Proceeding - Universitas Indonesiastaff.ui.ac.id/system/files/users/tjin.wiguna/...Ira Savitri Eliyati Ira Savitri Tanjung Noorhana Gitayanti Hadisukanto Hendi Yogya Ika Widyawati

The,,9'1 Congress of The'Asian Society for Child and AdolescentPsychiatry and Allied Professions (ASCAPAP) and

3'o National Congress of the lndonesian Association of Child and: ':::':, Adolescent Mental Health ( IACAMH ) '

'

Cultural Diversity, Challenging LW Events and Stigma :

ffia r;?\fu#:dcHrLD & ADoLEscEuiDlvrstoN

I.MPROVING CHILD ANDADOLESCENT OUALITY OF LIFE

Yogyakarta,24 - 26 August2Oi7

Proceeding BoolrEditor:

Tihin Wiguna, Fronsiska Koligis,.,. .Leslie Meliso j

##The 9'n Congress of The Asian Society for Child ard

Adolescent Psychiatry and Allied Professions (ASCAPAP) ard3'o National Congress of the lndonesian Association of

Child and Adolescent Mental Health ( IACAMH )

i

Proceeding Book lnternational Conference ASCAPAP & LACAMH

Proceeding BookInternational Seminar

The 9th Congress of The Asian Societyfor Child and Adolescent Psychiatry and Allied Professions1,lSC,lfAf1 & 3rd National Congress of the Indonesian Association of Chtld and Adolescent Mental

Health (IACAMH)

"Culture Diversity, Challenging Life Events and Stigma: Improving Child and Adolescent Quatity ofLtfe"

Editor: Tjhin Wiguna, Fransiska Kaligis, Leslie Melisa

Indonesian Psychiatric AssociationIn Collaboration with

Indonesian Association of Child and Adolescent Mental Health

ir\.filh. w'.9Ld-f'tr

Tentrem Hotel - Yogyakarta, August24-26,2017

Proceeding Book lnternationalConference ASCAPAP & *trl

The 9th Congress of The Asian Societyfor Child and Adolescent Psychiatry and Allied Professions(ASCAPAP) & 3rd National Congress of the Indonesian Association of Child and Adolescent

Mental Health (IACAMH)

"Culture Diversity, Challenging Life Events and Stigma:Improving Chiht and Adolescent Quality of Lifet'

€ttrt Ea$ r: Tjhin Wiguna, Fransiska Kaligis, Leslie Melisa

ISBN 97 8-602-61 r93 -2-2

Penerbit:Perhimpunan Dokter Spesialis Kedokteran Jiwa Indonesia (PDSzuD

Alama[Godmg Cimandiri One Lantai 4Jl. Cimandiri No. l, CikiniJakafiaPusat 10330Telp. (62-21)31926845E-mail: [email protected]

Proceeding Book International Conference ASCAPAP & LACAMH

to ASCAPAP 2017DatangAP 2017 is designed to bring together all practitioners of child and adolescent mental.health in

which includes the child psychiatrist, psychiatrist, representatives from the allied professions of[ics, psychology, nursing, public health, education, social work and other relevant fields

to improving child mental health global, regional and locally.fteme of congress is " Cultural Diversity, Challenging Live Events, and Stigma: Improving ChildAdolescent Quality of Live".

AP 2017 will allow us to meet each other, learn from a comprehensive scientific program,r and advocate for our research and ideas.

you. come to Indonesia you will enjoy a wide variety of local culture and beautiful naturalfrom the Indonesian's Archipelago.

