Undangan diskusi keslompok bersama Bp Fred Vrugteveen

Dengan ini saya memberitahukan bahwa akan diadakan Diskusi Kelompok dengan Bapak Fred Vrugteveen, seorang ahli pendidikan yang menspesialisasikan diri pada Autisme dan gangguan lainnya. Beliau adalah mantan direktur sekolah autisme di Utrecht Belanda, yang kini menjadi konsultan untuk sekolah-sekolah berkekhususan di Indonesia.

Tempat: Kasandra & Associates
Jl. Pela no. 210 Jakarta Selatan
Tel. 739 2068
Tanggal : 15 Desember 2008>
Hari : Senin
Jam ; 10.00 s/d selesai
Patungan/iuran : Rp. 300.000,-
Hubungi: Kasandra -- 0818 827 779

Diskusi ini akan diadakan dalam kelompok kecil antara 15 - 20 orang. Jadi kesempatan ini sangat bermanfaat bagi orang tua yang mempunyai anak terlambat bicara dengan diagnosa Autisme, ASD, ADD, dsbnya. Diskusi dalam bahasa Indonesia. Bp Fred Vrugteveen didampingi Ibu Julia Maria van Tiel.

Repotnya urusan ilmu keberbakatan

REPOTNYA URUSAN ILMU KEBERBAKATAN

Menjadi saya, setidaknya seorang ibu yang hidup diNegara Belanda yang mempunyai UU tentang anak berbakat (sebagai anak yang memerlukan perhatian khusus), mau tidak mau terjerat dalam sistem yang mengatur pendidikan anak berbakat. Menjadi orang tua anakberbakat, terlebih dual exceptional (mempunyaikeistimewaan ganda, yaitu potensi keberbakatan,sekaligus mengalami perkembangan tidak sinkron yang mengganggu perkembangannya), serta merta akan menjadi salah satu sasaran tembak perhatian berbagai fihak.

Orang tua mempunyai kewajiban membaca, harus mengikuti kursus ketrampilan pengasuhan, selalu dipantau apa saja yang kita kerjakan. Bagi saya urusan begini cukup menyenangkan, banyak teman untuk diajak berbicara, banyak ahli bisa ditanyai, dan apa yang sangat saya rasakan adalah,santapan ilmu keberbakatan yang saya kunyah terasa manis, menyenangkan, bagai suatu titian manis ditengah hijaunya sawah dan kebun. Baunya harum. Saya diwajibkan menjadi anggota kelompok orang tua anakberbakat yang dilindungi oleh pemerintah, dan dibimbing oleh pusat-pusat keberbakatan dari universitas. Ilmu yang dikucurkan kepada para anggota selalu melalui saringan ketat. Info terbaru cepat berada di tangan. Anggota selalu mendapatkan undan gangratis mengikuti kongres dan seminar.

Diskusi demi diskusi selalu kita lontarkan, ada yang berbahasa Belanda diikuti oleh masyarakat Belanda danBelgia (bagian yg berbahasa Belanda). Ada yang berbahasa Inggris, untuk masyarakat internasional. Namun ternyata ilmu ini selalu tidak manis, jika kita nglayap sampai luar negara-negara Eropa. Hal ini karena banyaknya definisi dan pengertian keberbakatan itu sendiri, yang kalau tidak hati-hati kita bisa benjol benjol dalam mendalaminya. Terutama yang sayarasakan jika mengikuti diskusi di mailing list Indonesia, benjolannya banyak luar biasa. Lima tahunan sudah saya mengikuti diskusi anakberbakat di berbagai mailinglist Indonesia dan turut berbicara di berbagai forum, ilmu yang saya sampaikan terasa bagai ilmu aneh dari negeri entah dimana.Sehingga rasanya sering seperti manusia dari planit Mars turun ke bumi. Ilmu keberbakatan yang harus dan mau tidak mau yang saya fahami adalah, bahwa keberbakatan adalah suatu potensi bawaan (genetic/nature) yang memerlukan pengasuhan yang sesuai dengan kebutuhan dan personalitasnya yang dipunyai setiap anak berbakat yang setiap anak berbakat pun berbeda-beda (nurture).

NATURE + NURTURE itulah formula yang harus kami pegang. Tetapi dalam berbagai diskusi di Indonesia sering muncul pendekar pendekar dari partai NURTURE yang membawa bendera berkibar kibar menggapai para orang tua dengan dalil: membantu menggali bakat anak,bagaimana menjadikan anak kita jenius unggulan, setiap anak pada dasarnya cerdas-berbakat-atau jenius. Atau kata-kata: kita juga bisa menjadi jenius. Mau tak mau partai nurture ini berhadap hadapan dengan partai kami. Perang tanding silat lidah, baik frontal maupun tidak. Lontaran mercon yang biasa kami terima antara lain:- sudah terbukti bahwa anak yang tidak punya orang tua dan nenek moyang pemusik ternyata jika ia dilatih baik baik bisa menjadi pemusik unggulan.

Jika pendapatnya kami tolak, maka ia akan melemparkan mercon kembali berbunyi begini:- anda kan dari bangsa NATURE jadi kan kalau punya anak pasrah pada genetic lalu anaknya dibiar-biarkan,sehingga potensi yang ada tidak dikembangkan. Jadi sering disangka partai kami adalah partai NATURE dan mereka membuat pertentangan antar partai ini menjadi NATUR vs NURTURE.

Cukup lama saya merenungi mengapa mereka tidak bisa menangkap jiwa partai kami (natur + nurture). Setelahmenjelajah dunia melalui berbagai diskusi lainnya,ternyata teori yang kami serap di belahan Eropa memang berbeda dengan ilmu keberbakatan yang popular diAmerika. Disinilah mulainya peperangan antar partai itu.

Adalah kenyataan yang harus dikunyah masyarakat, kaum politik, dan kelompok scientist Amerika, sejak diumumkannya hasil penelitian panjang longitudinal terhadap sebanyak 12.000 anak muda Amerika yang dilakukan pengukuran terhadap IQ nya, yang diikuti sejak tahun 1979. Hasilnya menunjukkan bahwa IQ kelompok anak-anak kulit putih lebih tinggi dari pada anak-anak kulit hitam, miskin, dan datang dari latarbelakang orang tua yang mempunyai pendidikan rendah.

