Notice

Call for Papers for Special Issue on "Slow Learners (Borderline Intellectual Functioning)"

The Journal of the Korean Academy of Child and Adolescent Psychiatry (JKACAP) calls for papers related to "Slow Learners (Borderline Intellectual Functioning)" (Section Editor: Keun-Ah Cheon, M.D., Ph.D., Department of Child and Adolescent Psychiatry, Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital)

Slow learners, often characterized by borderline Intellectual Functioning, require more time and effort in the learning process compared to their peers. Despite constituting a significant 13-15% of the total population, they often do not seek medical attention until complications arise in the clinical field. Slow learners face a heightened risk of developing secondary depression and interpersonal problems due to their ongoing struggles. Recognizing the potential long-term consequences, it is crucial to facilitate early intervention and support before these issues escalate.

Despite the prevalence of borderline Intellectual Functioning and the associated social costs, limited research has been conducted on this critical topic. This special issue aims to enhance our overall understanding of slow learners, welcoming original articles, reviews, and case studies. We are always open to submissions by scholars from worldwide regions and communities.

When submitting your manuscript please select the article type “Special Article". Then you can find the checkbox "Slow Learners (Borderline Intellectual Functioning)". Please submit your manuscript no later than 1 April 2024.

Please ensure you read the Guide for Authors before writing your manuscript. The Guide for Authors and link to submit your manuscript is available on the Journal’s homepage at: https://www.jkacap.org/authors/sub01.html.

Inquiries, including questions about appropriate topics, may be sent electronically to Jae Hyun Yoo, jayyoo84@gmail.com.

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Editorial

Understanding Evidence-Based Practice for Autism Spectrum Disorder: Korean Practice Clinical Guidelines

Hee Jeong Yoo

J Korean Acad Child Adolesc Psychiatry 2024;35(1):1-1

Special Articles: Korean Practice Guideline for Autism Spectrum Disorder

History of the Task Force for the Korean Clinical Guidelines of the Developmental Disorders

Bung-Nyun Kim and Joung-Sook Ahn

J Korean Acad Child Adolesc Psychiatry 2024;35(1):4-7

Under the Ministry of Health and Welfare of the Republic of Korea, the National Autism and Developmental Disorder Centers for people with developmental disabilities are gradually expanding. The headquarters of the National Autism and Developmental Disorder Center provides support for education, training, and research, and several centers have been effectively operating since 2020. This study aimed to provide practical recommendations and guidelines for specialists such as clinical psychologists, child psychiatrists, allied professionals, community workers, and related administrators. It was developed as a guideline to promote early diagnosis, provide important information on integrated treatment, and assist people with developmental disabilities in Korea to make the best decisions for their quality of life.
Key Words: Autism spectrum disorders; Developmental disabilities; Intellectual disability; Practice guideline
Special Articles: Korean Practice Guideline for Autism Spectrum Disorder

Korean Clinical Guideline for Autism Spectrum Disorder - Clinical Features, Course, Epidemiology, and Cause

Jun-Won Hwang and Jeong-Seop Lee

J Korean Acad Child Adolesc Psychiatry 2024;35(1):8-14

Autism spectrum disorder (ASD) is a heterogeneous developmental disorder characterized by impairments in two core areas: 1) social communication and interaction and 2) restricted and repetitive patterns of behaviors and interests. In general, ASD is known to be a lifelong disorder. Follow-up studies from childhood to adulthood have reported that the severity of the key symptoms ASD decreases over time. However, chronic health problems including mental health occur in many patients with ASD. The prevalence of ASD has increased from around 0.04% in the 1970s to 2.8% at present. The average age of diagnosis in developed countries is 38–120 months of age. Recent evidence suggests that biological factors which include genetic, congenital, immunological, neuroanatomical, biochemical, and environmental ones are important in causing autism. Until now, early signs and various risk factors of ASD have been suggested.
Key Words: Autism spectrum disorder; Associated features; Disease progression; Epidemiology; Cause
Special Articles: Korean Practice Guideline for Autism Spectrum Disorder

