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"Latar belakang Kemampuan meminta (mand) dan menyebut (tact) adalah kemampuan yang perlu ditingkatkan pada awal terapi verbal behavior pada anak autisme. Metode telehealth oleh orangtua dapat memberikan terapi dini. Tujuan penelitian untuk melihat efektivitas pelatihan yang dilakukan orangtua terhadap peningkatan kemampuan komunikasi awal anak GSA dalam meminta (mand) dan menyebut (tact). MetodeUji klinis acak terkontrol terhadap anak autisme berusia 2-5 tahun. Penilaian kemampuan anak menggunakan instrumen verbal behavior milestones assessment and placement program. Orangtua kelompok perlakuan mendapat modul video pelatihan dan bimbingan dari terapis, sebelum memulai terapi selama 3 bulan pada anak. Penilaian kemampuan ulang dilakukan pada kedua kelompok di akhir periode.HasilTerdapat 40 subyek yang masuk ke dalam level 1 VBMAPP. Skor VB MAPP sesudah pemberian intervensi meningkat dari 13,83 menjadi 24,43. Peningkatan median skor mand 1 menjadi 2 dan median skor tact 1 menjadi 3 (p<0,001). Perbandingan peningkatan median skor mand antara kedua kelompok menunjukkan hasil bermakna (p=0,003). Kenaikan proporsi skor mand dan tact tampak lebih tinggi pada kelompok perlakuan.SimpulanPelatihan mand dan tact oleh orangtua pada anak autisme dengan menggunakan metode telehealth efektif dalam meningkatkan kemampuan anak meminta, dan bermakna secara klinis dalam meningkatkan kemampuan anak menyebut. Metode telehealth dapat diterima oleh orangtua.

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Background

Mand and tact is a skill in verbal behavior therapy that needs to be improved initially. The telehealth method are helpful for those in rural area. This study aim was to assess effectiveness of telehealth mand and tact training by parents on increasing the child’s mand and tact skill.

Methods

A randomized controlled clinical trial of 2-5 years old children with ASD. Assessment of children's milestones using verbal behavior milestones assessment and placement program. Parents in the intervention group received video modelling and guidance from a therapist before giving therapy for 3 months. Re-assessment was done in both groups at the end of the period.

Results

A total of 40 subjects with ASD in level 1 VBMAPP meet criteria. A significant increase in the VB MAPP score after the intervention, namely 13.83 to 24.43. Mand median score increased from 1 to 2, and the tact, 1 to 3 with p<0.001. Comparison of the increase in the median mand score between the two groups showed significant results (p = 0.003). The increase in the proportion of mand and tact scores was higher in intervention group.

Conclusion

Telehealth mand and tact training by parents for children with ASD effective in improving mand, and clinically meaningful in improving tact. The telehealth method can be accepted by parents."

"This book examines current and emerging techniques for the dynamic and evolving field of autism assessment. It provides a detailed, research-based discussion of the latest innovations in assessment from a practical perspective accumulated from decades of autism assessment and treatment training and experience in both educational and clinical settings. The book provides personal insights into the engaging and intriguing autism population and case studies of children who have captured the hearts and minds of clinicians nationwide. As the rates of autism have grown more than 10-fold during the past decade, researchers have questioned whether unclear diagnostic guidelines may be to blame for the high numbers of recently diagnosed children. Rather, the authors argue, tighter agreed upon methods for diagnosis of autism have allowed for more accurate identification of children who indeed require supportive treatments and therapies. This unique volume provides readers with clarity about best-practice assessment approaches from sequential and pragmatic perspectives as well as an understanding of critical issues and hurdles in ascertaining the appropriate diagnosis. In addition, myriad potential comorbid conditions or differential diagnoses are addressed. This book is a must-have resource for clinicians and practitioners as well as researchers and graduate students in the fields of child and school psychology, behavioral therapy, social work, psychiatry, pediatrics, forensic psychology, and educational and healthcare policy"--Publisher's description."