Sementara itu pada saat itu teori keberbakatan mengatakan bahwa keberbakatan adalah merupakan genetic, atau bawaan. Maka hasil penelitian itu mengidikasikan bahwa kelompok orang kulit berwarna mempunyai genetic yang tidak baik, karena inteligensia rendah sering dihubungkan sebagai sumber terjadinya masalah masalah sosial seperti kekerasan, criminal,dan masalah sosial yang patologis lainnya, yang dengan catatan karena hal ini menyangkut masalahgenetic maka nasibnya tidak mungkin dirubah. Kesimpulan ini membawa reaksi yang hebat terhadap IQtest dan kelompok psikometrik, dengan tudingan IQ test merupakan alat untuk secara politis mendiskriminasi kelompok kulit berwarna.

Heboh baik dikalangan politik dan ilmuwan, membawa berbagai pemikiran baru. Banyak kalangan yang ingin menisbikan test IQ, dan mencari pemikiran baru terhadap apa artinya inteligensia.Karena IQ sudah menunjukkan bias sosial dan cultural yang luar biasa, yang bisa merugikan suatu kelompok. Inteligensia yang diukur melalui IQ test akan menghasilkan hal sebagai berikut:Ada kelompok yang mempunyai IQ sangat tinggi disebut sebagai jenius dengan jumlah yang sangat kecil yang kemudian dituding sebagai kelompok elit, ada kelompok gifted yang ber IQ lebih rendah daripada jenius,bahkan di bawah kelompok normal ada kelompok IQ below dan idiot. Pemaparan IQ dari kiri ke kanan dan dari rendah ke tinggi ini disebut Bell Curve. (Konflik ini bisa dibaca dalam buku The Bell Curve Wars).

Adalah seorang psikolog Havard University bernama Howard Gardner mempunyai ide, manusia tidak perlu lagi memikirkan nasibnya melalui test IQ (sebagai reaksi kenyataan tadi). Menurutnya sekalipun seseorang itu tidak mempunyai tangan ia masih bisa hidup dengan suaranya. Ia mencontohkan pada dirinya yang butawarna, sekalipun ia buta warna ia juga masih bisa berprestasi hebat. Karena itu ia mengusulkan menggunakan teorinya, yaitu multiple inteligence.Multiple inteligence ini merupakan klasifikasi berdasarkan observasi terhadap talenta apa saja yang bisa diwujudkan oleh seseorang. Talenta itu dalam wujud: linguistic, mathematical, musical, spatial,bodily/kinesthetic, interpersonal and intrapersonal,naturalist and existential Ia tidak membicarakan masalah giftedness (bakat) tetapi ia membicarakan tentang talenta.

Karena ia justru menghindari kata-kata inteligensia tinggi bila ditunjukkan melaluihasil test IQ yang tinggi. Bukunya menjadi best seller dimana mana yang diterbitkan tahun 1983 dengan judul The Frame of the Minds. Ia aktif berbicara dimana-mana, melakukan talkshow di radio, dan banyak menulis artikl dan buku. Salah satu bukunya yang juga terkenal dan banyak membicarakan multiple intelligence ini adalah: Intelligence Reformed, MultipleIntelligence for the 21st century.

Buku Howard Gardner ini sangat laris bahkan digunakan oleh banyak institusi yang mencoba menggali bakat anak. Karena menolak IQ sebagai bawaan maka masalah perkembangan otak yang menyangkut talenta ini dijelaskan bahwa setiap bagian otak mempunyai/merupakan bagian yang memiliki potensi talenta tadi yang perlu distimulasi. Dari sini maka muncullah upaya-upaya orang membuat program bagaimana menstimulasi otak anak terutama di usia masih sangat muda, yang dipercaya sebagai the golden period. Apalagi setelah munculnya buku The Myth of the FirstThree Years, dari John Bruer yang merupakan buku psedoilmiah mengatasnamakan neuroscience dan mendapat kecaman dari kelompok zero to three yaitu asosiasi dokter anak neuroscience and development Amerika.

Talenta versi Gardner yang menjelaskan bahwa setiap bagian otak memiliki potensi talenta yang perlu distimulasi (karena menolak genetik maka bisa dianggap bahwa semua otak orang sama saja), sekalipun sampai saat ini belum pernah ada yang bisa menjelaskan dan mampu menunjukkan dimana saja letak potensi itu di dalam otak, bahkan belum ada yang bisa mengukurnya,tetapi kini orang sudah repot menstimulasi otak kiri dan kanan.

Tulisan tulisan psedoilmiah tentang stimulasi otak kiri dan otak kanan bertebaran dimana-mana. Disambung selanjutnya dengan dongeng konflik teori yang membuat kita kebingungan dan sampai benjol benjol….

Salam

Julia Maria van Tiel

15 Juni 2005
Seminar online WRM



REPOTNYA ILMU ANAK BERBAKAT

Masih melanjut dongeng konflik anak berbakat yang membuat kita para orang tua sebagai konsumen ilmu jadi berkepala benjol-benjol karena menghadapi baku hantam teori yang harus dianut. Baku hantam yang pada dasarnya untuk memilih jalan dan titian yang harus ditempuh dalam tugas pengasuhan anaknya, pada umumnya berkisar pada keputusan yang harus diambil yang timbul dari pertanyaan-pertanyaan:
- Apakah keberbakatan itu keturunan atau bisa kita buat (diproses)
- Jika diturunkan artinya memang ada kelompok-kelompok tertentu yang memang di dunia ini menjadi kelompok anak berbakat yang tidak bisa diganggu gugat lagi, dan jika bisa dibuat bagaimana membuatnya? Pertanyaan bagaimana membuatnya ini juga bisa baku hantam lagi sampai benjol-benjol karena antara satu paket how to create geniusity dengan paket yang lainnya saling berlomba siapa paling hebatsss paling cepat, dan fullspeed. Mulai dari cara ngajak ngobrol dengan bayi sebagai cara yang paling murah, sampai yang menggunakan flaschcard, alat main educatif, CD musik dan VCD.



Konflik ini juga banyak dibahas-bahas oleh HJ Eysenck, seorang professor psikologi dari universitas London. Bersama L Kamin yang juga professor psikologi di Universitas Princetown –Amerika, Eysenck menulis buku berjudul INTELLIGENCE: THE BATTLE OF MINDS (1981), buku yang sangat laris bombastis karena menjelaskan pertempuran tentang inteligensia: diturunkan atau diproses? Kedua psikolog ini adalah ahli-ahli yang banyak melakukan penelitian keberbakatan dari sisi genetic. Buku ini banyak menjelaskan tentang mengapa terjadi konfrontasi dua kubu antara kubu yang mempercayai bahwa keberbakatan adalah tergantung dari genetic (nature) , dan di kubu lain tergantung dari pengaruh lingkungan (nurture).

