Latar belakang: : Gangguan spektrum autisme (GSA) adalah gangguan
neurodevelopmental yang menyebabkan gangguan komunikasi sosial, interaksi serta
perilaku restriktif dan repetitif yang meliputi gangguan sensori. Gangguan pemrosesan
sensorik menimbulkan kesulitan dalam meregulasi respons terhadap sensasi dan stimulus
spesifik sehingga membatasi kemampuan berpartisipasi dalam rutinitas harian normal.
Terapi okupasi sensori integrasi (TO-SI) digunakan untuk meningkatkan kemampuan
untuk memproses dan mengintegrasi informasi sensorik. Penelitian menunjukkan bukti
ilmiah rendah hingga sedang pada anak usia lebih besar. Berdasarkan pengalaman klinis
Pusponegoro, TO-SI dapat meningkatkan perilaku positif anak GSA terutama pada usia
di bawah 5 tahun. Penelitian ini bertujuan untuk mengevaluasi pengaruh TO-SI dalam
meningkatkan perilaku positif anak usia 2 sampai 5 tahun dengan GSA.
Metode: Penelitian pra-eksperimen di klinik Check My Child (CMC) dan Klinik Anakku
Kelapa Gading pada bulan Maret-Oktober 2019. Populasi penelitian adalah anak baru
dengan GSA usia 2-5 tahun berdasarkan DSM-5. Subyek dikumpulkan secara konsekutif
sampling. Pelaksanan TO-SI yaitu dua kali seminggu selama 12 minggu (24 kali), 60
menit 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 positif
berada pada kategori rendah. Setelah TO-SI, terdapat peningkatan bermakna domain
komunikasi, subdomain ekspresif, reseptif dan tertulis (p<0,001; p<0,001; p<0,001; p
0,035) terutama pada kelompok usia 2-4 tahun. Domain sosialisasi, subdomain hubungan
interpersonal serta subdomain waktu luang dan bermain juga meningkat bermakna (p
0.001; p<0.001; p,0.001) terutama pada kelompok usia 2 tahun. Tidak terdapat
peningkatan bermakna pada subdomain kemampuan coping, serta domain dan subdomain
keterampilan aktivitas harian.
Kesimpulan: Kami menemukan bahwa TO-SI dengan kepatuhan teori Ayres yang baik
dalam 60 menit, dua kali seminggu selama 12 minggu dapat meningkatkan perilaku
positif anak GSA usia dini terutama usia 2 hingga 5 tahun
Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental
disorder in social communication, interaction, and restrictive, repetitive pattern of
behavior (including sensory disorder). Sensory processing disorder yields difficulty in
regulating responses to sensation and spesific stimuli which limits the ability to
participate in normal life routines. Sensory integration occupational therapy (SI-OT) is a
method to increase ability to process and integrate sensory information. Most studies
showed that SI-OT has low to moderate evidence in older children. Based on clinical
experience of Pusponegoro, SI-OT might be useful for ASD treatment for children under
5 years old. We conducted a study to evaluate the effect of SI-OT in improving positive
behavior of children aged 2 to 5 years old with ASD.
Methods: A pre-post one group pre-experimental study conducted in Check My Child
clinic (CMC) and Klinik Anakku Kelapa Gading on March-October 2019. Study
population were recently diagnosed ASD children aged 2 to 5 years old. Subjects were
collected 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 positive
behavior 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 subjects
were 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. After
SI-OT, communication domain and subdomains (expressive, receptive, written
subdomain) were improved significantly (p<0.001; p<0.001; p<0.001; p 0.035). These
improvement were available in age group of 2,3, and 4 years old. Significant
improvements were also achieved in socialization domain (p 0.001) including
interpersonal 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 12
weeks could improve positive behavior, in communication domain (expressive, receptive,
written subdomain) aged 2-4 years old, and socialization domain (interpersonal
relationship, play and leisure time) aged 2 years old.