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Abstrak :
[ABSTRAK
Latar Belakang : Kemampuan berbahasa merupakan salah satu indikator perkembangan anak karena melibatkan kemampuan kognitif, sensori motor, psikologis, emosi dan lingkungan disekitar anak. Penilaian kemampuan bahasa anak sangat penting pada periode 2-4 tahun karena terjadi peningkatan jumlah dan kompleksitas dalam perkembangan bicara dan bahasa. Penilaian dapat dilakukan oleh tenaga kesehatan maupun oleh orang tua. Keterbatasan tenaga kesehatan di daerah rural menyebabkan penilaian berbasis orang tua sangat penting sehingga dibutuhkan instrumen yang sesuai dengan budaya, bahasa dan lingkungan anak. Tujuan penelitian adalah mengetahui akurasi instrumen penilaian kemampuan bahasa berbasis orang tua pada anak usia 18-36 bulan didaerah rural.

Metode : Subjek penelitian diambil dari anak usia 18 ? 36 bulan dan orang tua/pelaku rawat peserta posyandu di desa Sukarapih, Kecamatan Tambelang, Kabupaten Bekasi. Orang tua/pelaku rawat harus mampu membaca dan mengerti bahasa Indonesia. Perkembangan bahasa anak dinilai dengan skala REEL (Receptive Expressive Emergent Language) modifikasi oleh orang tua dan skala ELM (Early Language Milestone) oleh peneliti. Hasil penilaian skala REEL dibandingkan dengan skala ELM melalui uji diagnostik untuk mendapatkan nilai sensitivitas dan spesifitas, nilai prediksi positif dan negatif serta likelihood ratio (LR).

Hasil : Jumlah subjek terdiri dari 100 anak dan 100 orang tua/pelaku rawat yang diambil dari empat posyandu. Skala REEL mempunyai nilai sensitivitas 72,73 %, spesifisitas 98,87 %, nilai prediksi positif 88,89%, nilai prediksi negatif 96,70%, LR positif 64,73 dan LR negatif 0,28.

Kesimpulan : Skala REEL dapat dipakai dalam menilai gangguan perkembangan bahasa pada anak usia 18-36 bulan di daerah rural dengan menggunakan kalimat yang lebih sederhana dan mudah dipahami.

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ABSTRACT
Background : Language skill is one of the indicator of a child's development because it involves cognitive ability, sensory motor, the psychological, emotional and environment around children. Assessment of a child's language skill at the age of 2-4 years is very important due to an increase in the number and complexity in the development of speech and language. Assessment can be done by health professionals as well as by parents. Limitations of available health workers in rural areas increases the need for a parental-based assessment tool that is applicable with the culture, language and environment of the children. The research objective was to determine the accuracy of the parental-based language assessment instrument on children aged 18-36 months in rural areas.

Methods : The subjects were children aged 18-36 months and their parents / caregivers who were participants of Sukarapih neighborhood health center in the village, District Tambelang, Bekasi Regency. Parents / caregivers should be able to read and understand Bahasa Indonesia. The children's language development was assessed using the modified REEL (receptive Expressive Emergent Language) scale by their parents and the ELM (Early Language Milestone) scale by the researcher. The REEL-scale assessment results was compared with ELM scale through a diagnostic test for sensitivity and specificity, positive and negative predictive values as well as likelihood ratio (LR).

Results : The subjects consisted of 100 children and 100 parents / caregivers taken from four neighborhood health center. The REEL scale has 72.73% sensitivity, 98.87% specificity, 88.89% positive predictive value, 96.70% negative predictive value, 64.73 positive LR and of 0.28 negative LR.

