Taeyeop Lee

Objective To investigate the effects of methylphenidate and atomoxetine treatment on motor coordination in children with attention-deficit/hyperactivity disorder (ADHD).Methods In this single-site, open-label, naturalistic follow-up study, 157 children (7.6±1.4 years; 139 males) with ADHD were recruited between March 2015 and May 2020 from the Department of Psychiatry, Asan Medical Center, and treated for 12 weeks with methylphenidate (n=48) or atomoxetine (n=109). Children completed the Advanced Test of Attention (ATA), and caregivers completed the ADHD Rating Scale (ARS) questionnaire and Developmental Coordination Disorder Questionnaire (DCDQ) at baseline and at 12 weeks. Paired t-tests, a mixed-effects model, and linear regression were used to compare treatment groups and assess factors influencing motor coordination changes.Results Methylphenidate and atomoxetine resulted in significant improvement in DCDQ fine motor/handwriting, general coordination, and total scores over 12 weeks. Fine motor/handwriting had a significant main effect for time (F1=16.64, p<0.001, η2=0.097); however, the interaction effect between group and time was not significant (F1=0.24, p=0.625, η2=0.002). Changes in parent-reported ARS inattention scores (β=-0.174, p=0.029) and auditory commission errors of ATA (β=0.191, p=0.022) were significantly associated with changes in fine motor/handwriting. Additionally, changes in parent-reported ARS inattention scores (β=-0.177, p=0.034) and rater-reported ARS inattention scores (β=-0.198, p=0.017) were significant predictors of improvements in general coordination in separate models.Conclusion Methylphenidate and atomoxetine had a positive effect on motor coordination in children with ADHD. Improvement in motor coordination was associated with ADHD symptom improvement.

Taeyeop Lee and Hyo-Won Kim. J Korean Acad Child Adolesc Psychiatry 2025;36:11-7. https://doi.org/10.5765/jkacap.240040

Background and Objective This study aimed to investigate the reliability and validity of the Bedtime Procrastination Scale (BPS) among Korean high school students during the COVID-19 pandemic.Methods We conducted an online survey among a total of 300 high school students from October 18–24, 2021. We performed confirmatory factor analysis (CFA) on the two-factor model of the BPS. Psychometric properties were explored using the Graded Response Model and Rasch model. The reliability of internal consistency was assessed using Cronbach’s alpha. Convergent validity was examined regarding depression using the Patient Health Questionnaire-9 items and viral anxiety using the Stress and Anxiety to Viral Epidemics-6 items.Results The CFA results indicated a strong model fit for the BPS (χ2/df=0.597, CFI=1.000, TLI=1.012, RMSEA=0.000, and SRMR=0.040). Additionally, the BPS demonstrated strong reliability (Cronbach’s alpha=0.824). Bedtime procrastination was significantly correlated with depression (r=0.31, p<0.001) but not with viral anxiety.Conclusions The BPS is reliable and valid in assessing high school students, and bedtime procrastination is significantly associated with depression.

Objective This study compared adaptive functioning measured by the Korean version of Vineland Adaptive Behavior Scales, Second Edition (K-VABS-II), in preschool children with developmental disabilities (DD) and those with typical development (TD). We also examined the correlation of K-VABS-II adaptive profiles with developmental and behavioral assessments.Methods Two hundred preschool children (73 females and 127 males, mean age 54.7±9.1 months) were recruited from special educational centers, community-based daycare centers, and kindergartens. Eighty-one with DD comprising 61 with autism spectrum disorder, 63 with intellectual disability, 12 with language disorder, and 119 with TD were included. Their developmental profiles were measured by the Psychoeducational Profile-Revised (PEP-R), Preschool Receptive-Expressive Language Scale (PRES), K-VABS-II, Social Responsiveness Scale (SRS), and the Korean version of the Childhood Autism Rating Scale (K-CARS). The parent completed the Child Behavior Checklist (CBCL), and Aberrant Behavior Checklist (ABC).Results The K-VABS-II Adaptive Behavior Composite and all domain scores of K-VABS-II differed significantly between children with DD and TD (all p<0.001). In most domains, K-VABS-II had moderate-to-strong correlations with PEP-R, PRES, K-CARS, and SRS. The Maladaptive Behavior Index domain of K-VABS-II had moderate correlations with behavioral assessments, including CBCL and ABC.Conclusion These findings suggest that K-VABS-II is useful in evaluating developmental levels and adaptive and maladaptive behaviors of preschool children with DD. K-VABS-II also had significant correlations with cognitive, language, social, and behavioral assessments.

Objective Early detection and intervention of developmental disabilities (DDs) are critical to improving the long-term outcomes of afflicted children. In this study, our objective was to utilize facial landmark features from mobile application to distinguish between children with DDs and typically developing (TD) children.Methods The present study recruited 89 children, including 33 diagnosed with DD, and 56 TD children. The aim was to examine the effectiveness of a deep learning classification model using facial video collected from children through mobile-based application. The study participants underwent comprehensive developmental assessments, which included the child completion of the Korean Psychoeducational Profile-Revised and caregiver completing the Korean versions of Vineland Adaptive Behavior Scale, Korean version of the Childhood Autism Rating Scale, Social Responsiveness Scale, and Child Behavior Checklist. We extracted facial landmarks from recorded videos using mobile application and performed DDs classification using long short-term memory with stratified 5-fold cross-validation.Results The classification model shows an average accuracy of 0.88 (range: 0.78–1.00), an average precision of 0.91 (range: 0.75–1.00), and an average F1-score of 0.80 (range: 0.60–1.00). Upon interpreting prediction results using SHapley Additive exPlanations (SHAP), we verified that the most crucial variable was the nodding head angle variable, with a median SHAP score of 2.6. All the top 10 contributing variables exhibited significant differences in distribution between children with DD and TD (p<0.05).Conclusion The results of this study provide evidence that facial landmarks, utilizing readily available mobile-based video data, can be used to detect DD at an early stage.

