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"Latar belakang: : Gangguan spektrum autisme (GSA) adalah gangguanneurodevelopmental yang menyebabkan gangguan komunikasi sosial, interaksi sertaperilaku restriktif dan repetitif yang meliputi gangguan sensori. Gangguan pemrosesansensorik menimbulkan kesulitan dalam meregulasi respons terhadap sensasi dan stimulusspesifik sehingga membatasi kemampuan berpartisipasi dalam rutinitas harian normal.Terapi okupasi sensori integrasi (TO-SI) digunakan untuk meningkatkan kemampuanuntuk memproses dan mengintegrasi informasi sensorik. Penelitian menunjukkan buktiilmiah rendah hingga sedang pada anak usia lebih besar. Berdasarkan pengalaman klinisPusponegoro, TO-SI dapat meningkatkan perilaku positif anak GSA terutama pada usiadi bawah 5 tahun. Penelitian ini bertujuan untuk mengevaluasi pengaruh TO-SI dalammeningkatkan perilaku positif anak usia 2 sampai 5 tahun dengan GSA.Metode: Penelitian pra-eksperimen di klinik Check My Child (CMC) dan Klinik AnakkuKelapa Gading pada bulan Maret-Oktober 2019. Populasi penelitian adalah anak barudengan GSA usia 2-5 tahun berdasarkan DSM-5. Subyek dikumpulkan secara konsekutifsampling. Pelaksanan TO-SI yaitu dua kali seminggu selama 12 minggu (24 kali), 60menit untuk setiap sesi. Profil perilaku dinilai berdasarkan Vineland Adaptive Behavior-II sebelum dan sesudah TO-SI.Hasil: Penelitian dilakukan pada 36 subjek, 38,9% berusia 3 tahun diikuti usia 2 tahun(33,3%), rasio lelaki dibandingkan perempuan 3 : 1. Sebelum TO-SI, perilaku positifberada pada kategori rendah. Setelah TO-SI, terdapat peningkatan bermakna domainkomunikasi, subdomain ekspresif, reseptif dan tertulis (p<0,001; p<0,001; p<0,001; p0,035) terutama pada kelompok usia 2-4 tahun. Domain sosialisasi, subdomain hubunganinterpersonal serta subdomain waktu luang dan bermain juga meningkat bermakna (p0.001; p<0.001; p,0.001) terutama pada kelompok usia 2 tahun. Tidak terdapatpeningkatan bermakna pada subdomain kemampuan coping, serta domain dan subdomainketerampilan aktivitas harian.Kesimpulan: Kami menemukan bahwa TO-SI dengan kepatuhan teori Ayres yang baikdalam 60 menit, dua kali seminggu selama 12 minggu dapat meningkatkan perilakupositif anak GSA usia dini terutama usia 2 hingga 5 tahun

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Background: Autism spectrum disorder (ASD) is a complex neurodevelopmentaldisorder in social communication, interaction, and restrictive, repetitive pattern ofbehavior (including sensory disorder). Sensory processing disorder yields difficulty inregulating responses to sensation and spesific stimuli which limits the ability toparticipate in normal life routines. Sensory integration occupational therapy (SI-OT) is amethod to increase ability to process and integrate sensory information. Most studiesshowed that SI-OT has low to moderate evidence in older children. Based on clinicalexperience of Pusponegoro, SI-OT might be useful for ASD treatment for children under5 years old. We conducted a study to evaluate the effect of SI-OT in improving positivebehavior of children aged 2 to 5 years old with ASD.Methods: A pre-post one group pre-experimental study conducted in Check My Childclinic (CMC) and Klinik Anakku Kelapa Gading on March-October 2019. Studypopulation were recently diagnosed ASD children aged 2 to 5 years old. Subjects werecollected with consecutive sampling. The SI-OT were applied twice a week for 12 weeks(24 times), 60 minutes for each session. Pre and post SI-OT evaluation of positivebehavior profiles were assessed with Vineland Adaptive Behavior Scale-II tool.Results: A total of 36 ASD subjects aged 2 to 5 years old were studied. Most subjectswere 3 years old followed by 2 years old (38.9%; 33.3%), boys to girl ratio were 3 to 1.The characateristics of positive bahaviors were all in low category before SI-OT. AfterSI-OT, communication domain and subdomains (expressive, receptive, writtensubdomain) were improved significantly (p<0.001; p<0.001; p<0.001; p 0.035). Theseimprovement were available in age group of 2,3, and 4 years old. Significantimprovements were also achieved in socialization domain (p 0.001) includinginterpersonal relationship subdomain (p<0.001), play and leisure time sudomain(p<0.001), especially in age group of 2 years old. In contrary, subdomain coping skill,daily living skills domain and subdomains were not improving significantly.Conclusions: Good fidelity of Ayres theory SI-OT in 60 minutes, twice a week for 12weeks could improve positive behavior, in communication domain (expressive, receptive,written subdomain) aged 2-4 years old, and socialization domain (interpersonalrelationship, play and leisure time) aged 2 years old."

