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"ABSTRAKGangguan tidur yang kerap dialami oleh anak autis akan berdampak pada penyimpangan perilaku. Penelitian ini bertujuan untuk mengetahui gambaran gangguan tidur dan perilaku pada anak autis usia sekolah dan usia remaja. Penelitian ini menggunakan desain descriptif dengan pendekatan cross sectional. Responden sebanyak 41 anak autis di 7 sekolah formal maupun sekolah khusus autisme yang ada di Depok dipilih dengan teknik sampling snowball. Gangguan tidur diukur menggunakan Children?s Sleep Habits Questionnaire (CSHQ) dan perilaku menggunakan Child Behavior Checklist (CBCL) yang ditanyakan kepada orang tuanya. Hasil penelitian ini berdasarkan cut of point menunjukan bahwa 30 % anak autis mengalami gangguan tidur dan 10 % mengalami perilaku menyimpang. Perawat perlu memberi asuhan yang tepat terkait masalah tersebut.

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ABSTRACTSleep disorders that are often experienced by children with autism will have an impact on deviant behavior. This research aimed to describe sleep disorders and behavioral disorders among school age children and adolescence suffering autism. This research was a quantitative research with descriptive cross sectional design. The data was collected from 41 children in School. The children?s sleep disorders and behavioral disorders were measured with Children?s Sleep Habits Questionnaire (CSHQ) and Child Behavior Checklist (CBCL) which was rated by their parents. This research was conducted at seven inclusive schools and special schools for autism children in Depok. The result based on cut of point showed that 30% autism children experience sleep disorders and 10 % of them experiencing behavioral disorders. It is recommended that nurses provide nursing care to overcome sleep disorders and behavioral disorders among autism children."

"xLatar belakang: Kejadian leukemia akut sebagai kanker tersering pada anak terus meningkat setiap tahun menjadi penyebab morbiditas dan mortalitas tertinggi akibat penyakit. Umumnya, leukemia akut menyerang anak berusia <15 tahun dan remaja. Terapi definitif (kemoterapi) yang lama dan tidak menyenangkan berisiko dalam mengembangkan gangguan emosi dan perilaku pada anak. Di lain sisi, kehidupan pascapandemi juga turut meningkatkan penggunaan gawai pada kaum remaja yang turut berperan dalam terjadinya gangguan emosi dan perilaku. Penelitian ini bertujuan untuk mengetahu hubungan antara screen-time dengan gangguan emosi dan perilaku pada remaja leukemia. Metode: Desain penelitian ini adalah potong lintang yang dilakukan di Poli Hematoonkologi Anak RSUPN Dr. Cipto Mangunkusumo pada bulan November 2022. Penelitian ini menggunakan instrumen data screen-time dan kuesioner PSC-17. Analisis dilakukan secara univariat dan bivariat menggunakan aplikasi SPSS versi 24. Hasil: Jumlah remaja leukemia di RSCM 23 orang, tersebar merata secara usia, didominasi anak laki-laki (13/23), jenis leukemia LLA (22/23), tingkat pendidikan anak SD (12/23), tingkat pendidikan ayah dan ibu menengah (11/23; 9/23), pendapatan keluarga < UMP DKI Jakarta (10/23), dan seluruhnya mendapat dukungan emosional keluarga. Nilai median usia dan durasi sakit (bulan) adalah 12,94 (10,05-17,18) tahun dan 16 (0,83-96) bulan. Tingkat screen-time sebagian besar >2 jam/hari (22/23) dengan penggunaan terlama >6 jam/hari (12/23) dan rerata 6.5 ± 3,25 jam/hari, serta digunakan untuk hiburan. Gangguan Emosi dan Perilaku terjadi pada 2/23 orang yaitu gangguan internalisasi (1) dan gangguan eksternalisasi (1). Hubungan antara screen-time dengan gangguan emosi dan perilaku tidak dapat disimpulkan. Kesimpulan: Tingkat screen-time yang tinggi pada remaja leukemia perlu diedukasi kepada orangtua dan remaja, serta 2 orang pasien dengan gangguan emosi dan perilaku perlu diperiksa lebih lanjut.

