LP autis

LAPORAN PENDAHULUAN AUTIS

Oleh Ressa Bramantara

P27220014 089

Rma!hn" #"tra

P27220014 09$

Rsal"a Sr Sr" Pr Praset%an"n"n&s"h

P27220014 09 09'

Rs"ana L("an" D)"*a%ant"

P27220014 097

+E,ENTRIAN +ESEHATAN REPUBLI+ INDONESIA POLITE+NI+ +ESEHATAN SURA+ARTA PRO-RA, STUDI DII +EPERA.ATAN 201'

LAPORAN PENDAHULUAN

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 3erh3n&an !en&an mn"as" "nteras" ss"al !an at"("tas "ma*"nas"/ -e*alan%a tama tama a!a se3elm s"a t"&a tahn/ Bahan aa3"la at"s "n5ant"l &e*alan%a &e*alan%a s!ah a!a se*a 3a%"/ .rl! Health Or&an"6at"ns Internat"nal #lass"5"at"n 5 D"seases I#D:10; men!e5"n"s men!e5"n"s"an "an at"sme at"sme hssn%a hssn%a childhood autism se3a&a" a!an%a ea3nrmalan !an ata ata &an& &an&&a &an n er erem em3a 3an&a n&an n %an& %an& mn mnll se3el se3elm m s"a s"a t"&a t"&a tahn tahn !en&a !en&an n t"e t"e arater"st" t"!a nrmaln%a t"&a 3"!an& %a"t "nteras" ss"al mn"as" !an er"la %an& !"lan&:lan& World World Health Organozation Organozation h/ 2$< 1992;/ Ia Ia ."!%a)a !%a)at" t" 2001 2001;; men* men*el elas asa an n 3ah)a 3ah)a at" at"sm smee mer mera aan an &an&& &an&&a an n  erem3an&an er(as"5  /Pervasive Developmental Disorder PDD; PDD; ata !"se3 !"se3tt  Autism Specrtum Disorder ASD; %an& !"tan!a" !en&an a!an%a a3nrmal"tas !an = ata hen!a%a  erem3an&an %an& mnl se3elm s"a < tahn !an memn%a" 5n&s" %an& a3nrmal a3n rmal !alam < 3"!an& %a"t "nteras" > ss"al mn"as" !an er"la %an& ter3atas restr"t"5; !an 3erlan& reet"t"5;/ DS, I?  Diagnostic Statistical Manual %an& !"em3an&an !"em3an&an leh ara s""ater  s""ater  !ar" Amer"a; men!e5"n"s"an ana at"s se3a&a" 3 er"t> 1/ Ter!a Ter!aat at al"n& al"n& se!""t se!""t enam   !ar" elm elm a 3 !an  mel"t mel"t"" sera seran&: n&: ran&n%a> sat "tem !ar" elm a seran&:ran&n%a sat "tem !ar" elm   3 seran&:ran&n%a sat "tem !ar" elm  a/ -an&&a -an&&an n al"ta al"tat"5 t"5 !alam !alam "ntera "nteras" s" ss"al ss"al %an& !"tn* !"tn*an an leh al"n& al"n& se!"" se!""tt !a !"antara 3er"t> 1/; ,em"l"" ,em"l"" esl"tan esl"tan !alam men&naan men&naan 3er3a&a" er"la er"la nn (er3al seert" seert" nta mata esres" ma s"a t3h 3ahasa t3h la"nn%a %an& men&atr  "nteras" s"al 2/; ,em"l"" ,em"l"" esl"tan esl"tan !alam men&em3an&an men&em3an&an h3n&an h3n&an !en&an teman se3a%a ata teman %an& sesa" !en&an taha erem3an&an mentaln%a/
4/; +et"!aaman !alam mem3"na h3n&an ss"al ata ems" %an& t"m3al  3al"/  3/ -an&&an al"tat"5 !alam 3ermn"as" %an& !"tn*an leh al"n& se!""t sat !ar" %an& 3er"t> 1/; +eterlam3atan !alam erem3an&an 3"ara ata sama seal" t"!a 3an !"serta" !en&an men3a nt men&mensas"ann%a melal" ara:ara mn"as" alternat"5 seert" &eraan t3h ata la"nn%a; 2/; Ba&" "n!"("! %an& mam 3er3"ara ran& mam nt memla"  em3"araan ata memel"hara sat eraaan !en&an %an& la"n 1/; +eas"an !en&an sat ata le3"h la:la m"nat %an& ter3atas !an steret"e  3a" !alam "ntens"tas man !alam 5sn%a/ 2/; Tama t"!a 5les"3el ata a !en&an rt"n"tas ata r"tal %an& hss ata %an& t"!a mem"l"" man5aat/ meml: mlan ata men&&era&eraan tan&ann%a ata men&et:n&etan  *ar"n%a ata men&&eraan selrh t3hn%a;/ 4/; +eas"an %an& meneta !en&an 3a&"an:3a&"an !ar" 3en!a object ;/ 2/ Perem3an&an a3nrmal ata ter&an&& se3elm s"a t"&a tahn seert" %an& !"tn*an leh eterlam3atan ata 5n&s" %an& a3nrmal a!a al"n& se!""t sat !ar" 3"!an&:3"!an& 3er"t> erses"  perceiving ; intending  "ma*"nas" imagining ; !an  erasaan  $eeling ; %an& ter*a!" se3elm mr t"&a tahn !en&an !""r"an leh a!an%a ham3atan al"tat"5 !alam "nteras" ss"al mn"as" !an ter3ses" a!a sat

e&"atan ata 3%e %an& mana merea memerlan la%anan e!"!"an hss nt  men&em3an&an tens"n%a/