"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."

"Latar Belakang: Angka prevalensi GSA semakin meningkat dan kekhawatiran orang tua tentang kondisi anaknya, mendorong dilakukannya skrining deteksi dini GSA. Beberapa tanda untuk deteksi dini GSA yaitu 1) respon terhadap godaan, 2) respon ketika dipanggil dan 3) respon terhadap penghambatan. Terdapat tanda lain yang dapat digunakan sebagai deteksi dini GSA, yaitu respon colek. Tujuan: Mengetahui seberapa besar nilai diagnostik respon colek dalam mendeteksi GSA pada anak usia 18 bulan - 4 tahun dengan keterlambatan bicara. Metode:Studi potong lintang dilakukan terhadap subyek berusia 18 bulan - 4 tahun dengan keterlambatan bicara. Pada subyek diberikan rangsangan colek, godaan saat bermain, dipanggil namanya saat bermain dan penghambatan saat bermain (dengan tangan) kemudian dinilai respon subyek terhadap pemberi respon. Subyek kemudian dikelompokkan menjadi 2 kelompok, GSA dan bukan GSA berdasarkan kriteria DSM-5. Hasil:Dibandingkan ketiga respon lain, respon colek memiliki spesifitas paling tinggi (93%) dengan sensitivitas 75% dalam mendeteksi GSA. Bila ke 4 pemeriksaan uji diagnostik digabungkan, dengan hasil tes negatif menandakan tidak adanya respon terhadap pemeriksaan, maka akan didapatkan nilai spesifisitas sangat tinggi (100%) dengan sensitivitas 42%. Simpulan: Dibandingkan ketiga pemeriksaan yang sudah ada, respon colek memiliki spesifisitas paling tinggi dalam menyingkirkan GSA pada anak dengan keterlambatan bicara.Background: ASD prevalence are increasing and parents' concerns about their child's condition, encourage early detection by screening of ASD. Several signs for early detection of ASD: 1) teasing response, 2) calling response, 3) blocking response. There are other signs can be used as early detection of ASD, which is a poke response. Objective:To know the diagnostic value of poke response in detecting ASD in children aged 18 months - 4 years with speech delay. Methods:A cross-sectional study was conducted on subjects aged 18 months - 4 years with speech delay. The subjects given poke stimulation, teasing when playing, called by name and inhibition when playing then assessed the subject's responses. The subjects were grouped into 2 groups, ASD and not ASD based on DSM-5. Results:Compared to the other 3 responses, poke response had the highest specificity (93%) with 75% sensitivity in detecting ASD. If all 4 diagnostic test examinations are combined, with a negative test result indicating no response to the examination, a very high specificity (100%) with a sensitivity of 42% will be obtained. Conclusion:Compared the others, the poke response has the highest specificity to rule out ASD in children with speech delay."

"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: Autism Spectrum Disorder (ASD) adalah suatu kondisi heterogen dengan gejala yang bervariasi disebabkan berbagai etiologi, dan komorbiditas yang berdampak pada defisit komunikasi sosial, gangguan perilaku berulang dan minat terbatas. Sudah banyak penelitian yang mengaitkan ASD dengan variasi gambaran pemanjangan masa laten gelombang dan antar gelombang pada Brainstem Evoked Response Audiometry (BERA). Beberapa penelitian menghubungkan BERA dengan derajat keparahan ASD berdasarkan The Childhood Autism Rating Scale (CARS), namun masih kontroversi. Tujuan: Penelitian ini bertujuan untuk mengetahui apakah ada hubungan antara masa laten gelombang III dan V serta masa laten antar gelombang III-V BERA Click dengan derajat keparahan ASD berdasarkan skoring CARS anak usia 3-8 tahun dengan pendengaran normal. Metode: Studi potong lintang ini terdiri dari 26 subjek ASD yang memenuhi kriteria inklusi dan eksklusi. Penilaian derajat keparahan subjek dilakukan menggunakan skoring CARS dan pemeriksaan BERA. Pengolahan data dilakukan dengan analisis uji korelasi masa laten absolut dan masa laten antar gelombang BERA dan CARS. Hasil: Tidak ditemukan hubungan yang bermakna antara masa laten absolut gelombang III dan V serta masa laten antar gelombang III-V BERA Click dengan CARS (r<0,3 dan p>0,05). Namun berdasarkan analisis deskriptif, terdapat pemanjangan masa laten gelombang III dan V serta masa laten antar gelombang I-III pada anak ASD dengan pendengaran perifer normal. Kesimpulan: Anak ASD dengan pendengaran perifer normal menunjukkan karakteristik BERA abnormal. Hal ini menunjukkan potensi BERA sebagai alat objektif untuk mengevaluasi perkembangan ASD di masa depan namun diperlukan penelitian lebih lanjut.

