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Disusun Oleh:

Bellyana Octavia Chandra

07120110082

Pembimbing:

dr. Engelberta Pardamean, SpK

KEPANITERAAN KLINIK ILMU KESEHATAN JIWA

SANATORIUM DHARMAWANGSA

FAKULTAS KEDOKTERAN UNIERSITAS PELITA HARAPAN

PERIODE !" JUNI # $$ JULI %!$&

$

REFERAT

F'() GANGGUAN FUNGSI SOSIALDENGAN ONSET KHAS PADA MASA

KANAK DAN REMAJA

8/18/2019 REFERAT F94)

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DAFTAR ISI

[F94.0] MUTISME ELEKTIF......................................................3-11

APA ITU MUTISME ELEKTIF?..........................................................................3

KENAPA ANAK DAPAT MENJADI MUTISME ELEKTIF?......................................4

PERILAKU SEPERTI APA YANG DITUNJUKKAN OLEH SEORANG ANAK DENGANMUTISME ELEKTIF PADA LINGKUNGAN SOSIAL?...........................................5

KRITERIA DIAGNOSTIK UNTUK MUTISME ELEKTIF PADA ICD-10...................7

BAGAIMANA MUTISME ELEKTIF DISEMBUHKAN?..........................................

[F94.1] GANGGUAN KELEKATAN REAKTIF MASA KANAK..........11-17

DEFINISI GANGGUAN KELEKATAN REAKTIF................................................11

PEDOMAN DIAGNOSTIK RAD......................................................................13

[F94.2] GANGGUAN KELEKATAN TAK TERKENDALI MASA KANAK.17-18

PEDOMAN DIAGNOSTIK GANGGUAN KELEKATAN TAK TERKENTDALI MASAKANAK....................................................................................................... 17

[F94.8] GANGGUAN FUNGSI SOSIAL MASA KANAK LAINNYA........18

[F94.9] GANGGUAN FUNGSI SOSIAL MASA KANAN YANG TIDAKTERGOLONGKAN......................................................................18

%

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[F94.0] MUTISME ELEKTIF

Apa !" M"!#$% E&%'!()Mus*ime ele+*i, me-u./+/n su/*u g/nggu/n +e0em/s/n 1/ng +2m.le+s ./3/

m/s/ +/n/+4+/n/+ 3im/n/ 1/ng men5/3i 0i-i +h/s g/nggu/n ini /3/l/h

+e*i3/+m/m.u/n /n/+ un*u+ 3/./* be-*u*u- +/*/ 3/n be-+2muni+/si 3eng/n e,e+*i, 

 ./3/ bebe-/./ si*u/si s2si/l *e-*en*u6 /n*/-/ l/in se.e-*i 3i se+2l/h) An/+4/n/+ 3eng/n

g/nggu/n mu*isme ele+*i, memili+i +em/m.u/n un*u+ be-+2muni+/si /*/u be-bi0/-/

3eng/n s/ng/* b/i+ h/n1/ ./3/ bebe-/./ si*u/si 1/ng 3im/n/ me-e+/ me-/s/ n1/m/n6

/m/n6 3/n *en/ng) An/+ 3eng/n mu*isme ele+*i, se-ing +/li *e-3i/gn2sis +e*i+/

 be-umu- 7 s/m./i " */hun)

Lebih 3/-i '!8 /n/+ 1/ng memili+i mu*isme ele+*i, 0en3e-ung memili+i

g/nggu/n l/in se.e-*i .h2bi/ s.esi,i+ 1/i*u s20i/l .h2bi/6 3im/n/ /n/+4/n/+ ini */+u*

un*u+ be-in*e-/+si 3eng/n m/s1/-/+/* lu/-) Ke*i+/ /n/+ 3eng/n mu*isme ele+*i, 

3i./+s/ un*u+ be-s2si/lis/si ./3/ +e/3//n s2si/l *e-*en*u 3im/n/ me-e+/ me-/s/ /sing

3/n b/-u6 m/+/ /n/+4/n/+ ini /+/n me-/s/ s/ng/* be-/* 3/n *e-*e+/n) An/+4/n/+ 

3eng/n mu*isme ele+*i, ben/-4ben/- memili+i -/s/ +e*/+u*/n 3/n +e0em/s/n +e*i+/

3isu-uh /*/u 3i./+s/ un*u+ be-bi0/-/ 3i 3e./n umum /*/u be-in*e-/+si 3eng/n

ling+ung/n s2si/ln1/ 3im/n/ /n/+4/n/+ ./3/ umumn1/ *i3/+ memili+i +esuli*/n

mel/+u+/n h/l *e-sebu*) 9/n1/+ /n/+ 3eng/n mu*isme ele+*i, 0en3e-ung memili+i

+esuli*/n un*u+ 3/./* me-es.2n /*/u mel/+u+/n +2muni+/si n2n4e-b/l)

Se*i/. /n/+ 3eng/n mu*isme ele+*i, memili+i 0/-/ me-e+/ m/sing4m/sing

3/l/m mengh/3/.i +e0em/s/n +e*i+/ 3i././-+/n 3eng/n si*u/si s2si/l 3im/n/ me-e+/

*i3/+ me-/s/ n1/m/n) 9ebe-/./ /n/+ /+/n *e-3i/m 3/n membisu *2*/l6 se3/ng+/n bebe-/./ /n/+ 3/./* mengelu/-+/n bebe-/./ ./*/h +/*/ /*/u.un b/h+/n 3/./*

 be-bi0/-/ *e*/.i 3eng/n n/3/ su/-/ 1/ng be-bisi+) Si+/.4si+/. *e-sebu* membu/* /n/+ 

3eng/n mu*isme ele+*i, suli* se+/li 3/l/m hi3u. be-s2si/lis/si 3/n *e-+/3/ng 3i/ngg/.