Diagnosis and Assessment of Autism Spectrum Disorder in South Korea

Johanna Inhyang Kim and Hee Jeong Yoo

J Korean Acad Child Adolesc Psychiatry 2024;35(1):15-21

Autism spectrum disorder (ASD) is diagnosed by the clinical decision of a trained professional based on the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition or International Classification of Diseases 11th Revision diagnostic criteria. To obtain information for diagnostic formulation, professionals should explore detailed developmental history, and can use structured or semi-structured assessment tools to observe interaction between the child and parents or strangers. Diagnostic assessment should include a profile of the strength and weaknesses of the individual and should be conducted using an optimal approach by a multidisciplinary team with appropriate techniques and experience. Assessment of language, cognitive, neuropsychological, and adaptive functioning should be conducted in ASD individuals prior to establishing an individualized treatment plan. Genetic testing, brain magnetic resonance imaging or electroencephalogram testing can be considered for identification of underlying causes.
Key Words: Autism spectrum disorder; Diagnosis; Biomarker; Comorbidities; Differential diagnosis
Special Articles: Korean Practice Guideline for Autism Spectrum Disorder

Basic Management Strategies by Life Cycle for Treatment of the Persons With Autism Spectrum Disorder

Jung-Woo Son and Seok-Hyun Nam

J Korean Acad Child Adolesc Psychiatry 2024;35(1):22-28

Interventions for targeted symptoms are important when setting treatment strategies for individuals with autism spectrum disorder (ASD) and developmental disabilities. Especially, the goal should be to achieve individual “niche construction” by allowing them to select and adjust an environment where they can demonstrate their special characteristics and strengths. In addition, these choices should vary depending on the stage of development of each person with ASD and developmental disabilities. It is necessary to establish a detailed and systematic plan for diagnosis and treatment necessary for infants and toddlers, school placement in school age, and employment or self-reliance in adult transition period to establish customized treatment strategies that fit the individual level of people with ASD and developmental disabilities.
Key Words: Autism spectrum disorder; Developmental disabilities; Treatment; Individual treatment plan; Life cycle
Special Articles: Korean Practice Guideline for Autism Spectrum Disorder

Behavioral Interventions for Autism Spectrum Disorder: A Brief Review and Guidelines With a Specific Focus on Applied Behavior Analysis

Kyong-Mee Chung, Eunsun Chung, and Hoomyung Lee

J Korean Acad Child Adolesc Psychiatry 2024;35(1):29-38

We conducted a comprehensive review of behavioral and educational interventions for individuals with autism spectrum disorder (ASD). The most prominent type of intervention, Comprehensive Early Intervention, often referred to as Early Intensive Behavioral Intervention (EIBI), has been found to be particularly effective in improving intelligence and adaptive behaviors. The naturalistic developmental behavioral intervention, designed to enhance social and communication abilities, showed effectiveness in improving language, cognitive function, and social initiation. However, more studies are needed to examine its effectiveness. Intensive individualized intervention, which provides a tailored intervention for a specific target behavior, was effective in improving social skills and communication, as well as reducing sleep, eating, and toileting problems. Cognitive behavioral therapy (CBT) is the most effective method for dealing with emotional difficulties, but it has not been widely used because of the shortage of trained experts. Parent-mediated intervention (PMI) involves parents acquiring knowledge and specific skills to improve their child’s functioning or reduce challenging behaviors. Speech and language therapy, sensory integration, Treatment and Education of Autistic and related Communications Handicapped Children, developmental approaches, and social stories are frequently used interventions. However, evidence of their effectiveness has yet to be well established. Based on these findings, intervention recommendations for autism include EIBI, Early Start Denver Model, intensive individualized intervention, CBT, and PMI. The choice of intervention should be tailored to the individual’s needs and delivered by qualified professionals with expertise in the specific intervention.
Key Words: Autism spectrum disorder; Early Intensive Behavioral Intervention; Naturalistic developmental behavioral intervention; Parent-mediated intervention; Comprehensive treatment model; Focused intervention
Special Articles: Korean Practice Guideline for Autism Spectrum Disorder

Common Comorbid Condition of Patients With Autism Spectrum Disorder and Pharmacotherapy for Patients With Autism Spectrum Disorder

