Konseling dengan Teknik Demonstrasi untuk Meningkatkan Kemampuan Toilet Training pada Anak

ABSTRACT: COUNSELING WITH DEMONSTRATION TECHNIQUES TO IMPROVE ABILITY TOILET TRAINING FOR CHILDREN Abstract: Toilet training is a form of business carried out with the aim of controlling defecation (chapters) and urination (tub) which is carried out in children, this activity is carried out with the hope that children are able to prevent the occurrence of delays in controlling chapters and tubs. Children need to get attention, especially in the elements of growth and development that are carried out from the beginning of child development. So that the formation of children with abilities and qualities with great categories will achieve the future of children with superior categories so as to produce healthy and intelligent children.Objective: The purpose of this study was to determine the effect of demonstration technique counseling to improve toilet training abilities in children. Methods: This research was conducted with a quantitative type of research where the design used was a pre-experimental design using the One Group Pre-Test and Post-Test approaches. Results: The univariate results of this study obtained the characteristics of respondents from 15 respondents, most of the respondents, namely 11 respondents (73.3%) were at the age of 5 years. For the results of the bivariate analysis using the Wilcoxon Signed Ranks Test statistical test, the p value (value) = 0.001 <0.05.Conclusion: the conclusion of this study is that there is an effect of counseling with demonstration techniques to improve toilet training abilities in children. Keywords: Counseling, Demonstration, Toilet Training INTISARI: KONSELING DENGAN TEKNIK DEMONSTRASI UNTUK MENINGKATKAN KEMAMPUAN TOILET TRAINING PADA ANAK Pendahuluan: Toilet training ialah suatu bentuk usaha yang dilakukan dengan tujuan mengontrol buang air besar (bab) dan buang air kecil (bak) yang dilaksanakan pada anak, kegiatan ini dilakukan dengan harapan anak mampu mencegah terjadinya kondisi keterlambatan mengontrol bab dan bak. Anak perlu mendapatkan perhatian terutama dalam unsur tumbuh kembangnya yang dilakukan sejak awal perkembangan anak. Sehingga akan terbentuknya anak-anak dengan kemampuan dan kualitas dengan kategori hebat sehingga akan tercapainya masa depan anak dengan kategori unggul sehingga menghasilkan anak-anak yang sehat dan cerdas.Tujuan: Tujuan penelitian ini diketahui pengaruh konseling teknik demonstrasi untuk meningkatkan kemampuan toilet training pada anak. Metode: Penelitian ini dilakukan dengan jenis penelitian kuantitatif dimana desain yang digunakan ialah dengan desain pra eksperimen dengan menggunakan pendekatan One Group Pre-Test dan Post-Test. Hasil: Hasil univariat dari penelitian ini didapatkan karakteristik responden dari 15 responden sebagian besar responden yaitu 11 responden (73,3%) berada pada usia 5 tahun. Untuk hasil analisis bivariat dengan menggunakan uji statistik Wilcoxon Signed Ranks Test diperoleh nilai p (value) = 0,001 < 0,05.Kesimpulan: kesimpulan penelitian ini ialah ada pengaruh konseling dengan teknik demonstrasi untuk meningkatkan kemampuan toilet training pada anak. Kata kunci: Konseling, Demonstrasi, Toilet training

Every Picture Tells a Story: Parenting Advice Books Provide a Window on the Past

This paper comprises a collection of illustrations, along with background information, analysis, and commentary, from “baby books”—advice books published in the United States for a parent audience from the 1890s to the 1980s. These publications, and especially their drawings and photos, provide a window on past child rearing practices and beliefs. The paper provides historical background on parenting behaviors such as toilet training and infant feeding, then traces changes over time through drawings and photos that appeared in parenting advice publications. These publications grew in popularity as changing work and family structures removed traditional sources of information for parents, and scientific information and expert guidance took their place. Publications from a variety of sources, but especially the U.S. Children’s Bureau, are explored. A finding of note is that images of babies and their families, which in earlier publications were entirely white and middle class, became more diverse over time. The author concludes that published parental advice from professionals made for a fascinating study, was ideologically driven, and often lacked a basis in empirical scientific knowledge of child development, and therefore asserts that parents may regard such advice conditionally.

