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"Penelitian terapi pijat bagi anak dengan GSA yang dilakukan dalam kurun waktu 10 – 15 tahun lebih banyak ditujukan terhadap anak yang telah didiagnosis gangguan spektrum autisme dengan rerata usia anak berada di antara 3 – 6 tahun. Di Indonesia penelitian tentang terapi pijat pada anak dengan risiko gangguan spektrum autisme belum banyak dilakukan dan dipublikasikan di jurnal ilmiah.Prevalensi penderita gangguan spektrum autisme di beberapa belahan dunia cenderung meningkat, seperti di Negara Amerika Serikat, Cina dan negara berkembang seperti di Indonesia. Di Indonesia sendiri data dan informasi yang akurat dan lengkap dari penderita gangguan spektrum autisme (GSA) masih kurang, sehingga dikuatirkan banyak anak dengan gejala risiko gangguan spektrum autisme tidak mendapatkan penanganan secara dini.Penelitian ini bertujuan mengembangkan modul terapi pijat pada anak risiko gangguan spektrum autisme, mengetahui dan menganalisis modifikasi skor M-CHAT dan mengetahui hasil penerapan TPGSA dalam menurunkan skor M-Chat dan status risiko gangguan spektrum autisme pada anak Usia 18–36 bulan. Jenis penelitian yang digunakan adalah penelitian Desktiptif dengan pendekatan Studi Kasus. Populasi penelitian adalah anak usia 18-36 bulan yang telah mengikuti skrining/pemeriksaan M-CHAT di PKM Pasar Minggu, PKM Cipayung dan PKM Kebon Jeruk. sebanyak 1685 orang dengan angka kejadian anak risiko autisme sebanyak 14 orang (0,8%) dari bulan Mei tahun 2019 sampai dengan Maret 2020. Sampel penelitian sebanyak 10 orang yang memenuhi kriteria inklusi. Jumlah anak yang diskrining dalam rangka modifikasi Skor M-CHAT adalah 904 anak yang dianalisis dengan Receiver Operating Characteristic (ROC) untuk memperoleh nilai Cut off Point dan Sensitivitas.Hasil analisis dengan menggunakan ROC, diperoleh cut off point ≤ 24 dengan sensitivitas 87 % dengan Confidance Interval (CI) 95% dengan ROC area under the curve 0.912. Hasil penelitian dari penerapan terapi pijat diperoleh gambaran terdapat penurunan skor M-Chat dan perubahan status risiko gangguan spektrum autsime yang dimulai pada periode III hari ke 21-30 dan periode IV hari ke 31-40 pemberian terapi pijat.Kesimpulan penelitian ini adalah hasil analisis ROC pada modifikasi skor M-CHAT dapat digunakan untuk melakukan skrining dan menilai status risiko GSA, penerapan TPGSA dapat menurunkan skor risiko anak GSA dan dapat merubah anak risiko GSA dari risiko tingi menjadi risiko autisme dan normal.

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Research on massage therapy for children with ASD that was conducted over a period of 10-15 years was mostly aimed at children who had been diagnosed with autism spectrum disorders with the average age of children being between 3-6 years. In Indonesia, research on massage therapy in children at risk for ASD has not been widely carried out and reported in the form of scientific journal publications.

The prevalence of people with Autism Spectrum Disorders in some parts of the world tends to increase, such as in the United States, China and developing countries such as Indonesia. In Indonesia alone, accurate and complete data and information from people with Autism Spectrum Disorders (ASD) are still lacking, so it is feared that many children with risk symptoms of autism spectrum disorders do not get early treatment.

This study aims to develop a massage therapy modul for children at risk for ASD, find out and analyze the modification of The Modified Check List for Autism in Toddler (M-CHAT) score and determine the results of the application of MTASD in reducing the risk score for ASD in children aged 18-36 months. The type of research used is descriptive research with a case study approach. The study population was children aged 18-36 months who had participated in the M-CHAT screening/examination at the Pasar Minggu Community Health Center (CHC), CHC of Cipayung and CHC of Kebon Jeruk as many as 1685 people with the incidence of children at risk of autism as many as 14 people (0.8%) from May 2019 to March 2020. The research sample was 10 people who met the inclusion criteria. The number of children screened in order to modify the M-CHAT score was 904 children who were analyzed by Receiver Operating Characteristics (ROC) to obtain Cut off Point and Sensitivity values.

The results of the study based on ROC analysis obtained a cut off point ≤ 24 with a sensitivity of 87 % with a Confidance Interval (CI) of 95%, with an ROC area under the curve of 0.912. From the application of MTASD, it was found that a decrease in the M-CHAT score occurred in period III starting from day 30.

The conclusion of this study is that the results of the ROC analysis on the modified M-CHAT score can be used as a score to screen and assess the risk status of ASD, the application of MTASD can reduce the risk score of children with ASD and can change children at risk of ASD from high risk to autism risk and normal."

