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Autisme bisa Terjadi Sejak Bayi di Dalam Kandungan PDF Print E-mail
Written by Ambrosius Torro   
Friday, 01 March 2013 03:47

Penyebab gangguan mental seperti skizofrenia dan autisme masih menjadi misteri yang belum terpecahkan di kalangan medis. Namun, sebuah penelitian terbaru menemukan petunjuk bahwa ternyata gangguan mental tersebut berpotensi terjadi di awal masa kehamilan.

Tim peneliti dari University of Oxford, King College London dan Imperial College London mempelajari proses penggabungan saraf otak di bagian subplate pada seekor tikus. Subplate adalah daerah di mana sel-sel saraf untuk pertama kalinya berkembang.

Peneliti menemukan bahwa gen yang berkaitan dengan skizofrenia dan autisme menjadi aktif di masa-masa awal perkembangan otak janin.

Salah satu peneliti bernama Zoltan Molnar mengatakan, “Pembentukan otak itu seperti membangun rumah kartu. Koneksi awal memberikan fondasi bagi struktur otak dewasa dan munculnya gangguan berpotensi menjadi sumber hambatan perkembangan.”seperti dilansir Time Healthland.

Subplate pada tikus memang tidak sebesar ukuran manusia. Namun, jika pada otak tikus saja bisa berkembang, tentunya ukuran otak manusia yang lebih besar lebih berpotensi mengalaminya. Para peneliti masih membutuhkan identifikasi lebih lanjut untuk memastikan proses ini benar-benar terjadi pada otak manusia. (dan)
Sumber : http://id.she.yahoo.com


Last Updated on Friday, 01 March 2013 03:49
 
Best Practice Review: The Autism Spectrum Rating Scales (ASRS) PDF Print E-mail
Written by Ambrosius Torro   
Thursday, 11 October 2012 09:12
ASRSThe Autism Spectrum Rating Scales™ (ASRS™; Goldstein & Naglieri, 2009) are designed to measure behaviors, symptoms, and features associated with the Autism Spectrum Disorders (ASD) for children and adolescents aged 2 through 18 years. This standardized, norm-referenced instrument covers a wide range of behaviors associated with Autistic Disorder, Asperger’s Disorder (syndrome), and PDD-NOS, and incorporates symptom criteria from the DSM-IV-TR. The ASRS was standardized and normed on a large sample of 2,560 participants approximating the U.S. general population. Clinical samples were also created by collecting ratings from children and youth with clinical diagnoses (ASD, ADHD, Mood Disorders, Anxiety Disorders, Developmental Delay, and Communication Disorders).
The ASRS has full-length and short forms for young children aged 2 to 5 years, and for older children and adolescents aged 6 to 18 years. The full-length ASRS (2?5 Years) consists of 70 items, and the full-length ASRS (6?18 Years) contains 71 items. Separate parent (ASRS Parent Ratings) and teacher (ASRS Teacher Ratings) rating forms are available for each age group. The full-length form provides the most comprehensive assessment information, including the Total Score, ASRS Scales, and DSM-IV-TR Scale.
The ASRS Short Form contains items that best differentiated the nonclinical group from those diagnosed with ASD. The ASRS Short Form (2–5 Years) and ASRS Short Form (6–18 Years) both have 15 items, with parents and teachers completing the same form. This form provides a single total score, and can be used as a screening measure to determine which children and youth are likely to require a more comprehensive assessment for an ASD. The ASRS Short Form is also suitable for monitoring response to treatment/intervention.
The ASRS can be scored via paper-and-pencil and electronically. The ASRS Scoring Software and ASRS Online Assessment Center offer three report options: (1) an Interpretive Report with detailed results from one administration, (2) a Comparative Report providing a multi-rater perspective by combining results from up to five different raters, and (3) a Progress Monitoring Report that provides an overview of change over time by combining results of up to four administrations from the same rater. The ASRS Technical Manual provides step-by-step interpretation guidelines and an illustrative case study. An especially useful feature of the ASRS is the ability to compare results across raters. This can help determine if there is consistency across home and school contexts. Discrepancies can provide insight into differential responses and determine which symptoms are more prevalent in a particular setting.
The ASRS has strong psychometric qualities. Reliability data indicate high levels of internal consistency, good inter-rater agreement, and excellent test-retest reliability. Discriminative validity (classification accuracy) of both the ASRS full-length and ASRS Short Form indicate that the scales were able to accurately predict group membership with a mean overall correct classification rate of 90.4% on the ASRS (2-5) and 90.1% on the ASRS (6-18). Although the ASRS Technical Manual reports a moderate relationship between the ASRS Total Score and the Gilliam Autism Rating Scale, Second Edition (GARS-2) and the Gilliam Asperger’s Disorder Scale (GADS), criterion-related validity would have been enhanced by examining the consistency of the ASRS with a gold standard instrument such as the ADOS or ratings scales such as the Social Communication Questionnaire (SCQ) and Social Responsiveness Scale (SRS). The GARS and GADS are not currently recommended and should be used with caution due to significant weaknesses, including the underidentification of higher-functioning ASD and questions concerning standardization and norming procedures (Campbell, 2005; Norris & Lecavalier, 2010; Wilkinson, 2010).
In summary, the ASRS is a valuable tool that can help guide diagnostic and educational eligibility decisions, as well as for use in monitoring response to intervention and evaluating treatment outcomes. It is a reliable and valid instrument for assessing symptom severity across home and school contexts. Consistent with best practice, the ASRS should be used only as part of a more comprehensive developmental assessment that includes interviews and direct observation, together with a multidisciplinary assessment of social behavior, language and communication, adaptive behavior, motor skills, sensory issues, atypical behaviors, and cognitive functioning. An example of a comprehensive assessment battery can be found in  A Best Practice Guide to Assessment and Intervention for Autism and Asperger Syndrome in Schools.

