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Developing a Management Model of Early Education Services for Children With Autism Putranti, Alifiani Hikmah; Florentinus, Totok Sumaryanto; Sugiharto, Dwi Yuwono Puji; Herini, Elisabeth Siti
The Journal of Educational Development Vol 7 No 1 (2019): February 2019
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jed.v7i1.29891

Early education services for children with autism are a place for early intervention for autistic children of pre-school age as a bridge to further education. Autism is a neurological development disorder under the age of 3 years with characteristics of communication and behavioral disorders. Pre-school age is a period of rapid brain development so early intervention or early education for children with autism is an attempt to reduce the manifestation of autism clinics. Development of early education service management for children with autism aims to intervene with autism from an early age in a comprehensive manner and in accordance with their growth and development. This study applies the Research and Development approach through four stages, namely (1) preliminary research, (2) model development, (3) validation, and (4) final model. Data were drawn using open and closed questionnaires and interviews in four early education service institutions for children with autism in Semarang. The data were processed using descriptive analysis, percentage, average, and qualitative analysis. The final model of early education service management for children with autism focuses on aspects of management which consist of (1) comprehensive planning based on the standard parameters by considering comorbidities and health status and (2) early education for children with autism carried out comprehensively and sustainably between teachers, parents, and medical personnel.

Eating Behavior of Autistic Children Handayani, Maulina; Herini, Elisabeth Siti; Takada, Satoshi
Nurse Media Journal of Nursing Vol 2, No 1 (2012): (JUNE 2012)
Publisher : Department of Nursing, Faculty of Medicine, Diponegoro University

Association between autism and eating problem has been discussed in US and European countries recently, but there are only a few studies about that matter in Asian countries. Objective: This study provides information about eating behavior in autistic children in comparison with Typically Developing (TD) children in two different countries, which are Japan and Indonesia. Method: Participants of this study were 39 Japanese and 13 Indonesian parents with autistic children and 197 Japanese and 144 Indonesian parents of TD. Ages of subjects were between 3 to 6 years old. Eating behavior was evaluated by using Brief Autism Mealtime Inventory (BAMBI) completed by parents. Result showed that commonly children in both countries had eating behavior problems and children with autistic showed more problems than TD children. It is estimated that autistic children have a delay in eating development that may influence their eating behaviors. It is also reported that cultural background can be considered as another influencing factor in the difference of eating behavior in each country. Conclusion: Our study provided information that Autism children have problem in eating behavior. It needs to be noticed continually by clinicians and parents, although problem in eating behavior is not a core feature of autism; it can be an associate feature in autism. Key words: Autism, Eating behavior, Children

Developing a Management Model of Early Education Services for Children With Autism Putranti, Alifiani Hikmah; Florentinus, Totok Sumaryanto; Sugiharto, Dwi Yuwono Puji; Herini, Elisabeth Siti
The Journal of Educational Development Vol 7 No 1 (2019): February 2019
Publisher : Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/jed.v7i1.29891

Early education services for children with autism are a place for early intervention for autistic children of pre-school age as a bridge to further education. Autism is a neurological development disorder under the age of 3 years with characteristics of communication and behavioral disorders. Pre-school age is a period of rapid brain development so early intervention or early education for children with autism is an attempt to reduce the manifestation of autism clinics. Development of early education service management for children with autism aims to intervene with autism from an early age in a comprehensive manner and in accordance with their growth and development. This study applies the Research and Development approach through four stages, namely (1) preliminary research, (2) model development, (3) validation, and (4) final model. Data were drawn using open and closed questionnaires and interviews in four early education service institutions for children with autism in Semarang. The data were processed using descriptive analysis, percentage, average, and qualitative analysis. The final model of early education service management for children with autism focuses on aspects of management which consist of (1) comprehensive planning based on the standard parameters by considering comorbidities and health status and (2) early education for children with autism carried out comprehensively and sustainably between teachers, parents, and medical personnel.