/neh 2leh *em/n4*em/n se+i*/-n1/) D/l/m ling+ung/n s2si/l 1/ng menun*u*

+2muni+/si 1/ng b/i+6 /n/+4/n/+ 3eng/n mu*isme ele+*i, se-ing +/li 3i+u0il+/n

3i+/-en/+/n +e*i3/+m/m.u/nn1/ un*u+ be-in*e-/+si 3eng/n se+i*/-) An/+ 3eng/n

mu*isme ele+*i, 3/./* 3i/ngg/. seb/g/i /n/+ 1/ng .em/lu 3/n +e+u-/ng/n .e-0/1/

3i-i *e*/.i 3i 3/l/m *ing+/*/n 1/ng e+s*-im)

7

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An/+ 3eng/n +2n3isi ini memili+i 0i-i +h/s 3im/n/ /n/+ /+/n memilih 2-/ng

1/ng 3i/5/+ be-bi0/-/) An/+ ini *i3/+ 3/./* be-+2muni+/si se0/-/ em2si2n/l 3eng/n

semu/ 2-/ng6 /+/n *e*/.i /n/+ 3eng/n +2n3isi ini /+/n 3/./* be-bi0/-/ 3eng/n

*e-bu+/ h/n1/ 3eng/n 2-/ng42-/ng 1/ng i/ -/s/ n1/m/n) An/+ 3eng/n +2n3isi se.e-*i

ini menun5u++/n +em/m.u/n be-*u*u- +/*/ ./3/ si*u/si *e-*en*u6 n/mun *i3/+ ./3/

 bebe-/./ si*u/si) G/nggu/n ini se-ing 3i-/s/+/n mul/i *e-5/3i ./3/ usi/ 3ini /n/+ 3/n

*e-5/3in1/ s/m/ se-ingn1/ ./3/ .e-em.u/n /*/u.un l/+i4l/+i)

Ke/3//n mu*isme ini be-hubung/n e-/* 3eng/n 0i-i +e.-ib/3i/n +h/s meli.u*i

/n;ie*/s s2si/l6 si+/. men/-i+ 3i-i6 *e-l/lu .e+/6 /*/u mene*/ng) L/

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hi.2*esis 3im/n/ b/h=/ /n/+ 3eng/n *em.e-/men 1/ng men/-i+ 3i-i memili+i

/mb/ng -/ngs/ng/n 1/ng lebih -en3/h ./3/ /m1g3/l/)

H/l ini memung+in+/n +e*i+/ /n/+ mu*isme ele+*i, 3ih/3/.+/n 3eng/n si*u/si

1/ng men/+u*+/n6 /m1g3/l/ /+/n mene-im/ sign/l b/h=/ *e-3/./* .2*ensi /+/n

 b/h/1/ 3/n mul/i mengelu/-+/n -e/+si4-e/+si 1/ng memb/n*u /n/+ i*u un*u+ 

melin3ungi 3i-in1/) 9/gi /n/+ mu*isme ele+*i,6 si*u/si 1/ng be-b/h/1/ 3/./* be-u./

 .es*/ ul/ng */hun6 se+2l/h6 .e-+um.ul/n +elu/-g/6 */m/n be-m/in6 3ll)

Te-3/./* .eneli*i/n 1/ng menun5u++/n *i3/+ /3/n1/ +2-el/si /n*/-/ g/nggu/n

mu*isme ele+*i, ./3/ /n/+ 3eng/n *-/um/4*-/um/ .si+2s2si/l ./3/ .e-*umbuh/n /n/+)

An/+ 3eng/n mu*isme ele+*i, h/-us 3/./* 3ibe3/+/n 3eng/n /n/+ 1/ng mu*isme

+/-en/ su/*u .e-is*i=/ 1/ng membu/* *-/um/) An/+ 3eng/n g/nggu/n mu*isme ele+*i, 

 5el/s se+/li h/n1/ membisu ./3/ bebe-/./ si*u/si 1/ng i/ /ngg/. *i3/+ n1/m/n 3/n

3/./* membu/* .e-/s//n 0em/s 1/ng be-lebih6 n/mun *e*/. be-bi0/-/ ./3/ si*u/si

1/ng i/ /ngg/. n1/m/n 3/n /m/n b/gi 3i-in1/)