Campbell, J. M. (2005). Diagnostic Assessment of Asperger’s Disorder: A Review of Five Third-Party Rating Scales. Journal of Autism and Developmental Disorders, 35, 25-35
Goldstein, S., & Naglieri, J. A. (2009). Autism Spectrum Rating Scales (ASRS) Technical Manual. Tonawanda, NY: Multi-Health Systems, Inc.
Norris, M., & Lecavalier, L. (2010). Screening accuracy of level 2 autism spectrum disorder rating scales: A review of selected instruments. Autism, 14, 263-284.
Wilkinson, L. A. (2010). A best practice guide to assessment and intervention for autism and Asperger syndrome in schools. London: Jessica Kingsley Publishers.


Last Updated on Thursday, 11 October 2012 09:14
 
RETT SYNDROME PDF Print E-mail
Written by Ambrosius Torro   
Tuesday, 06 September 2011 04:15
What is Rett syndrome
Rett syndrome is a neurological and developmental disorder that mostly occurs in females.  Infants with Rett syndrome seem to grow and develop normally at first, but then stop developing and even lose skills and abilities.

For instance, they stop talking even though they used to say certain words.  They lose their ability to walk properly.  They stop using their hands to do things and often develop stereotyped hand movements, such as wringing, clapping, or patting their hands.

Rett syndrome is considered one of the autism spectrum disorders. Most cases of Rett syndrome are caused by a mutation on the MECP2 gene, which is found on the X chromosome.  For more information on the MECP2 gene, see the What causes Rett Syndrome? (PDF - 697 KB) section of NICHD's Rett Syndrome publication.

What are the symptoms of Rett syndrome?
Beginning between 3 months and 3 years of age, most children with Rett syndrome start to show some of the following symptoms:
  • Loss of purposeful hand movements, such as grasping with fingers, reaching for things, or touching things on purpose
  • Loss of speech
  • Balance and coordination problems, including losing the ability to walk in many cases
  • Stereotypic hand movements, such as hand wringing
  • Breathing problems, such as hyperventilation and breath holding, or apnea when awake
  • Anxiety and social-behavioral problems
  • Intellectual and developmental disabilities

There are a number of other problems common among those who have Rett syndrome.  But having these problems is not necessary to get a diagnosis of Rett syndrome.  These problems can include:

  • Scoliosis, a curving of the spine that occurs in approximately 80 percent of girls with Rett syndrome
  • Seizures
  • Constipation and gastro-esophageal reflux
  • Cardiac or heart problems, specifically problems with the rhythm of their heartbeat
  • Problems feeding themselves, trouble swallowing and chewing
  • Problems with sleep, specifically disrupted sleep patterns at night and an increase in total and daytime sleep.