Conclusion : The REEL Scale can be used to assess language development disorders in children aged 18-36 months in rural areas by using simplified and easy to understand sentences.;Background : Language skill is one of the indicator of a child's development because it involves cognitive ability, sensory motor, the psychological, emotional and environment around children. Assessment of a child's language skill at the age of 2-4 years is very important due to an increase in the number and complexity in the development of speech and language. Assessment can be done by health professionals as well as by parents. Limitations of available health workers in rural areas increases the need for a parental-based assessment tool that is applicable with the culture, language and environment of the children. The research objective was to determine the accuracy of the parental-based language assessment instrument on children aged 18-36 months in rural areas. Methods : The subjects were children aged 18-36 months and their parents / caregivers who were participants of Sukarapih neighborhood health center in the village, District Tambelang, Bekasi Regency. Parents / caregivers should be able to read and understand Bahasa Indonesia. The children's language development was assessed using the modified REEL (receptive Expressive Emergent Language) scale by their parents and the ELM (Early Language Milestone) scale by the researcher. The REEL-scale assessment results was compared with ELM scale through a diagnostic test for sensitivity and specificity, positive and negative predictive values as well as likelihood ratio (LR). Results : The subjects consisted of 100 children and 100 parents / caregivers taken from four neighborhood health center. The REEL scale has 72.73% sensitivity, 98.87% specificity, 88.89% positive predictive value, 96.70% negative predictive value, 64.73 positive LR and of 0.28 negative LR. Conclusion : The REEL Scale can be used to assess language development disorders in children aged 18-36 months in rural areas by using simplified and easy to understand sentences.;Background : Language skill is one of the indicator of a child's development because it involves cognitive ability, sensory motor, the psychological, emotional and environment around children. Assessment of a child's language skill at the age of 2-4 years is very important due to an increase in the number and complexity in the development of speech and language. Assessment can be done by health professionals as well as by parents. Limitations of available health workers in rural areas increases the need for a parental-based assessment tool that is applicable with the culture, language and environment of the children. The research objective was to determine the accuracy of the parental-based language assessment instrument on children aged 18-36 months in rural areas. Methods : The subjects were children aged 18-36 months and their parents / caregivers who were participants of Sukarapih neighborhood health center in the village, District Tambelang, Bekasi Regency. Parents / caregivers should be able to read and understand Bahasa Indonesia. The children's language development was assessed using the modified REEL (receptive Expressive Emergent Language) scale by their parents and the ELM (Early Language Milestone) scale by the researcher. The REEL-scale assessment results was compared with ELM scale through a diagnostic test for sensitivity and specificity, positive and negative predictive values as well as likelihood ratio (LR). Results : The subjects consisted of 100 children and 100 parents / caregivers taken from four neighborhood health center. The REEL scale has 72.73% sensitivity, 98.87% specificity, 88.89% positive predictive value, 96.70% negative predictive value, 64.73 positive LR and of 0.28 negative LR. Conclusion : The REEL Scale can be used to assess language development disorders in children aged 18-36 months in rural areas by using simplified and easy to understand sentences., Background : Language skill is one of the indicator of a child's development because it involves cognitive ability, sensory motor, the psychological, emotional and environment around children. Assessment of a child's language skill at the age of 2-4 years is very important due to an increase in the number and complexity in the development of speech and language. Assessment can be done by health professionals as well as by parents. Limitations of available health workers in rural areas increases the need for a parental-based assessment tool that is applicable with the culture, language and environment of the children. The research objective was to determine the accuracy of the parental-based language assessment instrument on children aged 18-36 months in rural areas. Methods : The subjects were children aged 18-36 months and their parents / caregivers who were participants of Sukarapih neighborhood health center in the village, District Tambelang, Bekasi Regency. Parents / caregivers should be able to read and understand Bahasa Indonesia. The children's language development was assessed using the modified REEL (receptive Expressive Emergent Language) scale by their parents and the ELM (Early Language Milestone) scale by the researcher. The REEL-scale assessment results was compared with ELM scale through a diagnostic test for sensitivity and specificity, positive and negative predictive values as well as likelihood ratio (LR). Results : The subjects consisted of 100 children and 100 parents / caregivers taken from four neighborhood health center. The REEL scale has 72.73% sensitivity, 98.87% specificity, 88.89% positive predictive value, 96.70% negative predictive value, 64.73 positive LR and of 0.28 negative LR. Conclusion : The REEL Scale can be used to assess language development disorders in children aged 18-36 months in rural areas by using simplified and easy to understand sentences.]