9th Congress of The Asian Society for Child and Adolescent Psychiatry and Allied ProfessionsAP) will be a joint meeting with the 3rd National Congress of the Indonesian Association of

and Adolescent Mental Health (IACAMH)

Tis easier to build strong children than to repair broken men." (Frederick Douglass)want to go fast, go alone, if you want to go far, go together " (African proverb)

SapufroChairman

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CONGRESS CHAIRMAN : Dwidjo Saputro

SCIENTIFIC COMMITTEE

-i.:

Chairman

Secretary

Members

il\.\S'

ORGANIZING COMMITTEEChairman

Vice Chairman

Secretary

Treasurer

Funding & Exhibition

Publication & Dokumentasi

Accommodation

: fihin Wiguna

: Fransiska Ifuligis

: Budi Anna KeliatBudi PratitiIkaWidyawatiIndra Laksmi GamayantiJan Prasetyo

n Noorhana S WinarsihRaden Irawati IsmailSasanti YuniarVeranita Pandya

Suzy Yusna Dewi

Maria Poluan

Ira Savitri

EliyatiIra Savitri TanjungNoorhana

Gitayanti HadisukantoHendi YogyaIka WidyawatiSurilena HasanTheresia Kaunang

Isa MultazamTendry SeptaThomas Sino

Dian VitaraGusti Ayu Maharatih

Social & Cultural Programme: AdelineAnggita HapsariHasrini

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TABLE OF CONTENTS

0rganizing

I.ECTUREL2. Application of Transcultural Child and Adolescent Psychiatry in Clinical Practice............9

Jan Prasetyo, IndonesiaLl. Autism in Indonesia: Recent Updates ......................11

Melly Budhiman, Indonesia

PLENARYPL.1.1. Religiousity and Spirituality Raising Children

Dwidjo Saputro, lndonesiaPL.l.z. Promoting Resilience of War-Exposed Children and tr'amilies: Experience and Data

from the Fie1d............ ...........................21John Fayyad, Lebanon

PL.1.3 The Influence of Javanese culture towards chitdhood Psychopathology ............ .............23Edith Humris Pleyte, Indonesia

PL.z.l Aberrant Behavior among Children with Autism Spectrum Disorder : Common or

1- hin Wiguna, Indone s iaPL.2.2. Assessing Aberrant Behaviour in Clinical Setting......... .............28

Suzy Yusna Dewi, Indonesia

SYMPOSIUMSP.1.1. Conduct and Oppositional Defiant Disorder...... .........................31

Willem de Jong, (MSEN), The NetherlandssP.l.4. Multimodal Ipproach in Managing children with Behavior probtems ......3$"

Veranita Pandia, Indonesia " o:lSP2.1. Collaborative Works Between Parents and Teachers at School: A Positive School

Mental Health ..................44 !Juke R. Siregar, Indonesia

SP.3.1. Infant Depression: Diagnosis and Treatment............... ...............52Ika Widyawati

SP.3.2. Early Recognition, Diagnosis,Interventions for Infants with PervasiveDevelopmental Disorders................... ........................54

Sadaaki Shirataki, JapanSP.3.3. Feeding Difficulties and Disorders among Infant and Young Children: A Brief

Theoretical Review........ ........................59ljhin Wiguna, Indonesia

I

Proceeding Book lnternational Conference ASCAPAP & TACAMH

SP.3.4. Infant Mental Health as Worldwide Early Intervention: the Critical Role of Cliniciansin Providing Psychological Interventions for the Infant and Toddler within the FamilyandExtendedSocialNetwork..... .......66Campbell Paul, Australia

SP.4.1. Impact of the Great East Japan Earthquake on Child Mental Health andNeurodevelopment: A Longitudinal Study of Support for Children Born After theDisaster and their Families...... .............68Junko Yagi, Japan

SP.5.3. The Importance of Resiliency as a Protective Factor in Traumatized and Suicidal Youth

Ryan Alvares, USASP.6.2. Teen Pregnancy in the Perspective of an Obstetric-Gynecologist.. ................74,lll AriettaPusponegoro,IndonesiaSPS.4. Delinquency Among Adolescent and Its Related Issues: A Literature Review..................84

K. Maria Poluan, IndonesiaSP.7.1. Autism and Neurodevelopmental Disorders in Bangladesh: Some Issues of Concern......88

Helal Uddin Ahmed, BangladeshSP.7.3. Prevention and Early Intervention of Psychiatric Disorders in Children and Adolescents

Fransiska Kaligis, IndonesiaSP.7.4. Nicotine Use in Adolescents .................96

Hussien Elkholy, EgyptSP. 8.1. Sleep Disorder in Chi1dren................. .....................99