Se3/ng+/n ./3/ /n/+ mu*isme +/-en/ .e-is*i=/ *-/um/*i+6 si+/. membisu

/+/n */m./+ ./3/ si*u/si /./.un6 en*/h si*u/si *e-sebu* /sing /*/u.un n1/m/n b/gi

/n/+ *e-sebu*) >/ng *e-.en*ing l/gi mu*isme /+ib/* .e-is*i=/ 1/ng membu/* *-/um/

 bi/s/n1/ memili+i 2nse* 1/ng *ib/4*ib/ sehingg/ */m./+ 5el/s mu*isme 1/ng *e-5/3i

+/-en/ su/*u .e-is*i=/ 1/ng menge5u*+/n /n/+ *e-sebu*)

%&a'" #%p%! apa /a* +!"*,"''a* &%

#%a* a*a' +%*a* $"!#$% %&%'!( pa+a

&*'"*a* ##a&)

An/+ mu*isme ele+*i, */m./+ n2-m/l se.e-*i /n/+ l/inn1/ 5i+/ 3ilih/* se0/-/

,isi+ 3/n .e-il/+un1/ +e*i+/ i/ be-/3/ ./3/ si*u/si 1/ng n1/m/n b/gin1/) 9i/s/n1/

2-/ng *u/ 3/-i /n/+ mu*isme ele+*i, /+/n be-0e-i*/ *en*/ng b/g/im/n/ lu0u6 men/-i+6

 b/=el6 +e-/s +e./l/ /n/+n1/ 3i -um/h6 n/mun /n/+ mu*isme ele+*i, /+/n s/ng/*

 be-be3/ +e*i+/ be-/3/ ./3/ si*u/si s2si/l 3i lu/- -um/h)

>/ng 3i-/s/+/n /n/+ mu*isme ele+*i, +e*i+/ 3ih/3/.+/n 3eng/n 3uni/ lu/- 

/3/l/h se.e-*i be-/3/ 3i /*/s ./nggung se*i/. s//*) R/s/ 0em/s 1/ng 3i-/s/+/n /n/+ 

mu*isme ele+*i, mem.eng/-uhi b/g/im/n/ 0/-/ /n/+ ini be-si+/. *e-h/3/. ling+ung/ns2si/ln1/) Du+ung/n 3/-i 2-/ng *u/ s/ng/* .en*ing 3/l/m *e-/.i b/gi /n/+ mu*isme

&

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ele+*i,) Ti3/+ 5/-/ng /n/+ 3eng/n mu*isme ele+*i, memili+i e+s.-esi =/5/h 1/ng

+2s2g +e*i+/ 3i/5/+ be-bi0/-/ 3/n b/h+/n *i3/+ 3/./* *e-sen1um s/m/ se+/li) 9/n1/+ 

 5ug/ 1/ng menun5u++/n .2s*u- *ubuh 1/ng +/+u 3/n /neh +e*i+/ be-/3/ 3i ling+ung/n

s2si/l lu/-)

An/+ mu*isme ele+*i, /+/n me-/s/ s/ng/* *i3/+ sen/ng 3/n *i3/+ n1/m/n

+e*i+/ 3i./+s/ un*u+ be-s2si/lis/si) 9ebe-/./ 3/-i me-e+/ /+/n menu5u++/n */n3/4

*/n3/ +e0em/s/n se.e-*i menggeleng4geleng+/n +e./l/n1/6 menggigi*4gigi -/mbu*6

menghin3/-i +2n*/+ m/*/6 be-3i-i 3i .252+/n -u/ng/n 1/ng -/m/i6 3/n lebih memilih

un*u+ be-m/in sen3i-i) Te*/.i *i3/+ semu/ /n/+ mu*isme ele+*i, 0en3e-ung

mengis2l/si 3i-in1/) 9ebe-/./ /n/+ 1/ng memili+i g/nggu/n mu*isme ele+*i, 3/./*

menun5u++/n ge5/l/ 1/ng *i3/+ *e-l/lu ./-/h6 3im/n/ me-e+/ m/sih m/u be-m/in

3eng/n bebe-/./ *em/nn1/ *e*/.i *e*/. +esuli*/n un*u+ be-in*e-/+si 3eng/n

+eb/n1/+/n *em/n 3/n gu-un1/)

Ciri!ciri yang "ering tampa# pada ana# dengan gangg$an m$ti"me ele#ti%&

$) Kesuli*/n un*u+ be-bi0/-/ 3i si*u/si s2si/l *e-*en*u6 mis/ln1/ se+2l/h)

%) G/nggu/n be-+2muni+/si 1/ng *e-5/3i lebih 3/-i $ bul/n

7) E+s.-esi =/5/h +2s2ng s//* gelis/h

() Ku-/ng *e-sen1um +e*i+/ 0em/s

&) Me-/s/ 0/nggung 5i+/ gelis/h

?) Kesuli*/n +2n*/+ m/*/ s//* be-in*e-/+si

@) Membu*uh+/n =/+*u lebih l/m/ 3/-i 2-/ng l/in s//* me-es.2n .e-*/n1//n

") Ti3/+ n1/m/n ./3/ +2n3isi bising6 g/3uh6 /*/u -/m/i 2-/ng

') Te-l/lu .e+/ /*/u sensi*i, 

Meng/b/i+/n /n/+ 1/ng meng/l/mi h/l se.e-*i ini bis/ men0i.*/+/n .e-il/+u

1/ng sem/+in ./-/h 1/ng ./3/ /+hi-n1/ /n/+ 3eng/n mu*isme ele+*i, /+/n sem/+in

+esuli*/n un*u+ be-e+s.-esi se0/-/ e-b/l)