Abstrak :
Gangguan komunikasi pada anak dengan palsi serebral dapat meliputi gangguan pada proses berbicara dan berbahasa baik ekspresif maupun reseptif. Gangguan fungsi komunikasi berpengaruh secara bermakna terhadap kualitas hidup anak dengan palsi serebral terutama dalam domain aktivitas sehari-hari dan partisipasi dalam hubungan sosial. Sistem penilaian fungsi komunikasi pada anak dengan palsi serebral sangat diperlukan untuk mendapatkan data dasar fungsi komunikasi anak. Communication Function Classification System (CFCS) merupakan instrumen yang dipakai untuk mengelompokkan fungsi komunikasi anak dengan palsi serebral. Penelitian ini bertujuan untuk menguji kesahihan dan keandalan instrumen CFCS yang diadaptasi dan diterjemahkan dalam budaya dan bahasa Indonesia. Penelitian ini dilaksanakan di poliklinik Departemen Rehabilitasi Medik divisi Pediatri RSCM dari 1 Oktober 2021 hingga 28 Februari 2022. Metode yang digunakan adalah desain potong lintang dengan sampel berjumlah 42 orang. Uji kesahian menggunakan validitas isi. Data diolah dengan uji keandalan inter-rater menggunakan koefisien Kappa dan test-retest menggunakan Intraclass Correlation Coefficient (ICC). Hasil penelitian menunjukkan nilai koefisien Kappa antara rater dokter dengan terapi wicara adalah 0,643 (baik), nilai antara rater dokter dengan pelaku rawat adalah 0,385 (lemah) dan nilai antara rater terapi wicara dengan pelaku rawat adalah 0,333 (lemah). Nilai ICC pada rater dokter adalah 1,000, rater terapis wicara adalah 0.973 dan pada rater pelaku rawat adalah 0,937. Berdasarkan hasil dari proses translasi, adaptasi bahasa, uji keandalan inter rater dan test retest maka dapat disimpulkan CFCS versi bahasa Indonesia merupakan instrumen yang sahih dan memiliki keandalan yang baik antara rater dokter dan terapi wicara untuk digunakan sebagai alat klasifikasi fungsi komunikasi penderita palsi serebral di Indonesia. ......Communication disorders in children with cerebral palsy can include disturbances in speech and language processes, both expressive and receptive. Impaired communication function significantly affects quality of life of children with cerebral palsy, especially in the domain of daily activities and participation in social relationships. The communication function classification system in children with cerebral palsy is needed to obtain basic data on children's communication functions. The Communication Function Classification System (CFCS) is an instrument used to classify the communication functions of children with cerebral palsy. This study aims to test the validity and reliability of the CFCS instrument adapted and translated into Indonesian culture and language. This research was conducted at the Polyclinic of Department of Medical Rehabilitation in Pediatrics Division of RSCM from October 1, 2021 to February 28, 2022. The method used was a cross-sectional design with a sample of 42 subjects. Validity test using content validity. The data was processed by inter-rater reliability test using Kappa coefficient and test-retest using Intraclass Correlation Coefficient (ICC). The results showed that the Kappa coefficient between raters of doctors and speech therapy was 0.643 (good), the value between raters of doctors and caregivers was 0.385 (weak) and the value between raters of speech therapy and caregivers was 0.333 (weak). The ICC value for the doctor rater is 1,000, the speech therapist rater is 0.973 and the caregivers rater is 0.937. Based on the translation process, language adaptation, inter rater reliability test and test retest, it can be concluded that the Indonesian version of the CFCS is a valid instrument and has good reliability between rater doctors and speech therapy to be used as a means of classifying the communication function of patients with cerebral palsy in Indonesia.