Leo Kamin salah seseorang yang mendisain sensus nasional IQ Amerika tahun 1979 yang menghasilkan gambaran yang menghebohkan, dimana kelompok kulit berwarna dan kelompok miskin menunjukkan IQ yang lebih rendah dari IQ kulit putih, yang kesimpulan dengan dasar IQ kulit berwarna secara genetic lebih buruk dari kulit putih, sementara itu rendahnya intelligensia sering dihubung-hubungkan dengan masalah sosial yang patologis (kriminal, kekerasan, drugs, dlsb). Genetik, artinya tidak bisa diperbaiki lagi. Sementara itu dalam sejarahnya Amerika selalu mengalami konflik antar ras, perbudakan, dan diskrimiansi. Leo Kamin menjadi sasaran tudingan penipuan ilmiah yang mampu memperkuat konflik diskriminasi di Amerika. Hasil akhir IQ akhirnya memicu perang antar ilmuwan, yang reaksinya dipelopori oleh kelompok ilmuwan sosial. Hingga akhirnya muncullah kelompok nurture yang terkenal yang menisbikan IQ, yaitu kelompok MI (multiple intelligence), EQ (Emotional Intelligence) dan SQ (Spritual Intelligence).

Sementara di Amerika perang kedua kelompok yang tak pernah rampung hingga kini, yang debatnya bisa membuat benjol, bahkan konflik ini meleber ke belahan dunia lain, di belahan Eropa mempunyai sejarah sendiri dalam perkembangan keberbakatan.

Sejarahnya dimulai di tahun 1970 dengan penelitian panjang yang diketuai oleh JF Mönks seorang psikolog pendidikan dari Universitas Nijmegen (kini menjadi Direktur European Council for High Ability untuk ke 3 kalinya, dengan selang kepemimpinan yang dipegang oleh orang lain). Hal yang mendorong diadakannya penelitian ini adalah karena banyaknya anak-anak yang mendapatkan diagnosa MBD (Minor Brain Damage, pada waktu itu diagnosa ini lebih populer) dan mendapatkan berbagai terapi dan revalidasi, serta ditempatkan di panti-panti dan sekolah untuk anak-anak yang sangat bermasalah, namun berbagai tindakan yang diberikan ini bukan memecahkan masalah tetapi lebih memperburuk keadaan. Pada waktu Mönks melakukan assessment perkembangan inteligensia, menunjukkan bahwa anak-anak ini ternyata mempunyai potensi giftedness tinggi yang tidak pernah menjadi bahan pertimbangan dalam pendidikannya. Kepada anak-anak ini kemudian dilakukan rehabilitasi, namun ternyata upaya rehabilitasi lebih sulit jika giftedness anak-anak seperti ini telah dapat dideteksi dan segera diberikan pendidikan yang terstruktur sejak dini.

Maka sejak tahun 1973 dimulailah penelitian panjang tentang anak-anak gifted Belanda, yang dilakukan oleh Pusat Penelitian Keberbakatan atau CBO (Centrum voor Begaafdheids Onderzoek) Universitas Nijmegen. Hasil penelitian itu menunjukkan bahwa setengah populasi anak-anak berbakat ternyata mengalami prestasi rendah yang tidak sesuai dengan potensi yang diharapkan. Berbagai hal yang menyebabkan jatuhnya prestasi ini antara lain karena dukungan terhadap berbagai perkembangan dan intelektual si anak baik di sekolah, keluarga maupun masyarakat menunjukkan dukungan yang tidak mencukupi (artinya faktor nurture juga berperanan). Hasil penelitian ini kemudian melengkapi teori Triadik Renzulli menjadi Triadik Renzulli-Mönks yang dipublikasinya tahun 1988 (Monks & Ypenburg,1995). Teori inilah yang kini menjadi dasar perundang-undangan dan pendidikan anak-anak gifted di berbagai negara di Eropa.

Istilah gifted di Belanda lebih dikenal dengan sebutan hoogbegaafd (potensi tinggi) yang dalam penggunaan bahasa Inggris lebih dikenal dengan istilah high ability yang pengertiannya lebih mengacu pada potensi yang dimiliki setiap anak gifted, daripada produk atau prestasi yang dihasilkan. Istilah high ability ini kini lebih banyak digunakan dan menjadi istilah resmi di berbagai negara Eropa. Dalam kerjasama pendidikan anak-anak gifted di Eropa, berbagai negara bersatu dan membentuk sebuah lembaga konsil dengan nama ECHA (European Council for High Ability). Sementara Amerika masih menggunakan istilah Gifted Center (ECHA,2004, http://www.echa.ws/) . Perbedaan dasar teori dua belahan benua antara Eropa dan Amerika ini juga membawa dampak pada debat teoritis tentang anak-anak gifted yang membutuhkan pendekatan dan waktu yang tidak sedikit. Debat teoritis yang belum selesai ini akan membawa pada tidak pernah selesainya perundang-undangan tentang pendidikan anak-anak gifted di Amerika yang sebetulnya model pendekatannya kemudian banyak ditiru oleh banyak negara yang mengacu pada pendidikan model Amerika.

Mönks, bersama ECHA-nya terus menerus melakukan kampanye pendekatan baru pendidikan anak-anak berbakat ke seluruh dunia melalui kongres-kongres internasionalnya. Debat Nature vs Nurture harus dihentikan, karena yang menjadi korban adalah anak-anak generasi muda sebagai produk rekayasa sistem perundang-undangan yang mengatur sistem pendidikan jika didasari hanya salah satu kubu tersebut (nature atau nurture).