Eva Devita Harmoniati, IndonesiaSP. 8.2. The Mechanisms of Action of Valproate in Bipolar Disorder...... ................104

Nurmiati Amir, IndonesiasP. 8.4 Attention Deficit Hyperactivity Disorder in Preschool children...... ............108

Theresia Kaunang, IndonesiaSP.9.2. The Effectiveness of Aripiprazole for Tics, Social Adjustment, and Parental Stress in

Children and Adolescents with Touretters Disorder...... ............115WJ Chou, Taiwan

SP.l1.1. Interventions for Children in Conflict Situations: The World Awareness for ChildreninTrauma programme .........................124Panos Vostanis, UK.

SP.11.2. Risk Factors and Prevention Programme on Children with Trauma in Indonesi........l30Suzy Yusna Dewi, Indonesia

SP.l1.3. Play Activities for Children with Violence and Trauma.................,. ...........135Isa Multazam Noor, Indonesia

SP.12.2. Serious Game and Gamification Implementation for (Child and Adolescent) MentalHealth .........142Eko Nugroho, Indonesia

SP.12.3. Comorbidities of Social Media Addiction among Children andAdolescent.. ...................147Surilena Hasan, Indonesia

SP.12.4. Social Media Addiction and Attention Deficit and Hyperactivity Symptoms in HighSchool Students in Bangkok. ..............154Kunya Panichsiri, Thailand

SP.13.4. Sexual Behaviors of Thai Male Students in Bangkok: Prevalence and Associated Factors

Pichaya Poj anapotha, Thailand


814.1. Neurodevelopmental Markers for Early Psychosis in Adolescent: A BiologicalPerspective. .................160kwan Supriyanto, Indonesia

gFJ4.2. Risk Factor of Early Psychotic in Adolescent................... ..........................165Budi Pratiti, Indonesia

SP.l43. Management of Early Psychosis in Adolescent .................. ................,.......16gCarla R. Marchira, Indonesia

SP.14.4. Early Psychosis in Taiwan: Neuropsychological Studies and Future Directions... ......174Jane Pei-Chen Chang, Chia-Cheng Wu, Taiwan

SP.I5.2. A Sketch of Bullying Behavior among Junior High School Students in Indonesia:A Nowadays Portrait....... ..................193Raden Irawati Ismail, 1-hin Wiguna, Joedo Prihartono, Noorhana S. Winarsih, FransiskaRini Sekartini, Dian Vietara, Albert P. Limawan. Subhan Rio Pamungkas, Indonesia

sP.15.3. Bullying and Psychiatric Problems among Japanese Adolescents ...........199Kaneko Hitoshi, Japan

SP.15.4. Asian and European Study on Bullying...... ......192Ong Say How, Singapore

SP.l6.l.Oxidative Stress in Attention Deficit/Hyperactivity Disorder

Sasanti Juniar, lndonesiaSP.16.2. Interaction of Gene-Environment in Attention Deficit/Hyperactivity Disorder (ADIID)

The Importance from Developmental Perspectives.............. .......................197Yunias Setiawati, Indonesia

SP.16.4. Conduct Disorder: A Review from Central Java........... ......201Gusti Ayu Maharatih, Indonesia

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SCHEDULEC ultur al div ersity, C h all engin g Events and Stigna: Child und Adolescent QualitY of LW

Workshop 1: Risk Assessment and Intervention ofSuicide amons Adolescent

08:00 - 12:00Willem de JongWorkshop 2: Disturbed Children in School: Trauma and

Attachment Problem in The Classroom

John FayyadWorkshop3: How to combine research andinterventions for traumatized children in developingcountries

Panos VostanisWorkshop 4: Psychosocial Management of Childrenwith Traumatic Experience and Violence in DevelopingCountries

l3:00 - 17:00Campbell Paul

Worlshop 5: Early Infant Mental Health Intervention:Helping Parents and Babies Understand Each Other intheFirst Months of Life: the Newborn Behavioural