For more details on symptoms of Rett syndrome and other associated problems, see What are the typical features of Rett syndrome? (PDF - 697 KB) in NICHD's Rett Syndrome publication.

What is the usual course of Rett syndrome?
Health care providers view the onset of Rett syndrome symptoms in four stages:
  • Early Onset Phase – Development stalls or stops.
  • Rapid Destructive Phase – The child loses skills (regresses) quickly.  Purposeful hand movements and speech are usually the first skills lost.
  • Plateau Phase – Regression slows, and other problems may seem to lessen or improve. Most people with Rett syndrome spend most of their lives in stage 3.
  • Late Motor Deterioration Phase – Individuals may become stiff or lose muscle tone; some may become immobile.

Most girls with Rett syndrome live until adulthood.  They will usually need care and assistance throughout their lives

What is the treatment for Rett syndrome?

There is currently no cure for Rett syndrome. However, girls can be treated for some of the problems associated with the condition. These treatments generally aim to slow the loss of abilities, improve or preserve movement, and encourage communication and social contact.

People with Rett syndrome often benefit from a team approach to care, in which many kinds of health care providers play a role, along with family members.  Members of this team may include:

  • Physical therapists, who can help patients improve or maintain mobility and balance and reduce misshapen back and limbs
  • Occupational therapists, who can help patients improve or maintain use of their hands and reduce stereotypic hand movements.
  • Speech-language therapists, who can help patients use non-verbal ways of communication and improve social interaction.

Other options, such as medication (such as for constipation or heart problems) or surgery (to correct spine curvature or correct heart defects) are also effective for treating some of the symptoms of Rett syndrome.

For more details on treatment, see the Are there treatments for Rett syndrome? (PDF - 697 KB) section of NICHD's Rett Syndrome publication.


 
Do You Feel Guilty About Your Child's Autism? PDF Print E-mail
Written by Ambrosius Torro   
Tuesday, 13 September 2011 03:03

Whose fault is autism?

It was a very long time ago that the "refrigerator mother" theory of autism was tossed out the window.  Now, no reasonable person would suggest that mom's bad attitude is a direct cause of autism.

So why do so many parents have feelings of guilt about autism?  There are two likely reasons.

First, some parents may feel that their genetic legacy is the problem.  They've seen autistic symptoms in their own family, and now note their child is an awful lot like Uncle Bill or Aunt Sally...  Of course, this is perfectly possible - but of course no parent can control the genes they pass along.  One could decide not to have children at all, given genetic flaws in one's heritage, but that would certainly limit the number of children in the world.  After all, none of us comes from a long line of genetically perfect people!

The second reason so many seem to feel guilty about their child's autism relates to the belief that something mom or dad did directly caused autism in an otherwise healthy child.  This concern is much more serious, because it suggests that mom, dad, or both could have prevented the autism if only they'd taken or avoided a specific action.  And the media around autism certainly supports this idea.  Could the autism have been prevented if only mom had avoided the tuna or the flu shot during pregnancy?  Could dad have "just said no" to autism by taking a job in a town that was less polluted?  Was it all about the vaccines that mom and dad "allowed" their pediatrician to inject?   Blogs, videos, TV interviews and radio all offer up stories of parents beating themselves up over just this sort of possibility.

What makes all this even tougher is the fact that very few families really know why their child is autistic.  Unless your child has a specific (rare) genetic disorder or there has been a known exposure to unusual substances (valproic acid in utero, and a few others), you will likely never know.

Do you feel guilty about your child's autism?

Share your thoughts!


 
5 Kebutuhan Empati Anak Autis PDF Print E-mail
Written by Ambrosius Torro   
Thursday, 01 September 2011 01:16

KOMPAS.com - Orangtua yang memiliki anak penyandang autisme perlu bersabar, lebih peduli, memahami kebutuhan anak, berupaya tegas namun tidak keras, dan semuanya itu bisa dijalankan dengan berempati.