Ji+/ *i3/+ 3i2b/*i h/l ini /+/n mengg/nggu ,ungsi /n/+ 3/l/m h/l /+/3emis6

+ehi3u./n s2si/l 3/n .e-+emb/ng/n em2si2n/l se.e-*i :

$) memben*u+ -/s/ 0em/s 1/ng be-lebih

%) .en/-i+/n 3i-i 3/-i ling+ung/n s2si/l

7) -/s/ -en3/h 3i-i

?

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() .en2l/+/n 3/n menu-unn1/ h/sil /+/3emis /*/u .-es*/si b/i+ 3i se+2l/h

/*/u.un 3uni/ +e-5/ +el/+ 

&) .enggun//n 2b/*42b/*/n

?) +-imin/lisme

@) .emi+i-/n un*u+ bunuh 3i-i

Menu-u* PPDGJ6 .e32m/n 3i/gn2s*i+ g/nggu/n ini 3i.e-lu+/n bebe-/./ h/l6

/n*/-/ l/in:

/ Ting+/* .enge-*i/n b/h/s/ 1/ng n2-m/l /*/u h/m.i- n2-m/lB

 b Ting+/* +em/m.u/n be-*u*u- +/*/ 1/ng 0u+u. un*u+ +2muni+/si s2si/lB

0 9u+*i 1/ng n1/*/ b/h=/ /n/+ be-s/ng+u*/n 3/./* 3/n be-*u*u- +/*/ se0/-/

n2-m/l /*/u h/m.i- n2-m/l 3/l/m bebe-/./ si*u/si *e-*en*u)

>/ng *e-.en*ing l/gi 3/l/m meneg/++/n 3i/gn2sis g/nggu/n ini 3ibu*uh+/n

 bu+*i 3/-i +eg/g/l/n be-bi0/-/ /n/+ 1/ng be-si,/* +2nsis*en 3/l/m bebe-/./ si*u/si

s2si/l *e-*en*u6 *e*/.i *i3/+ ./3/ si*u/si l/inn1/) Keg/g/l/n bi0/-/ ini h/-us 0u+u.

l/m/ un*u+ 3/./* 3i/m/*i sehingg/ *e-lih/* b/h=/ /n/+ ini ben/-4ben/- *i3/+ ingin

 be-*u*u- +/*/ ./3/ bebe-/./ si*u/si s2si/l)

K!%a +a*#!' "*!"' M"!#$% E&%'!(pa+a ID-10

A) E+s.-esi b/h/s/ 3/n .em/h/m/n6 seb/g/im/n/ 3inil/i ./3/ *es 1/ng

*el/h 3is*/n3/-is/si se0/-/ /3minis*-/si in3ii3u/l6 be-/3/ 3/l/m b/*/s

s*/n3/- 3ei/si % un*u+ usi/ /n/+)

9) A3/ bu+*i 1/ng menun5u++/n +eg/g/l/n +2nsis*en un*u+ be-bi0/-/

3/l/m si*u/si s2si/l *e-*en*u 3i m/n/ /n/+ 3ih/-/.+/n un*u+ be-bi0/-/

Cmis/ln1/ 3i se+2l/h6 mes+i.un be-bi0/-/ 3/l/m si*u/si l/in)

) Du-/si mu*isme ele+*i, melebihi ( minggu)

D) Ti3/+ /3/ g/nggu/n .e-+emb/ng/n .e-/si,)

E) Kel/in/n ini *i3/+ 3i.e-hi*ung+/n 2leh +u-/ngn1/ .enge*/hu/n *en*/ng

 b/h/s/ lis/n 1/ng 3ibu*uh+/n 3/l/m si*u/si s2si/l 3i m/n/ /3/

+eg/g/l/n un*u+ be-bi0/-/)

@

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What are the diagnostic criteria for Selective Mutism?

aa$a*a $"!#$% %&%'!( +#%$5"'a*)

Tu5u/n u*/m/ 3/-i *e-/.i ./3/ /n/+ mu*isme ele+*i, /3/l/h un*u+ menu-un+/n

"

 DSM-IV-TR (2000) defines Selective Mutism as follows:

1. onsistent failu!e to s"ea# in s"ecific social situations (in w$ic$ t$e!e is an

e%"ectation fo! s"ea#in&' e.&.' at sc$ool) des"ite s"ea#in& in ot$e!

 situations.

2. T$e distu!ance inte!fe!es wit$ educational o! occu"ational ac$ievement o!

wit$ social communication.

. T$e du!ation of t$e distu!ance is at least 1 mont$ (not limited to t$e fi!st

mont$ of sc$ool).