Panom Ketumam

Joe NuttornPityaratstianSirirat Ularntinon

Workshop 6: CBT for Children and Adolescents UsingCartoon-Based Workbook


Time Topics Speaker/lVloderator

fi.00 - 08.00 Registration (Foyer Ballroom)

m.00 - 08.45

Presidential Speech Chin Lee Toh(Malaysia)

m.45 - 09.15

Cultural Diversity, Challenging Life Events and Stigma: Improving Child andAdolescent Quality of Life

Bruno Fulissard(France)

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09.30 - 10.00Critical Roles of Parenting in Promoting Mental Health and Quality of Life of

Asian Children and AdolescentsMichael Hong(South Korea)

10.00 - 10.30The Application ofTrans-cultural Child and Adolescent Psychiafy in Clinical

PracticeJan Prasegto(lndonesia)

10.30-t r.4s

Cultures and Values in Child and Adolescent Mental Health:Threats or Opportunities

Chair: Edith Humries Pleyte

Religiousity and Spirituality in Raising Children

Promoting Resilience of War-Exposed Children and Families: Experience andData from the Field

The Influence ofJavanese Culture towards Childhood Psychopathotogy

Dwidjo Saputro(Indonesia)

John Fayyad(Lebanon) :.

1l

Etlith Hunris Pi:fiu(Indonesia)

Proceeding Book lnternational Confer*nce ASCAPAP & TACAMH

13.00 - 14.30

fontrs l H$itrrg.dlt Tentrem 2 Ballroom

::::iiiiffSl&I$0sium I Symposium 2 Symposium 3 .lg..:.( f*p, } (AKESWARI) ti ,' *,O ili Li.,r"$

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Physical andPsychosocial

lntervention for$chool-Age Children

Chair :Ira Savitri Tanjung

(Indonesia)

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Collaborative Worksbetween Parents and

Teachers at School: A'Positive School

Mental HealthIuke Roosjati Siregar

(Indonesia)

FamilyPsychoeducation

Towards Child MentalHealth Issues

GitayanrtHadisukaxto(Indonesia)

t{'$#offic Aili&Attsfl tion Deficitxi.::.

Siti Awinti:h(Intionesia)

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Delivering PhysicalRehabilitation at

Primary School : Whatand How to Do?

Lah Karuniltl{ahyuni

(Indonesia)

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}d$.{iqlqd41..4 ash.$:M e. itdren

, rirrier=,Sektniqft,.]...... . .,,

ProblemsYerafiiis Pcndia l

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Hospital-Based MentalRehabilitation forChildren: A BriefExperience fromMarzuki'Mahdi

Hospital, Bogor, WestJava

Ira Sqritti Tanjung$ndonesia)

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l4s- I5,iqq;

i5.00 - 16.30

Tentrem 2 Ballroom Ba-kau-Bar gkirai:'Raom

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Fre* Pap*r::= Ctiaii: ' .',{la't.ltntRawawi

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f**ent nSSri*idramong Teeds

Chair:Erik Kinaiease; .,i:

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Adolescent MentalHealth in Daily

Clinical PracticesChair:

Noorhanq S Winarsih(lndoneiia)

Adolescent MentatHealth lssues

Nowadays inUrbanCities

Noorkana S lhinarsih(lndanesia)

Sui*ia.}r*e;ori;Nortfr Sutewesi:Opportu*tes en*

Challenge$Linny Liiadi

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(Iidanesia)

Teen Pregnancy irr thePerspective from

Obstetric-Gynaecology

Arielta Pusponegoro$ndonesia)

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PratectiveFactor in l

riaumatizea#a,S"i.tduiVquth ,xyan A,ti-arei

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Fsychosocial Supportfor Adolescent with

Mental llealthProblems,

Iadi Savitri(lndonesia)

Deliquency amongAdolescent and its

Related Issuesfi[aria Poluan

(Indanesia)::,:1:1:1:::;.:::::il:!//t////P.!!W

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Time Topics Speaker/l\{oderator

08.00 - 08.30

Autism in Indonesia : Recent UpdatesMelly Budhiman

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o"$.-r rClinical Perspective towards Aberrant Behaviour among Children with

Autism Spectrum Disorder., Chair : Ikn Widyawati (Indonesia)