Abstrak :
Latar belakang: GPK adalah gangguan neurodevelopmental yang dikarakteristikkan dengan gangguan performa motorik dalam melakukan aktivitas sehari-hari yang tidak konsisten dengan usia dan intelegensi anak. Penyandang GPK juga memiliki gangguan keseimbangan selain gangguan motorik kasar dan halus yang memiliki ciri khas berupa kesulitan dalam proses pembelajaran motorik, sehingga akan membutuhkan waktu yang lebih lama dalam prosesnya. Akibat gangguan yang dimilikinya, anak dengan GPK cenderung melakukan isolasi dan restriksi dari beragam aktivitas fisik yang apabila tidak dikoreksi dapat memberikan defisit di bidang lainnya seperti akademis, perawatan diri bahkan mental yang akhirnya dapat mempengaruhi kualitas hidup anak. Gangguan ini dapat menetap hingga dewasa namun apabila diberikan intervensi dapat memberikan keluaran yang lebih baik dalam performa motorik anak, sehingga sebuah intervensi penting untuk diberikan. Penyandang GPK memiliki defisit mulai dari gerakan yang diinisiasi diri, gangguan motorik prefungsional, Kemampuan kontrol motoric dan performa motorik serta keterampilan motorik yang akhirnya mempengaruhi fungsi motoric adaptifnya, dalam hal ini bermain. Sementara engklek sendiri berperan dalam fungsi motorik adaptif yaitu bermain bersama dalam komunitas, yang aktivitasnya meliputi lompat,lempar dan berbalik, yang dengan pelatihan dapat meningkatkan fungsi koordinasi serta keseimbangan dan tidak lupa peningkatan motivasi bergerak serta memenuhi unsur praktek berulang. Metode: Penelitian ini merupakan studi intervensi dengan consecutive sampling pada 18 orang anak sekolah dasar berusia 6-12 tahun dengan GPK yang memiliki skor motorik pada zona merah berdasarkan penilaian dengan Movement Assessment Battery for Children-2. Intervensi yang diberikan berupa latihan engklek sebanyak 2x/minggu sebanyak 10 kali putaran selama 6 minggu. Hasil: Dari hasil penilaian skor pada awal, minggu ketiga dan akhir penelitian didapatkan peningkatan fungsi keseimbangan, namun hasilnya tidak signifikan secara statistik. Tidak signifikannya perbaikan ini dapat didasari oleh dasar mekanisme pada GPK yaitu kesulitan dalam proses pembelajaran motorik itu sendiri. Dalam penelitian ini, tiap anak hanya mendapatkan 120x momen permainan engklek total yang setara dengan 520 kali pengulangan lompat dengan satu kaki. Sehingga,penyandang GPK perlu lebih banyak latihan untuk menyesuaikan dengan kondisinya Kesimpulan: permainan tradisional engklek memberikan perbaikan skor keseimbangan pada anak dengan GPK yang tidak signifikan secara statistik ......DCD is a neurodevelopmental disorder characterized by motor performance problems in daily activities that are inconsistent with the age and intelegency. Children with DCD also has a balance problem in addition to fine and gross motor problems with a characteristic of difficulty in the motor learning process, which can take a longer time in motor learning process. Due to his or her problems, child with DCD tends to make a self isolation and restriction to various physical activities. Uncorrected problems in DCD children leads to other areas deficits such as academic, self-care even mental problems that can eventually affect children quality of life. These disorders can remain to adulthood but when given the intervention can provide better output in children motor performance, so that an intervention is important to this condition. DCD children have a deficit ranging from self-initiated movements, prefunctional Motor disorders, motoric control capabilities and motor performance as well as motor skills that ultimately affect its adaptive motoric function like plays. While the Engklek itself plays a role in adaptive motor function like play together in the community, whose activities include jumping, throwing and turning, which with training can improve the function of coordination as well as balance and also increased motivation to moves and fulfill elements of repetitive practice. Methods: This research is an intervention study with consecutive sampling in 18 elementary school children aged 6-12 years with DCD that has a motor score in the red zone based on the assessment with the Movement Assessment Battery for Children-2. The intervention given is 2x/week of Engklek training as much as 10 rounds for 6 weeks. Results: Assessment was taken at baseline, third and final week of study which shows improved balance function, but the results were not statistically significant. This finding might because of the based on the basic mechanism of DCD i.e difficulty in the motor learning process itself. In this study, each child only gained 120x a total game moment equivalent to 520 times the jump loop with one foot. Thus, DCD child needs more exercise to adjust to its condition. Conclusion: Engklek traditional game usually provide balance function score improvement in children with DCD but not statistically significant

