해 보았다.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제21권3호
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• pp.153-160
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• 2010

Objectives: The purpose of this study was to evaluate the prenatal, perinatal, and infancy history of children with autism spectrum disorder (ASD) as compared to unaffected siblings (SIB) and typically developing children (TC). Methods: Subjects with ASD, their SIB, and TC were recruited. All subjects were assessed using both the Korean version of Autism Diagnostic Interview-Revised (K-ADI-R) and the Korean version of Autism Diagnostic Observation Schedule (K-ADOS) and were subsequently identified as affected or unaffected. Prenatal, perinatal, and infancy history was obtained from the primary caregivers and each facet was compared in those with ASD, the SIB, and the TC groups using SPSS ver. 17.0 (p<.05). Results: 70 individuals with ASD (63 males, 87.94${\pm}$37.8months), 53 SIB (27 males, 85.4087.94${\pm}$48.06 months), and 32 TC (19 males, 104.1987.94${\pm}$23.409 months) were analyzed. The ASD group showed significantly higher rates of insufficient vaccination as they aged age ($x^2$=15.54, p=.000). Among the scheduled vaccinations, the DPT vaccination ($x^2$=10.08, p=.006) was insufficient in ASD groups. The ASD group also showed higher rates of sleep disturbances from infancy. Differences in maternal/paternal age at conception, gestational age, and growth parameters at birth were not significantly difference among the three groups. Conclusion: These results do not support the previous controversies regarding the relationship between prenatal/perinatal complications and ASD. However, these results indicate that perinatal and prenatal factors may contribute to the development of ASD.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제29권2호
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• pp.80-85
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• 2018

Objectives: We aimed to assess the test-retest reliability, internal consistency, and validity of the Korean version of the Quantitative Checklist for Autism in Toddlers (Q-CHAT). Methods: The Korean version of the Q-CHAT and the Korean version of the Child Behavior Checklist (CBCL) 1.5-5 were completed by parents of 24 toddlers and preschoolers with autism spectrum disorder (ASD) and 80 unselected toddlers and preschoolers. Parents of the ASD group also completed the Social Communication Questionnaire (SCQ), and Childhood Autism Rating Scale (CARS) scores were obtained from medical records. Results: The ASD group scored higher on the Q-CHAT than the unselected group. The Cronbach's alpha coefficient of the Q-CHAT was 0.658, and test-retest reliability was calculated to be 0.836. The estimated area under the curve was 0.793. The total scores of the Q-CHAT in the ASD group demonstrated significant positive correlations with findings regarding pervasive development problems in the CBCL, SCQ, and CARS. A total score of 33.5 may be a useful cutoff point to use when identifying toddlers at risk of ASD. Conclusion: The Korean version of the Q-CHAT has good reliability and validity and can be used as a screening tool in order to identify toddlers and preschool children at risk of ASD.