Abenant Behavior in Children with Autism Spectrum Disorder

Assessing Aberrant Behavior in Clinical Setting

Clinical Experience in Treating Aberrant Behaviour in Children with AutismSpectrum Disorder by Using Aripiprazole

Tjhin Wiguna(Indonesia)

Suzlt Yusna Dewi(lndonesia)

Ika Widyawati(Indonesia)

09.30 - 10.00

Parenting Program in Finland: Can it be applied in Asian countries ?Andre Sourander

(Finland)

10.00- 11.15Child and Adolescent Mental Well-being in Asia Beyond 2020

Daniel Fung(Singapore);

Cornelio Banaag(Phillipines);

Chin Lee Toh(Malaysia);

Yi Zheng(China);

Michael Hong(South Rorea);

Savita Malhotra(India);

Dwidjo Saputro(lndonesia)


Il - 13.00

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Various IssuesRelated ts children

and.AdolescentiMentalHealth:

A Nowad*ysPerspectives

Chair:Theresia Kaunang

{Indonesia)

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Sleep Disorder inChildren

EvaDevita(Indonesia)

Mechanisms of Actiorrof Yalproate in

Eipolar DisorderNurwiuti Amir

(Indonesia)

Treatable IntelectualDisabitities due toInbom Erors ofMetatiolisms:Challenges to

Diagno*e and Treat inDeveloping Countries

Dtmqanti RasliSiarif lItdo*esia)

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, AttenfionDeficit,rHyperavtivityDisorder in Preschool

Theresia Kauxang(lidonesia)

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Proceeding Sook lnternational Conference ASCApAP & LACAMH


sP.3.3.Feeding Difficulties and Disorders Among Infant and Young Children:

A Brief Theoretical Review

Tjhin WigunaIndonesia

ft dn important process in every human being; it could be the time for family member to share theirqnint of view and also affection. For an infant, feeding process could be a time for playing andig an attachment with their parents or caregivers. Meanwhile, feeding is also part of bonding process1roents and their infant. Therefore, parent - infant relational process seems to be the core issue that

addressed in infant feeding practice. However, the infant feeding practice sometimes does not workbe for example depressed parents might intemrpt the parent - infant bonding and lead to feedingOn the other hand, developmental problems tend to be more challenging for parents in handling

in feeding their infant.

difficulties are major concerned for every parent nowadays worldwide. When parents were askedmre than 50% of mothers claimed that at least one of their children eats poorly.r'2 Another studylhat the proportion of feeding difficulties are estirirated up to 25o/o of normally developing children

ion increased in up to 35% of children with neurodevelopmental disabilities.2 Another studyet a1(2004)3 also revealed that 30%was described by their parents as poor eater as part of their

. Therefore, feeding difficulties can be defined as the inability or refuse to eat certain foodsa broad range of symptoms, from mild (so-called picky eating) to severe (as seen in

Fs€ding fiffis Fu**ffimft€dfftrgprotlcmtn-4S?*of*hiidren

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rcpresentation of young children with feeding behavior (from: Kerzner B, et al. A ptactical

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iE dmanaging feeding difficulties. Pediatrics. 2015; 135:344 - 53)a

Proceeding Book lnternational Conference ASCAPAP &

There are several terms that try to describe this condition such as neophobia (rejection of foods that are

known previously by the child), picky eating (showing a low appetite child with only eat particularfeeding difficulty (a more general term that is used by parents to describe the child feeding problems)-small portion of feeding difficulties that is not managed well lead to feeding disorder and manifest inother physical or psychological problems such as nutritional deficiency, mental health problemsdevelopmental deviant; the age of onset, duration and severity of the feeding problems usuallywith those conditions. Feeding disorders are recognized in the Diagnostic and Statistical Manual ofDisorders, Fifth Edition (DSM-V) and International Statistical Classification of Diseases and RelatedProblems coding systems. Therefore, early recognition and management should be put in caution.5-7