B/ Per"la Ana At"s 1/ Per"la Ss"al Per"la ss"al memn&"nan seran& "n!"("! nt 3erh3n&an !aan 3er"nteras" !alam set"n& ss"al/ T"n*aan tentan& esl"tan !e5""ts; ss"al a!a anaana at"s  3ar:3ar "n" mnl Ha)l"n 198' !alam +athleen Ann "ll 199$;/ Ana:ana  at"s %an& nn(er3al telah !"etah" 3ah)a merea men&a3a"an ignore; ran& la"n memerl"hatan masalah mm !alam 3er&al !en&an ran& la"n seara ss"al/ Esres" ss"al merea ter3atas a!a esres" ems":ems" %an& estr"m seert" men*er"t menan&"s ata terta)a %an& se!alam:!alamn%a / Ana:ana at"s t"!a  men%a" er3ahan ss"al ata &an&&an !alam rt"n"tas sehar":har" !an le3"h sa aa3"la !n"a merea teta sama/ Aa3"la ter*a!" er3ahan merea aan le3"h m!ah marah nth> merea aan marah aa3"la men&am3"l rte lan& !ar" selah %an&  3er3e!a !ar" %an& 3"asa !"le)at" ata s"s" 5rn"tr !" !alam elas 3er3ah !ar" semla/ Ana:ana at"s ser"n& memerl"hatan er"la %an& meran&san& !"r"n%a sen!"r"  sel$%stimulating ; seert" men&ea:n&eaan tan&an hand $lapping ; men&a%n:a%n tan&an e !ean !an e3elaan& mem3at sara:sara %an& teta n&eh; ata men%a"t" !"r" sen!"r"  sel$%in$licting injuries; seert" men&&ar: &ar a!an& sama" terla mens:ns/ Per"la meran&san& !"r" sen!"r"  sel$%stimulating ; le3"h ser"n& ter*a!" a!a )at %an& 3er3e!a !ar" eh"!an ana  ata selama s"tas" ss"al 3er3e!a I)ata et all 1982 !alam +athleen Ann "ll 199$;/ Per"la "n" le3"h ser"n& la&" ter*a!" a!a saat ana at"s !"t"n&&al sen!"r" ata se!an& sen!"r"an !ar"a!a )at !"a s"3 !en&an t&as:t&as %an& hars !"er*aann%a !an 3erran& setelah ana 3ela*ar nt 3ermn"as"/ #arr  Drran! 198$@ !alam +athleen Ann "ll 199$;/ 2/ Per"la +mn"as" Bahasa termas em3entan ata:ata 3ela*ar atran:atran nt meran&a" ata: ata men*a!" al"mat !an men&etah" mas! ata sat alasan men&&naan 3ahasa/ Bahasa meraan sesat %an& a3tra/ Pemahaman 3ahasa memerlan 5n&s"  en!en&aran %an& 3a" !an erses" en!en&aran %an& 3a" la/ Bahasa ra&mat"s

%an& meraan ener*emahan interpreting ; !an en&&naan 3ahasa !alam ntes ss"al seara "s"  physical ; !an ntes l"n&"st"/ Pra&mat"s !an mn"as"  3erh3n&an erat nt men*a!" seran& mn"atr %an& 3erhas"l seran& ana  hars mem"l"" en&etahan tentan& 3ahasa %an& !"er&naann%a sama 3a"n%a !en&an emahaman tentan& mans"a !an !"mens" !n"a %an& 3an mans"a/ +mn"as" le3"h !ar"a!a emaman nt 3"ara ata emaman nt  meran&a" ata:ata !alam rtan %an& teat ."lsn 1987 +athleen Ann "ll 199$;/ +mn"as" adalah &emampuan untu& membiar&an orang lain mengetahui apa yang diingin&an oleh individu! menjelas&an tentang suatu &ejadian &epada orang  lain! untu&  menggambar&an tinda&an dan untu& menga&ui &eberadaan atau &ehadiran orang lain/ +mn"as" !aat !"laan seara (er3al !an nn(er3al/ +mn"as" !aat !"*al"n melal" &eraan t3h melal" tan!a "sarat ata !en&an menn*an &am3ar ata ata:ata/ Seara t"!a lan&sn& mn"as" men%ataan sat s"tas" ss"al antara !a "n!"("! ata le3"h/ Dalam mn"as" ran& %an& mem3a)a esan !"se3t emraarsa initiator ; se!an&an ran& %an& men!en&aran  esan !"se3t ener"ma esan/ Pesan 3er&ant"an antara emraarsa !an ener"ma  esan/ Unt memenh" emaman competent ; !alam eteram"lan ra&mat"s ana  hars men&etah" !an memaham" e!a eran terse3t se3a&a" remraarsa !an se3a&a" ener"ma esan/ #/ Catr Pen%e3a3 1/ Catr -enet"  Le3"h ran& 20 !ar" ass:ass at"sme !"se3a3an leh 5atr &enet"/ Pen%a"t &enet" %an& ser"n& !"h3n&an !en&an at"sme a!alah t3ers slers"s 17:$8; !an s"n!rm 5ra&"le  20:<0;/ D"se3t 5ra&"le: arena seara s"t&enet" en%a"t "n" !"tan!a" leh a!an%a erahan 5ra&"le; %an& tama seert" atahan !"*n& ah"r len&an an*an& rmsm  4/ S"n!rme 5ra&"le  meraan en%a"t %an& !")ar"san seara :l"ne!  teran&a"; %a"t melal" rmsme / Pla  enrnann%a t"!a mm %a"t t"!a seert" en%a"t !en&an e)ar"san :l"ne! la"nn%a arena t"!a 3"sa !"&l"n&an se3a&a" !m"nan ata reses" la":la" !an  ereman !aat men*a!" en!er"ta man em3a)a s"5at arr"er;/ Dr/ Sltana ,H Cara!6 Ph/D 200<;

