Hallym University Sacred Heart Hospital

The JoongAng Ilbo held an interview with Dr. Gerald Fischbach at Lotte Hotel on August 12, 2008. Dr. Fischbach is a scientific director at the Simons Foundation and dean emeritus of the faculty of medicine at Columbia University. He was interviewed by the JoongAng Ilbo on Autism, Attention Deficit Hyperactivity Disorder (ADHD) and other neurological diseases. The Interview was also attended by Dr. Yong-Sun Kim, dean of the college of medicine at Hallym University, Dr. Sang-Kyu Lee and Dr. Narei Hong from department of psychiatry, Hallym University Medical Center (HUMC). Dr. Fischbach received an honorary doctoral degree in philosophy from Hallym University in Chuncheon on August 11.

Dr. Kim: Despite an increasing number of patients with autism and ADHD which constitute social issues today, people in general do not have enough information on and recognition of them. Some Korean parents seem to have a wrong conception of such diseases. For example, they hesitate to get treatment as they tend to have greater fears of being branded as families with psychiatric patients and believe that the diseases might cause problems with family discipline and the attitude of nurturing their children.

Dr. Fischbach: Autism is also one of grave social problems in the United States. Luckily, a genetic research related to autism has made active progress for the last ten years. Three or four candidate risky genes have been identified so that they could provide clues, mechanisms and possible treatments. And I believe there are as many as 50 different genes that predispose to autism.

Dr. Lee: Some people often misunderstand that the excessive use of the internet in childhood may be a cause of autism. The reason is that children with autism are likely to stick to computer games or internet surfing. In other words, they show similar signs with autism such as impaired performance due to continuous addiction to computer games or internet surfing.

Dr. Fischbach: Many parents, especially mothers, feel guilty because of all disproven hypotheses that parents treat their children cold, in one psychiatric phrase, 'refrigerator mothers.' There still remain misconceptions although there is a clear proof which has no relationship between affection for the child and autism.

Dr. Kim: Many Koreans worry that aluminum or mercury contained in immune vaccination of measles, mumps and rubella could induce autism.

Dr. Fischbach: It is not true. Autism has increased in the early 1980s. Furthermore, it is still increasing even if mercury was eliminated from vaccination eight years ago. The worst thing is that people refuse to get their children vaccination, being afraid of wrong hypotheses. Actually, a number of cases and deaths from measles have increased dramatically in the United States and the Great Britain.

Dr. Hong: Children with autism require detection and medical treatments as early as possible. Diverse treatments need to be applied as pervasive developmental disorders occur over a long period of life. It is really dangerous to employ treatments found on the internet which have not yet been generally accepted.

Dr. Fischbach: An applied behavioral therapy is more effective for young children. Therapists direct their attention or focus their interests face-to-face. Children are able to decrease in aggressive and uncontrolled behaviors and learn measurement of self-control. Some medication could also help decrease in violent behaviors.

Dr. Lee: Treatment for the autistic children is mainly dependedent on the roles of their parents. In Korea, there are various community educational programs for autism in the Seoul metropolitan area. However, a proper treatment is not available in local areas due to poor medical services.

Dr. Kim: Patients with ADHD become more serious than those with autism in Korea. It is true that genetic factors affect ADHD, but some researchers reported that environmental factors in big cities lead to an increasing number of ADHD patients. Luckily, medications help alleviate symptoms of ADHD. However, as for treating patients with ADHD, the use of medications accounts for fifty percent in America while their use comes to ten percent in Korea.

Dr. Fischbach: Like autism, earlier diagnosis and medical treatments are also important to handle patients with ADHD. We could expect better results when they take stimulants to come down the hyperactivity.

Dr. Hong: Many Korean parents are worried about any side effect of psychiatric drugs on developments of child's brain.

Dr. Fischbach: Brian continuously develops very rapidly in adolescence. So people must take a serious consideration on medications that could affect brain function. Drugs for ADHD are effective and safe only if people in general do not abuse them. It is more desirable that proper discipline methods could be applied to children rather than thoughtlessly taking medicines.

Dr. Lee: The bigger problem here in Korea is that proper medical treatments are not provided at a right time. We need to alert the general public to the misuse of drugs for ADHD as helping students do better in their studies.

Dr. Fischbach: As for as my knowledge goes, an intensive behavioral therapy would be the one of alternatives to help treat patients with ADHD. It would be much better to take both behavioral and medical therapies.

By Seung-Kyu Oh, Int'l Operations Team, HUMC