Faktor-Faktor yang Berhubungan dengan Masalah Tidur Remaja Selama Pandemi Covid-19 Sri Hartini; Khairun Nisa; Elisabeth Siti Herini
Sari Pediatri Vol 22, No 5 (2021)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.5.2021.311-7

Latar belakang. Masalah tidur pada remaja selama pandemi Covid-19 dilaporkan sekitar 20-66%. Rendahnya dukungan sosial, gangguan akademik dan kesehatan fisik yang menurun, paparan informasi, pengetahuan dan sikap tentang kesehatan tidur berhubungan dengan masalah tidur dan kebiasaan tidur pada remaja. Tujuan. Tujuan penelitian ini untuk mengetahui gambaran masalah tidur remaja dan faktor yang berhubungan selama pandemi Covid-19. Metode. Penelitian ini menggunakan desain cross-sectional. Seratus empat (104) remaja berusia 12-15 tahun di Kecamatan Samaturu, Kabupaten Kolaka, Sulawesi Tenggara di rekruit menjadi responden penelitian. Sleep Disturbance Scale for Children (SDSC), kuesioner pengetahuan dan sikap tentang tidur digunakan untuk mengukur masalah tidur, pengetahuan dan sikap tentang tidur. Uji regresi linear digunakan untuk menganalisis faktor-faktor yang berhubungan dengan tidur remaja. Hasil. Prevalensi masalah tidur pada remaja selama pandemi Covid-19 sebesar 78%. Gangguan transisi tidur bangun merupakan jenis masalah tidur yang paling tinggi ditemukan (53%). Pengetahuan dan sikap tentang tidur berhubungan dengan masalah tidur remaja selama pandemik Covid-19. Kesimpulan. Sebagian besar remaja berusia 12-15 tahun mengalami masalah tidur selama pandemi Covid-19. Faktor yang paling dominan berhubungan dengan masalah tidur adalah sikap remaja tentang kesehatan tidur.

Luaran Klinis Anak dengan Epilepsi yang Mengalami Relaps Setelah Penghentian Obat Antiepilepsi Agung Triono; Elisabeth Siti Herini; Irawan Mangunatmadja
Sari Pediatri Vol 20, No 6 (2019)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Penghentian obat antiepilepsi (OAE) yang terburu-buru meningkatkan risiko relaps. Risiko resistensi obat pada anak dengan epilepsi yang mengalami relaps sangat tinggi. Hingga saat ini belum ada kesepakatan mengenai pengobatan kejang pasca relaps. Tujuan. Penelitian ini bertujuan untuk mengetahui insiden relaps, karakteristik, prediktor, luaran, dan perjalanan elektroensefalografi (EEG) anak dengan epilepsi setelah mengalami relaps. Metode. Penelitian dilakukan pada Juni-Desember 2016. Desain studi adalah potong lintang, multisite dari rekam medis tahun 2012-2016. Subjek adalah anak dengan epilepsi yang mengalami relaps. Hasil. Epilepsi relaps terjadi paling banyak dalam tahun pertama setelah dosis OAE diturunkan, 41,3% relaps terjadi dalam 6 bulan, dan 31,7% antara 6-12 bulan. Riwayat waktu kejang terkontrol lama (â‰¥1 tahun) pada kejang sebelumnya merupakan faktor yang memengaruhi (RP 1,846 95% IK 1,056 â€“ 3,228) kejang yang tidak terkontrol dalam waktu 6 bulan pasca relaps. Sementara variabel lain tidak signifikan berpengaruh terhadap terkontrolnya kejang dalam 6 bulan pasca relaps. Kesimpulan. Anak dengan epilepsi relaps yang memiliki riwayat waktu terkontrol kejang lama (â‰¥1 tahun) akan lebih sulit mencapai remisi kedua pasca relaps.Â