2/ -an&an a!a S"stem S%ara5  Ban%a enel"t"an %an& melaran 3ah)a ana at"s mem"l"" ela"nan a!a ham"r sema strtr ta/ Teta" ela"nan %an& al"n& ns"sten a!alah a!a ta  e"l/ Ham"r sema enel"t" melaran 3erran&n%a sel r"n%e !" ta e"l  a!a at"sme/ Berran&n%a sel r"n%e !"!&a !aat meran&san& ertm3han asn &l"a !an m%el"n seh"n&&a ter*a!" ertm3han ta %an& a3nrmal ata se3al"n%a ertm3han asn %an& a3nrmal !aat men"m3lan sel r"n%e mat"/ Ota e"l 3er5n&s" men&ntrl 5n&s" lhr !an e&"atan mtr" *&a se3a&a" s"r"t %an& men&atr erhat"an !an en&"n!raan/ F"a s"r"t "n" rsa ata ter&an&& maa aan men&&an&& 5n&s" 3a&"an la"n !ar" s"stem sara5 sat seert" m"saln%a s"stem l"m3" %an& men&atr ems" !an er"la/
&an&&an

meta3l"sme

%an&

mles

!an

setelah

!"laan

 emer"saan nt aler&" tern%ata !ar" 120 ran& ana %an& !"er"sa> 100 ana  8<<<; men!er"ta aler&" ss sa" &lten !an maanan la"n 18 ana 1$; aler&" terha!a ss !an maanan la"n 2 ran& ana 1'' ; aler&" terha!a &lten !an maanan la"n/ Dr/ ,ell% B!"man S+F 200<;/ Penel"t"an la"n men&h3n&an at"sm !en&an et"!ase"m3an&an hrmnal en"n&atan a!ar !ar" 3ahan "m"a)" tertent !" ta seert" ""! %an& menrnan erses" n%er" !an mt"(as" 4/ +emn&"nan La"n In5es" %an& ter*a!" se3elm !an setelah elah"ran !aat mersa ta seert" ("rs r3ella %an& ter*a!" selama eham"lan !aat men%e3a3an ersaan ta  +emn&"nan %an& la"n a!alah 5atr s"l&"s arena es"3an ran& tan%a

seh"n&&a t"!a mem"l"" )at nt 3ermn"as" !en&an ana ata ana t"!a   ernah !"a*a 3er3"ara se*a e"l "t *&a !aat men%e3a3an ana men!er"ta at"sme/

D/ +las"5"as" +las"5"as" At"sme !aat !"3a&" 3er!asaran 3er3a&a" en&elman n!"s" 1/ +las"5"as" 3er!asaran saat mnln%a ela"nan a/ At"sme "n5ant"l "st"lah "n" !"&naan nt men%e3t ana at"s %an& ela"nann%a s!ah nama  se*a lah"r   3/ At"sme 5"sas"@ a!alah ana at"s %an& a!a )at lah"r n!"s"n%a nrmal tan!a:tan!a at"sn%a mnl em!"an setelah 3ermr !a ata t"&a tahn 2/ +las"5"as" 3er!asaran "nteletal a/ At"s !en&an eter3elaan&an mental se!an& !an 3erat I !"3a)ah $0;/ Pre(alens" '0 !ar" ana at"st"   3/ At"s !en&an eter3elaan&an mental r"n&an I $0:70; Pre(alens" 20 !ar" ana  at"s / At"s %an& t"!a men&alam" eter3elaan&an mental Intele&ens" !"atas 70; Pre(alens" 20 !ar" ana at"s a/ +elm %an& men%en!"r"  3an%a terl"hat a!a ana %an& menar" !"r" ah ta ah !an esal 3"la !"a!aan en!eatan ss"al serta menn*an er"la !an erhat"an %an& t"!a  han&at  3/ +elm %an& as"5  !aat mener"ma en!eatan +elm %an& at"5 ta" aneh > seara sntan aan men!eat" ana %an& la"n namn "nteras"n%a t"!a sesa" !an ser"n& han%a se"ha/ 4/ +las"5"as" 3er!asaran re!"s" eman!"r"an> a/ Pr&ns"s 3r  t"!a !aat man!"r" 2=< !ar" en%an!an& at"s;

 3/ Pr&ns"s se!an& ter!aat ema*an !"3"!an& ss"al !an en!"!"an )alan r3lem er"la teta a!a 1=4 !ar" en%an!an& at"s; / Pr&ns"s 3a"  memn%a" eh"!an ss"al %an& nrmal ata ham"r nrmal !an 3er5n&s" !en&an 3a" !" selah atan !"temat er*a/ 1=10 !ar" en%an!an& at"s;/ B Pe!man Penan&anan Dan Pen!"!"an At"sme PA#;

E/ Pat5"s"l&" Sel sara5 ta nern; ter!"r" atas 3a!an sel !an sera3t nt men&al"ran "mls l"str" asn; serta sera3t nt mener"ma "mls l"str" !en!r"t;/ Sel sara5  ter!aat !" la"san lar ta %an& 3er)arna ela3 rtes;/ Asn !"3n&s selat  3ernama m"el"n terleta !" 3a&"an ta 3er)arna t"h/ Sel sara5 3erh3n&an sat sama la"n le)at s"nas/ Sel sara5 ter3ent saat s"a an!n&an t"&a sama" t*h 3lan/ Pa!a tr"mester et"&a em3entan sel sara5 3erhent" !an !"mla" em3entan asn !en!r"t !an s"nas %an& 3erlan*t sama" ana 3ers"a se"tar !a tahn/ Setelah ana  lah"r ter*a!" rses en&atran ertm3han ta 3era 3ertam3ah !an 3erran&n%a strtr asn !en!r"t !an s"nas/ Prses "n" !"en&arh" seara &enet" melal" se*mlah 6at "m"a %an& !"enal se3a&a" 3ra"n &r)th 5atrs !an rses 3ela*ar ana/ ,a"n 3an%a s"nas ter3ent ana ma"n er!as/ Pem3entan asn !en!r"t !an s"nas san&at ter&antn& a!a st"mlas" !ar" l"n&n&an/ Ba&"an ta %an& !"&naan !alam 3ela*ar menn*an ertam3ahan asn !en!r"t !an s"nas/ Se!an&an 3a&"an ta %an& ta !"&naan menn*an emat"an sel 3erran&n%a asn !en!r"t !an s"nas/ +ela"nan &enet"s eranan l&am 3erat !an ntr"s" %an& t"!a a!eat !aat men%e3a3an ter*a!"n%a &an&&an a!a rses G rses terse3t/ Seh"n&&a aan men%e3a3an a3nrmal"tas ertm3han sel sara5/ Pa!a emer"saan !arah 3a%":3a%" %an& 3ar lah"r !"etah" ertm3han a3nrmal a!a en!er"ta at"s !"" leh  3erle3"hn%a nertr"n !an neret"!a ta 3ra"n:!er"(e! nertrh" 5atr nertrh"n:4 (asat"(e "ntest"nal et"!e al"tn"n:relate! &ene et"!e; %an& meraan 6at "m"a ta %an& 3ertan&&n& *a)a3 nt men&atr enam3ahan sel