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Background: The incidence of acute leukemia, the most common cancer in children, continues to increase yearly, becoming the highest cause of morbidity and mortality due to disease. Generally, acute leukemia attacks children aged <15 years and adolescents. Long and unpleasant definitive therapy (chemotherapy) is at risk of developing emotional and behavioral disorders in children. On the other hand, post-pandemic life has also increased the use of gadgets among adolescents, contributing to emotional and behavioral disorders. This study aims to determine the relationship between screen time and emotional and behavioural disorders in leukaemic adolescents. Methods: The design of this study was a cross-sectional study conducted at the Children's Hematooncology Polyclinic at RSUPN Dr. Cipto Mangunkusumo in November 2022. This study used screen-time data instruments and the PSC-17 questionnaire. The analysis was carried out univariate and bivariate using the SPSS version 24 application. Results: The number of leukemia adolescents in RSCM was 23 people, evenly distributed by age, dominated by boys (13/23), type of leukemia ALL (22/23), education level of children SD (12/23), middle education level of father and mother (11/23; 9/23), family income < UMP DKI Jakarta (10/23), and all of them received family emotional support. The median values for age and illness duration (months) were 12.94 (10.05-17.18) and 16 (0.83-96). The screen-time level is mostly >2 hours/day (22/23), with the most frequent use being >6 hours/day (12/23) and an average of 6.5 ± 3.25 hours/day, and it is used for entertainment. Emotional and behavioral disorders occur in 2/23 people, namely internalization disorders (1) and externalization disorders (1). The relationship between screen time and emotional and behavioral disorders is inconclusive. Conclusion: The high level of screen time in adolescents with leukemia needs to be educated to parents and adolescents, and two patients with emotional and behavioral disorders need to be examined further."

"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."

"The paper about children and youth with behavioral disturbance is written and based on the concern of phenomenon that happens to children and youth. Violation against norms and criminal deeds that harm people are frequently done by children and youth with behavioral disturbance and deviation. many factors influence the deeds, both internal and external. Psychological condition, racism, discrimination, poverty, social isolation, community problem, cultural erosion, lack of education program based on culture, inadequate caring skill, lack of resources for community like recreational facility, and lack of positive figures, as causes of behavioral disturbances. There are several handling models that can be offered and implemented to children and youth with behavioral disturbances, through individual, family, and social depending on the problem they face. Early problem identification should be done so that intervention planning that will be made can be described "

"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."

"Latar belakang. Gangguan interaksi sosial merupakan karakteristik utama dari gangguan spektrum autisme (GSA), selain itu 59-79% anak GSA dilaporkan mengalami gangguan gerak. Gangguan gerak merupakan komorbiditas yang mungkin memengaruhi kemampuan sosialisasi anak GSA. Hingga saat ini belum ada data mengenai gangguan gerak kasar pada anak GSA di Indonesia, termasuk kemungkinan kaitannya dengan kemampuan sosialisasi. Tujuan. Penelitian ini bertujuan untuk mengetahui: (1) apakah kemampuan gerak kasar anak GSA lebih rendah dibandingkan anak normal, (2) gambaran kemampuan gerak kasar anak GSA, (3) gambaran kemampuan sosialisasi anak GSA, (4) hubungan kemampuan gerak kasar dengan kemampuan sosialisasi pada anak GSA. Metode. Penelitian potong lintang pada Agustus-September 2013 dengan subjek berusia 18 bulan sampai 6 tahun. Subjek GSA didapatkan dari Klinik Anakku dan kelompok kontrol diperoleh dengan matching usia. Kemampuan gerak kasar dan sosialisasi kedua kelompok dinilai melalui wawancara kepada orangtua dengan instrumen Vineland Adaptive Behavior Scales, edisi ke-2 (Vineland-II). Hasil. Sebanyak 40 subjek GSA (12 gangguan autistik, 3 gangguan Asperger, dan 26 PDD-NOS) dan 40 kontrol memenuhi kriteria penelitian. Kemampuan gerak kasar di bawah normal ditemukan pada 8 dari 40 (20%) anak GSA. Rerata v-scale gerak kasar pada kelompok GSA 15,1 (SD 3,12), lebih rendah dibandingkan kelompok kontrol 18,7 (SD 2,09) dengan p 0,000 (p<0,05) dan interval kepercayaan 95% (IK95%) - 4,725;-2,525 berdasarkan uji T-berpasangan. Perbedaan tersebut tampak nyata pada klaster melempar dan menangkap bola, menggunakan tangga, melompat, dan mengendarai sepeda. Subdomain hubungan interpersonal menunjukkan nilai v-scale terendah (median 9, rentang 3-15) dibandingkan kedua subdomain lain (subdomain waktu bermain dan bersantai dengan rerata 11,2 (SD 3,2) dan subdomain kemampuan coping dengan median 15, rentang 10-18). Kemampuan gerak kasar berhubungan dengan kemampuan sosialisasi pada anak GSA. Anak GSA dengan gangguan gerak kasar memiliki rerata nilai standar domain sosialisasi 66,6 (SD 6,50). Nilai tersebut lebih rendah dibandingkan 85,7 (SD 10,90) pada anak GSA tanpa gangguan gerak kasar, dengan p 0,000 dan IK95% -25,327;-12,736. Simpulan. Kemampuan gerak kasar anak GSA lebih rendah dibandingkan anak normal. Dua puluh persen anak GSA mengalami gangguan gerak kasar berdasarkan Vineland-II, khususnya pada klaster melempar dan menangkap bola, menggunakan tangga, melompat, dan mengendarai sepeda. Anak GSA memiliki kemampuan sosialisasi yang rendah khususnya pada subdomain hubungan interpersonal. Anak GSA dengan gangguan gerak kasar memiliki kemampuan sosialisasi lebih rendah dibandingkan anak GSA yang tidak mengalami gangguan gerak kasar.