"ABSTRAKPentingnya peran pengasuhan dalam mengoptimalkan executive function (EF) anak membuat para peneliti bidang perkembangan kognitif berupaya menggali lebih jauh keterkaitan kedua variabel tersebut. Penggunaan bahasa orangtua (management language/ML) dalam mengontrol perilaku anak, baik pada anak typical maupun Autistic Spectrum Disorder (ASD) serta hubungannya dengan peforma EF menjadi topik riset pengasuhan yang cukup marak dilakukan saat ini untuk mendapatkan hasil yang konklusif. Sayangnya, riset yang dilakukan lebih berfokus pada peran pengasuhan ibu dibandingkan ayah. Padahal pengasuhan ayah mempunyai pola dan dampak yang berbeda pada anak sehingga keberadaannya tidak boleh diabaikan. Penelitian ini bertujuan mengukur kontribusi ML ayah dan kondisi perkembangan anak (typical dan ASD) terhadap performa EF anak dan mengamati bagaimana kondisi perkembangan anak memprediksi ML ayah. 22 anak typical dan 9 anak ASD bersama ayah mereka terlibat dalam penelitian ini. ML ayah diobservasi secara terstruktur melalui interaksinya dengan anak, sedangkan EF anak diukur melalui serangkaian tes EF. Hasil menunjukkan bahwa ML dengan tipe direction berkontribusi negatif terhadap perkembangan EF anak, bahkan setelah mengontrol variabel usia anak, inteligensi anak, status sosial ekonomi dan pendidikan ayah, sedangkan kondisi perkembangan tidak berkontribusi terhadap ML ayah. Riset ini menekankan perlunya meminimalisir penggunaan ML tipe direction dalam mengontrol perilaku anak, terlepas dari apapun kondisi perkembangannya.

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ABSTRACTThe importance of the parentings role in optimizing the executive function (EF) of children makes researchers in cognitive development field conduct further study involving those two variables. The use of language (language management / ML) to control childrens behavior, both in typical and Autistic Spectrum Disorder (ASD) children and its relation to EF performance became the topic of parenting research, which frequently done nowadays to get conclusive results. However, prior studies emphasized more on the role of mothers, while fathers role actually have different patterns and influences on children that should not be ignored. This study aims to examine the contribution of paternal ML and the childs development condition (typical and ASD) on the childs EF performance and how childrens development predicts fathers ML. 22 typical children and 9 ASD children and their father were involved in this study. Fathers ML were observed in a structured manner through their interactions with children, while childrens EF is examined through the EF test. The results showed that the directive type of ML contributed negatively to EFs childrens development, even after controlling for the childs age, childrens intelligence, socio-economic status and fathers education, while childs development condition did not contribute to fathers ML. This study emphasizes the need to minimize the use of the direction type of ML in controlling children, regardless of the childs development condition."

"Latar belakang: Autisme adalah salah satu gangguan nerodevelopmental yang muncul pada abad ke-20. Berbagai studi epidemiologi menunjukkan peningkatan tajam prevalensi gangguan spektrum autisme (GSA). Berdasarkan Diagnostic and Statistical Manual 5 gangguan sensorik merupakan salah satu kriteria utama GSA. Sampai saat ini belum ada pedoman tatalaksana nonmedikamentosa GSA. Sebagian besar penelitian menekankan bahwa terapi perilaku adalah terapi terbaik untuk GSA sedangkan terapi okupasi sensorik integrasi (TO-SI) hanya memiliki bukti rendah hingga sedang. Pusponegoro dan beberapa ahli saraf anak di Indonesia berdasarkan pengalaman klinis mengamati bahwa TO-SI dapat mengurangi perilaku negatif anak GSA terutama pada usia di bawah 5 tahun. Penelitian ini bertujuan untuk mengevaluasi pengaruh TO-SI dalam mengurangi perilaku negatif anak usia 2 sampai 5 tahun dengan GSA. Metode: Sebuah penelitian pra-eksperimen pertama dilakukan di klinik Check My Child (CMC) dan Klinik Anakku Kelapa Gading pada bulan Desember 2017 hingga April 2018. Populasi penelitian adalah anak baru dengan GSA usia 2 hingga 5 tahun. Subyek dikumpulkan secara konsekutif sampling. Profil perilaku dinilai berdasarkan Aberrant Behavior Checklist (ABC)-2 sebelum dan sesudah TO-SI dua kali seminggu selama 12 minggu (24 kali), 50 menit untuk setiap sesi. Analisis nilai normal dengan uji t dan uji Wilcoxon untuk nilai terdistribusi tidak merata. Hasil: Penelitian dilakukan pada 42 subjek usia 2 hingga 5 tahun dengan GSA, 50% usia 3 tahun, rasio anak lelaki dibandingkan perempuan 5 banding 1. Rerata profil perilaku negatif tertinggi adalah hiperaktifitas 23,61 (SD 8,91), diikuti oleh penarikan sosial 16,81 (SD 8,16), dan iritabilitas 11,43 (SD 6,99). Median perilaku stereotipik adalah 5,25 dan bicara tidak tepat 2,00. Setelah TO-SI, semua perilaku negatif menurun secara signifikan p <0,001. Perilaku hiperaktifitas menurun menjadi 12,71 (SD 8,36) sekitar 53,8%, penarikan sosial menjadi 7,94 (SD 6,18) 47,2%, iritabilitas hingga 6,62 (SD 4,99) 57,9 %, dan median stereotipik 19,0% dan bicara tidak tepat 50%. Kami mendapatkan spektrum profil perilaku anak dengan GSA yang cukup luas. Kesimpulan: Kami menemukan bahwa TO-SI dua kali seminggu selama 12 minggu dapat menurunkan perilaku negatif anak GSA usia dini terutama usia 2 hingga 5 tahun.