sara5 m"&ras" !"5erens"as" ertm3han !an erem3an&an *al"nan sel sara5/ Bra"n &r)th 5atrs "n" ent"n& 3a&" ertm3han ta/ Pen"n&atan ner"m"a ta seara a3nrmal men%e3a3an ertm3han a3nrmal a!a !aerah tertent/ Pa!a &an&&an at"st" ter*a!" n!"s" &r)th )"tht &"!ane !" mana 3a&"an:3a&"an ta tm3h !an mat" seara ta 3eratran/ Pertm3han a3nrmal 3a&"an ta tertent menean ertm3han sel sara5 la"n/ Ham"r  sema enel"t" melaran 3erran&n%a sel Pr"n%e sel sara5 temat elar has"l  emrsesan "n!era !an "mls sara5; !" ta e"l a!a at"sme/ Berran&n%a sel Pr"n%e !"!&a meran&san& ertm3han asn &l"a *ar"n&an enn*an& a!a s"stem sara5 sat; !an m"el"n seh"n&&a ter*a!" ertm3han ta seara a3nrmal ata se3al"n%a ertm3han asn seara a3nrmal memat"an sel Pr"n%e/ an& *elas  en"n&atan 3ra"n !er"(e! nertrh" 5atr !an nertrh"n:4 men%e3a3an emat"an sel Pr"n%e/ -an&&an a!a sel Pr"n%e !aat ter*a!" seara r"mer ata sen!er/ B"la at"sme !"se3a3an 5atr &enet" &an&&an sel Pr"n%e meraan &an&&an r"mer %an& ter*a!" se*a a)al masa eham"lan/ De&eneras" sen!er ter*a!"  3"la sel Pr"n%e s!ah 3erem3an& em!"an ter*a!" &an&&an %an& men%e3a3an ersaan sel Pr"n%e/ +ersaan ter*a!" *"a !alam masa eham"lan "3 m"nm alhl  3erle3"han ata 3at seert" thal"!m"!e/ Penel"t"an !en&an ,RI menn*an ta e"l ana nrmal men&alam" at"(as" selama melaan &eraan mtr" 3ela*ar sensr":mtr atens" rses men&"n&at serta e&"atan 3ahasa/ -an&&an a!a ta e"l men%e3a3an reas" atens" le3"h lam3at esl"tan memrses erses" ata mem3e!aan tar&et (erselet"("tas !an e&a&alan men&eslras" l"n&n&an/ Pem3esaran ta seara a3nrmal *&a ter*a!" a!a ta   3esar 3a&"an !ean %an& !"enal se3a&a" l3s 5rntal"s/ +emer !an Baman meneman 3erran&n%a ran sel nern !" h"ams a&"an !ean ta 3esar  %an& 3ereran !alam 5n&s" lhr !an rses memr"; !an am"&!ala 3a&"an sam"n& !ean ta 3esar %an& 3ereran !alam rses memr";/ Penel"t"an a!a mn%et !en&an mersa h"ams !an am"&!ala men&a"3atan 3a%" mn%et 3ers"a !a 3lan menn*an er"la as"5:a&res"5/ ,erea t"!a memla" nta ss"al teta" t"!a  menlan%a/ Namn a!a s"a enam 3lan er"la 3er3ah/ ,erea menla   en!eatan ss"al mn%et la"n menar" !"r" mla" menn*an &eraan steret"" !an

h"erat"("tas m"r" en%an!an& at"sme/ Sela"n "t merea memerl"hatan &an&&an &n"t"5/ Catr l"n&n&an %an& menentan erem3an&an ta antara la"n ean s"&en rte"n ener&" serta 6at &"6" m"r seert" 6at 3es" sen& %!"m hrmn t"r"! asam lema esens"al serta asam 5lat/ A!an hal %an& mersa ata men&&an&& erem3an&an ta antara la"n alhl eranan t"mah h"tam alm"n"m serta met"lmerr" "n5es" %an& !"!er"ta "3  a!a masa eham"lan ra!"as" serta a"n/

C/ Path)a%

-/ Fen"s -an&&an A!a 3e3eraa *en"s &an&&an erem3an&an er(as"5 se3a&a" 3er"t > 1/ -an&&an at"st"  -e*ala "n" ser"n& !"art"an ran& saat men!en&ar ata at"s/ Pen%an!an&n%a mem"l"" masalah "nteras" ss"al 3ermn"as" !an erma"nan "ma&"nas" a!a ana !"  3a)ah s"a t"&a tahn/ 2/ S"n!rm Aser&er  Ana %an& men!er"ta s"n!rm Aser&er 3"asan%a mr le3"h !ar" < th mem"l""  r3lem 3ahasa/ Pen!er"ta s"n!rm "n" en!ern& mem"l"" "ntele&ens" rata:rata ata le3"h t"n&&"/ Namn seert" haln%a &an&&an at"st" merea esl"tan 3er"nteras" !an 3ermn"as"/
 NOS=Per(as"(e !e(elmental !"sr!er nt ther)"se se"5"e!; / -e*ala "n" !"se3t  *&a nn t""al at"sme/ Pen!er"ta mem"l"" &e*ala:&e*ala at"sme namn 3er3e!a !en&an *en"s at"sme la"nn%a/ I en!er"ta "n" ren!ah/ 4/ S"n!rm Rett S"n!rm "n" ter*a!" han%a a!a ana ereman/ ,lan%a ana tm3h nrmal/ Pa!a s"a sat h"n&&a emat tahn ter*a!" er3ahan la mn"as" !en&an  en&lan&an &eraan tan&an !an er&ant"an &eraan tan&an/ $/ -an&&an D"s"nte&ras" Ana  Pa!a &e*ala at"sme "n" ana tm3h nrmal h"n&&a tahn e!a/ Selan*tn%a ana  aan eh"lan&an se3a&"an ata sema emaman mn"as" !an eteram"lan ss"aln%a/