Objective This study compared parenting stress in preschool children with developmental disabilities (DD) or typical development (TD). We also investigated children’s factors that affect parenting stress.Methods A total of 196 preschool children participated in the study (aged 54.8±9.2 months). There were 79 children with DD (59 with autism spectrum disorder, 61 with intellectual disability, 12 with language disorder) and 117 with TD. The high parenting stress and the low parenting stress groups were divided based on the Total Stress of Korean Parenting Stress Index Fourth Edition (K-PSI-4) with an 85-percentile cutoff score. Pearson’s correlation analysis was conducted to calculate the correlation between K-PSI-4 and the children’s or parents’ measures.Results The difference in parenting stress between DD and TD was significant in the Total Stress of K-PSI-4 (p<0.001). The Total Stress scale of K-PSI-4 represented a modest to strong correlation with cognitive development, adaptive functioning, social communication, and behavioral problems in children with DD. Our results showed that caregivers of children with DD reported higher parenting stress than those with TD. Parenting stress was strongly associated with cognitive development, adaptive functioning, social communication, and behavioral problems in children with DD. Among the children’s factors, especially social communication, attention problems, and aggressive behavior had association with caregivers’ higher parenting stress.Conclusion These findings suggest the need for early intervention for parenting stress in caregivers by assessing child characteristics, including social cognition, awareness, communication, and inattention and hyperactivity, in the evaluation of children with DD.

Objective The aim of the present study was to investigate the influence of comorbid oppositional defiant disorder (ODD) on clinical features and neuropsychological profiles of children with attention-deficit/hyperactivity disorder (ADHD).Methods We divided the participants into three groups: the ADHD with ODD (ADHD/ODD) (n=36), ADHD without ODD (ADHD/noODD) (n=307), and control groups (n=128). Parents of the participants completed the ADHD Rating Scale, Social Responsiveness Scale (SRS), Korean Personality Rating Scale for Children (K-PRC), and 10-item mania scale from the Parent General Behavior Inventory (P-GBI-10M). Neuropsychological profiles were assessed using the Advanced Test of Attention (ATA), Children’s Color Trails Test, and Stroop Color and Word Test.Results The ADHD/ODD group had more ADHD symptoms and functional impairments in relationships with teachers and peers, and self-esteem than the ADHD/noODD group. The ADHD/ODD group scored higher in Social Communication (p<0.001) and Autistic Mannerisms (p<0.001) subscales of SRS, P-GBI-10M (p<0.001), and Delinquency (p<0.001) and Psychosis (p<0.001) subscales of K-PRC than the ADHD/noODD group. Commission Errors (p<0.001) and Response-Time Variability (p<0.001) in Visual ATA and Commission Errors (p<0.001) in Auditory ATA were significantly higher in the ADHD/ODD group than in the ADHD/noODD group.Conclusion The present study suggests that patients with ADHD with ODD experience more ADHD symptoms and neuropsychological deficits than those with ADHD without ODD. These results also imply that comorbid ODD is associated with greater social impairment and emotional dysregulation.

Sumi Ryu, Taeyeop Lee, Yunshin Lim, Haejin Kim, Go-eun Yu, Seonok Kim, and Hyo-Won Kim. J Korean Acad Child Adolesc Psychiatry 2023;34:258-67. https://doi.org/10.5765/jkacap.230045

Objective Mobile-based cognitive training programs can be a viable alternative to in-person interventions, but their efficacies have not been established yet. In this study, we examined the efficacy of DoBrain, a mobile-based cognitive training program designed for children with developmental disabilities (DDs), in comparison with general educational apps named Junior Naver and Kakao Kids.Methods Children aged 34 to 77 months were recruited and randomized at a 1:1 ratio to use DoBrain or general educational apps. Each group used the assigned app on a daily basis at home for 30 minutes for 24 weeks. Parents were instructed to help the children with the app usage. A total of 166 children completed the post-test visit (DoBrain group, n=85, 55.4±8.7 months old; general educational app group, n=81, 53.7±9.9 months old). The primary outcome was cognitive development measured by Psychoeducational Profile-Revised (PEP-R), administered at baseline and at post-test.Results DoBrain had no superior effect over general educational apps on the PEP-R Developmental Quotient. When the changes before and after app usage were compared, the DoBrain group and the general educational app group both showed declines in imitation (adjusted p=0.049 and 0.022), perception (adjusted p=0.004 and <0.001), and gross motor (adjusted p=0.003 and 0.002) domains of the PEP-R. Among the DoBrain group, children with DD showed a significantly greater gain in the eye-hand coordination domain of PEP-R compared with those without DD (adjusted p=0.047).Conclusion DoBrain did not show a superior effect over general educational apps on overall cognitive development in preschool children, regardless of the presence of DD. Careful monitoring of the negative effect of mobile-based cognitive training programs is necessary.