Faktor Risiko Sekuele Meningitis Bakterial pada Anak Muriana Novariani; Elisabeth Siti Herini; Suryono Yudha Patria
Sari Pediatri Vol 9, No 5 (2008)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Mortalitas akibat meningitis bakterial menurun dengan ditemukan antibotik yang potendan penanganan yang baik pada saat pasien kritis. Walaupun demikian, sekuele akibat meningitis bakterialmasih tinggi, sekitar 50%-65% di negara berkembang.Tujuan. Mengetahui faktor risiko yang terkait dengan sekuele pada pasien meningitis bakterial yangbertahan hidup.Metode. Penelitian kasus kontrol dilakukan di RSUP Dr. Sardjito, RSUD Banyumas dan RSU SuradjiTirtonegoro Klaten. Kasus adalah pasien yang terdiagnosis meningitis bakterial pada tahun 2003 â€“ 2006yang hidup dengan sekuele. Kontrol adalah pasien meningitis bakterial yang hidup tanpa sekuele. Datadiambil dari catatan medis, luaran ditetapkan setelah 6 bulan.Hasil. Terdapat 78 pasien yang memenuhi kriteria inklusi. Hasil analisis multivariat menunjukkan bahwafaktor risiko yang terkait dengan meningitis bakterial adalah kejang >30 menit saat masuk rumah sakit(OR 4,29; IK 95% 1,38â€“12,99), PCS (Pediatrics Coma Scale) <8 (OR 3,76 ; IK 95% 1,15-12,28), dankejang yang tidak terkontrol >72 jam (OR 5,24 ; IK 95% 1,49â€“18,43). Onset - gejala >48 jam mempunyaiOR 2,43 (IK 95% 0,73 â€“ 8,13).Kesimpulan. Kejang >30 menit saat masuk rumah sakit, PCS <8, dan kejang yang tidak terkontrol >72 jammerupakan faktor risiko yang indipenden untuk menimbulkan sekuele.

Faktor Prognostik Kegagalan Terapi Epilepsi pada Anak dengan Monoterapi Agung Triono; Elisabeth Siti Herini
Sari Pediatri Vol 16, No 4 (2014)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Epilepsi merupakan salah satu penyakit neurologi utama pada anak. Banyak faktor yangmemengaruhi kegagalan monoterapi epilepsi pada anak sehingga akan berdampak pada keberhasilan terapiepilepsi secara keseluruhan.Tujuan. Mengetahui faktor prognostik yang dapat digunakan untuk memprediksi kegagalan monoterapiepilepsi pada anakMetode. Penelitian kasus-kontrol pada pasien epilepsi usia 6 bulan sampai dengan 18 tahun yang berobatke Poli Anak RSUP Dr. Sardjito tahun 2009. Kasus adalah pasien epilepsi yang gagal dengan monoterapidan kontrol adalah pasien epilepsi yang berhasil dengan monoterapi.Hasil. Didapat 120 pasien dengan 60 pasien kelompok kontrol dan 60 kelompok kasus. Dilakukan analisisunivariat pada masing-masing faktor prognostik. Berdasarkan analisis univariat didapatkan beberapa faktorprognostik kegagalan monoterapi, yaitu terapi epilepsi yang tidak segera, frekuensi serangan kejang sebelumterapi, status epileptikus, adanya defisit neurologis, dan adanya kelainan neurologi penyerta. Setelah dianalisissecara multivariat, faktor frekuensi serangan kejang sebelum terapi >10 kali (OR 14,196, IK95%:3,576-56,348; p<0,01) dan adanya kelainan neurologi penyerta (OR 18,977, IK95%:3,159-113,994; p<0,01 )merupakan faktor prognostik kegagalan monoterapiKesimpulan. Hasil penelitian ini menunjukkan bahwa anak epilepsi dengan serangan kejang lebih darisepuluh kali sebelum terapi dan adanya kelainan neurologi penyerta merupakan faktor prognostik kegagalanmonoterapi.

Luaran Terapi Gancyclovir dan atau Valgancyclovir pada Pasien Infeksi Cytomegalovirus di Instalasi Kesehatan Anak RSUP Dr Sardjito Agung Triono; Elisabeth Siti Herini; Braghmandita Widya Indraswari; Dian Kesumapramudya Nurputra; Sari Wardhani
Sari Pediatri Vol 22, No 1 (2020)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp22.1.2020.1-6