H/ +arater"st" ana at"s 1/ +arater"st" !alam "nteras" ss"al a/ ,en%en!"r" al5; terl"hat a!a ana %an& menar" !"r" ah ta ah !an esal 3"la !"a!aan  en!eatan ss"al serta menn*an er"la !an erhat"an %an& ter3atas t"!a  han&at;/  3/ Pas"5 !aat mener"ma en!eatan ss"al !an 3erma"n !en&an ana la"n *"a la  erma"ann%a !"sesa"an !en&an !"r"n%a/ / At"5 ta" aneh seara sntan aan men!eat" ana la"n namn "nteras" "n" ser"n&al" t"!a  sesa" !an ser"n& han%a se"ha/ 2/ +arater"st" !alam mn"as" antara la"n a!alah > a/ Ber&mam  3/ Ser"n& men&alam" esaran !alam memaham" art" ata:ata !an esaran !alam men&&&naan 3ahasa !alam ntes %an& sesa" !an 3enar  / Ser"n& men&lan& ata:ata %an& 3ar sa*a merea !en&ar ata %an& ernah merea !en&ar se3elmn%a tana 3ermas! nt 3ermn"as"

!/ B"la 3ertan%a ser"n& men&&naan ata &ant" ran& !en&an ter3al" seert" sa%a men*a!" am !an men%e3t !"r" sen!"r" se3a&a" am@ e/ Ser"n& 3er3"ara a!a !"r" sen!"r" !an men&lan& tn&an ata ata la& !ar" "lan t( !an men&aann%a !" ma ran& la"n !alam sasana %an& t"!a  sesa"/ 5/ Pen&&naan ata:ata %an& aneh ata !alam art" "asan seert" seran& ana   3erata sem3"lan set"a al" "a mel"hat ereta a"/ &/ ,en&alam" esaran !alam 3ermn"as" )alan merea !aat 3er3"ara !en&an 3a" arena t"!a tah aan &"l"ran merea 3er3"ara mem"l"h t"   em3"araan ata mel"hat ea!a la)an 3"aran%a h/

B"aran%a mntn a !an men*eman/

"/

+esaran !alam men&esres"an erasaan ata ems"n%a melal" na!a sara

 */

T"!a menn*an ata memaa" &eraan t3h nt men%ama"an e"n&"nann%a teta" !en&an men&am3"l tan&an ran&tan%a nt men&am3"l 3%e %an& !"mas!

/ ,en&alam" &an&&an !alam mn"as" nn(er3al@ merea ser"n& t"!a  men&&naan &eraan t3h !alam 3ermn"as" nt men&esres"an  erasaann%a

ata

nt

mera3arasaan

erasaan

ran&

la"n

m"saln%a

men&&elen&an eala melam3a"an tan&an men&an&at al"s !an se3a&a"n%a/
-an&&an emsatan erhat"an "mls"5"tas r!"nas" mtr" ter&an&& esl"tan !alam melaan at"("tas eh"!an sehar":har"

4/ +arater"st" &n"t"5  a/ Ham"r 7$:80 ana at"s men&alam" retar!as" mental !en&an !era*at rata:rata se!an&/

 3/ Se3an%a $0 !ar" "!"t sa(ants retar!as" mental %an& menn*an emaman lar 3"asa; a!alah seran& en%an!an& at"sme/

I/ Tera" At"sme 1/ Tera" Per"la 'A(A! )O*AAS! +,A""H! Son%rise ) Ana at"s ser"n&al" merasa 5rstras"/ Temantemann%a ser"n&al" t"!a  memaham" merea merea merasa sl"t men&esres"an e3thann%a ,erea  3an%a %an& h"ersens"t"5 terha!a sara aha%a !an senthan/ Ta heran 3"la merea ser"n& men&am/ Seran& tera"s er"la terlat"h aan menar" latar   3elaan&

!ar"

er"la

ne&at"5

terse3t

!an

menar"

sls"n%a

!en&an

meremen!as"an er3ahan l"n&n&an !an rt"n ana terse3t nt memer3a""  er"lan%a/ Tera" er"la 3eha("r therah%; a!alah tera" %an& !"lasanaan nt men!"!" !an men&em3an&an emaman er"la ana %an& terham3at !an nt men&ran&" er"la:er"la %an& t"!a )a*ar !an men&&ant"ann%a !en&an  er"la %an& 3"sa !"ter"ma !alam mas%araat/ Tera" er"la "n" meraan !asar   3a&" ana:ana at"s %an& 3elm ath 3elm 3"sa nta mata !an !! man!"r"; arena r&ram !asar=n" tera" er"la a!alah melat"h eathan !an eathan "n" san&at !"3than saat ana:ana aan men&"t" tera":tera" la"nn%a seert" tera" )"ara tera" as" 5"s"tera" arena tana eathan "n" tera" %an& !""t" t"!a aan ernah 3erhas"l/ Tera" er"la %an& !"enal !" selrh !n"a a!alah Al"e! Beha("ral Anal%s"s ABA; %an& !""taan leh O/I(ar L(aas PhD !ar" Un"(ers"t% 5 #al"5rn"a Ls An&eles U#LA;/ Dalam tera" er"la 5s enan&anan terleta a!a em3er"an re"n5rement s"t"5 set"a al" ana 3eresns 3enar sesa" "nstrs" %an& !"3er"an/ T"!a a!a hman n"shment; !alam tera" "n" aan teta" 3"la ana 3eresns ne&at"5 salah=t"!a teat; ata t"!a 3eresns sama seal" maa "a t"!a  men!aatan re"n5rement s"t"5 %an& "a sa" terse3t/ Perlaan "n" !"haraan men"n&atan emn&"nan ana nt