Namun upaya ini bukannya mudah, sangat sulit, sekalipun UNESCO telah menyerukan Deklarasinya di tahun 1994 yang terkenal dengan deklarasi Salamanca yang ditandatangani oleh seluruh anggota Unesco dari seluruh dunia (entah kenapa kok Indonesia engga ikutan), bahwa setiap anak adalah unik, yang mempunyai hak untuk mendapatkan pendidikan yang sebaik-baiknya. Realisasi deklarasi ini adalah turunnya upaya-upaya pendekatan pendidikan yang disebut pendidikan inklusif yang merubah filosofi sistem pendidikan dari content based curriculum (kurikulum berbasis materi) ke arah competence-based curriculum (kurikulum berbasis kompetensi). Pendidikan haruslah menghormati setiap anak dengan kompetensinya masing masing. Pada akhirnya sistem pendidikanpun menjadi pendidikan yang adaptif, artinya tawaran pendidikan harus bisa diterima oleh setiap anak, harus sesuai dengan keunikan anak.

Hasil deklarasi ini juga menurunkan pengertian tentang anak-anak yang membutuhkan perhatian khusus, karena keunikannya tadi, antara lain adalah anak-anak berbakat (gifted). Anak gifted bukan lagi dipandang sebagai menjadi anak yang istimewa yang akan dengan sendirinya mampu menyapu medali, tetapi anak-anak ini memerlukan juga pendekatan yang arif. Banyak diantara anak-anak penyandang gen gifted yang ternyata mengalami gangguan belajar (learning disabilities) sebagai hidden disabilities, suatu cacat yang disandangnya dan sulit nampak dari luar. Dalam sejarahnya banyak anak-anak gifted yang menderita, karena ketidak mengertian kita padanya.
(kisah ini saya tuangkan di Kompas, baca:http://gifted-disinkroni.blogspot.com/2004/09/kisah-duka-anak-anak-jenius.html yang ternyata banyak menarik pembaca dan mengirim email pada saya).

Kisah-kisah dan sejarah ilmu keberbakatan ini artinya mengisyaratkan pada kita bahwa, siapapun anak kita, bagaimanapun anak kita ia mempunyai keunikan sendiri-sendiri. Genetik saja bukan jaminan jika tidak diberi dukungan pendidikan dan pengasuhan yang sesuai. Artinya memiliki IQ tinggi saja bukan jaminan, dan yang mempunyai IQ sedang sedang saja bukan berarti tidak akan menjadi orang sukses jika tidak diikuti dengan pendidikan dan pengasuhan yang baik. Seorang yang mempunyai IQ sedang sedang saja pun akan mampu menjadi orang sukses.

Mudah-mudahan tulisan ini bisa menghentikan debat kita, dan mulailah dengan tenaga baru membuka wacana baru mengasuh dan memahami anak kita, tak perlu terpancing pada konflik dunia.

Julia Maria van Tiel
16 Juni 2005
Seminar Online WRM

PDD-NOS vs terlambat bicara

“Anakku juga PDD-NOS tapi perkembangannya sekarang oke….”


Dalam syering-syering pengalaman di berbagai milis tentang anak-anaknya. Jika ada yang menanyakan bagaimana caranya agar anaknya keluar dari autismenya.

Banyak syering yang mengatakan bahwa anaknya sekarang sudah oke, bukan autis lagi karena pakai terapi anu-anu anu….
Yang lain ikut, dan melaporkan juga bahwa dia menggunakan terapi anu… juga perkembangannya oke.
Kesimpulannya, pakai apa saja bisa oke…
Tapi ada juga yang tidak oke…
Lalu bagaimana sebenarnya?

PDD-NOS adalah bentuk autisme yang tidak memenuhi kriteria secara penuh dari kriteria autisme DSM IV. Jika 2 dari tiga kriteria memenuhi syarat maka ia akan disebut sebagai PDDNOS. Tetapi DSM IV tidak menjelaskan lagi tentang bagaimana melakukan diagnosa banding dengan anak yang mengalami keterlambatan bicara yang sebetulnya anak normal hanya saja terlambat bicaranya.

Sehingga banyak sekali anak terlambat bicara akhirnya masuk sebagai anak PDD-NOS.

Andaikan anda mendapatkan diagnosa PDD-NOS maka upayakan lagi untuk mencari info diagosa pembandingnya, yaitu al:
- mental retarded
- terlambat bicara (murni karena perkembangan)

Sensory Integration Therapy (SIT) tidak efektif

Sensory Integration Therapy (SIT) gak ngepek....


Sensory Integration Therapy (SIT)
Sensory integration therapy (SIT) has been proposed as a method to
improve the way the brain processes and organizes external stimuli,
such as touch, movement, body awareness, sight and sound. SIT is
usually performed by occupational or physical therapists, who provide
sensory stimulation in combination with muscle activities,
theoretically in order to improve how the brain processes and
organizes sensory information. SIT usually requires activities that
involve full-body movement using different kinds of equipment, such
as scooter boards, swings, ramps and textured mitts. Therapy is given
in one to three sessions per week over several months or a few years,
with sessions typically lasting 60–90 minutes. SIT was originally
developed as a treatment for learning disabilities and subsequently
has been proposed as treatment for autism, mental retardation, Down
syndrome, and developmental delays.

Definitive patient selection criteria have not been established for
SIT.
Researchers hypothesize that a sensory integration (SI) disorder can
cause academic difficulties that might initially be diagnosed as a
learning disability. Learning-disabled children have normal
intelligence, as measured by intelligence quotient (IQ) testing.
However, their academic skills are considered delayed for their age.
In order to be classified as having SI disorders, therapists indicate
that learning-disabled children must display such symptoms as
problems with motor function or physical coordination. These children
are often described as clumsy, but standardized testing must reveal
difficulties in the processing of vestibular, proprioceptive, or
tactile stimuli. Proponents of SIT believe that SI dysfunctions
contribute to learning disabilities, since up to 70% of children with
learning disabilities have SI disorders (Hayes, 2004).
The following are classifications of the general areas in which a
child is tested to support the diagnosis of SI dysfunction (Hayes,
2004):

• Dysfunction in the vestibular system: This is usually indicated by
a decreased duration of nystagmus (i.e., a repetitive eye motion,
following spinning of the child).

• Apraxia: This is a disorder in the planning and executing of motor
acts, and identification is based on difficulty with imitating the
posture of another person.

• Disorders in space perception: This may cause the child to stand
too close to another person.

• Auditory or language problems

• Tactile defensiveness: This may be defined as physical or emotional
discomfort when touched by an examiner during tests of tactile
perception.