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Background: Autism is one of emerging neurodevelopmental disorder on 20th century. Studies showed a remarkable increasing prevalence of autism spectrum disorder (ASD). Since 2013, Diagnostic and Statistical Manual 5 included sensory disorder as one of main criteria of ASD. Treatment guideline remain unclear. Most studies stressed that behavior therapy was the best treatment for ASD and sensory integration occupational therapy (SI-OT) only has low to moderate evidence. Pusponegoro and pediatric neurologists in Indonesia based on their clinical experience observed that SI-OT might be useful as ASD treatment for young children especially under 5 years old. Based on that situation, the objective of this study was to evaluate the influence of SI-OT in decreasing negative behavior of children ages 2 to 5 years with ASD. Methods: A first pre-post one group pre-experimental study conducted in Check My Child clinic (CMC) and Klinik Anakku Kelapa Gading on December 2017 to April 2018. The study population were new ASD children ages 2 to 5 years. Subject were collected with consecutive sampling. Behavior profile were assessed with Aberrant Behavior Checklist (ABC)-2 before and after SI-OT twice a week for 12 weeks (24 times), 50 minutes for each session. Analysis of normal value with t test and Wilcoxon test for unequally distributed value. Results: A total of 42 ASD subject ages within 2 to 5 years old were studied, 50% were 3 years, and boys to girl ratio were 5 to 1. The highest mean negative behavior profile was hyperactivity 23,61 (SD 8,91) followed by social withdrawal 16,81 (SD 8,16), and irritability 11,43 (SD 6,99). Stereotypic median was 5,25 and inappropriate speech 2,00. After SI-OT, all negative behavior decreased significantly p<0.001. Hyperactivity behavior decreased to 12,71 (SD 8,36) about 53,8%, social withdrawal to 7,94 (SD 6,18) 47,2%, irritability to 6,62 (SD 4,99) 57,9%, and median of stereotypic 19,0% and inappropriate speech 50%. We found a broad-spectrum behavior profile of ASD children. Conclusions: We found that SI-OT twice a week for 12 weeks could decrease negative behavior of young ASD children especially ages 2 to 5 years."

"Penggunaan media elektronik yang berlebihan merupakan perilaku yang sering tampak pada anak dengan autism spectrum disorder (ASD). Perilaku ini penting untuk diintervensi karena penggunaan media elektronik yang berlebihan berkorelasi dengan berbagai efek negatif, seperti masalah kesehatan, tampilnya karakteristik adiksi, serta penurunan keterlibatan anak dalam aktivitas akademik dan sosial. Meskipun banyak penelitian telah dilakukan untuk menginvestigasi efektivitas penerapan prinsip modifikasi perilaku terhadap penggunaan media elektronik pada anak dengan perkembangan normal, namun masih sedikit peneiltian yang berfokus pada anak dengan ASD. Pada penelitian ini, beberapa teknik modifikasi perilaku, yaitu positive reinforcement, extinction, serta penggunaan prompt dan token economy, digunakan untuk menurunkan durasi penggunaan komputer tablet pada anak dengan ASD. Hasil penelitian menunjukkan bahwa penerapan prinsip modifikasi perilaku berhasil menurunkan durasi penggunaan media elektronik pada anak dengan ASD.