Un Sun Chung and Ji-Hoon Kim

J Korean Acad Child Adolesc Psychiatry 2024;35(1):39-43

This article describes common comorbid condtion of the autism spectrum disorder (ASD) and recommends treatment guidelines of pharmacotherapy for patients with ASD. More than 95% of people with ASD have at least one additional disorder and guidelines how to evaluate and treat comorbid conditions in patients with ASD and 7 recommendations for treatment with medication for ASD.
Key Words: Autism; Comorbidity; Pharmacotherapy; Guideline
Special Articles: Korean Practice Guideline for Autism Spectrum Disorder

Multifaceted Approach to Addressing Problem Behaviors in Developmentally Challenged Children

Yearin Kim, Bung-Nyun Kim, and Yeni Kim

J Korean Acad Child Adolesc Psychiatry 2024;35(1):44-50

Parents of children with autism spectrum disorder (ASD) often encounter unique challenges when attempting to understand their children’s challenging behaviors such as self-injury, aggression, noncompliance, and stereotypies. In this study, we aimed to analyze and clarify the definition of challenging behaviors in individuals with ASD, identify the variables associated with challenging behaviors, and determine the function of these behaviors. Systematic observation and data collection are crucial to understand the functions of specific behaviors exhibited by individuals with ASD based on their antecedents and consequences. Knowledge regarding these will enable clinicians to develop and implement effective interventions. Additionally, the treatment approach should aim for generalization to improve the quality of lives of both children with ASD and their caregivers.
Key Words: Autism spectrum disorders; Problem behaviors; Behavior therapy; Parenting education
Special Articles: Eating Disorder

Autism Spectrum Disorder and Eating Problems: The Imbalance of Gut Microbiota and the Gut-Brain Axis Hypothesis

Jiyoung Kim

J Korean Acad Child Adolesc Psychiatry 2024;35(1):51-56

This review explores the complexities of autism spectrum disorder (ASD), primarily focusing on the significant eating challenges faced by children and adolescents with this neurodevelopmental condition. It is common for individuals with ASD to exhibit heightened sensitivity to various sensory aspects of food such as taste, texture, smell, and visual appeal, leading to restricted and less diverse diets. These dietary limitations are believed to contribute to an imbalance in the gut microbiota. This review elaborates on how these eating problems, coupled with the distinctive characteristics of ASD, might be influenced by and, in turn, influence the gut-brain axis, a bidirectional communication system between the gastrointestinal tract and the brain. This discussion aims to shed light on the multifaceted interactions and potential implications of diet, gut health, and neurological development and function in children and adolescents with ASD.
Key Words: Autism spectrum disorder; Eating disorder; Gastrointestinal tract; Microbiome; Gut-brain axis
Special Articles: Eating Disorder

Assessment Methods for Problematic Eating Behaviors in Children and Adolescents With Autism Spectrum Disorder

Miji Lee, Seolha Lee, Jong-Woo Sohn et al.

J Korean Acad Child Adolesc Psychiatry 2024;35(1):57-65

Autism spectrum disorder (ASD) can be associated with eating problems. However, currently, there is a lack of established guidelines for assessing and addressing eating behaviors in individuals with ASD. This gap in research exists due to the challenges associated with using traditional assessment methods, which may lead to discrepancies in responses and unintentional potential biases from caregivers. In this review, we provided a comprehensive overview of various eating behaviors commonly observed in individuals with ASD. These behaviors include 1) food neophobia, 2) selective eating, 3) binge eating, 4) food avoidance, 5) chewing and swallowing problems, 6) pica, 7) rumination, 8) rituals, and 9) problematic behaviors. Furthermore, we provide a perspective of utilizing digital tools: 1) augmentative and alternative communication; 2) ecological momentary assessment; and 3) video analysis, behavioral analysis, and facial expression analysis. This review explores existing assessment methods and suggests novel assessment aiding together.
Key Words: Eating disorder; Autism spectrum disorder; Deep learning; Telemedicine
Special Articles: Eating Disorder

Case Reports of Binge Eating Patterns in the Recovery Phase of Anorexia Nervosa Patients With and Without Food Addiction