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Background. Social impairment is considered the core deficit in autism spectrum disorders (ASD) and 59-79% of ASD children were reported as having poor gross motor. Gross motor deficit is a comorbidity which may influence socialization skills in ASD. There is no data in Indonesia about gross motor problems, including the possible association with socialization skills, in ASD children.

Objectives. This study aimed: (1) to compare gross motor skills in ASD to normal children, (2) to describe gross motor problems in ASD, (3) to describe socialization skills in ASD, (4) to identify the relationship of gross motor and socialization skills in ASD.

Method. A cross-sectional study involving 18-months-old to 6-years old children was taken on August-September 2013. ASD children were recruited in Klinik Anakku while control group were their age-matched children with normal development. Gross motor and socialization skills were scored using Vineland Adaptive Behavior Scales, 2nd edition (Vineland-II).

Results. Forty ASD children (12 autistic disorder, 3 Asperger syndrome, 26 PDD-NOS) and 40 age-matched control fulfilled study criteria. Gross motor below normal were reported in 8 of 40 (20%) ASD children. Mean gross motor v-scale of ASD group 15.1 (SD 3.12), significantly lower than control group 18.7 (SD 2.09) with p value 0.000 (p < 0.05) and confidence interval 95% (CI95%) -4.725;-2.525 using paired T-test. The differences were prominent in several cluster− throwing and catching ball, using stairs, jumping, and bicycling. The lowest v-scale score was found in interpersonal relationship subdomain (median 9, interval 3-15), compared to the other subdomains (play and leisure time with mean 15 (SD 3.2) and coping skills with median 15, interval 10-18). Gross motor skills is associated with socialization skills in ASD. ASD children with gross motor impairments showed socialization domain mean score 66.6 (SD 6.50). The score is lower than 85.7 (SD 10.90) in those without gross motor impairments, with p value 0.000 and CI95% -25.327;-12.736.

Conclusion. Gross motor skill in ASD is lower than normal children. Gross motor impairments were found in 20% ASD children based on Vineland-II, especially in several cluster - throwing and catching ball, using stairs, jumping, and bicycling. ASD children showed poor socialization skill especially in interpersonal relationship subdomain. ASD children with gross motor impairments showed lower socialization skills compared to those without gross motor impairments."

"Tingginya angka penggunaan media elektronik pada anak tipikal dan autism spectrum disorder (ASD) di Indonesia sudah tergolong pada level mengkhawatirkan. Hal ini berkontribusi terhadap penurunan performa executive function (EF). Meskipun demikian, sejumlah penelitian terkini menemukan hubungan yang positif antara penggunaan media elektronik dan performa EF. Penelitian ini bertujuan untuk mengetahui kontribusi kondisi perkembangan anak (tipikal dan ASD) dan durasi penggunaan media elektronik terhadap performa EF, dengan sebelumnya melakukan uji regresi antara kondisi perkembangan anak dan durasi penggunaan media elektronik. Partisipan terdiri dari 24 anak tipikal dan 9 anak ASD yang berusia 48-96 bulan dan memiliki tingkat inteligensi ≥ 70. Hasil penelitian menunjukkan bahwa kondisi perkembangan anak yang mengalami gangguan ASD berasosiasi secara signifikan dengan peningkatan durasi penggunaan media elektronik dan penurunan performa EF, namun durasi penggunaan media elektronik tidak berkontribusi dengan performa EF. Penelitian ini menekankan pentingnya mengatur penggunaan waktu media elektronik pada anak, baik tipikal maupun ASD, untuk mengoptimalkan EF mereka.