*. T$e failu!e to s"ea# is not due to a lac# of #nowled&e of' o! comfo!t wit$' t$e

 s"o#en lan&ua&e !e+ui!ed in t$e social situation.

,. T$e distu!ance is not ette! accounted fo! a ommunication Diso!de!

(e.&.' stutte!in&) and does not occu! e%clusivel du!in& t$e cou!se of a

 e!vasive Develo"mental Diso!de!' Sc$i/o"$!enia' o! ot$e! sc$otic

 ssociated featu!es of Selective Mutism ma include e%cessive s$ness' fea!

of social ema!!assment' social isolation and wit$d!awal' clin&in&' com"ulsive

t!aits' ne&ativism' tem"e! tant!ums' o! cont!ollin& o! o""ositional e$avio!'

 "a!ticula!l at $ome. T$e!e ma e seve!e im"ai!ment in social and sc$ool

 functionin&. Teasin& o! &oadin& "ee!s is common. lt$ou&$ c$ild!en wit$ t$is

diso!de! &ene!all $ave no!mal lan&ua&e s#ills' t$e!e ma occasionall e an

associated ommunication Diso!de! (e.&.' $onolo&ical Diso!de!' %"!essive

 an&ua&e Diso!de!' o! Mi%ed Rece"tive- %"!essive an&ua&e Diso!de!) o! a

 &ene!al medical condition t$at causes ano!malities of a!ticulation. Mental

 Reta!dation' $os"itali/ation o! e%t!eme "sc$osocial st!esso!s ma e associatedwit$ t$e diso!de!. In addition' in clinical settin&s c$ild!en wit$ Selective Mutism a!e

almost alwas &iven an additional dia&nosis of n%iet Diso!de!' es"eciall Social

 $oia is common. (DSM-IV-TR) (' 2000)

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+/3/- +e0em/s/nn1/6 mening+/*+/n -/s/ .e-0/1/ 3i-i /+/n 3i-in1/ sen3i-i6 3/n

mening+/*+/n -/s/ .e-0/1/ 3i-i un*u+ be-s2si/lis/si 3/n be-+2muni+/si) 9ebe-/./

*e+ni+ *e-/.i 1/ng 3/./* 3il/+u+/n /*/u 3i+2mbin/si+/n6 /n*/-/ l/in seb/g/i be-i+u*:

$) Behavi'ral (herapy& Du+ung/n 1/ng .2si*i, me-u./+/n *e+ni+ u*/m/ 3/l/m

 .e-/=/*/n .e-il/+u un*u+ mu*isme ele+*i,6 se-*/ mengh/.us semu/ *e+/n/n4

*e+/n/n b/gi /n/+ un*u+ be-bi0/-/)>/ng *e-.en*ing /3/l/h un*u+ *i3/+ 

mem/+s/ /n/+ un*u+ be-bi0/-/m *e*/.i mengu-/ngi -/s/ +e0em/s/n 1/ng

3i-/s/+/nn1/) Mem.e-+en/l+/n /n/+ +e./3/ ling+ung/n s2si/l 3eng/n 0/-/

1/ng h/lus 3/n *i3/+ meng/n0/m me-u./+/n 0/-/ *e-b/i+ un*u+ memb/n*u

/n/+ me-/s/ lebih n1/m/n6 se.e-*i 02n*2h 2-/ng *u/ 3/./* memb/=/ /n/+n1/

+e se+2l/h 3/n mem.e-+en/l+/n /n/+n1/ +e bebe-/./ 2-/ng se+i*/- un*u+ 

memi0u /n/+n1/ un*u+ 3/./* be-l/*ih be-bi0/-/) D/./* 5ug/ 3eng/n memb/=/

 bebe-/./ *em/n se+2l/h 1/ng memung+in+/n b/gi /n/+n1/ un*u+ 3/./*

 be-m/in be-s/m/ /*/u 3eng/n membu/* +el2m.2+4+el2m.2+ +e0il 3eng/n

h/n1/ se5uml/h /n/+4/n/+ 3/./* memb/n*u .e-il/+u /n/+ mu*isme ele+*i, 

un*u+ 3/./* lebih *e-bu+/ +e./3/ se+i*/-) O-/ng *u/ 5ug/ 3/./* i+u* se-*/

3/l/m +el/s un*u+ menem/ni /n/+n1/ /g/- /n/+n1/ me-/s/ n1/m/n) L/lu

se*el/h /n/+ *e-sebu* me-/s/ 0u+u. n1/m/n 3/n be-bi0/-/ 3eng/n n2-m/l 3i

se+2l/h6 m/+/ gu-u 3/n bebe-/./ *em/n se+el/sn1/ se0/-/ be-*/h/.