3eresns s"t"5 !an

men&ran&"

emn&"nan "a 3eresns ne&at"5 ata t"!a 3eresns; terha!a "nstrs" %an& !"3er"an/ Seara le3"h ter"t"s r"ns" !asar tera" "n" !aat !"*a3aran se3a&a" A:B: #@ %an" A antecedent-  %an& !""t" !en&an B behavior ; !an !""t" !en&an #

conse.uence;/ Antecedent hal %an& men!ahl" ter*a!"n%a er"la; 3era "nstrs" %an& !"3er"an leh seseran& ea!a ana at"s/ ,elal" &a%a en&a*arann%a %an& terstrtr ana at"s em!"an memaham" (ehavior er"la; aa %an& !"haraan !"laan lehn%a ses!ah "nstrs" terse3t !"3er"an !an er"la terse3t !"haraan en!ern& ter*a!" la&" 3"la ana memerleh "onse.uence / akibat nseens" er"la ata a!an& 3era "m3alan; %an& men%enan&an/ T*an  enan&anan "n" tertama a!alah nt men"n&atan emahaman !an eathan ana  terha!a atran/ Tera" "n" mmn%a men!aatan has"l %an& s"&n"5"an 3"la !"laan seara "ntens"5 teratr !an ns"sten a!a s"a !"n"/ Dalam ABA !"saranan )at %an& !"3than a!alah 40 *am=m"n&& teta" e3erhas"lan tera" "n" !"en&arh" 3e3eraa 5atr > a/ Berat r"n&ann%a !era*at at"sme  3/ Us"a ana saat ertama al" !"tan&an" = tera" / Intens"tas tera" !/ ,et!e tera" e/ I ana 5/ +emaman 3er3ahasa &/ ,asalah er"la h/ Peran serta ran& ta !an l"n&n&an/ ,eth!a la"n !ar" tera" er"la "n" a!alah tera" 3erma"n Son rise/ Sn r"se a!alah r&ram tera" 3er3as"s rmah nt ana:ana !en&an %an& men&alam" &an&&an mn"as" !an "nteras" ss"al/ Pr&ram "n" !aat mem3ant men"n&atan nta mata mener"ma e3era!aan ran& la"n/ Dan %an& le3"h  ent"n& r&ram "n" t"!a mem3er"an punishment 3era eerasan ea!a ana/ Prses"n" !"laan !en&an haraan ana merea !aat J3er3ahJ !an men*a!"

n!"s"

%an&

le3"h

3a"/

,et!e

"n"

t"!a

3"sa

!"teraan=!""mlementas"an a!a sema ass tertama ass at"s %an& mas"h 3era!a a!a taha r"lm a)al/ +emaman erem3an&an 3erma"n meraan hal %an& ent"n& !alam r&ram "n" sela"n *&a emaman mn"as" !an ss"al"sas"/ Pr&ram sn r"se men%ataan 3ah)a *"a "ta men&a!aan en!eatan e ana seara s"t"5 !en&an rasa "nta aan

mem3at ana men*al"n "nteras" !en&an "ta !"3an!"n&an

3"la "ta

men&e!eanan s"a marah !ll/ I!e !asar ter" "n" a!alah 3ah)a set"a ana  termas at"sme le3"h men%a" sasana 3ela*ar %an& men%enan&an/ Ban%a  ran& ta 3ersaha mener"ma e3era!aan ana merea %an& ter!"a&nsa at"s sn r"se meneanan 3ah)a eran serta ran& ta !aat mem3er"an srt %an& s"t"5 3a&" erem3an&an = ema*an ana merea/ Den&an r&ram tera" %an& la"n seert" ,et!e DIR = floortime, mem"l"" esamaaan !alam hal e3than art" "nta !an Jener"maaanJ/ Den&an asms" 3ah)a ana:ana at"s mem"l"" rasa !an men&ert" tentan& e3era!aan "ta 3ahasa t3h !an 3ahasa (er3al la"nn%a/ Sn:r"se !"&naan sesa" !en&an n!"s" anan%a ana !"3er" t*an nt men&"t" men&"t" ana sesa" !en&an t&as %an& !"3er"an; se!an&an 5lr:t"me mrn" 3erma"n !en&an t&as %an& !"3er"an=3erma"n  3e3as sa*a/ TEA##H +reatment and ,ducation o$ Austistic and elated  "ommunication Handicapped "hildren and Adults;/ +emaman 3er3"ara !an ss"al seseran& menentan t"n&at erem3an&an ss"aln%a ata t"n&at  en&asaan emaman nt 3ert"n&ah la sesa" !en&an tnttan mas%araat serta menentan eman!"r"an !an es"aan ana !alam men&"t"  rses 3ela*ar !" selah/ +eatan !asar "n" san&at menentan emaman  er"la a!at"5 ana %an& !alam en&ert"an le3"h sem"t !"art"an se3a&a"  er"la %an& sesa" !en&an e3"asaan %an& !aat !"ter"ma seara ss"al/ Peneanan a!a ase ss"al "n" san&at ent"n& men&"n&at mans"a termas  ana at"s a!alah mahl ss"al !an memn%a" e3than nt melaan "nteras"

ss"al/

Oleh

arena

"t

erl

!"em3an&an

emaman

 s"ss"aln%a !en&an men&&naan met!e "n"/ 2/ Tera" ."ara Tera" )"ara  speech therapy; meraan sat eharsan arena ana at"s memn%a" eterlam3atan 3"ara !an esl"tan 3er3ahasa/ T*ann%a a!alah nt melanaran tt:tt mlt a&ar !aat 3er3"ara le3"h 3a"/ Ham"r  sema ana !en&an at"sme memn%a" esl"tan !alam 3"ara !an 3er3ahasa/ B"asan%a hal "n"lah %an& al"n& menn*l 3an%a la "n!"("! at"s %an& nn: (er3al ata emaman 3"aran%a san&at ran&/ +a!an&:a!an& 3"aran%a

 3erem3an& namn merea t"!a mam nt memaa" 3"aran%a nt 3ermn"as"=3er"nteras" !en&an ran& la"n/ Dalam hal "n" tera" )"ara !an 3er3ahasa aan san&at menln&/
as"