Timing is everything: Clinical courses of Hunter syndrome associated with age at initiation of therapy in a sibling pair

Hunter syndrome, or mucopolysaccharidosis (MPS) II, is a rare lysosomal disorder characterized by progressive, multi-system disease. As most symptoms cannot be reversed once established, early detection and treatment prior to the onset of clinical symptoms are critical. However, it is difficult to identify affected individuals early in disease, and therefore the long-term outcomes of initiating treatment during this optimal time period are incompletely described. We report long-term clinical outcomes of treatment when initiated prior to obvious clinical signs by comparing the courses of two siblings with neuronopathic Hunter syndrome (c.1504T>G[p.W502G]), one who was diagnosed due to clinical disease (Sibling-O, age 3.7 years) and the other who was diagnosed before disease was evident (Sibling-Y, age 12 months), due to his older sibling’s findings. The brothers began enzyme replacement therapy within a month of diagnosis. Around the age of 5 years, Sibling-O had a cognitive measurement score in the impaired range of <55 (average range 85-115), whereas Sibling-Y at this age received a score of 91. Sibling-O has never achieved toilet training and needs direct assistance with toileting, dressing, and washing, while Sibling-Y is fully toilet-trained and requires less assistance with daily activities. Both siblings have demonstrated sensory-seeking behaviors, hyperactivity, impulsivity, and sleep difficulties; however, Sibling-O demonstrates physical behaviors that his brother does not, namely biting, pushing, and frequent elopement. Since the time of diagnosis, Sibling-O has experienced significant joint contractures and a steady deterioration in mobility leading to the need for an adaptive stroller at age 11, while Sibling-Y at age 10.5 could hike more than 6 miles without assistance. After nearly a decade of therapy, there were more severe and life-limiting disease manifestations for Sibling-O; data from caregiver interview indicated substantial differences in Quality of Life for the child and the family, dependent on timing of ERT. The findings from this sibling pair provide evidence of superior somatic and neurocognitive outcomes associated with presymptomatic treatment of Hunter syndrome, aligned with current considerations for newborn screening.

Modified Duhamel Retrorectal Pull-Through for Hirschsprung’s Disease

Objectives: To evaluate the post-operative complications and short-term outcomes of modified Duhamel retrorectal pull-through procedure for Hirschsprung’s disease. Design: Prospective descriptive study Place and Duration of Study: Department of Paediatric Surgery Sahiwal Teaching Hospital Sahiwal from 1stJanuary 2018 to 31st December 2020. Methodology: Thirty seven histologically confirmed cases of Hirschsprung’sdisease having previous decompressing colostomy/stoma age between 1 to 12 years of agewere included. Children under one year of age, with sever comorbidities like Down syndrome and cardiac abnormalities, and those who require re-do pull through procedure were excluded. Modified Duhamel retrorectal pull-through procedure was performed in all cases. The demographic information included age, sex, proximal level of aganglinosis, complications of definite procedure, length of hospitalization andmortality. Other information recorded included long term complications like obstructive symptoms, enterocolitis, incontinence and soiling at follow up. Krickenbeck classification was used to evaluate faecal incontinence and constipation. Kelly’s clinical score was used to assess the anal sphincter. Bowel habits were assessed only in children above three years of age. Results: Twenty six (70.27%) were males and 11 (29.72%) females with male to female ratio 2.3:1 and mean age at operation was 2.89±1-9 years. Twenty nine (78.37%) children were ≤3 years of age and 8 (21.62%) were >3 years. Mean weight was 12.91 kgs, operation time was 126.81 time, fasting time was 6.67 days and hospital stay was 11.91 days. Length of aganglionic segment was short segment 27 (72.97%), long segment 9 (24.32%) and total colonic 1 (2.7%). Hirschsprung associated enterocolitis 7 (18.91%) and wound infection 6(16.21%) were most common reported complications. Constipation in 5(13.51) and soiling with retentive constipation was present in 3 (8.10%) patients. Out of total 31 patients who reached toilet training age, 28 (90.32%) developed satisfactory voluntary bowel habits. Conclusion: Modified Duhamel pull-through procedure was found to be safe, applicable and with lower associated complications and satisfactory short term functional outcomes in our settings. Key words: Hirschsprung’s disease, Modified Duhamel pull-through procedure, Complications, Outcomes