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The high rate of electronic media usage in typical and autism spectrum disorder (ASD) children in Indonesia were highly concerning, which could contribute to the lowering executive function (EF) performance. However, recent studies found positive association between the use of electronic media and childrens EF performance.

This study aims to determine of the contribution of childrens development state (typical and ASD) and duration of electronic media use in childrens EF performance, with prior measurement using regression analysis for childrens development state and their duration of electronic media use. The participants of this study were 24 typical children and 9 children with ASD, which were 48-96 months of age and had IQ score of ≥ 70.

The results showed that childrens development state with ASD significantly associated with increasing in duration of electronic media use and decreasing in childrens EF performance. However, the duration of electronic media use was not contributed in childrens EF performance. This study emphasized in the importance of managing the duration of electronic media use in typical and ASD children, to promote optimum EF development."

"Anak dengan autism spectrum disorder (ASD) memiliki kemampuan komunikasi yang belum berkembang optimal karena adanya gangguan pada masa perkembangan. Mereka memiliki cara meminta yang kurang tepat, misalnya menampilkan perilaku yang kurang sesuai sebagai bentuk permintaan. Diperlukan cara lebih efektif untuk mengganti perilaku meminta yang kurang tepat pada anak dengan ASD. Picture Exchange Communication System (PECS) merupakan sistem komunikasi berbasis gambar yang dirancang untuk membantu meningkatkan kemampuan komunikasi fungsional anak dengan ASD. PECS memungkinan anak untuk berkomunikasi dengan cara menukarkan kartu untuk mendapatkan keinginan dan kebutuhannya yang dilatih menggunakan reinforcement, prompt, dan error-correction. Pada penelitian ini, terdapat dua subjek anak dengan ASD, yakni laki-laki berusia 8 dan perempuan berusia 9 tahun dengan kemampuan komunikasi verbal yang terbatas. Penelitian ini bertujuan untuk mengetahui efektivitas penerapan program intervensi PECS fase dua dalam meningkatkan kemampuan komunikasi. Desain penelitian yang digunakan adalah single subject research design dengan metode pengukuran pre dan post intervensi. Program intervensi PECS fase dua merupakan kelanjutan dari intervensi PECS fase satu yang sebelumnya dilakukan. Hasil dari intervensi ini menunjukkan terdapat peningkatan kemampuan anak dalam melakukan PECS fase dua sebelum dan sesudah intervensi. Hasil ini dipengaruhi oleh faktor karakteristik anak, motivasi terkait reinforcement, serta dukungan orang tua.

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Children with autism spectrum disorder (ASD) have communication difficulties due to developmental disorders. They have inappropriate ways to communicate, such as displaying aggressive behavior as a form of request. Therefore, a more effective way to replace inappropriate behaviors in children with ASD is required. Picture Exchange Communication System (PECS) is a communication system designed to help improve the functional communication skills of children with ASD. PECS allows children to communicate by exchanging cards to get their wants and needs which are trained using reinforcement, prompt, and error-correction. In this study, there were two children with ASD (8 years-old boy and 9 years-old girl) with limited communication skills. The purpose of this study was to determine the effectiveness of PECS phase two in improving children communication skills. This study used single subject research design with pre and post intervention measurement method. The PECS phase two program is a follow-up intervention to the previously implemented PECS phase one program. The results of this intervention showed that there was an increase in children's ability to perform PECS phase two before and after the intervention. This result was influenced by child characteristics, motivation, and parental support."

"Autism Spectrum Disorder (ASD) merupakan kelainan perkembangan yang dapat mempengaruhi kemampuan kognitif, komunikasi, dan tingkah laku. Penelitian ini bertujuan melihat apakah ada hubungan antara jenis kelamin dan PB/U dengan risiko autisme pada balita. Metode yang digunakan adalah pengumpulan data sekunder dari studi cross-sectional yang melibatkan 90 balita di Kelurahan Gajahmekar dan Kelurahan Andir yang diperoleh melalui metode clustered random sampling. Seluruh subjek telah menyetujui lembar informed consent untuk dilakukan pengambilan data dengan metode kuesioner. Kuesioner data diri digunakan untuk memperoleh data pribadi, termasuk jenis kelamin, panjang badan, dan usia balita. Kuesioner M-CHAT digunakan untuk memperoleh risiko autisme pada balita. Data yang telah memenuhi kriteria diolah dengan menggunakan aplikasi IBM SPSS 20 dan hubungan antar variabel diuji menggunakan uji chi-square dengan tabel 2x2. Hasil yang diperoleh adalah proporsi risiko medium-tinggi autisme pada balita perempuan sebanyak 40% dan laki-laki sebanyak 37,1%. Proporsi risiko medium-tinggi autisme pada balita berperawakan pendek-sangat pendek sebanyak 46,3% dan berperawakan normal sebanyak 27,8%. Uji chi-square hubungan jenis kelamin dengan risiko autisme menunjukkan nilai p=0,786 dan hubungan PB/U dengan risiko autisme menunjukkan nilai p=0,077. Kesimpulan pada penelitian ini adalah terdapat hubungan antara jenis kelamin dan PB/U dengan risiko autisme pada balita di Kelurahan Gajah Mekar dan Kelurahan Andir dengan kelompok jenis kelamin perempuan dan perawakan pendek-sangat pendek yang lebih banyak memiliki risiko medium-tinggi autisme. Namun hubungan jenis kelamin dan PB/U dengan risiko autisme pada balita tidak bermakna secara statistik dengan nilai p berturut- turut 0,786 dan 0,077.

