Tesis

Pengaruh terapi okupasi sensori integrasi dalam meningkatkan perilaku positif anak 2 sampai 5 tahun dengan gangguan spektrum autisme = The effect of sensory integration occupational therapy in improving positive behaviors of children aged 2 to 5 years old with autism spectrum disorders .

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 BehaviorII 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.
Kata kunci: gangguan spektrum autisme, terapi sensori integrasi, perilaku positif


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.
Key words: autism spectrum disorder, sensory integration occupational therapy, positive behavior