-Identification of feeding difficulties and feeding disorderTt$re is no universal definition of feeding difficulty nowadays. It is a diverse condition with variessytrlptom that can be categorized as spectrum of symptoms such as limited interest on foods (multipledislikes), food refusal partially or totally (withdrawn child), emotional problem during mealtime (excessicrying), unable to self-feeding, low appetite (might seen in active child), fear of feeding (such as

traumatic feeding experience), etc. Several factors have been revealed to explain this condition, but thercno single factor that can be claimed. Health condition, developmental and growth history, andrelationship (such as controlling, indulgent, and neglected parenting style) are factors that associatedfeeding difficulty. Chatoor et al (2004)8 added a condition that was said as 'sensory food aversion';condition is characterized by refusal to eat certain food that related with its' texture, temperature,appearance or smell. Consequently, a thorough clinical evaluation needs to be done includingperception on their kids feeding behaviors' and nutritional status, assessment of the child healthdevelopmental history, mealtime and growth history, and review of child's eating behavior, may assist

recognize the occurrence and the degree ofseverity ofa feeding problem.

A limited case of unresolved feeding difficulty is said to becoming a feeding disorder. Studies showed25% of children identified by parents to have feeding difficulties, only an estimated l% to 5% that metcriteria of feeding disorder.e'r0 Irene Chatoor (2009)10 categorized several feeding disorders that associwith parents' chief complaints (table l).

_ . P_roceeding Book lnte_rnational Conference ASCAPAP-& LACAMH

. Parents' chief complaints and associated with feeding disorderl0

fhents' chief complaints Suspected feeding disorderHas poor appetite anddoes not eat enough toglow

Shows little hunger andinterest in feeding andwants to play ratherihan eat

A. If presents <6 months old, considers feeding disorder of stateregulation.Diagnostic criteria:a. The infant's feeding difflrculties start in the first few months of life and

should be present for at least 2 weeks.b. The infant has difficulty reaching and maintaining a calm state of

alertness for feeding; he or she is either too sleepy or too agitated and/ordistressed to feed.

c. The infant fails to gain age-appropnate weight or may show loss ofweight.

d. The infant's feeding diffrculties cannot be explained by physical illness.

B. If presents > 6 months old, considers infantile anorexia.Diagnostic criteria:a. The feeding disorder is characterized by the infant's or toddler's refusal

to eat adequate amounts of food for at least I month.b. Onset of the food refusal often occurs during the transition to spoon and

self-feeding, typically between 6 months - 3 years of age.c. The infant or toddler rarely communicates hunger, lack of interest in food

and eating, and would rather play, walk around, or talk than eat.

d. The infant or toddler shows significant growth deficiency (acute and/orihronic malnutrition according to Waterlow et al (1997)'or the child'sweight deviates across two major percentiles in a2 - 6 month period.

Has limited diet of a

few foods

Consistently refusescertain foods or wholefood groups

Consider:l. Sensory food aversions

a. Infant's or child's consistent refusal to eat certain foods withspecific tastes, textures, temperafures, or smells for at lea& 1

+:b. The onset of the food refusal occurs during the introduction'of"new or different type of food that is aversive to the child

c. The child's reactions to aversive foods range from grimacing orspitting out the food to gagging and vomiting.

d. The child is reluctant to try unfamiliar new foods but eats

without difficulty when offered prefened foods.e. Without supplementation, the child demonstrates specific

dietary deficiencies but usually does not show any growthdehciency and may even show any growth deficiency and maybe overweight

f. The food refusal does npt follow a haumatic event to theoropharynx

61


1;

Refusal to eat specific foods is not related to food allergies orany other medical illness.