Numerous neuropsychological batteries have been developed to evaluate
levels of dysfunction with relation to these five categories of SI
disorders. These lengthy tests, which comprise multiple subtests, are
administered by individuals who are certified by a private
organization, SI International (Torrance, CA). These tests include
(Hayes, 2004):

• Southern California SI Tests

• Southern California Postrotary Nystagmus Test

• SI and Praxis Tests

Literature Review for Sensory Integration Therapy
Miller et al. (2007) conducted a pilot, randomized controlled trial
of the effectiveness of occupational therapy using a sensory
integration approach (OT-SI) in children with sensory modulation
disorders (SMDs). SMDs are impairments in regulating the degree,
intensity and nature of responses to sensory input, resulting in
considerable problems with daily roles and routines The trial
included 24 children who were randomly assigned to one of three
treatment conditions: OT-SI (n=7), activity protocol (n=10) and no
treatment (n=7). Pretest and post-test measurements of behavior,
sensory and adaptive functioning, and physiology were performed at
baseline and at 10 weeks. As compared to the other groups, the OT-SI
group made significant gains on goal attainment scaling (GAS)
(p<0.001 compared to no treatment and activity protocol) and on the
Attention subtest (p=0.03 compared to no treatment; p=0.07 compared
to activity protocol) and the Cognitive/Social composite of the
Leiter International Performance Scale-Revised (p=0.02 compared to
activity protocol). The OT-SI group showed improvement trends in the
hypothesized direction on the Short Sensory Profile, Child Behavior
Checklist and electrodermal reactivity. Larger randomized controlled
studies are needed to determine whether OT-SI is an effective
intervention, for which patients, and what conditions.
A review of SI outcomes research in relation to faithfulness of
intervention to underlying therapeutic principles or fidelity was
performed (Parham, et al., 2007). The review included 34 studies
which were analyzed for consistency of intervention descriptions with
the following elements: structural (e.g., equipment used, therapist
training) and therapeutic process categories. The reviewers made the
following findings:

• Most studies described structural elements related to therapeutic
equipment and interveners' profession.

• Only one of the 10 process elements, presentation of sensory
opportunities, was addressed in all studies. Most studies described
fewer than half of the process elements.

• Intervention descriptions in 35% of the studies were inconsistent
with one process element, therapist-child collaboration.

The authors note that the validity of SI outcomes studies is affected
by weak fidelity in regard to the therapeutic process.
Watling and Dietz (2007) reported on a study of the effect of Ayres's
sensory integration-based occupational therapy on the behavior and
task engagement of four children with autism spectrum disorders
(ASD). The single-subject study used an ABAB design to compare the
immediate effect of SI and a play scenario on the undesired behavior
and task engagement. The participants each received a different
number of study sessions due to absences and different enrollment
dates. The sessions ranged from 31 to 34. The results indicated that
no clear patterns of change in undesired behavior or task management
emerged through objective measurements. The subject data suggested
that each child exhibited positive changes during and after
intervention.
Smith et al. (2005) conducted a study for the purpose of comparing
the effects of occupational therapy, using a sensory integration
approach along with a control intervention of tabletop activities, on
the frequency of self-stimulating behaviors. The study involved seven
children, ranging in age from 8–19, diagnosed with pervasive
developmental delay and mental retardation. The study took place over
a four-week time period. During the second and fourth weeks, a
sensory integration treatment was provided for daily 30-minute
sessions, five times a week. During the first and third weeks, a 30-
minute controls session was provided, following the same schedule.
The study found that the frequency of self-stimulating and self-
injurious behaviors declined during the weeks when SIT was provided.
Limitations with the study included the small sample size, use of a
single clinical site, and the short-term follow-up. It was noted that
continued research is needed to examine the long-term effects of more
extensive intervention.
Dawson and Watling (2000) conducted a systematic review of the
research regarding the effectiveness of interventions for sensory and
motor abnormalities in autism. The interventions included SIT and
auditory integration training (AIT). Four studies on the
effectiveness of sensory integration therapy in autism that utilized
objective measures of behavior to assess outcome were found. All but
one had sample size of fewer than six subjects. None of the studies
had a comparison group. One study that had a larger sample size and
better design found no change in vocal behavior following brief
participation in sensory activities. Five studies were found
regarding the effectiveness of auditory integration training, three
of which included a control condition. Two of the studies that
included a control condition found improvement in both AIT and
control conditions. The third study that included control conditions
did find improvement in the AIT condition as compared to the control
condition; however, it was noted that there were methodological
difficulties with this study. The review concluded that although
sensory and motor impairments are commonly found in autism, the
interventions developed to address them have not been well validated.
In the case of SIT, it was noted, "there exist so few studies that
conclusions cannot be drawn" (Dawson and Watling, 2000). In the case
of AIT, it is noted that "there is no, or at best equivocal support
for this intervention approach based on the available controlled
studies" (Dawson and Watling, 2000).There is little known regarding
which ages or subgroups of individuals are most likely to benefit
from therapies addressing sensory and motor difficulties, and further
research is recommended.
A meta-analysis was conducted for the purpose of determining whether
existing studies of treatment using sensory integration approaches
support the efficacy of this method (Vargas, et al., 1999). Sixteen
studies were used to compare SIT with no treatment, and 16 studies
were used to compare SIT with alternative treatments. The review
noted that there was a significant difference between the average
size of effect of the earlier studies compared to the more recent
studies. The authors concluded that in the SIT and no treatment
studies, the recent studies did not demonstrate an overall positive
effect and that the sensory integration methods were found to be as
effective as various alternative treatment methods.
The peer-reviewed literature fails to demonstrate that SIT, compared
with other treatments or with no treatment, provides clinically
relevant, long-term improvements in outcomes in children with
learning disabilities, Down syndrome, developmental disorders or SI
disorders. Studies of SIT in children with cerebral palsy or autism
are also lacking, and therefore the evidence is insufficient to
evaluate SIT for these indications as well.

Professional Societies/Organizations for Sensory Integration Therapy
An assessment conducted by the National Academy of Sciences (NAS)
concluded that there is insufficient evidence as to the effectiveness
of SIT for autism. The NAS report states that there is a paucity of
research
concerning SIT in autism and that these interventions have not yet
been supported by empirical studies (NAS, 2001).
The American Academy of Pediatrics (AAP) Committee on Children with
Disabilities has stated that the scientific legitimacy of SIT has not
been established for children with motor disabilities (Michaud, et
al., 2004).
The Association for Science in Autism Treatment (ASAT) has noted in a
viewpoint appearing on their website that the overwhelming scientific
evidence indicates that SIT is ineffective and that practitioners of
this therapy need to provide reliable evidence of its effectiveness
instead of opinions and anecdotal reports (Fox, 2004).

http://www.cigna.com/customer_care/healthcare_professional/coverage_po
sitions/medical/mm_0283_coveragepositioncriteria_sensory_auditory_inte
gration_therapy.pdf.