A Study to Assess Prevalence of Nocturnal Enuresis and Its Associated Factor among School Going Children in Selected Rural Areas of Vadodara

Background: Nocturnal enuresis, also called bedwetting, is involuntary urination while asleep after the age at which bladder control usually begins. Bedwetting in children and adults can result in emotional stress. Little is known about toilet training in pre-modern societies, but attitudes toward training in recent history have fluctuated substantially, and may vary across cultures and according to demographics. Treatments range from behavioral therapy, such as bedwetting alarms, to medication, such as hormone replacement, and even surgery such as urethral dilatation. Since most bedwetting is simply a developmental delay, most treatment plans aim to protect or improve self-esteem. Treatment guidelines recommend that the physician counsel the parents, warning about psychological consequences caused by pressure, shaming, or punishment for a condition children cannot control. Bedwetting is the most common childhood complaint. Children may face certain risks associated with training, such as slips or falling toilet seats, and toilet training may act in some circumstances as a trigger for abuse. Aims: The aim of this study is to assess the prevalence of nocturnal enuresis and its associated factors among school going children in selected rural areas of Vadodara. Methods: A descriptive research design was carried out for this study. The sample size of the study is 500. Participants were selected using stratified sampling technique. The tool is consists of two parts. First part consist of demographic data of the sample and second part consist of assertiveness self-assessment questionnaire. Results: While assessing the associated factors of nocturnal enuresis in school going children, 15% children are having mild nocturnal enursesis,77%children are having moderate nocturnal enuresis and 8% children are having severe nocturnal enuresis. While assessing the association, there are three demographic variables age, sex and education of father has no significant association. So H0 has been rejected and H1 is accepted. Conclusion: The present study concluded that majority of the children’s is having moderate level of nocturnal enuresis (77%) and minority of the children’s is having severe level of nocturnal enuresis (8%).

THE PERCEPTIONS, ATTITUDES AND BEHAVIORS OF MOTHERS IN PROVIDING EARLY SEX EDUCATION

Background : Cases of child sexual abuse in Indonesia continue to increase. The need for a parent's role in providing sex education from an early age is expected to prevent children from sexual abuse. Savy Amira Women Crisis Centre mentions that Tambaksari sub-district has the highest crime rate in Surabaya. Perceptions, attitudes and behaviors of parents in the provision of sex education in early childhood can be described in PAUD Tunas Mandiri Pacar Keling Subdistrict Tambaksari Method: This research method is qualitative with phenomenological approach. The number of samples as many as 10 mothers with purposive sampling techniques. The variables studied were perception, attitude and behavior of the mother. Data is collected by indepth interview method and processed with Interactive Model Of Analysis. Result : Most respondents have a perception that sex education is behavior, but respondents know that sex education has a good purpose. This is reflected in the attitudes and behaviors shown by most respondents about how they provide sex education. All they've been doing is part of sex education, it's just that they don't know or realize that. The age, level of education and employment in this study had little effect on perceptions of providing sex education. Conclusion: Almost all mothers interpret the provision of sex education in early childhood is still a taboo thing to give, while for the attitude and behavior of the mother is shown by limiting the child and supervision when playing gadgets,introducing genitalia and teaching toilet training.

Toilet training

Becoming toilet trained is an important new skill that takes time and patience for both you and your child. But when is it the right time to start doing this and how should you go about it?