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Background: Autism Spectrum Disorder (ASD) is a heterogeneous condition with variable symptoms due to various etiologies, and comorbidities that result in social communication deficits, repetitive behavioral disorders and restricted interests. Many studies have linked ASD to variations in the latent wave and inter-wave lengthening images on Brainstem Evoked Response Audiometry (BERA). Some studies have linked BERA to ASD severity based on The Childhood Autism Rating Scale (CARS), but it is still controversial. Aim: This study aims to determine whether there is a correlation between latencies of waves III and V, as well as interpeak latencies of waves III-V BERA Click and ASD severity based on CARS scoring in children aged 3-8 years with normal hearing. Methods: This cross-sectional study consisted of 26 subjects with ASD met the inclusion and exclusion criteria. Subjects were assessed for severity using CARS scoring and BERA examination. Data processing was done by correlation test analysis between latencies of waves III and V BERA and CARS waves. Results: There was no significant relationship between the latencies of waves III and V and interpeak latencies of waves III-V and interpeak latencies of waves III-V BERA Click with CARS (r < 0.3 and p>0.05). However, based on descriptive analysis, there was a lengthening of the latency of waves III and V and interpeak latency of waves I-III in ASD children with normal peripheral hearing. Conclusion Children with ASD display abnormal ABR characteristics. This shows the potential of BERA as an objective tool to evaluate ASD development in the future but further research is needed"

"Tujuan dari penelitian ini untuk mengetahui persepsi kemampuan perawat pada anak dengan gangguan spektrum autisme (GSA) yang dirawat di rumah sakit. Desain penelitian ini adalah deskriptif analisis dengan menggunakan metode cross sectional dengan teknik total sampling menggunakan sampel 59 perawat dari rawat inap anak, unit thalasemia, serta ruang bedah anak di RSUPN Cipto Mangunkusumo. Instrumen yang digunakan Survey. Brachlow5 milik Allison Golnik tahun 2009 dengan perubahan demografi sesuai kebutuhan populasi di Indonesia. Hasil penelitian antara lain persentase usia muda 54,2%, perempuan 91,5%, jenjang pendidikan D3 78%, pengalaman kerja kurang dari 5 tahun 39%, lokasi ruangan rawaat inap 57,6%, tidak pernah training 98,3%, tingginya kapasitas perawat 55,9%, tingginya kapasitas perawat 58,8%, tingginya pengetahuan perawat 57,1%, tingginya kepercayaan orang tua 100%, hambatan perawat 59,3% mengaku kurangnya pendidikan mengenai gangguan spektrum autisme. Saran dari penelitian antara lain diadakan training pada perawat di rumah sakit serta penambahan ilmu mengenai GSA di instansi pendidikan.

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The purpose of this study was to determine the perception of the ability of nurses in children with autism spectrum disorders (ASD) were hospitalized. This study was a descriptive analysis using cross sectional method with a total sampling technique using samples of 59 nurses from the children’s inpatient, thalassemia unit, as well as the child's surgery in Cipto Mangunkusumo Hospital. Instruments used Survey.Brachlow5 owned by Allison Golnik (2009) with the changing demographics of the population in Indonesia as needed.

The results of the study include the percentage of young age of 54.2%, 91.5% female, 78% diploma degree, work experience of less than 5 years of 39%, the location of the children’s inpatient was 57.6%, 98.3% said never training, the high capacity of nurses 55.9%, 58.8% of high source of knowledge, nurse 57.1% high knowledge, high trust of parents 100% , barrier 59.3% of nurses admitted lack of education about autism spectrum disorders. Suggestions of research are conducted training to nurses in hospitals as well as the addition of knowledge about the ASD in educational institutions."

"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."

"Keeping children's bodies, minds and emotions on task just got easier with this new book from self-regulation expert Teresa Garland. It features more than 200 practical and proven interventions, strategies and adaptation for helping children gain more control over their lives. Each chapter provides rich background and theoretical material to help the reader better understand the issues our children face. Topics include: Basic and advanced methods to calm a child and to prevent outbursts and melt-downs; Interventions to help with attention problems, impulse control, distractibility and the ability to sit still; Stories and video-modeling for autism, along with techniques to quell repetitive behaviors; Sensory strategies for sensitivity and craving; Behavioral and sensory approaches to picky eating; Ways to increase organization skills using technology and apps; Strategies for managing strong emotions as well as techniques for releasing them.Keeping children bodies, minds and emotions on task just got easier with this new book from self-regulation expert Teresa Garland. Featuring more than 200 practical and proven interventions, strategies and adaptation for helping children gain more control over their lives. Each chapter provides rich background and theoretical material to help the reader better understand the issues our children face. Topics include: =​ Basic and advanced methods to calm a child and to preventing outbursts and melt-downs =​ Interventions to help with attention problems, impulse control, distractibility and the ability to sit still =​ Stories and video-modeling for autism, along with techniques to quell repetitive behaviors =​ Sensory strategies for sensitivity and craving =​ Behavioral and sensory approaches to picky eating =​ Ways to increase organization skills using technology and apps =​ Strategies for managing strong emotions as well as techniques for releasing them."

"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 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."