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"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."

"Latar belakang: Penentuan kebutuhan nutrisi secara tepat pada anak sakit kritis perludilakukan untuk menghindari underfeeding dan overfeeding. Rumus estimasi menjadidasar perkiraan kebutuhan energi jika kalorimetri indirek sebagai baku emas tidaktersedia. Akurasi rumus pada studi terdahulu sangat bervariasi dan dipengaruhi olehkarakteristik populasi setempat, sehingga akurasinya perlu diuji pada populasi Indonesia.Tujuan: Mengevaluasi akurasi rumus Schofield WH, Schofield W, dan WHOdibandingkan kalorimetri indirek, serta mengevaluasi dampak penambahan faktor stresterhadap akurasi.Metode: Penelitian deskriptif analitik potong lintang ini mengikutsertakan pasien anakyang menggunakan ventilasi mekanik Mei sampai Juli 2019. Analisis kesesuaiandilakukan dengan membandingkan perhitungan rumus Schofield WH, Schofield W, danWHO, dengan dan tanpa faktor stres terhadap pengukuran kalorimetri indirek.Hasil: Penelitian mengikutsertakan 52 subjek pada hari perawatan 1-5 di PICU denganmedian usia 5 tahun (1 bulan 10 hari hingga 17 tahun 9 bulan). Kebutuhan energi yangdiukur kalorimetri indirek adalah 60,7 ± 23,5 Kkal/kg/hari. Estimasi rumus SchofieldWH, Schofield W, dan WHO lebih rendah dari hasil pengukuran tersebut dengan %biasberturut-turut -13 ± 19, -15 ± 20, dan -16 ± 21. Nilai estimasi dan hasil pengukurankalorimetri indirek berkorelasi kuat (intraclass correlation coefficient r > 0,9) namuninterval kesesuaian (limit of agreement) dari %bias sangat lebar. Hanya 12 (23%) subjekyang memiliki nilai estimasi akurat sesuai dengan kalorimetri indirek. Pada populasipenelitian ini faktor stres meningkatkan akurasi rumus estimasi.Simpulan: Rumus Schofield WH, Schofield W, dan WHO tidak akurat sebagai estimasikebutuhan energi anak sakit kritis. Hasil prediksi rumus tersebut lebih rendah darikebutuhan aktual jika faktor stres tidak digunakan.

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Background: Accurate estimation of energy expenditure in critically ill children isimportant to avoid underfeeding and overfeeding. Prediction formula helps to estimateenergy expenditure when the gold standard indirect calorimetry is not available. Previousstudy on estimation accuracy yielded variable result in different populationcharacteristics, therefore the accuracy of prediction formula in Indonesian populationneeds to be evaluated.Objective: To assess the accuracy of Schofield WH, Schofield W, and WHO formulacompared to indirect calorimetry. To evaluate the impact of additional stress factor on theaccuracy of prediction formula.Methods: This is a descriptive analytic cross-sectional study on mechanically ventilatedcritically ill children held in May-July 2019. We analyze the agreement of measuredenergy expenditure using indirect calorimetry and estimated energy expenditurecalculated by Schofield WH, Schofield W, and WHO formula, with and withoutadditional stress factor.Results: This study included 52 subjects with median age 5 years old (1 month 10 days -17 years 9 months) on day 0-5 after they were admitted to PICU. Mean measuredenergy expenditure was 60,7 ± 23,5 Kcal/kg/day. All estimated energy expenditure bySchofield WH, Schofield W, and WHO were lower than measured energy expenditurewith % bias of -13 ± 19, -15 ± 20, and -16 ± 21, respectively. Estimated and measuredvalue have strong correlation (intraclass correlation coefficient r > 0.9) but the limit ofagreement interval is too wide. Only 12 (23%) subjects have accurate estimation ofenergy expenditure. In this population stress factor improves the accuracy of predictionformulas.Conclusion: Schofield WH, Schofield W, and WHO formula have poor accuracy inestimating energy expenditure in critically ill children. Without additional stress factor,the estimated value were lower than actual/measured energy expenditure"