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The excessive use of electronic media is prevalent among children with autism spectrum disorder. There are several negative effects due to excessive electronic media use, such as health problems, addiction, and lack of or limited participation in academic and social activities. If left untreated, this can become a serious problem. Several studies have indicated that behavior modification intervention is effective in reducing the use of electronic media in typically developing children. However, there is not much research done on the use of behavior modification to reduce the use of electronic media among children with autism. Thus, this research is interested in evaluating the effectiveness of behavior modification intervention in reducing electronic media use in children with ASD. The result shows that behavior modification principles are effective in reducing electronic media use in a child with ASD."

"Latar Belakang. Anak dengan Spektrum Gangguan Autisme (SGA) seringkali mengalami gangguan gerak halus, yang dapat menimbulkan hambatan dalam melakukan aktivitas sehari-hari serta mengganggu performa sekolah. Hingga saat ini belum ada data mengenai prevalens maupun gambaran gangguan gerak halus pada anak SGA di Indonesia, termasuk dampaknya terhadap performa sekolah.Tujuan. Mengetahui prevalens gangguan gerak halus anak SGA, mengetahui gambaran gangguan gerak halus anak SGA, mengetahui dampak gangguan gerak halus terhadap performa sekolah anak SGA.Metode. Penelitian analitik potong lintang dilakukan sejak bulan Januari sampai Mei 2014. Subjek anak SGA didapatkan dari Klinik Anakku CMC Kayu Putih. Subjek pada kelompok kontrol dari sebuah sekolah swasta yang telah dilakukan matching usia dan jenis kelamin dengan kelompok SGA. Terhadap subjek penelitian dilakukan pemeriksaan keterampilan gerak halus dengan BOT-2 dan penilaian performa fungsional sekolah melalui pengisian kuesioner SFA oleh guru atau terapis.Hasil. Subjek penelitian pada kelompok SGA dan kelompok kontrol masing- masing berjumlah 43 anak. Prevalens gangguan gerak halus pada kelompok SGA sebesar 91%. Jumlah subjek pada kelompok SGA yang mengalami gangguan gerak halus pada komposit fine manual control dan manual coordination, serta subtes fine motor precision, fine motor integration, manual dexterity, dan upper- limb coordination lebih besar dibanding kelompok kontrol, dengan median skor kelompok SGA yang lebih rendah pada semua komposit/subtes dibandingkan dengan kelompok kontrol. Terdapat hubungan bermakna antara gangguan gerak halus kelompok SGA dengan performa fungsional sekolah.Simpulan. Prevalens gangguan gerak halus anak SGA pada penelitian ini adalah 91%. Gangguan gerak halus yang dialami anak SGA berdasarkan pemeriksaan dengan BOT-2 mencakup komposit fine manual control dan manual coordination, serta subtes fine motor precision, fine motor integration, manual dexterity, dan upper-limb coordination. Pada anak SGA, gangguan gerak halus berhubungan dengan gangguan pada performa fungsional sekolah.

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Background. Children with Autism Spectrum Disorders (ASD) often have fine motor impairment, which may present barriers in performing their daily activities and interfere with their school performance. Until now there has been no data on the prevalence and description of fine motor impairment in children with ASD in Indonesia, including its impact on the children’s school performance.

Objective. To determine the prevalence of fine motor impairments in children with ASD, to provide the description of fine motor impairments in children with ASD, and to determine the impact of fine motor impairments on the school performance of children with ASD.

Method. A cross-sectional analytic study conducted from January to May 2014. Subjects were children with ASD from Klinik Anakku CMC Kayu Putih. Subjects in the control group were students from a private school matched by age and sex with the ASD group. Fine motor examination was performed using BOT-2 and assessment of school functional performance was conducted through SFA questionnaires filled by teachers or therapists.

Result. There were 43 subjects each on ASD and control groups. Prevalence of fine motor impairments in children with ASD in this study was 91%. The number of subjects in the ASD group having fine motor impairement on the fine manual control and manual coordination composites, as well as fine precision motors, motors fine integration, manual dexterity, and upper-limb coordination subtests are greater than the control group, with median score of all the composites/subtests lower on ASD group compared to that in the control group. There was a significant correlation between fine motor impairments in ASD children with their school function performance.

Result. Prevalence of fine motor impairments in children with ASD in this study was 91%. Fine motor impairments experienced by children with ASD based on examination using BOT-2 covers fine manual control and manual coordination composites, as well as fine precision motors, motors fine integration, manual dexterity, and upper-limb coordination subtests. In children with ASD, fine motor impairment was associated with disturbances in the school function performance."