Younjoo Song, Min-Jung Park, and Hyung Jin Choi

J Korean Acad Child Adolesc Psychiatry 2024;35(1):66-74

Food addiction refers to a condition in which individuals exhibit addictive-like behaviors toward food, like those observed in substance abuse. Although still debated, evidence supporting the validity and usefulness of the concept of food addiction is growing. Food addiction is particularly associated with obesity and eating disorders involving binge eating. This study discusses the cases of two adolescent patients who presented with anorexia nervosa. During the recovery phase of anorexia nervosa, binge eating was observed, and the patterns of binge eating significantly differed between patients, with and without food addiction. Therefore, healthcare professionals treating eating disorders should be aware of food addiction and modify their treatment strategies accordingly.
Key Words: Food addiction; Binge eating; Anorexia nervosa
Original Article

The Relationship Between Bullying and Risk of Suicide Among Adolescents During the COVID-19 Pandemic in Indonesia

Iyus Yosep, Heni Purnama, Linlin Lindayani et al.

J Korean Acad Child Adolesc Psychiatry 2024;35(1):75-81

Objectives: Although adolescents appear less vulnerable to coronavirus disease (COVID-19), the side effects of this pandemic can still be devastating. Bullying and suicidality are significant global issues with detrimental effects on young people, particularly during school closure. This study aimed to identify the relationship between bullying and suicide risk among adolescents in Indonesia during the COVID-19 pandemic.
Methods: A cross-sectional study was conducted on adolescents aged 14–18 years in May 2020 in Bandung, Indonesia, using a web-based closed survey. The Adolescent Peer Relations Instrument and the Suicide Behavior Questionnaire-Revised were used to measure bullying and risk of suicide. Multinomial logistic regression analysis was performed.
Results: This study included 268 participants in 2020 and 175 participants in 2019. In 2020, the prevalence of perpetrators and victims of bullying combined was 74.6%. Meanwhile, in 2019, the prevalence of perpetrators and victims of bullying combined was 82.9%. Risk of suicide increased from 26.1% in 2019 (before the COVID-19 pandemic) to 36.5% in 2020 (during the first wave of the COVID-19 pandemic). The risk of perpetrators and suicide victims was higher than that of perpetrators and victims alone (odds ratio [OR]=4.0, 95% confidence interval [CI]=1.5–6.6 vs. OR=1.3, 95% CI=1.0–2.9 and OR=1.6, 95% CI=1.1–2.8, respectively).
Conclusion: Bullying can enhance the likelihood of suicide among adolescents in Indonesia, and the risk was highest for the combination of victims and perpetrators. It is very important to provide early risk prediction for youths with bullying behavior and improve the knowledge and understanding of families and schools regarding the negative effects of bullying behavior.
Key Words: Adolescents; Bullying; COVID-19; Suicide
Original Article

Effectiveness and Tolerability of Combination Pharmacotherapy With Stimulant and Non-Stimulant in Children With Attention Deficit Hyperactivity Disorder

Hyung Nam Park, Na Yeong Kong, Hee-Cheol Kim et al.

J Korean Acad Child Adolesc Psychiatry 2024;35(1):82-89

Objectives: This study aimed to investigate the effectiveness and safety of combining psychostimulants and nonstimulants for patients under treatment for attention deficit hyperactivity disorder (ADHD).
Methods: The study included 96 patients aged 6–12 years who were diagnosed with ADHD, among whom 34 received combination pharmacotherapy, 32 received methylphenidate monotherapy, and 30 received atomoxetine monotherapy. Statistical analysis was conducted to compare treatment and adverse effects among groups and to analyze changes before and after combination pharmacotherapy. The difference between combination pharmacotherapy and monotherapy was investigated. Logistic regression analysis was used to identify the predictors of combination pharmacotherapy.
Results: No significant differences were observed between the groups in terms of age or pretreatment scores. The most common adverse effect experienced by 32% of patients in the combination pharmacotherapy group was decreased appetite. Clinical global impression-severity score decreased significantly after combination pharmacotherapy. All three groups showed significant clinical global impression-severity score improvements over time, with no significant differences among them. The predictive factors for combination pharmacotherapy included the Child Behavior Checklist total score internalizing subscale.
Conclusion: Combination pharmacotherapy with methylphenidate and atomoxetine is a relatively effective and safe option for patients with ADHD who do not respond to monotherapy.
Key Words: Attention deficit hyperactivity disorder; Combination; Methylphenidate; Atomoxetine; Child
Original Article

Standardized Treatment and Shortened Depression Course can Reduce Cognitive Impairment in Adolescents With Depression

Penghui Cao, Junjie Tan, Xuezhen Liao et al.