TERAPI2 yang TANPA DUKUNGAN ILMIAH

Special Education Perspectives, Volume 13, Number 1, pp. 66-74, 2004

A TEACHER'S GUIDE TO
CONTROVERSIAL PRACTICES

Jennifer Stephenson
University of Technology, Sydney
ABSTRACT

Correspondence: Dr Jennifer Stephenson, Faculty of Education, University of Technology, Sydney, PO Box
222, Lindfi eld, NSW, 2070. Ph: (02) 9514 5354. Email: Jennifer.Stephenson@uts.edu.au


Information promoting controversial and
unsupported interventions and therapies for
students with special education needs seems
to abound on the Internet. However, there
are many sites that appear to offer a more
balanced, evidence-based assessment of the
effi cacy of interventions and treatments. This
article provides a guide to such sites in regard
to a number of controversial treatments in order
to assist teachers and families make informed
decisions about the practices they adopt.


Any teacher in search of information about
teaching students with special education needs
who visits the Internet will immediately be
confronted with a plethora of programs and
therapies that are claimed to be effective.
Similarly, families of these students, who are
searching for help with the education and
treatment of their child, are likely to locate the
same range of programs and therapies. Families
may then approach teachers and schools and
request that particular strategies be used with
their child. How do teachers and families make
informed decisions about which practices to
pursue and which to ignore?

The use of ineffective
therapies may not only cause harm, but may mean
that children do not receive interventions that are
known to be effective. This article will review
some of the controversial practices advocated
on Internet sites (and elsewhere), and provide
Internet sites that publish more sober advice on
these practices.

Several authors (Herbert, Sharp, & Gaudino,
2002; McWilliam, 1999; Park, 2003;
Scheuermann & Evans, 1997; Simpson, 1995;
Worrall, 1990), concerned with the uptake and
use of interventions and therapies that may be
regarded as frauds or fads, have developed a set
of indicators that may serve as warning signs that
a practice has not been shown to be effective:
• The practice is supported by anecdotes and
testimonies, not by the results of scientifi c
studies reported in refereed journals.
• The practice is reported directly to the mass
media and does not appear in professional,
refereed journals.
• The treatment recommended does not have
a logical connection to the presumed cause
of the diffi culty.
• The practice is not supported by established,
related bodies of knowledge.
• Proponents claim they are conspired against
by the “establishment”.
• Proponents make exaggerated claims
about effectiveness and may claim to cure
a condition.
• Proponents may have a fi nancial stake in the
treatment.
• Those completing the assessment to
determine if the treatment is suitable, are
the same people who will gain fi nancially
by selling the treatment.
• Practice can only be implemented by
specially trained people.
• May require the interventionist to have
“faith” in the treatment.
• Proponents claim the practice cannot
be properly evaluated using scientific
methods.
• Marketing is based on strong emotional
appeals.
• The practice should be used exclusively.
• The treatment is very intense.
• Legal action has been taken over the
treatment.

There are several useful Internet sites that guide
you through a set of questions, which should
reveal if any of these warning signs apply to the
therapy in question. These include the Autism
Association of South Australia (2003) and
Vanderbilt Children’s Hospital (2003).

Writers who have used these criteria have
identified a number of educational and
therapeutic practices as controversial and
unsupported by scientific research. The
following list is drawn from a number of refereed
publications: conductive education, facilitated
communication, sensory integration, Doman-
Delacato patterning, auditory integration
therapies, Irlen lenses and coloured overlays,
and multisensory environments (MSEs) or
snoezelen approaches (Arendt, MacLean, &
Baumeister 1988; Dawson & Watling, 2000;
Herbart et al., 2002; Hogg, Cavet, Lambe, &
Smeddle, 2001; Jacobson, Mulick, & Schwatz,
1995; McWilliam, 1999; New York State Health
Department, 1999; Shaw, 2002; Simpson,
1995; Stephenson, 2002; Worrall, 2001).

Thisknowledge base contained in the research
literature is, however, largely inaccessible to
families and practitioners who may have neither
the skills nor the time and interest to search,
read and understand this literature.

Fortunately however, just as the Internet has brought
increased access to information promoting
controversial and unproved practices, it has also
provided access to more balanced evaluations of
these practices. The next section of this paper will
briefl y review some controversial therapies and
include sources such as position papers, policies
and fact sheets from professional organisations,
special interest organisations and individuals
that are readily available on the Internet. The
URLs are provided in the reference list.

Auditory Integration Therapies (AIT)
This label covers strategies such as the Berard
method, Samonas Sound Therapy, and the
Tomatis method. The American Academy
of Paediatrics Committee on Children with
Disabilities (1998, Recommendations, para.
12) reviewed auditory integration training as a
therapy for children with autism and concluded
that although AIT “may help some children
with autism, as yet there are no good controlled
studies to support its use.”

More recently, The American Speech-Language Hearing
Association (2004) produced both a technical
report and a position paper which found that
Auditory Integration training is “experimental
in nature and has not yet met scientifi c standards
as a mainstream treatment” (p.1). The American
Academy of Audiology (n.d.) position statement
on Auditory Integration Training states that
the technique should be regarded as “purely
investigational” because of the lack of published
research showing its effectiveness, and that
consumers should understand this before they
begin treatment.

The Educational Audiology Association (n.d.)
supports the position taken
by the American Academy of Audiology and
the American Speech-Language-Hearing
Association that “Auditory Integration Therapy
has not been proven to be a viable treatment for
any disability”.