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Autism Spectrum Disorder (ASD) is a developmental disorder that can affect cognitive abilities, communication, and behavior. This study aims to see whether there is a relationship between gender and Height/Age with the risk of autism in children under five. The method used is secondary data from a cross-sectional study involving 90 children under five in Gajahmekar and Andir villages obtained through clustered random sampling method. All subjects had agreed to the informed consent sheet for data collection using a questionnaire method. The personal data questionnaire was used to obtain personal data, including gender, body length, and age of children under five. The M-CHAT questionnaire was used to determine the risk of autism in children under five. Data that met the criteria were processed using the IBM SPSS 20 application and the relationship between variables was tested using the chi-square test with a 2x2 table. In this study, the results obtained from the proportion of medium-high risk of autism in girls as much as 40% and boys as much as 37.1%. The proportion of medium-high risk of autism in toddlers with short-very short stature was 46.3% and normal stature was 27.8%. Chi-square test for the relationship between gender and the risk of autism showed p value = 0.786 and the relationship between Height/Age and the risk of autism showed p value = 0.077. The conclusion of this study is there is a relationship between gender and Height/Age with the risk of autism in children under five in Gajah Mekar and Andir villages with the female sex group and very short-short stature, have more medium-high risk of autism. However, the relationship between gender and Height/Age and the risk of autism in children under five was not statistically significant with p values of 0.786 and 0.077, respectively."

"Pola asuh merupakan rangkaian interaksi intensif yang melibatkan orang tua dan anak. Sibling relationship adalah interaksi antar dua individu maupun lebih yang memiliki hubungan secara biologis. Penelitian ini bertujuan untuk mengetahui hubungan pola asuh orang tua terhadap sibling relationship dengan anak penyandang Autisme Spectrum Disorder (ASD). Penelitian ini menggunakan pendekatan potong silang pada 107 responden dipilih melalui teknik purposive sampling. Peneliti melihat pola asuh orang tua menggunakan kuesioner Parenting Style and Dimensions Questionnaire (PSDQ) dan sibling relationship menggunakan kuesioner Sibling Relationship Questionnaire (SRQ). Hasil penelitian menunjukkan 77,78% ibu yang menerapkan pola asuh demokratis memfasilitasi sibling relationship bersifat positif dan 74,28% ayah yang menerapkan pola asuh demokratis memfasilitasi sibling relationship bersifat negatif. Analisis bivariat menunjukkan bahwa tidak ada hubungan antara pola asuh responden dengan sibling relationship (p>0,05; α=0,05). Penelitian selanjutnya dapat dilakukan observasi dan wawancara langsung kepada sibling serta memperluas lokasi penelitian untuk lebih menggambarkan populasi penelitian.

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Parenting is an intensive interaction involving parents and children. Sibling relationship is the interaction between two or more individuals who have a biological relationship. The aim of this research was to identify the relation between parenting style of sibling relationship with Autism Spectrum Disorder (ASD).

This research used cross-sectional on 107 respondents was involved with purposive sampling technique. Researcher used Parenting Style and Dimensions Questionnaire (PSDQ) to study parenting style and Sibling Relationship Questionnaire (SRQ) to measure sibling relationship.

The result showed that 77,78% mother applying authoritative facilitate sibling relationship is positive and 74,28% applying authoritative facilitate sibling relationship is negative. Bivariate analysis result showed that there was no relation between parenting style of sibling relationship with Autism Spectrum Disorder (p>0,05; α=0,05). It is recommended that research should conduct observation and interview are more appropriate toward sibling. Beside, the future research can increasing the number of respondents will benefit the future research."