J Korean Acad Child Adolesc Psychiatry 2024;35(1):90-97

Objectives: This study aimed to explore the influence of depression severity, disease course, treatment status, and other factors on cognitive function in adolescents with depressive disorders.
Methods: Participants who met the inclusion criteria were enrolled in the study. Sociodemographic data of each participant were recorded, including age, sex, and family history of mental disorders. Zung’s Self-Rating Depression Scale was used to assess depression status in adolescents. Moreover, P300 and mismatch negativity (MMN) were used to objectively evaluate the participants’ cognitive function.
Results: Only 26.8% of the adolescents with depression received standard antidepressant treatment. The latencies of N2 (267.80±23.34 ms), P3 (357.71±32.09 ms), and MMN (212.10±15.61 ms) in the adolescent depression group were longer than those in the healthy control group (p<0.01). Further analysis revealed that the latency of MMN was extended with increased levels of depression in adolescents. The MMN latency was short in participants with depression receiving standardized treatment. Furthermore, the latency of MMN was positively correlated with the severity and duration of depression (correlation coefficients were 0.465 and 0.479, respectively) (p<0.01).
Conclusion: Receiving standardized treatment and shortening the course of depression can reduce cognitive impairment in adolescents with depression.
Key Words: Adolescent; Depression; Standardized treatment; Depression course; Cognitive function
Media Review

The Last Rise and Fall Shown to us by the Man Who Chose “Swollen Foot”: The Film The Whale

