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Abstrak :
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

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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.

Abstrak :
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. ......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.