"Minum merupakan tantangan bagi bayi prematur karena imaturitas dan penyakit yang menyertainya. Bayi prematur yang dinyatakan siap minum seringkali tidak mampu minum. Saat ini belum terdapat tata laksana yang konsisten dan mempertimbangkan kompleksitas proses minum secara komprehensif. Tujuan penelitian ini adalah menentukan berbagai faktor yang memengaruhi ketidakmampuan minum dan membuktikan efektivitas tata laksana metode baru terhadap kemampuan minum bayi prematur.Penelitian dilakukan di lima rumah sakit di Jakarta pada bulan Agustus–November 2021. Studi potong lintang meneliti faktor yang memengaruhi ketidakmampuan minum 120 bayi prematur siap minum usia kehamilan 28–34 minggu, yaitu tonus postural fleksi fisiologis, stabilitas fisiologis, refleks rooting, kemampuan regulasi diri, morbiditas, dan behavioral state. Selanjutnya dilakukan randomized controlled trial (RCT) membandingkan tata laksana metode baru dan konvensional 70 bayi prematur belum mampu minum dari studi potong lintang. Metode baru mencakup therapeutic positioning fleksi fisiologis melalui pembedongan dan intervensi oromotor berupa stimulasi oral, gerakan sinergis three finger jaw control, dan isapan non-nutritif menggunakan empeng khusus. Metode konvensional mencakup pembedongan tradisional, stimulasi oral, dan isapan non-nutritif menggunakan empeng yang biasa digunakan di ruang perawatan. Analisis data studi potong lintang dilakukan dengan uji bivariat menghitung prevalence ratio (PR) dan nilai p; uji multivariat, penentuan titik potong skor faktor risiko ketidakmampuan minum melalui kurva Receiving Operating Characteristic (ROC), serta penentuan sensitivitas dan spesifisitasnya. Uji klinis membandingkan rentang waktu tercapainya kemampuan minum bayi yang diberikan kedua jenis metode. Data dianalisis dengan program STATA versi 14.2 (tingkat kemaknaan p < 0,05).Hasil studi potong lintang menunjukkan regulasi diri sebagai faktor utama yang memengaruhi ketidakmampuan minum bayi prematur dengan PR 1,96 (1,61–3,34; IK 95%) dan p = 0,012, diikuti tonus postural, behavioral state, dan morbiditas (PR 1,91; 1,59; 1,56). Skor faktor risiko ketidakmampuan minum memiliki area under the curve (AUC) sebesar 0,698, titik potong optimal pada skor ≥ 7 dengan sensitivitas 71,4% dan spesifisitas 54%. Hasil uji klinis membuktikan metode baru lebih efektif dibandingkan metode konvensional (4 vs. 7 hari; p = 0,02).Berbagai faktor yang memengaruhi ketidakmampuan minum bayi prematur siap minum adalah regulasi diri, tonus postural, behavioral state, dan morbiditas. Metode baru lebih efektif dibandingkan metode konvensional.

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Feeding for premature infants is a challenge because of their immaturity and comorbidities. Premature infants who are ready to feed are often not able to feed. Current managements have not been consistent and consider the complexity of the feeding process comprehensively. The purpose of this study was to determine various factors influencing feeding inability of premature infants and to verify the effectiveness of a new method management on the premature infants’ feeding ability.

The study was conducted in five hospitals in Jakarta in August–November 2021. A cross-sectional study examined factors influencing the oral feeding inability on 120 ready to feed premature infants born at 28–34 weeks of gestation. Evaluation of feeding inability risk factors included physiological flexion postural tone, physiological stability, rooting reflex, self-regulation ability, morbidity, and behavioral state. Subsequently, a randomized controlled trial (RCT) comparing the new and conventional method was conducted in 70 premature infants who were not able to feed from the cross-sectional study participants. The new method encompasses physiological flexion therapeutic positioning swaddling, and oromotor intervention consisting of oral stimulation, synergic three finger jaw control, and non-nutritive sucking by using a specific pacifier. The conventional method consists of traditional swaddling, oral stimulation, and non-nutritive sucking using the usual pacifier in the nursery room. In the cross-sectional study, bivariate analysis was done to determine the prevalence ratio (PR) and p value; multivariate analysis, Receiving Operating Characteristic (ROC) curve to determine the scoring system cut-off point, as well as its sensitivity and specificity. Clinical trial data analysis compared the new and conventional method effectivity in terms of duration needed to achieve feeding ability in premature infants. STATA version 14.2 was used for data analysis (level of significance p < 0,05).

The results from the cross-sectional study showed that self-regulation had the highest influence of feeding inability with PR 1,96 (1,61–3,34; IK 95%) and p = 0,012, followed by postural tone, behavioral state, and morbidity (PR 1,91; 1,59; 1,56). The feeding inability risk score had an area under the curve (AUC) of 0.698, an optimal cut–off point of ≥ 7, as well as sensitivity of 71,4%, and specificity of 54%. In clinical trials, it was proven that the new method was more effective than the conventional method (4 vs. 7 days; p = 0,02).

Factors influencing feeding inability in premature infants were self-regulation, postural tone, behavioral state, and morbidity. The new method management was more effective than the conventional method."