3im/su++/n +e 3/l/m +el2m.2+ *e-/.i)

%) Play (herapy& 3eng/n mel/+u+/n .l/1 *he-/.1 m/+/ /+/n 3/./* 3i*emu+/n

+/3/- +e*/+u*/n /*/u +e0em/s/n ./3/ /n/+ mu*isme ele+*i, sehingg/ 3/./*

3i*en*u+/n 0/-/ .en3e+/*/n 1/ng ./ling 0202+ /g/- /n/+ 3/./* me-/s/ n1/m/n

3/n *i3/+ 0em/s)

7) C'gnitive Behavi'ral (herapy& me-u./+/n *e-/.i 1/ng memb/n*u /n/+4/n/+ 

mengub/h .e-il/+u me-e+/ 3eng/n memb/n*u me-e+/ meng/-/h+/n +e*/+u*/n

3/n +e+h/=/*i-/n me-e+/ men5/3i .i+i-/n .2si*i, ) 9T .e-lu mengg/bung+/n

+es/3/-/n 3/n .eng/+u/n +e0em/s/n 3/n si+/. mu*isme i*u sen3i-i)

Keb/n1/+/n /n/+ 3eng/n mu*isme ele+*i, +h/=/*i- *en*/ng 2-/ng l/in

men3eng/- su/-/ me-e+/ 6 memin*/ me-e+/ .e-*/n1//n *en*/ng meng/./

me-e+/ *i3/+ be-bi0/-/ 3/n men02b/ un*u+ mem/+s/ me-e+/ un*u+ be-bi0/-/ )

F2+us *e-/.i ini h/-us ./3/ /*-ibu* .2si*i, 1/i*u memb/ngun +e.e-0/1//n

3/l/m .eng/*u-/n s2si/l 3/n menu-un+/n +e0em/s/n 3/n +e+h/=/*i-/n se0/-/

'

8/18/2019 REFERAT F94)

10/19

+eselu-uh/n)

() )edicati'n&  S*u3i menun5u++/n b/h=/ .eng2b/*/n +2mbin/si beh/i2-/l

*he-/.1 3eng/n 2b/*42b/*/n 3/./* men5/3i *e-/.i 1/ng 0u+u. e,e+*i,) 9i/s/n1/

 beh/i2-/l *he-/.1 me-u./+/n *e-/.i /=/l sebelum /n/+ 3ibe-i+/n *e-/.i 2b/*4

2b/*/n) Ji+/ /n/+ *i3/+ membu/* 0u+u. +em/5u/n 3eng/n beh/i2-/l *he-/.1

s/5/6 m/+/ 2b/*42b/*/n 3/./* 3i-e+2men3/si+/n un*u+ mengu-/ngi *ing+/*

+e0em/s/n 1/ng men5/3i m/s/l/h u*/m/ ./3/ /n/+ mu*isme ele+*i,) Se-2*2nin

-eu.*/+e inhibi*2- CSSRI se.e-*i P-2

8/18/2019 REFERAT F94)

11/19

@) Sch''l inv'lvement: Pe-lu b/gi 2-/ng *u/ un*u+ membe-i+/n .enge-*i/n

+e./3/ gu-u4gu-u 3i se+2l/h mengen/i +e/3//n /n/+n1/ *e-sebu* /g/- /n/+ 

3eng/n mu*isme ele+*i, *i3/+ 3i*e+/n /*/u 3i./+s/ *e-l/lu be-lebih)

[F94.1] GANGGUAN KELEKATAN REAKTIFMASA KANAK 

D%6*# Ga*"a* K%&%'a!a* R%a'!( 

G/nggu/n +ele+/*/n -e/+*i, CRe/0*ie A**/*0hmen* Dis2-3e- /3/l/h g/nggu/n+linis 1/ng 3i*/n3/i 3eng/n .e-il/+u s2si/l men1im./ng ./3/ /n/+ +e0il 1/ng

men0e-min+/n .e-l/+u/n *e-h/3/. ling+ung/n 1/ng s/l/h 1/ng mengg/nggu

 .e-+emb/ng/n .e-il/+u +ele+/*/n n2-m/l) Te-3/./* +e*i3/+m/m.u/n se2-/ng /n/+

+e0il un*u+ mengemb/ng+/n in*e-/+si s2si/l n2-m/l) Ti3/+ se.e-*i +eb/n1/+/n

g/nggu/n 3/l/m -eisi *e+s e3isi +e4( M/nu/l Di/gn2s*i+ 3/n S*/*is*i+ G/nggu/n

Men*/l CDSM4I4TR6 3i/gn2sis RAD 3i3/s/-+/n ./3/ /ngg/./n b/h=/ e*i2l2gi

se0/-/ l/ngsung *e-+/i* 3eng/n +e+u-/ng/n .eg/l/m/n ling+ung/n 1/ng 3i/l/mi 2leh

/n/+) Hubung/n 3/s/- ini /3/l/h .-23u+ 3/-i +ebu*uh/n /n/+ mu3/ un*u+

 .e-lin3ung/n6 .emelih/-//n6 3/n +en1/m/n/n 3/n in*e-/+si 2-/ng *u/ 3/n /n/+ 3/l/m

memenuhi +ebu*uh/n *e-sebu*)

G/nggu/n ini se-ing +/li *e-5/3i ./3/ b/1i 3/n /n/+ +e0il 1/ng bi/s/n1/

3i*/n3/i 2leh be-l/n5u*n1/ g/nggu/n .2l/ hubung/n s2si/l /n/+ +e*i+/ /n/+ be-/n5/+