!"laan

nt

mem3ant

men&atan

memer3a""

r!"nas" !an eteram"lan tt a!a ana at"s !en&an ata la"n nt melat"h mtr" hals ana/ Ham"r sema ana at"s memn%a" eterlam3atan !alam  erem3an&an mtr" hals/ -era:&er"n%a a !an asar merea esl"tan nt meme&an& "ns"l !en&an ara %an& 3enar esl"tan nt meme&an& sen! !an men%a maanan emltn%a !an la"n se3a&a"n%a/ Dalam hal "n" tera" as" san&at ent"n& nt melat"h memer&naan tt Gtt halsn%a !en&an 3enar/ #nthn%a loortime0 4/ Tera" C"s"  At"sme a!alah sat &an&&an erem3an&an er(as"5/ Ban%a !"antara "n!"("! at"st" memn%a" &an&&an erem3an&an !alam mtr" asarn%a/ +a!an&:a!an& tns ttn%a lem3e seh"n&&a *alann%a ran& at/ +ese"m3an&an t3hn%a ran& 3a&s/ C"s"tera" !an tera" "nte&ras" sensr"s aan san&at 3an%a menln& nt men&atan tt:ttn%a !an memer3a"" ese"m3an&an t3hn%a/ H%!rtera" meraan salah sat nth tera" 5"s"  %an& !aat mem3ant ana at"st" nt meleasan ener&" %an& 3erle3"han  a!a !"r" ana/ $/ Tera" Berma"n nt melat"h men&a*aran ana melal" 3ela*ar sam3"l 3erma"n/ ,es"n ter!en&arn%a aneh seran& ana at"s mem3than ertln&an !alam 3ela*ar   3erma"n/ Berma"n !en&an teman se3a%a 3er&na nt 3ela*ar 3"ara mn"as" !an "nteras" ss"al/ Seran& tera"s 3erma"n 3"sa mem3ant ana  !alam hal "n" !en&an ten":ten" tertent/ Tera" 3erma"n "n" 3ert*an sela"n nt 3erss"al"sas" *a& 3ert*an nt tera" er"la 3erma"n sesa" atran/ '/ Tera" ,e!"amentsa 3at:3atan !r& thera%; nt menenan&an melal" em3er"an 3at:3atan leh !ter %an& 3er)enan&/ nt e3a"an !an e3&aran n!"s" t3h a&ar 

terleas !ar" 5atr:5atr %an& mersa !ar" eranan l&am 3erate5e eler&"/ Tera" 3"me!" !"em3an&an leh elm !ter %an& ter&a3n& !alam DANK  De$eat Autismem 1o2-0 Ban%a !ar" ara er"nt"sn%a memn%a" ana  at"st"/ ,erea san&at &"&"h melaan r"set !an meneman 3ah)a &e*ala: &e*ala ana "n" !"erarah leh a!an%a &an&&an meta3l"sme %an& aan  3er!ama a!a &an&&an 5n&s" ta/ Oleh arena "t ana:ana "n" !"er"sa seara "ntens"5 emer"saan !arah r"n 5eses !an ram3t/ Sema hal a3nrmal %an& !"teman !"3eresan seh"n&&a ta men*a!" 3ers"h !ar" &an&&an/ Tern%ata le3"h 3an%a ana men&alam" ema*an 3"la men!aatan tera" %an& mrehens"5 %a"t tera" !ar" lar !an !ar" !alam t3h sen!"r" 3"me!"s;/ 7/ Tera" ,elal" ,aandiet therapy; Unt mene&ah ata men&ran&" t"n&at &an&&&an at"sme/ 8/ Tera" "nte&ras" sensr"s nt melat"h eeaan !an !"nas" !a%a "n!ra ana at"s/ 9/ Tera" Inte&ras" A!"tr" nt

melat"h

eeaan

en!en&aran

sa%a

le3"h

semrna/

Daatmen&&naan sn6ellen/ 10/ Tera" ,s"  nt melat"h a!"tr" anamenean ems"melat"h nta mata !an nsentras"/ 11/ Tera" An&&ta +elar&a mem3er" erhat"an %an& enh/ B"sa !en&an men&&naan nsel"n& &n"t"5   er"la ++P;/ 12/ Tera" Ss"al +eran&an %an& al"n& men!asar 3a&" "n!"("! at"sme a!alah !alam 3"!an& mn"as" !an "nteras" / Ban%a ana:ana "n" mem3than ertln&an !alam etram"lan 3ermn"as" 2 arah mem3at teman !an ma"n 3ersama !"temat 3erma"n/ Seran& tera"s ss"al mem3ant !en&an mem3er"an 5as"l"tas a!a merea nt 3er&al !en&an teman:teman se3a%a !an men&a*ar" ara:aran%a/

1
nt

men&em3an&an

etram"lan

mn"as"/

#nth

la"n

men&&naan 450 "omputer picture0 Pem"l"han tera" terse3t !"atas %an& !"3er"an a!a ana ter&antn& !ar" n!"s" emaman !an e3than ana/ Fa!" t"!a sema tera" sesa" !en&an e3than ana namn tera" tama 3a&" ana a!alah tera" er"la tera" )"ara !an tera" as"/

KONSEP ASUHAN KEPERAWATAN PADA ANAK AUTISME 1. Pengk!in

a/ I!ent"5"as"

Ana at"s %an& aan !"laan enan&anan !an en!"!"an hars !"laan terle3"h !ahl "!ent"5"as"/ Dar" mla" nama alamat tan&&al lah"r !s3/ I!ent"5"as" !aat !"laan !en&an men&&naan alat "!ent"5"as" seert" > DS, I? ,:#hat I#D 10 T*an asesmen ana at"s nt men&etah" 1)

+emaman !an +et"!amaman = esl"tan %an& !"alam" ana !" 3"!an& > '4- 6ogniti$! '7- Motori&  &asar! '8- Motori& halus! '9- (ahasa dan &omuni&asi! '5- #ntera&si sosial! ':- 6emampuan bina diri! ';-  Penglihatan! '<- Pendengaraan! dan '=- otot%otot mulut 