"Latar Belakang: Perilaku abberant sering terdapat pada pasien GSA. Salah satu kuesioner yang bisa digunakan untuk menilai perilaku abberant adalah kuesioner ABC-C 2017. Kuesioner ABC-C 2017 mengukur 5 domain perilaku abberant (iritabilitas, penarikan diri secara sosial, perilaku stereotipik, hiperaktivitas/ ketidakpatuhan dan pola bicara yang tidak tepat) pada anak dan remaja dengan diagnosis GSA, saat ini belum ada versi Bahasa Indonesia.Metode: Penelitian ini menggunakan desain potong lintang untuk menilai kesahihan dan keandalan kuesioner ABC-C 2017 versi Bahasa Indonesia. Kesahihan isi dihitung menggunakan Content Validity Index for Items (I-CVI) dan Content Validity Index for Scales (S-CVI). Uji keandalan konsistensi internal dihitung menggunakan Cronbach alpha. Penelitian ini juga menilai proporsi perilaku abberant berdasarkan 5 domain kuesioner ABC-C 2017 versi Bahasa Indonesia, pada anak dan remaja dengan GSA di Poliklinik Jiwa Anak dan Remaja RSCM.Hasil: Hasil analisis menunjukkan nilai I-CVI dan S-CVI kuesioner ABC-C 2017 versi Bahasa Indonesia sebesar 0,917, sehingga kesahihan isi kuesioner ini dinilai baik. Hasil keandalan konsistensi internal baik sampai excellent dengan nilai Cronbach’s alpha untuk masing-masing domain iritabilitas 0,938; penarikan diri secara sosial 0,936; perilaku stereotipik 0,930; hiperaktivitas, ketidakpatuhan 0,949 dan domain pola bicara yang tidak tepat 0,869. Proporsi perilaku abberant berdasarkan penilaian 5 domain kuesioner ABC-C 2017 versi Bahasa Indonesia, pada anak dan remaja dengan GSA di Poliklinik Jiwa Anak dan Remaja RSCM, didapatkan hasil, domain iritabilitas derajat ringan sebesar 70,6%; penarikan diri secara sosial derajat ringan 72,5%; perilaku stereotipik 100% derajat ringan; hiperaktivitas/ketidakpatuhan derajat sedang 47,1%, dan pola bicara yang tidak tepat 100% derajat ringan. Proporsi perilaku abberant berdasarkan usia dan jenis kelamin juga didominasi derajat ringan, kecuali domain hiperaktivitas/ketidakpatuhan derajat sedang. Tidak didapatkan perbedaan yang bermakna secara statistik, proporsi perilaku abberant berdasarkan usia dan jenis kelamin anak.Kesimpulan: Kuesioner ABC-C 2017 versi Bahasa Indonesia dapat dipakai di Indonesia untuk penelitian selanjutnya, mendeteksi 5 domain perilaku abberant pada pasien GSA dan sebagai modul pendidikan bagi tenaga kesehatan.

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Background: Abberant behavior is often found in ASD patients. One of the questionnaires that can be used to assess abusive behavior is the 2017 ABC-C questionnaire. The 2017 ABC-C questionnaire measures 5 domains of abberant behavior (irritability, social withdrawal, stereotypic behavior, hyperactivity/non-compliance and inappropriate speech patterns) in children. and adolescents with a diagnosis of ASD, currently there is no Indonesian version.

Methods: This study used a cross-sectional design to assess the validity and reliability of the Indonesian version of the 2017 ABC-C questionnaire. Content validity was calculated using the Content Validity Index for Items (I-CVI) and the Content Validity Index for Scales (S-CVI). Internal consistency reliability test was calculated using Cronbach alpha. This study also assessed the proportion of abusive behavior based on the 5 domains of the Indonesian version of the 2017 ABC-C questionnaire, in children and adolescents with ASD at the Children and Adolescent Mental Polyclinic RSCM.