3e=/s/) G/nggu/n ini be-hubung/n 3eng/n g/nggu/n em2si2n/l 3/n si+/. -e/+*i,

*e-h/3/. .e-ub/h/n ling+ung/n) >/ng se-ing *imbul me-u./+/n -/s/ */+u* 3/n

=/s./3/ 1/ng bes/- be-lebih/n 1/ng *i3/+ be-/+si *e-h/3/. u./1/ menen/ng+/n

me-u./+/n 0i-i 1/ng +h/s ./3/ /n/+ 3eng/n g/nggu/n se.e-*i ini) i-i l/in 3/-i /n/+

3eng/n g/nggu/n +ele+/*/n -e/+*i, 3/./* be-u./ lem/hn1/ in*e-/+si s2si/l 3eng/n

+el2m.2+ seusi/n1/6 /g-esi *e-h/3/. 3i-i sen3i-i 3/n 2-/ng l/in6 .e-/s//n me-/n/6 3/n

3/l/m bebe-/./ +/sus *e-5/3i +eg/g/l/n 3/l/m .e-*umbuh/nn1/) G/nggu/n ini 3/./*

*imbul seb/g/i /+ib/* l/ngsung 3/-i 2-/ng *u/ 1/ng menel/n*/-+/n /*/u s/l/h

men/ng/ni /n/+ *e-sebu*)

$$

8/18/2019 REFERAT F94)

12/19

E!& Ga*"a* K%&%'a!a* R%a'!( 

G/nggu/n Kele+/*/n Re/+*i, e-/* 3ihubung+/n 3eng/n .eng/ni/1//n6

*e-m/su+ .eng/b/i/n em2si2n/l6 +e+e-/s/n ,isi+6 /*/u +e3u/n1/ se+/ligus) Pe-/=/*/n

1/ng s/l/h se0/-/ 5el/s ./3/ b/1i /*/u /n/+ +e0il 3eng/n .eng/suh mung+in

men1eb/b+/n +e*e-+/i*/n s2si/l n1/*/ *e-g/nggu 1/ng bi/s/n1/ 5el/s) Pene+/n/nn1/

/3/l/h ./3/ .en1eb/b se/-/h6 1/i*u .eng/suh mel/+u+/n sesu/*u 1/ng be-*en*/ng/n

/*/u l/l/i un*u+ b/1i /*/u /n/+ *e-sebu*) 9ebe-/./ h/l h/-us 3i.e-*imb/ng+/n 3/l/m

membu/* 3i/gn2sis *e-sebu*6 /n*/-/ l/in h/l4h/l se.e-*i b/1i /*/u /n/+ *em.e-/men6

+e+u-/ng/n /*/u 0/0/*6 /n/+ .en1/n3/ng 0/0/* .e-+emb/ng/n /*/u *e-g/nggu

sens2-is6 3/n +e*i3/+0202+/n .eng/suh *e-*en*u)Kemung+in/n .eng/b/i/n mening+/* 3eng/n +e*e-bel/+/ng/n men*/l

2-/ng*u/6 +u-/ngn1/ +e*e-/m.il/n 2-/ng*u/6 is2l/si s2si/l6 /*/u +e+u-/ng/n 3/n

+u-/ngn1/ +esem./*/n un*u+ bel/5/- *en*/ng .e-il/+u .eng/suh/n6 3/n men5/3i 2-/ng

*u/ 3ini Csel/m/ m/s/ -em/5/ /=/l 3/n *eng/h6 3i m/n/ 2-/ng *u/ *i3/+ m/m.u un*u+ 

men/ngg/.i6 3/n me-/=/*6 +ebu*uh/n b/1i 3/n 3i m/n/ +ebu*uh/n 2-/ng *u/ sen3i-i

3i3/hulu+/n melebihi +ebu*uh/n b/1i /*/u /n/+ me-e+/) Pe-ub/h/n .eng/suh 1/ng

se-ing se.e-*i 1/ng mung+in *e-5/3i 3/l/m .elemb/g//n6 -/=/* in/. ./n5/ng be-ul/ng6

3/n bebe-/./ /n/+ /suh 5ug/ 3/./* men1eb/b+/n g/nggu/n +ele+/*/n -e/+*i, m/s/

 b/1i /*/u /n/+ usi/ 3ini)

Da*## +a* F!" K&*# +a RAD

An/+4/n/+ 3eng/n RAD /=/ln1/ mung+in 3ii3en*i,i+/si 2leh se2-/ng gu-u

 .-/se+2l/h /*/u 2leh 32+*e- s.esi/lis /n/+ be-3/s/-+/n .eng/m/*/n l/ngsung -es.2ns

s2si/l /n/+ 1/ng *i3/+ sesu/i) Di/gn2sis RAD 3i3/s/-+/n ./3/ 0/*/*/n bu+*ig/nggu/n +ele+/*/n 1/ng meng/-/h +e .e-il/+u s2si/l 1/ng *i3/+ ./n*/s 1/ng mun0ul

sebelum usi/ & */hun)