2; +e3than aa!em" !an nn aa!em"   3/ / / !/

+elhan Utama R")a%at &an&&an s""atr"=*")a a!a elar&a/ R")a%at elar&a %an& terena at"sme/ R")a%at esehatan et"a ana !alam an!n&an/ 1; Ser"n& teraar 6at ts" seert" t"m3al/ 2; #e!era ta  e/ Stats erem3an&an ana/ 1; Ana ran& meresn ran& la"n/ 2; Ana sl"t 5s a!a 3*e !an sl"t men&enal" 3a&"an t3h/ Ana men&alam" esl"tan !alam 3ela*ar/ Ana sl"t men&&naan esres" nn (er3al/ +eter3atasan +n&n"t"5/

<; 4; $; 5/ Pen&a*"an DDST &/ Pemer"saan 5"s"  1; T"!a a!a nta mata a!a ana/ 2; Ana tertar" a!a senthan men%enth=!"senth;/ <; Ter!aat Elal"a/ 4; T"!a a!a esres" nn (er3al/ $; Sl"t 5s a!a 3*e semla 3"la ana 3eral"n& e 3*e la"n/ '; Ana tertar" a!a sara ta" 3an a!a mana 3en!a terse3t/ 7; Pea terha!a 3a/

". Dignos Ke#er$tn a/ +elemahan "nteras" ss"al 3erh3n&an !en&an et"!amaman nt era%a

 a!a ran& la"n/

 3/ Ham3atan mn"as" (er3al !an nn (er3al 3erh3n&an !en&an ransan&an sensr" t"!a

a!eat

&an&&an

eteram"lan

reset"5

!an

et"!amaman

men&n&aan erasaan/ / R"s" t"n&&" "!era > men%a"t" !"r" 3erh3n&an !en&an ran& en&a)asan/ !/ +eemasan a!a ran& ta 3eh3n&an !en&an erem3an& ana/

%. Inter&ensi a/ +elemahan "nteras" ss"al 3erh3n&an !en&an et"!amaman nt era%a

 a!a ran& la"n/ T*an > +l"en ma memla" "nteras" !en&an en&ashn%a Inter(ens"> > 1; Batas" *mlah en&ash a!a ana/ 2; Tn*an rasa ehan&atan=eramahan !an ener"maan a!a ana/ <; T"n&atan emel"haraan !an h3n&an eera%aan/ 4; ,t"(as" ana nt 3erh3n&an !en&an ran& la"n/ $; Pertahanan nta mata ana selama 3erh3n&an !en&an ran& la"n/ '; Ber"an senthan sen%man !an elan nt men&atan ss"al"sas"/  3/ Ham3atan mn"as" (er3al !an nn (er3al 3erh3n&an !en&an ransan&an sensr" t"!a a!eat &an&&an eteram"lan reset"5 !an et"!amaman men&n&aan erasaan/ T*an > +l"en !aat 3ermn"as" !an men&n&aan erasaan ea!a ran& la"n/ Inter(ens" > 1; Pel"hara h3n&an sal"n& era%a nt memaham" mn"as" ana/ 2; -naan al"mat se!erhana !an lam3an&=ma"n& se3a&a" me!"a/ <; An*ran ea!a ran& ta=en&ash nt melaan t&as seara ns"sten/ 4; Panta emenhan e3than mn"as" anasama" ana men&asa"/ $; +ran&" eemasan ana saat 3ela*ar mn"as"/ '; ?al"!as" t"n&at emahaman ana tentan& ela*aran %an& telah !"3er"an/ 7; Pertahanan nta mata !alam men%ama"an n&aan nn (er3al/ 8; Ber"an re)ar! a!a e3erhas"lan ana/ 9; B"ara seara *elas !an !en&an al"mat se!erhana/ 10; H"n!ar" e3"s"n&an saat 3ermn"as"/ / R"s" t"n&&" "!era > men%a"t" !"r" 3erh3n&an !en&an ran& en&a)asan/ T*an > +l"en t"!a men%a"t" !"r"%a/ Inter(ens" > 1; B"na h3n&an sal"n& era%a/ 2; Al"han r"la men%a"t" !"r" %an& ter*a!" a"3at resn !ar" en"n&atan eemasan/ <; Al"han=ran&" en%e3a3 %an& men"m3lan eemasan/

4; Al"han erhat"an !en&an h"3ran=at"("tas la"n nt menrnan t"n&at eemasan/ $; L"n!n&" ana et"a r"la men%a"t" !"r" ter*a!"/ '; S"aan alat el"n!n&=rtes"/ 7; Pertahanan l"n&n&an %an& aman/ !/ +eemasan a!a ran& ta 3eh3n&an !en&an erem3an& ana/ T*an > +eemasan 3erran&=t"!a 3erlan*t/ Inter(ens" > 1; Tanaman a!a ran& ta 3ah)a at"s 3an a"3=en%a"t/ 2; An*ran ran& ta nt mem3a)a ana e temat tera" %an& 3er)al"tas 3a"  serta melaan seara ns"sten/ <; Ber"an mt"(as" ea!a ran& ta a&ar !aat mener"ma n!"s" anan%a %an& ses"al/ 4; An*ran ran& ta nt men&"t" ermlan ran& ta !en&an ana at"s seert" e&"atan At"s A)areness Cest"5al/ $; Ber"an "n5rmas" men&ena" enan&anan ana at"s/ '; Ber"tahan ea!a ran& ta tentan& ent"n&n%a men*alanan tera" seara ns"sten !an nt"ne

DACTAR PUSTA+A

B!"man ,ell% 200<; >angguan Metabolisme pada Ana& Autisti& di #ndonesia  maalah; Faarta> +n5erens" Nas"nal At"sme:I/ B Pe!man Penan&anan !an Pen!"!"an At"sme PA#/ 2010/ !5;/ D"ases a!a 22 ,aret 201' Se"rs Al/ 1981/ Pe!"atr"s 5r Nrses/ D"ter*emahan leh a"n S"!hartan"/ 1992/ Ilm +esehatan Ana nt Pera)at/ Semaran&> I+IP Semaran& Press