Results: The results of the analysis show that the I-CVI and S-CVI scores of the 2017 ABC-C Indonesian version of the questionnaire are 0.917, so the validity of the contents of this questionnaire is considered good. The results of the reliability of internal consistency are good to excellent with Cronbach's alpha value for each irritability domain 0.938; social withdrawal 0.936; stereotypic behavior 0.930; hyperactivity, non-compliance 0.949 and inappropriate speech pattern domain 0.869. The proportion of abnormal behavior based on the assessment of the 5 domains of the 2017 ABC-C questionnaire in Indonesian version, in children and adolescents with ASD at the Child and Adolescent Mental Polyclinic RSCM, the results obtained, the domain of mild irritability was 70.6%; mild social withdrawal 72.5%; 100% mild stereotypic behavior; moderate degree of hyperactivity/non-compliance is 47.1%, and inappropriate speech is 100% mild. The proportion of abberant behavior based on age and gender was also dominated by mild degrees, except for the moderate degree of hyperactivity/non-compliance domain. There was no statistically significant difference, the proportion of abusive behavior based on the age and sex of the child.

Conclusion: The Indonesian version of the ABC-C 2017 Questionnaire can be used in Indonesia for further research, detecting 5 domains of abnormal behavior in ASD patients and as an education module for health workers."

"ABSTRAKLatar belakang. Gangguan tidur merupakan gangguan penyerta pada anak gangguan spektrum autisme (GSA), yang memiliki prevalens tinggi serta dapat mengakibatkan perilaku negatif terhadap lingkungannya atau perilaku maladaptif eksternalisasi. Gangguan tidur pada anak GSA perlu dideteksi secara dini, karena bila tidak akan menyebabkan keterlambatan terapi dan menyebabkan anak makin berperilaku negatif serta menyebabkan stres pada keluarga.Tujuan. Mengetahui pola gangguan tidur dan gambaran perilaku maladaptif eksternalisasi pada anak GSA, serta mengetahui perbedaan rerata nilai indeks perilaku maladaptif eksternalisasi (v-scale), pada anak GSA dengan gangguan tidur dan tanpa gangguan tidur.Metode. Penelitian potong lintang analitik di klinik dan tempat terapi anak berkebutuhan khusus di Jakarta pada bulan Juni-Agustus 2014. Skrining gangguan tidur dengan kuesioner Sleep Disturbance Scale for Children (SDSC) dan penilaian perilaku maladaptif eksternallisasi dengan kuesioner Vineland-II dilakukan terhadap 40 anak GSA yang dipilih secara konsekutif. Subjek penelitian dibagi menjadi dua kelompok yaitu kelompok gangguan tidur (20 anak) dan kelompok tanpa gangguan tidur (20 anak).Hasil. Rentang usia dalam penelitian ini adalah 3-18 tahun dengan median usia 3,5 tahun. Proporsi terbanyak gangguan tidur pada anak GSA terdapat pada kelompok usia 3-5 tahun (15 dari 20 subjek). Pola gangguan tidur terbanyak pada anak GSA adalah gangguan memulai dan mempertahankan tidur (17 dari 20 subjek) diikuti oleh gangguan somnolen berlebihan (8 dari 20 subjek). Nilai median v-scale perilaku maladaptif eksternalisasi pada anak GSA adalah 18 (rentang 12-22), dan terdapat kecenderungan peningkatan nilai median v-scale perilaku maladaptif eksternalisasi seiring dengan peningkatan usia pada kedua kelompok. Nilai rerata v-scale perilaku maladaptif eksternalisasi pada kelompok GSA dengan gangguan tidur lebih tinggi dibandingkan kelompok tanpa gangguan tidur (18,8 dan 17,6 secara berurutan, mean difference 1,2; p 0,35 (p ≥ 0,05)).Simpulan. Proporsi terbanyak gangguan tidur pada anak GSA terdapat pada kelompok usia 3-5 tahun. Pola gangguan tidur terbanyak pada anak GSA adalah gangguan memulai dan mempertahankan tidur diikuti oleh gangguan somnolen berlebihan. Anak GSA dengan gangguan tidur memiliki nilai rerata indeks perilaku maladaptif eksternalisasi yang lebih tinggi dibandingkan tanpa gangguan tidur, namun tidak bermakna secara klinis dan statistik.