Jung-Woo Son

J Korean Acad Child Adolesc Psychiatry 2024;35(1):98-100

The film The Whale goes beyond just depicting one aspect of the life of a morbidly obese man. As the audience watches Charlie, the main character who helplessly chose to live a morbidly obese life, we are compelled to reflect on what it means for ourselves to rise from the ground as we live in a gravitational field. Ultimately, this film is in line with director Darren Arnofsky’s previous masterpiece, Black Swan. While the Oedipus complex runs through both films, this film goes one step further than Black Swan to face head-on the theme of “swollen foot,” which is the original meaning of Oedipus. Through this move, we realize the essence of the Oedipus complex—something more fundamental than castration anxiety—something that we have been missing.
Key Words: The Whale; Oedipus complex; Mytheme
CURRENT ISSUE
J Korean Acad Child Adolesc Psychiatry 2024;35(1):1-100
Editorials
Understanding Evidence-Based Practice for Autism Spectrum Disorder: Korean Practice Clinical Guidelines
Hee Jeong Yoo
J Korean Acad Child Adolesc Psychiatry 2024;35(1):1-1
Cutting-Edge Research on Eating Disorders Beyond Eating: Comprehensive Understanding Linking Autism, Gut-Brain Axis, Gut Microbiota, Digital Tools, and Food Addiction
Hyung Jin Choi
J Korean Acad Child Adolesc Psychiatry 2024;35(1):2-3
Special Articles: Korean Practice Guideline for Autism Spectrum Disorders
History of the Task Force for the Korean Clinical Guidelines of the Developmental Disorders
Bung-Nyun Kim and Joung-Sook Ahn
J Korean Acad Child Adolesc Psychiatry 2024;35(1):4-7
Korean Clinical Guideline for Autism Spectrum Disorder - Clinical Features, Course, Epidemiology, and Cause
Jun-Won Hwang and Jeong-Seop Lee
J Korean Acad Child Adolesc Psychiatry 2024;35(1):8-14
Diagnosis and Assessment of Autism Spectrum Disorder in South Korea
Johanna Inhyang Kim and Hee Jeong Yoo
J Korean Acad Child Adolesc Psychiatry 2024;35(1):15-21
Basic Management Strategies by Life Cycle for Treatment of the Persons With Autism Spectrum Disorder
Jung-Woo Son and Seok-Hyun Nam
J Korean Acad Child Adolesc Psychiatry 2024;35(1):22-28
Behavioral Interventions for Autism Spectrum Disorder: A Brief Review and Guidelines With a Specific Focus on Applied Behavior Analysis
Kyong-Mee Chung, Eunsun Chung, and Hoomyung Lee
J Korean Acad Child Adolesc Psychiatry 2024;35(1):29-38
Common Comorbid Condition of Patients With Autism Spectrum Disorder and Pharmacotherapy for Patients With Autism Spectrum Disorder
Un Sun Chung and Ji-Hoon Kim
J Korean Acad Child Adolesc Psychiatry 2024;35(1):39-43
Multifaceted Approach to Addressing Problem Behaviors in Developmentally Challenged Children
Yearin Kim, Bung-Nyun Kim, and Yeni Kim
J Korean Acad Child Adolesc Psychiatry 2024;35(1):44-50
Special Articles: Eating Disorders
Autism Spectrum Disorder and Eating Problems: The Imbalance of Gut Microbiota and the Gut-Brain Axis Hypothesis
Jiyoung Kim
J Korean Acad Child Adolesc Psychiatry 2024;35(1):51-56
Assessment Methods for Problematic Eating Behaviors in Children and Adolescents With Autism Spectrum Disorder
Miji Lee, Seolha Lee, Jong-Woo Sohn, Ki Woo Kim, and Hyung Jin Choi
J Korean Acad Child Adolesc Psychiatry 2024;35(1):57-65
Case Reports of Binge Eating Patterns in the Recovery Phase of Anorexia Nervosa Patients With and Without Food Addiction
Younjoo Song, Min-Jung Park, and Hyung Jin Choi
J Korean Acad Child Adolesc Psychiatry 2024;35(1):66-74
Original Articles
The Relationship Between Bullying and Risk of Suicide Among Adolescents During the COVID-19 Pandemic in Indonesia
Iyus Yosep, Heni Purnama, Linlin Lindayani, Yen-Chin Chen, Diwa Agus Sudrajat, and Muhammad Rizka Firdaus
J Korean Acad Child Adolesc Psychiatry 2024;35(1):75-81
Effectiveness and Tolerability of Combination Pharmacotherapy With Stimulant and Non-Stimulant in Children With Attention Deficit Hyperactivity Disorder
Hyung Nam Park, Na Yeong Kong, Hee-Cheol Kim, Yang Tae Kim, Sung-Won Jung, and Hojun Lee
J Korean Acad Child Adolesc Psychiatry 2024;35(1):82-89
Standardized Treatment and Shortened Depression Course can Reduce Cognitive Impairment in Adolescents With Depression
Penghui Cao, Junjie Tan, Xuezhen Liao, Jinwei Wang, Lihuan Chen, Ziyan Fang, and Nannan Pan
J Korean Acad Child Adolesc Psychiatry 2024;35(1):90-97
Media Review
The Last Rise and Fall Shown to us by the Man Who Chose “Swollen Foot”: The Film The Whale
Jung-Woo Son
J Korean Acad Child Adolesc Psychiatry 2024;35(1):98-100
Journal of the Korean Academy of Child and Adolescent Psychiatry (J Korean Acad Child Adolesc Psychiatry) covers the whole range of child and adolescent psychiatry and neuroscience. It also seeks to promote the well-being of children and families by publishing scholarly ...
 
Dissociative Identity Disorder in an Adolescent With Nine Alternate Personality Traits: A Case Study
Sang-Hun Lee, Na Ri Kang, and Duk-Soo Moon
Received March 10, 2022; Accepted May 24, 2022.
Stimulant Induced Movement Disorders in Attention Deficit Hyperactivity Disorder
Seok-Hyun Nam, Myung Ho Lim, and Tae Won Park
Received December 22, 2021; Accepted January 19, 2022.
Clinical Characteristics of Adolescents Hospitalized Through Emergency Room for Intentional Self-Harm or Suicide Attempts
Tae Yeon Yoon, Hyun Sook Lee, Jung-Woo Son, Sang Mi Kim, and Je Jung Lee
Received March 2, 2022; Accepted May 10, 2022.