Vision therapies
These include the use of eye exercises, fi lters,
and coloured lenses which purport to improve
a child’s reading. The American Academy
of Paediatrics, the American Association for
Pediatric Ophthalmology and Strabismus and
the American Academy of Ophthalmology
(1998) produced a joint policy statement on
these approaches in relation to students with
learning disabilities, especially those who have
diffi culty learning to read. The policy states,
“Visual problems are rarely responsible for
learning difficulties. No scientific evidence
exists for the effi cacy of eye exercises (“vision
therapy”), or the use of special tinted lenses in
the remediation of these complex paediatric
neurologic conditions” (Policy, para. 2). They
note that studies of these practices, which
claim improvements, have usually included
educational remedial techniques, and these
most likely explain reported benefi ts. The use of
tinted lenses for reading diffi culties purportedly
caused by Scotopic Sensitivity Syndrome named
by Irlen (American Optometric Association,
2003) has been assessed by the American
Optometric Association (2003) who found
that “there is currently no scientifi c research
to support the ‘scotopic sensitivity’ syndrome
hypothesis”, and that the use of coloured lenses
requires further investigation.

Sensory Integration Therapy
Sensory Integration Therapy (SIT) was
developed by Jean Ayres in the 60s and 70s,
with the aim of improving the way “the brain
processes and organises sensations” (Ayres,
1979 cited in Arendt et al., 1988, p.402.). The
therapy involves providing sensory stimulation
in various ways, such as by providing deep
pressure sensations, vestibular stimulation,
having students wear weighted vests, and/or
use scooter boards (Arendt et al., 1988; Shaw,
2002). Arendt et al. (1988) reviewed its use
with people with intellectual disability and
concluded “until the therapeutic effectiveness
of sensory integration therapy with mentally
retarded persons is demonstrated, there exists
no convincing empirical or theoretical support
for the continued use of this therapy with that
population outside of a research context” (p.
409). Hoehn and Baumeister (1994) critiqued
the theory and practice of SIT with children with
learning disabilities and supported the fi ndings
of Arendt et al. (1988), concluding (p.348) that
“the current fund of research findings may
well be suffi cient to declare SI therapy not
only merely an unproven, but a demonstrably
ineffective, primary or adjunctive remedial
treatment for learning disabilities and other
disorders.” More recent reviews continue to
support this conclusion.

Pollock (2000) concluded that its use is contentious,
and Shaw (2002) concluded that there is no evidence of its
effectiveness with students with autism, learning
diffi culties or other developmental disabilities.
In a response to Shaw’s critique, Miller (2003),
although supporting sensory integration therapy
within a broader framework of occupational
therapy, conceded that the approach remains
unproven from a scientifi c perspective.

Doman-Delacato Patterning Treatment

This technique involves a demanding regimen
of daily exercises (often carried out with a
team of volunteers) that is claimed to improve
neurological organisation. The Institutes for the
Achievement of Human Potential who offer the
program state because of the intensive nature
of the program “there is no time for the child
to engage in other programs or school while
enrolled in the Intensive Treatment Program”
(Brain Injury and Early Childhood Education
Resources: IAHP, n.d., Content, para. 8).
Cummins (1988) offers a review and critique
of this treatment. More recently, the American
Academy of Pediatrics Committee on Children
with Disabilities (1999) has issued a position
paper that concluded that the efficacy is
unproven and the demands on families may be
harmful. This position paper was endorsed by the
National Down Syndrome Congress (n.d.).

Facilitated Communication (FC)

FC is a method whereby a person is assisted
to type or to use a communication device by
a facilitator who may provide full support to
the hand, wrist or arm, or who may provide
emotional support. It has been shown that for the
vast majority of users with autism or intellectual
disability, the content of the communication
comes from the facilitator (Jacobson et
al., 1995). The American Speech-Hearing
Association (1994) has produced a lengthy and
thorough review that concluded that “neither
the reliability nor the validity of techniques
associated with facilitated communication
have been demonstrated satisfactorily at this
time” (p. 127). This position is supported by the
American Psychological Association (1994) and
the American Academy of Child and Adolescent
Psychiatry (1997).

Conductive Education (CE)

CE aims to teach children with cerebral palsy or
other movement disorders to achieve personal
goals, increase their independence and exercise
choice (Ludwig, Leggett, & Harstall, 2000).
Ludwig et al. (2000) carried out a comprehensive
review and concluded that the effectiveness of
CE is not established for children with cerebral
palsy. They note that there are many local
adaptations of conductive education, which
have moved away from the full-time, intensive
residential approach originally developed in
Hungary, and that these adapted approaches
also need rigorous evaluation. United Cerebral
Palsy National (1995, 1997), in two fact sheets,
similarly call for more research to demonstrate
the superior effi cacy of conductive education
over more traditional approaches.

Multisensory Environments (MSEs) or
Snoezelen

These approaches were originally designed
as a leisure option for people with severe and
multiple disabilities. Current proponents have
gone beyond their use as a potentially enjoyable
leisure option, and make a wide range of claims
for the benefits of sensory stimulation as
delivered by these environments (Stephenson,
2002). Unfortunately, review articles, or
materials based on them, which suggest these
claims are unfounded, have yet to reach Internet
sites. However, two review articles (Hogg et al.,
2001 and Stephenson, 2002) which, between
them, located only fi ve studies on children with
intellectual disabilities and none on children
with autism, suggest that the use of MSEs to
achieve educational or therapeutic goals with
school aged children is currently without a fi rm
research base.
With the increasing demand for evidence based
practices in medicine and in the therapies allied
with special education, practitioners have a
responsibility to make careful decisions about
the interventions they use or endorse (Bennett
& Bennett, 2000). The URLs provided above
are easily accessible and provide information
that assists balanced decision making. In
addition to these sites, there are other sites
that provide more general advice or lead into
more specifi c sites. A very useful bibliography
of controversial practices that includes both
published and Internet sources is available from
Lakehead University (n.d.). A more general site,
which also contains user-friendly information,
along with references to the professional
literature, is Stephen Barrett’s Quackwatch
site that is directed at quackery in general, but
includes information of relevance to therapists and
educators. The National Council Against Health
Fraud has a newsletter, which is available online
and which provides brief articles on relevant topics
such as quackery in autism treatments (2001).
It is fair to acknowledge, of course, that
any intervention starts as an unsubstantiated
treatment before it is researched and its effi cacy
tested. It is also true that even a strategy with a
fi rm research base may not work for all students
in all contexts. This is one of the reasons why
accepted best practice in special education
involves the setting of clear outcomes and careful
monitoring of student responses to interventions
(Westling & Fox, 2000). The advice provided by
Pollock (2000) in relation to sensory integration
provides sensible guidelines for those wishing
to trial unsupported therapies. She suggests that
“clear, measurable, functional outcomes should
be established”, and then the treatment should be
assessed against those outcomes after an eight
to ten week trial. Similar guidance is provided
by the American Speech-Language Association
(1994) in relation to facilitated communication,
and they also suggest informed consent should
be obtained before implementing unsupported
practices.
Teachers have a responsibility to select
interventions that are likely to be effective,
and to monitor the impact of the interventions
they do select to ensure that their students are
learning. This is especially so for children with
special education needs who, because they have
diffi culty learning, have less time to be wasted
on poor interventions. Teachers can make better
decisions if they are fully informed about the
nature of the interventions they choose. They
can also help families make fully informed
decisions if they are aware of easily accessible
information based on sound research. This
article has attempted to provide a brief overview
of more common controversial therapies, and
inform readers about accessible Internet sites
that counteract the claims made by promotional
Internet sites.