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ABSTRACTBackground. Sleep disorders is a comorbidity in Autism Spectrum Disorders (ASD), which has high prevalence and can cause negative behavior toward his surrounding or externalizing maladaptive behavior. Sleep disorders in ASD needs to be early detected, otherwise it will delay the treatment and children will behave more negative and cause the stress in family.Objectives. To identify sleep patterns and externalizing maladaptive behavior in children with ASD, and to identify the mean difference of index score of externalizing maladaptive behavior of (v-scale) in ASD children with or without sleep disorders.Methods. This study was analytical cross-sectional performed in the clinic and a therapy for children with special needs in Jakarta, in Juni-August 2014. Sleep disorders were screened using Sleep Disturbance Scale for Children (SDSC) questionnaire and externalizing maladaptive behavior was assessed using Vineland-II questioinnaire in 40 ASD children consecutively. They were divided into two groups, one group of sleep disorders (20 children) and other without sleep disorders (20 children).Results. Age range in this study was 3-18 years old, with median age of 3.5 years old. The majority of sleep disorders in ASD was in age range 3-5 years (15 of 20 subjetcs). The most frequent sleep disorders in ASD were difficulty in initiating and maintaning sleep (17 of 20 subjetcs), followed by disorder of excessive somnolence (8 of 20 subjetcs). The v-scale median score in ASD was 18 (range 12-22), and there was tendency of increased v-scale median score along with increased age. The mean of v-scale in externalizing maladaptive behavior in ASD with sleep disorders group was higher than without sleep disorders group (18.8 and 17.6 respectively, mean difference 1,2; p 0.35 ((p ≥ 0,05)).Conclusion. The majority of sleep disorders in ASD was in age range 3-5 years. The most frequent sleep disorders in ASD were difficulty in initiating and maintaning sleep, followed by disorder of excessive somnolence. Autism spectrum disorders children with sleep disorders has higher index externalizing maladaptive behavior mean than without sleep disorders, but was not meaningful clinically and statistically."

"Latar Belakang: Gangguan Spektrum Autisme (GSA) adalah gangguan neurodevelopmental yang terdiri atas gangguan komunikasi, interaksi sosial serta adanya perilaku restriktif dan repetitif. Hal ini dapat menyebabkan masalah dalam kemampuan adaptif anak sehingga menghambat anak dalam melakukan kemampuan dasar aktivitas harian, seperti makan, mandi, melepas dan memakai baju, dan lain-lain. Penggunaan video-modeling merupakan salah satu metode intervensi yang dikembangkan beberapa tahun terakhir untuk melatih kemampuan aktivitas harian pada anak GSA. Nemun demikian, hingga saat ini belum ada penelitian mengenai penggunaan video-modeling aktivitas mandi pada anak GSA. Penelitian ini bertujuan untuk mengetahui perbedaan kemampuan imitasi sequence aktivitas mandi sebelum dan sesudah pengggunaan video-modeling aktivitas mandi pada anak GSA. Metode: Disain penelitian ini adalah kuasi eksperimental (pre-post test analysis) dengan subjek penelitian adalah anak usia 6-10 tahun yang telah didiagnosis GSA oleh SpA konsultan neurologi anak yang datang ke Klinik Anakku Check My Child (CMC) Kayu Putih, Klinik Anakku BSD Serpong, Pondok Pinang, Depok dan Bekasi, serta Sekolah Anakku Pulomas pada periode April-Juni 2023. Subjek dikumpulkan dengan metode consecutive sampling. Besar sampel yang dibutuhkan untuk power 80%, derajat kemaknaan 5%, effect size 0,6 serta perkiraan drop out 20% adalah 33 subjek. Penelitian diawali dengan pembuatan video-modeling berupa animasi kegiatan mandi serta checklist penilaian kegiatan mandi berdasarkan 20 sequence kegiatan aktivitas mandi pada video tersebut. Pemaparan video dilakukan minimal 1x/hari selama 4 minggu. Subjek dengan frekuensi pemaparan <75% akan dieksklusi dari analisis. Penilaian dilakukan berdasarkan checklist aktivitas mandi dengan memberikan poin 1 untuk setiap sequence aktivitas yang mandi yang dilakukan subjek tanpa adanya instruksi verbal dan prompt motorik. Nilai pre-test adalah hasil penjumlahan penilaian checklist aktivitas mandi sebelum paparan video-modeling, sedangkan nilai post-test diambil setelah proses intervensi selama 4 minggu. Hasil: Dari 35 subjek yang mengikuti awal penelitian, hanya tersisa 29 anak (82,8%) yang menyelesaikan penelitian hingga 4 minggu. Sebagian besar subjek (94,2%) berusia 6-8 tahun dengan perbandingan laki dan perempuan sebesar 5:1. Nilai median kemampuan aktivitas mandi anak GSA sebelum dan sesudah penggunaan video-modeling adalah 3 (0-10) dan 6(1-17), pada skala 20. Terdapat perbedaan nilai yang bermakna (nilai p< 0,0001) antara perbedaan nilai sebelum dan sesudah penggunaan video-modeling, dengan nilai median selisih 3 (-4 – 13), pada skala 20. Kesimpulan: Terdapat perbedaan yang bermakna secara statistik antara nilai imitasi sequence aktivitas mandi pada anak GSA sebelum dan sesudah penggunaan video-modeling. Diperlukan penelitian lebih lanjut untuk menentukan kemaknaan nilai tersebut secara klinis.