2. Post traumatic feeding disordera. The feeding disorderis characterized by the acute onset of

severe and consistent food refusalb. The onset of the food refusal can occur at any age, from

infancy to adulthoodc. The food refusal follows a traumatic event or repeated

traumatic insults to the oropharynx or gastrointesti-nal tract.d. Consistent refusal to eat manifests in one of the following

ways, depending on the mode of feeding experienced by the

child in association with the traumatic event(s), either bottlefeeding or feeding of solid food

e. Reminders of the traumatic event(s) cause distress as

manifested by one or more of the followingi. Shows anticipatory distress when positioned for

feedingii. Shows intense resistance when approached with

bottle or foodiii. Shows resistahce to swallow food placed in mouth

f. Food refusal poses an acute and/or long-term threat to thechild's nutrition, and gtowth, and threatens the progression

' ofage-appropriate feeding development ofthe child

J. o Refuses to drink from abottle or cup, but eats

solids., Refuses to eat solid

foods, but drinls froma bottle or cup

Consider:Posttraumatic feeding disorder

4. Refuses all solid foods,but eat pureed foods

Consider:A. Sensory food aversionsB. Posttraumatic feeding disorder

5. Refuses most of allfeedings and depends onnasogastric/gastrostomytube feeding

Consider:A. Posttraumatic feeding disorderB. Feeding disorder associated with a concurrent medical condition

6. Refuses to eat somethingone day, but may eat itthe next day

Consider:A. If there are no weight concerns: Oppositional feeding behavior whifi

can be associated with food refusal of toddlers in generalB. Ifthere are weight concerns: Infantile anorexia

,7, o Cries a lot and archesduring feeding

Consider:A. If less than 6 moths old: Feeding disorder of state regulation

62

Tires quickly duringfeeding and eats toolittle

B. Feeding disorder associated with a concurrent medical condition

Consider:If less than 6 moths old: Feeding disorder of state regulation

Gags or vomits before,&ning, or after feedinds

Consider:A. Posthaumatic feeding disorderB. Sensory food aversionC. Feeding disorder associated with a concurrent medical condition

when positionedfu feeding or when

Consider:Posttraumatic feeding disorder


for feeding difficulties and disorderof feeding difficulty usually involves a multidisciplinary team depending on several basic

such as; (l) mealtime conflicts that triggers family or child frustration or anxiety; (2)I milestones; unexpected delayed oral motor skills development due delayed oral motor

by introducing aged appropriate food; (3) growth retardation because ofimbalance ofnutritionalthat happens due to unresolved feeding problems; (4) swallowing dysfunction that might induce

pneumonia and other illness related with oral aspiration; (5) unresolved parent and childconflict.7 Basic strategies to overcome feeding difficulty can be categorized;iological and environmental changes (all ages)

Although mealtime sets in structured schedule but still refening the demands of infant. No food ordrinks are permitted between scheduled meals. However, if the child is thirsty, water may beoffered for up to 2 h before the next scheduled meal.Time limited for each meal.hovide a quiet place with few distractions during feeding the child (no loud radio or television,m toy$.Character of the feeder should be calm and being positive during the mealtime and should be onefeeder for each meal. -t.Positioned of the child during mealtime should be comfortable antl developmentally approfl,fi-tnie.seat,,forexamples;highchair,ifthechildisabletositindependently.

rules' for children with self-feeding skillsEncouraging the child to self-feed as long as it is possible.I)on't give food as a present or reward.Ilo not play during the mealtime. Avoiding using games to persuade the child to eat. Food shouldbe removed after 10 to 15 minutes if child seems to play with the food without eating.The meal should be terminated if the child throws food in anger.

rules for children with self-feeding skills


Mealtime rules should be set for each family (for example; remain seated, use silverwarefingers, no ttrowing of food). The rules should flexible based on the child aged. Usually itwith no more than three rules and it can be gradually added depends on how far the childleam appropriate mealtime behavior.Avoid nagging in each meal, therefore mealtime rules should be explained until the childcomply consistently.

o Set up pleasant mealtimes is necessary; communication during mealtimes is importantchildren should be included in active conversations; praise good behaviors that are

each child is a good approach to maintain this good behavior.o The child's behavior needs to be fixed if they often break the mealtime rules. They need to

appropriate behavior, if it is hard for the kids to followed the rules, then we need to evaluatestep in feeding process including the rules, the feeder and the child; in order to findappropriate rules that match with the entire family members. If mealtime rules are broken,child and the feeder should practice the correct behaviors. The third time that the rules are

it should set a disciplinary time-out.o We start to offer an appropriate portion of food base on the child demands; and praise them

time they successfully eat it.o The meal should be removed if the mealtime is over even though the plate hasn't finished

Don't offer any other meal or dessert or snack or milk until the next schedule. If the child nags

other food, let them know to wait and if they get temper, angry or whiny, parents should begive explanation ifpossible and never give up easily.