REFERENCES
American Academy of Audiology (n.d.).
Position statement: Auditory integration
training. Retrieved June 28, 2003, from
http://www.audiology.org/professional/positions/
ait.php
American Academy of Child and Adolescent
Psychiatry (1997). Facilitated communication.
Retrieved June 28, 2003, from http://
www.aacap.org/publications/policy/ps30.htm
American Academy of Pediatrics, American
Association for Pediatric Ophthalmology
and Strabismus, & American Academy of
Ophthalmology (1998). Policy statement:
Learning disabilities, dyslexia and
vision. Retrieved June 28, 2003, from
http://www.aao.org/aao/member/policy/
disability.cfm
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on Children with Disabilities (1998).
Auditory integration training and facilitated
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431-433. Retrieved April 19, 2002, from
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American Academy of Pediatrics Committee
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1159-1151. Retrieved June 28, 2003, from
http://www.aap.org/policy/re9919.html
American Optometric Association (2003).
The use of tinted lenses for the treatment of
dyslexia and other related reading and learning
disorders. Retrieved June 28, 2003, from
http://www.aoa.org/clincare/pediatrics-tinted.asp
American Psychological Association (1994).
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American Psychological Association. Retrieved
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thefci/apafc.htm
72
J. Stephenson
American Speech-Language Hearing Association
(1994). Facilitated communication. Rockvillle,
MD: Author. Retrieved December 19, 2002, from
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Retrieved June 28, 2002, from http://
www.aap.org/policy/pprgtoc.cfm
Arendt, R. E., MacLean, W. E., & Baumeister,
A. A. (1988). Critique of sensory integration
therapy and its application in mental retardation.
American Journal on Mental Retardation, 95,
401-411.
Autism Association of South Australia (2003).
Questions to consider before beginning new
therapies or interventions. Retrieved June
29, 2003, from http://www.autismsa.org.au/
questions.html
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page. Retrieved July 19, 2003, from http://
www.quackwatch.org
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process of evidence-based practice in
occupational therapy: Informing clinical
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Resources: IAHP (n.d.). The Institutes for the
Achievement of Human Potential. Retrieved
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hurt/programs/intensive.html
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to facilitate auditory, visual and motor integration
in autism: A review of the evidence. Journal
of Autism and Developmental Disorders, 30,
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Herbart, J. D., Sharp, I. R., & Gaudino, B.
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73
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74
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http://www.aspect.org.au/publications/ControversialPractices.pdf.

Main trial and error mengajar baca anak?

Main trial and error mengajar baca anak?


Apa yang menyedihkan bagiku adalah, dimana-mana ada syering mengajar membaca pada anak, padahal anaknya terlambat bicara. Masih kecil tiga tahun dikasih berpuluhan bahkan 100-an flash card. Flash card nya bertuliskan segala macam kata. Menurut syering-syering, katanya anaknya berhasil membaca (mengingat jelasnya) kata-kata dalam flash card yang setiap hari diseliwerin di depan matanya itu.

Benarkah cara ini? JELAS TIDAK BENAR.

Sekalipun banyak testemoni yang bilang berhasil padahal anaknya terlambat bicara (entah cuma terlambat bicara, entah autis ringan….). Tetapi cara ini TIDAK BENAR. Justru menjerumuskan anak untuk mengalami kesulitan saat belajar membaca yang benar kelaknya.

Anak-anak terlambat bicara adalah anak yang memanfaatkan memori visualnya untuk belajar, memang. Ia akan mudah mengingat bentuk logo-logo. Karena itu ia akan mudah diajar belajar dengan menggunakan metoda visual. Tapi JANGAN BUAT BELAJAR MEMBACA.

Sebab membaca harus menggunakan selain mata (visual) juga telinga (auditori) secara seimbang dan kerjasama keduanya yang baik.

Untuk itu diperlukan kemampuan anak dalam bentuk kemampuan fonologis yaitu mengenal BUNYI-BUNYIan dan UCAPAN untuk sebuah HURUF (disebut FONEM), dimana huruf2 akan membentk suku kata. Suka kata akan membentuk sebuah kalimat. Kemampuan ini disebut PHONIC & PHONEMIC AWARENESS. Kemampuan ini ditunjang oleh fungsi auditori (telinga).

Selain kemampuan mengenal bunyian dan ucapan huruf, ia juga harus mengenal BENTUK setiap HURUF. Namanya GRAFEM.
Kemamuan ini ditunjang oleh kemampuan visual.

Jadi anak itu harus menguasai otomatisasi GRAFEM – FONEM dan FONEM – GRAFEM setiap huruf. Untuk kemudian, huruf membentuk suku kata, suku kata membentuk kata. Bolak balik, saat membaca (dengan mata), dan saat dikte (dengan telinga).

Bukan diajarkan langsung seperti halnya Glen Doman.
Sebab metoda Glen Doman justru akan memperdalam jurang kemampuan anak (disinkronitasnya akan semakin besar) antara kemampuan visual dan kemampuan auditori.
Anak-anak terlambat bicara mempunyai kekurangan/kelemahan dalam auditori. Malah diajarin untuk menambah kuat visual…. Sama saja namanya secara tak sadar akan melakukan abusing pada anak.
Seharusnya kepadanya justru diperhatikan agar ia mampu meningkatkan kemampuan auditorinya, bukan justru diblokade dengan cara meningkatkan perkembangan visualnya dengan cara mengajarinya belajar baca pakai flash card….. Apalagi sambil bilang: saya coba-coba…. Siapa tahu berhasil…..

ANAK_ANAK TERLAMBAT BICARA HARUS DIPERKUAT DALAM KEMAMPUAN FONOLOGISNYA.