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ackground: Autism Spectrum Disorder (ASD) is a range of neurodevelopmental disorders characterized by impaired communication, social interaction and the presence of stereotypic and repetitive behavior. It may affect children's adaptive behaviour which consequently hinder them in carrying out basic daily living skills, such as eating, bathing, grooming, etc. Video-modeling is one of the newest intervention methods for the last decades to train daily living skills among individuals with ASD. However up to now there is scarce evidence for using video-modeling to improve bathing skills in children with ASD. This study aims to evaluate the difference of sequence imitation skills in bathing activity before and after using video-modeling of bathing in children with ASD. Method: The design of this study was a pre-post test analysis. The subjects are children aged 6-10 years who had been diagnosed as GSA by a pediatric neurology consultant and attended the Anakku Clinic Check My Child (CMC) Kayu Putih, Anakku Clinic BSD Serpong, Pondok Pinang, Depok, Bekasi, as well as Anakku Pulomas School within period of April until June 2023. The sampling method was consecutive sampling method. It required total of 33 subjects for 80% power, 5% significance level, 1 point of effect size along with pre-estimated 20% drop out. Firstly, we formulated an animation video-modeling of bathing activity along with its checklist evaluation instrument. The checklist consisted of 20 sequences shown in video-modeling of bathing. Subjects were mandated to watch the video-modeling minimum once a day for duration of 4 weeks. Subjects with the video exposure less than 75% were excluded from the analysis. The evaluation was conducted by adding 1 point for each sequence activity performed by ASD child, without any verbal instructions nor motoric prompts. Pre-test score is the sum of the bathing activity checklist before subject was exposed with the video-modeling, meanwhile the post-test score was taken after 4 weeks intervention period of video-modeling. Result: Among 35 subjects attended in the beginning of the study, only 29 children (82.8%) completed the study for 4 weeks. Most of the subjects (94.2%) were aged 6-8 years with a male and female ratio of 5:1. Median score of ASD childrens’ bathing activity before and after the video-modeling exposure is 3 (0–10) and 6 (1–17), on a scale of 20. The pre- and post-test difference is statistically significant which gives result of 3 point of difference (-4–13), on a scale of 20. Conclusion: There is a statistically significant difference between the sequence imitation skills of bathing activity in ASD children before and after using video-modeling. Further research is needed to determine the clinical significance of this value."

"Tujuan penelitian ini adalah melihat efek moderasi dari kedua faktor common dyadic coping terhadap hubungan antara kepuasan pernikahan dengan parenting stress pada orang tua dari anak dengan spektrum autisme di Indonesia. Penelitian dilakukan kepada 131 partisipan di Jabodetabek, Bali, dan Lampung. Penelitian menggunakan alat ukur Couples Satisfaction Index–Short Form, Parenting Stress Index, dan Dyadic Coping Inventory. Analisis data dilakukan dengan korelasi Pearson, analisis regresi linear, dan Hayes Macro Process. Hasil penelitian menunjukkan bahwa terdapat korelasi negatif yang signifikan antara kepuasan pernikahan dan parenting stress serta tidak ditemukan efek moderasi dari kedua faktor common dyadic coping terhadap hubungan kepuasan pernikahan dan parenting stress.

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The aim of this study is to evaluate the moderating effect of the two factors of common dyadic coping in the relationship between marital satisfaction and parenting stress for parents of individuals with autism spectrum disorder in Indonesia. The study was conducted to 131 participants in Jabodetabek, Bali, and Lampung area. This study uses Couples Satisfaction Index–Short Form, Parenting Stress Index, and Dyadic Coping Inventory to measure the variables. Data is analyzed using Pearson correlation, linear regression analysis, and Hayes Macro Process. Findings of the study showed that there is a significant negative correlation between marital satisfaction and parenting stress, and there is no moderating effect from the two factors of common dyadic coping to that relationship."