4. Conflict between parent and child relationship needs to be resolved; for this purpose, we needassess comprehensively those conflicts therefore making a referral to mental health professinecessary. Parents also need continues support and encouraging as they becomes easily frustrated-

ConclusionFeeding difficulty and disorders are major concerns for parents, mental health professional and

due to the effects on growth and development however it could be managed if it is assessed comprehensiTherefore, a complete management should be designed to fit the child ad family needs. Mostlycomprehensive treatrnent included child and adolescent psychiatrist, pediatrician and other mentalprofessionals that related with the infants and young children. The key component is be patient andinclusively.

References:

l. Aarilehto S, Lapinleimu H, Keskinen S, Helenius H, Talvia S, Simell O. Growth, energy intake, andpattem in five-year-old children considered as poor eaters. J Pediatr. 2004;144:363-7Camrth BR, Ziegler PJ, Gordon A, Barr SI. Prevalence of picky eaters among infants and toddlerstheir caregivers' decisions about offering a new food. J Am Diet Assoc. 2004;104: 557-364

3. Wright CM, Parkinson KN, Shipton D, Drewett RF. How do toddler eating problems relate to theirbehavior, food preferences, and growth? Pediatrics. 2007 ;120:e1069 -7 5

r':.7

Book International Conference ASCAPAP & TACAMH

B, et al. A practical approach to classiffing and managing feeding difficulties. Pediatrics. 2015;-s3KI, Collins BN, Fisher JO, Davey A. Do infants fed directly from the breast have improvedregulation and slower growth during early childhood compared with infants fed from a bottle?

Behav Nutr Phys Act. 201I;8:89-100I. Feeding disorders in infants and toddlers: diagnosis and treatment. Child Adolesc Psychiatr

N Am. 2002;l I (2): 163-83B, Milano K, Maclean WC, Berall G, Stuart S, Chatoor I. A Practical Approach to Classiffing

ing Feeding Difficulties. Pediatrics. 2015 ;135 :344-53surles J, Ganiban J, Beker L, Paez LM, Kerzner B. Failure to thrive and cognitivet in toddlers with infantile anorexia. Pediatrics. 2004;113:201-12

G, Canals J, Jan6 C, Ballespi S, Vifias F, Domdnech E. Feeding problems in nursery children:and psychosocial factors. Ac ta P a e di atr. 2004 ; 93 : 663-8

L{, Sundelin C. Early feeding problems in an affluent society. I. Categories and clinical signs. ActaScand. 1986;75:37U9I. Diagnosis and treatment of feeding disorders in infants, toddlers, and young children.

: ZeroTo Three; 2009.D, Benoit D. Feeding problems in infancy and early childhood: Identification and. Paediatr Child Health. 1998;l:21-7.

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This certificdte is presented to

Tjhin Wigunaos

SPEAKER

of

The 9'n Congress of The Asian Society for Child and Adolescent Psychiatry and Allied Professions (ASCAPAP) and3'o Nationat Congress of the lndonesian Association of Child and Adolescent Mental Health ( IACAMH )

Culturul Diversity, Challenging Life Events und Stigmu :

.di

IMPROVING CHILD AND ADOLESCENT OUALITY OF LIFEYogyokortc, - lndonesio, 24 - 26 August 2077

I Dl Accreditati on; OL29O I PB I A.4 I 07 / 21rt7Participant: L2 Points :: Speaker: 14 Points :: Moderator: 6 Points :: Cornmittee: 3 Pointsn,/ /{7rrruT

DWIDJO SAPUTROChoirmon of Congress

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CHIN LEE TOHPresident of ASCAPAP

Documents

Proceeding - Universitas Indonesiastaff.ui.ac.id/system/files/users/tjin.wiguna/...Ira Savitri Eliyati Ira Savitri Tanjung Noorhana Gitayanti Hadisukanto Hendi Yogya Ika Widyawati