Latar belakang. Infeksi Cytomegalovirus (CMV) merupakan penyebab tersering infeksi kongenital anak di negara berkembang. Infeksi ini dapat menyebabkan tuli sensorineural (SNHL) dan gangguan perkembangan. Di RSUP dr Sardjito, pasien dengan infeksi CMV aktif bergejala akan menjalani terapi 6 minggu Ganciclovir atau 2 minggu terapi Ganciclovir dilanjutkan 4 minggu terapi Valganciclovir. Namun, luaran terapi tersebut belum diteliti lebih lanjut.Tujuan. Melihat luaran terapi ganciclovir dan atau valganciclovir pada pasien infeksi Cytomegalovirus di Instalasi Kesehatan Anak RSUP Dr Sardjito.Metode. Penelitian ini menggunakan metode kohort retrospektif dari data rekam medis pasien dengan diagnosis infeksi CMV aktif di Instalasi Kesehatan Anak RSUP dr Sardjito periode Januari 2014 sampai dengan April 2018. Variabel luaran (BERA dan Denver II) dibandingkan antara pre dan post terapi ganciclovir. Analisis statistik data dasar menggunakan analsisi deskriptif. Untuk variable luaran menggunakan T test.Hasil. Didapatkan hasil yang signifikan untuk perbaikan fungsi pendengaran pada telinga kanan (p<0,001) dan kiri (p<0,03) dibandingkan dengan yang mengalami perburukan. Sementara untuk perbandingan gangguan perkembangan sebelum dan sesudah terapi ganciclovir tidak berbeda bermakna (p>0,05).Kesimpulan. Pemberian terapi ganciclovir dan valganciclovir dapat memperbaiki fungsi pendengaran (tes BERA), tetapi perbaikan tidak didapatkan pada aspek neurodevelopmental (tes Denver II) dari pasien dengan infeksi CMV.

The role of exclusive breastfeeding in prevention of childhood epilepsy Alexander Kurniadi; Elisabeth Siti Herini; Wahyu Damayanti
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Background Epilepsy affects 1% of children worldwide. The highest incidence is in the first year of life, and perinatal factors, such as hypoxic-ischemic injury, infection, and cortical malformation may play etiologic roles. Breast milk contains optimal nutrients for human brain in early life. Breastfeeding has been associated with lower risk of infections, better cognitive and psychomotor development. However, the role of breastfeeding in preventing childhood epilepsy remains unclear. Objective To evaluate an association between exclusive breastfeeding and childhood epilepsy. Methods A case-control study conducted from 1 May to 3 July 2013 involving children with epilepsy aged 6 months to 18 years who were attending pediatric outpatient clinic of Dr. Sardjito Hospital, Yogyakarta. Neurologically normal children, individually matched by age and sex, visiting the same clinic were considered as controls. Exclusion criteria were children with structural brain abnormality, history of epilepsy in family, and who had history of neonatal seizure, intracranial infection, febrile seizure, and head trauma before onset of epilepsy. History of breastfeeding was obtained by interviewing the parents. The difference of exclusively breastfeeding proportion between cases and controls was analyzed by McNemar test. Results The total number of participants was 68 cases and controls each. Subjects with epilepsy had lower proportion of exclusively breastfed (48.5%) compared with controls (54.4%), but the difference was not statistically significant (P=0.541). Exclusively breastfeeding showed no statistical significance in decreasing risk of epilepsy (OR=0.71; 95%CI 0.32 to 1.61). Conclusions Exclusive breastfeeding for 4-6 months has no effect against childhood epilepsy.

Postpartum lactation counseling and exclusive breastfeeding: analysis of the 2017 Indonesian Demographic and Health Survey Warantika Rikma Yuniarini; Elisabeth Siti Herini; Abdul Wahab
Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.1.2021.25-33

Background The percentage of exclusive breastfeeding in Indonesia on 2018 dropped from 39.8% in infants aged 0 monthsto 15.3% in infants aged 5 months. According to the 2018 Indonesian Basic Health Research Survey (Riskesdas), an average of 37.3% of infants were exclusively breastfed until the age of 6 months. This rate is far from the target of 80% by Ministry of Health of Indonesia. Objective To assess for an association between postpartum counseling and the practice of exclusive breastfeeding in Indonesia. Methods This retrospective cohort study used data from the 2017 Indonesian Demographic and Health Survey (IDHS). The sample comprised 258 infants aged 6 months. Postpartum counseling and other variables were analyzed for possible associations with exclusive breastfeeding by Chi-square test; risk ratios (RR) with 95% confidence intervals (CI) were calculated. Logistic regression test was used to analyze for adjusted odds ratios. Results In 6 months period, the percentage of subjects who received postpartum counseling was 59.7% and who exclusively breastfed was 18.8%. There was no significant association between postpartum lactation counseling and exclusive breastfeeding. However, there were significant associations between exclusive breastfeeding and not using currently as well as maternal residence in rural areas. Conclusion Postpartum counseling on breastfeeding lacks a significant association with exclusive breastfeeding practice at 6 months of age. Therefore, the Ministry of Healthshould reevaluate the implementation of its counseling services.

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