Abstrak :
esis ini bertujuan untuk mengetahui kesahihan dan keandalan Eating and Drinking Ability Classification System (EDACS) versi Bahasa Indonesia pada anak Palsi serebral. EDACS diterjemahkan dan diadaptasi kultural ke dalam Bahasa Indonesia menggunakan metode FACIT (Functional Assessment of Chronic Illness Therapy). Kesepakatan antar rater terapis wicara dan dokter ketika menggunakan EDACS dinilai menggunakan koefisien Kappa. Sebanyak 30 anak dengan Palsi serebral (usia rata-rata 6 tahun, SD 3,2 tahun, kisaran 3-16 tahun) diklasifikasikan kemampuan makan dan minumnya dengan EDACS. Hasil reabilitas inter rater terapis wicara menunjukkan tingkat kesepakatan yang sangat kuat (tingkat EDACS, k=0.871) dan kuat (tingkat pendampingan k=0.80). Reliabilitas inter rater dokter menunjukkan tingkat kesepakatan yang kuat (tingkat EDACS, k=0.703; tingkat pendampingan, k= 0.788. Keeratan kesepakatan inter rater terapis wicara dan dokter untuk tingkat EDACS dan tingkat pendampingan adalah sangat kuat ( k =0.828 dan k =0.895). Kesimpulan dari penelitian ini adalah EDACS versi bahasa Indonesia sahih dan andal digunakan oleh dokter dan terapis bahasa wicara dalam mengklasifikasikan kemampuan fungsional makan dan minum pada anak Palsi serebral. .......This thesis aims to determine the validity and reliability of the Indonesian version of the Eating and Drinking Ability Classification System (EDACS) in children with cerebral palsy. EDACS was translated and culturally adapted into Bahasa Indonesia using the FACIT (Functional Assessment of Chronic Illness Therapy) method. Agreement between speech therapist and medical doctor raters when using EDACS was assessed by Kappa coefficient. A total of 30 children with cerebral palsy (mean age 6 years, SD 3.2 years, range 3-16 years) had their ability to eat and drink classified using EDACS. The speech therapist inter-rater reliability results showed a very strong agreement (EDACS level, κ=0.871) and strong agreement (EDACS level of assistance κ=0.80). The inter-rater reliability of medical doctors showed a strong agreement (EDACS level, κ=0.703; EDACS level of assistance, κ= 0.788). The agreement between speech therapists and medical doctors for EDACS level and level of assistance is very strong (κ =0.828 and κ =0.895). The conclusion of this study is the Indonesian version of EDACS is valid and reliable to be used by medical doctors and speech therapists in classifying functional eating and drinking abilities in children with cerebral palsy.