Psikiater, dr Kresno Mulyadi, SpKj, menyebutkan lima kebutuhan anak penyandang autisme, yang perlu diperhatikan lebih ekstra oleh orangtua juga keluarganya. "Dalam mengasuh dan merawat anak dengan autisme, kunci utamanya adalah empati," katanya kepada Kompas Female di sela acara peluncuran buku karangannya, Autism is Treatable,  yang diterbitkan Sekolah Tinggi Ilmu Komunikasi The London School of Public Relations Jakarta memeringati hari jadi LSPR Jakarta ke-19, di Jakarta, Minggu (10/7/2011).

Perlu dipahami, autisme merupakan suatu spektrum dengan rentang yang luas. Artinya ada autisme berat, sedang, ringan, dan sangat ringan. Semuanya bisa diterapi. Semuanya juga membutuhkan empati orangtua dalam mengasuh dan merawat anak autis.

1. Komunikasi
Biasanya, yang terjadi pada pengasuhan anak dengan autisme adalah komunikasi yang tidak optimal antara anak autis dan orangtuanya. Setiap kali berkomunikasi dengan anak autis, orangtua perlu bersabar dan tidak menekan anak.

"Ajak anak bicara pelan-pelan, beritahu anak apa maksud Anda. Saat berkomunikasi, bisa jadi anak sedang berimajinasi, sehingga ia tidak menangkap pesan Anda saat itu. Jadi, bersabarlah, dan pahami kondisinya saat itu, ajak lagi ia berbicara agar maksud Anda tersampaikan dan diterima anak dengan baik," jelas motivator anak yang akrab disapa Kak Kresno ini.

2. Sosialisasi
Pada anak dengan autisme berat ia cenderung menyendiri, sedangkan anak dengan autisme ringan cenderung memberi kesan ia pilih-pilih terhadap sesuatu. 

Sekali lagi, pesan Kak Kresno, kenali autisme pada anak, dan jangan melarang anak melakukan apa yang disukainya atau membuatnya nyaman. Temani anak dalam berkegiatan, usahakan jangan ada pemaksaan. Jangan juga memberikan labeling pada anak ketika ia melakukan sesuatu yang menurut kebanyakan orang, aneh. Pahami kondisi anak Anda, berempati lah atasnya.

3. Emosi
Anak penyandang autisme memiliki emosi yang labil. Ia mudah marah, takut yang tidak rasional, tertawa berlebihan, jelas Kak Kresno. Namun jangan pernah menganggap perilaku anak autis sebagai sesuatu yang aneh.

Sebagai orangtua, Anda perlu memperlakukan anak autis dengan lebih bijak. Pahami emosinya. Bagaimana pun anak autis memiliki perasaan yang peka. Ia bisa sangat peka, namun juga bisa tidak punya empati sama sekali. Perlakuan orangtua atau keluarga yang keliru atas emosinya, berdampak pada anak autis.

"Dengan tidak memahami emosi, tidak berempati atas emosi anak autis, konsep dirinya akan jatuh. Sama seperti anak pada umumnya, ketika ia diberi label, maka ia justru akan menjadi seperti yang dilabelkan kepadanya. Jika mengatakan anak nakal, maka ia akan benar-benar bersikap nakal," jelas Kak Kresno.

4. Repetitif

Anak penyandang autisme cenderung melakukan sesuatu yang disenanginya secara berulang. Lagu yang disukainya diputarnya berulang kali. Makanan yang disukainya akan terus menerus dikonsumsinya setiap kali ia lapar. Pakaian yang disenanginya akan terus dipilihnya, cuci pakai berulang-ulang,

"Perilaku repetitif ini dialami sejumlah anak penyandang autisme. Tugas orangtua adalah mengenalkan hal lain yang berbeda kepadanya. Kalau anak belum mau, tidak apa, jangan dipaksa, namun jangan juga memberikan labeling kepada anak atas perilaku repetitifnya," lanjutnya.

5. Persepsi
Anak autis kerapkali tidak nyaman dengan penginderaannya. Ia tak menyukai suara tertentu yang didengarnya. Matanya tak nyaman saat memandang sinar tertentu. Orangtua perlu berempati dan memahami kondisi ini.

"Orangtua perlu menyikapi dengan cara yang tepat. Sabar, berempati, namun tidak memanjakan. Berupaya tegas namun tidak keras," tandas Kak Kresno.


 
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