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ABSTRAK
Tesis ini melaporkan gambaran skor nasalance pada defek celah palatum, hubungan antara skor nasalance percontoh celah palatum dan percontoh tanpa celah palatum serta mengetahui faktor-faktor yang berhubungan dengan skor nasalance pada pasien celah palatum berdasarkan klasifikasi Veau. Desain penelitian adalah comparative cross sectional. Pengambilan percontoh dilakukan dengan purposive sampling, dilakukan di Departemen THT-KL FK UI-RSCM serta Instalasi Rehabilitasi Medik RSUP Fatmawati. Percontoh dikelompokkan menjadi 2 yaitu kelompok celah palatum dan tanpa celah palatum sebagai kontrol. Jumlah percontoh adalah 17 untuk masing-masing kelompok. Dilakukan pengumpulan data berupa wawancara, pengisian kuesioner, selanjutnya pemeriksaan THT, audiometri, timpanometri, nasoendoskopi dan nasometri. Didapatkan hasil gambaran rerata skor nasalance percontoh celah palatum Uji Gajah kelompok Veau 1 45,40% ± 10,6; Veau 2 41,74% ± 11,6; Veau 3 52,88%; celah palatum sub mukosa 55,67% ± 6,2. Pada Uji Hantu didapatkan rerata skor nasalance kelompok Veau 1 43,90 % ± 6,8; Veau 2 40,59% ± 13,7; Veau 3 59,8% dan celah palatum sub mukosa 49,02% ± 7,5. Pada Uji Sengau, rerata kelompok Veau 1 40,16 % ± 7,2; Veau 2 41,77% ± 13,4; Veau 3 70,51% dan celah palatum sub mukosa 62,75% ± 6,3. Terdapat perbedaan yang bermakna antara skor nasalance percontoh celah palatum dan tanpa celah palatum pada Uji Gajah dan Uji Hantu (p<0,001), sedangkan pada Uji Sengau tidak bermakna (p>0,05). Pada analisis multivariat secara keseluruhan faktor-faktor yang berhubungan dengan skor nasalance ((adenoid, Otitis Media Efusi (OME) dan gangguan pendengaran)) dan keberadaan celah palatum berpengaruh secara signifikan terhadap skor nasalance pada semua uji nasalance (p<0,05) pada pengujian terhadap kedua kelompok percontoh, dan tidak berpengaruh secara signifikan pada pengujian kelompok celah palatum saja. Bila dilihat secara parsial faktor adenoid berpengaruh secara signifikan terhadap skor semua uji nasalance baik pada analisis kedua kelompok percontoh maupun pada percontoh celah palatum saja.

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ABSTRACT
This paper reported nasalance score in cleft palate patients, the correlation between nasalance score in cleft palate and non cleft palate patients and also factors related with nasalance score in cleft palate patients in Veau criteria. The design of this study is comparative cross sectional, with purposive sampling in ENT Department of Indonesian University-Cipto Mangunkusumo Hospital and Instalation of Medical Rehabilitation Fatmawati Hospital. Sample devided in to 2 groups, cleft palate and non cleft palate group with 17 samples in each group. Data was collected with interview, questioner application, ENT examination, audiometry, tympanometry, nasoendoscopy and nasometry. The result of this study reported mean of nasalance score in cleft palate patients, Uji Gajah in Veau 1 patients is 45,40% ± 10,6; Veau 2 41,74% ± 11,6; Veau 3 52,88% and sub mucous cleft palate 55,67% ± 6,2. In Uji Hantu the nasalance score are Veau 1 patients 43,90 % ± 6,8; Veau 2 40,59% ± 13,7; Veau 3 59,8% and sub mucous cleft palate 49,02% ± 7,5. In Uji Sengau, the score are Veau 1 40,16 % ± 7,2; Veau 2 41,77% ± 13,4; Veau 3 70,51% and sub mucous cleft palate 62,75% ± 6,3. There is significant difference in nasalance score between cleft palate and non cleft palate patients in Uji Gajah and Uji Hantu (p>0,05) but no differences in Uji Sengau. In multivariate analysis, in general the factors related with nasalance score ((adenoid, Otitis Media with Effusion, hearing loss)) and also existancy of cleft palate is significantly correlated with nasalance score in all nasalance test (p<0,05) in both groups analysis but no signifficant correlation in cleft palate group analysis. Partially, adenoid is significantly correlated with nasalance score in both group analysis and cleft palate group analysis.