G/mb/-/n +linis s/ng/* be-/-i/si6 *e-g/n*ung ./3/ usi/ +-2n2l2gis 3/n men*/l

/n/+6 *e*/.i in*e-/+si s2si/l 1/ng 3ih/-/.+/n 3/n +e/+*i,/n *i3/+ mun0ul) Se-ing+/li6

/n/+ *i3/+ meng/l/mi +em/5u/n .e-+emb/ng/n /*/u se0/-/ 5el/s meng/l/mi +u-/ng

gi

8/18/2019 REFERAT F94)

13/19

s.2n*/n) 9/1i *e-lih/* se3ih6 mu-/m6 3/n sengs/-/) 9ebe-/./ b/1i 5ug/ */m./+ */+u*

3/n =/s./3/6 3eng/n */*/./n) N/mun 3emi+i/n6 me-e+/ mung+in menun5u++/n

-es.2n *e-*un3/ un*u+ s*imulus 1/ng /+/n menimbul+/n +e*/+u*/n /*/u .en/-i+/n 3/-i

 b/1i n2-m/l) D/l/m +/sus lu/- bi/s/ ./-/h6 g/mb/-/n +linis m/-/smus 3/./* mun0ul)

9e-/* b/1i se-ing 3i b/=/h .e-sen*il +e*ig/ 3/n n1/*/ 3i b/=/h be-/* b/3/n

1/ng sesu/i un*u+ *inggi b/3/nn1/) Ji+/ -i=/1/* be-/* b/3/n 1/ng *e-se3i/6 .e-sen*il

 be-/* b/3/n mung+in sem/+in menu-un +/-en/ .enu-un/n be-/* b/3/n /+*u/l /*/u

+eg/g/l/n un*u+ men3/./*+/n be-/* b/3/n 3eng/n mening+/*n1/ +e*inggi/n) Ling+/-

+e./l/ bi/s/n1/ n2-m/l un*u+ usi/ b/1i) O*2* mung+in bu-u+) Mung+in +uli* lebih

3ingin6 .u0/* /*/u be-bin*i+4bin*i+ 3ib/n3ing /n/+ n2-m/l) H/sil l/b2-/*2-ium

 bi/s/n1/ 3/l/m b/*/s n2-m/l6 +e0u/li un*u+ *emu/n /bn2-m/l be-*e./*/n 3eng/n

m/lnu*-isi6 3ehi3-/si6 /*/u .en1/+i* 1/ng *imbul be-s/m//n) Usi/ *ul/ng bi/s/n1/

*e-bel/+/ng) K/3/- h2-m2n .e-*umbuh/n bi/s/n1/ n2-m/l /*/u mening+/*6 sebu/h

*emu/n 1/ng menun5u++/n b/h=/ +eg/g/l/n .e-*umbuh/n ./3/ /n/+4/n/+ /3/l/h

se+un3e- un*u+ +e+u-/ng/n +/l2-i 3/n gi

8/18/2019 REFERAT F94)

14/19

Si+/. */+u* /*/u +e=/s./3//n 1/ng be-lebih/n C,-2

8/18/2019 REFERAT F94)

15/19

7) .e-ub/h/n be-ul/ng4ul/ng 3/-i .eng/suh u*/m/ 1/ng men0eg/h

 .emben*u+/n +ele+/*/b s*/bil Cmis/ln1/6 .e-ub/h/n se-ing 3i /suh

D) A3/ /ngg/./n b/h=/ .e-/=/*/n 3/l/m +-i*e-i/ be-*/nggung 5/=/b /*/s

 .e-il/+u *e-g/nggu 3/l/m K-i*e-i/ A Cmis/ln1/6 g/nggu/n 3/l/m K-i*e-i/ A

mul/i mengi+u*i .e-/=/*/n 1/ng s/l/h 3/l/m K-i*e-i/ )

S.esi,i+/si *i.e:

  Jenis inhibisi: 5i+/ K-i*e-i/ A$ men2n52l 3/l/m .-esen*/si +linis

  Jenis 3isinhibisi: 5i+/ K-i*e-i/ A% 32min/n 3i .-esen*/si +linis

$&

8/18/2019 REFERAT F94)

16/19

%*a!a&a'#a*aa* +a* !%ap RAD

Re+2men3/si 3/l/m .engel2l//n RAD h/-us 3imul/i 3eng/n .enil/i/n 1/ng

+2m.-ehensi, 3/-i *ing+/* +esel/m/*/n 3/n .eng/suh/n 1/ng mem/3/i) Deng/n

3emi+i/n6 .e-*imb/ng/n .e-*/m/ 3/l/m meng2b/*i g/nggu/n *e-sebu* /3/l/h

+e/m/n/n /n/+) Deng/n 3ug//n .eng/ni/1//n s//* be-*/h/n 3i -um/h6 +e.u*us/n

 .e-*/m/ 1/ng se-ing 3i*en*u+/n /3/l/h /./+/h /n/+ 3i-/=/* in/. /n/+ /*/u un*u+

men02b/ .eng2b/*/n semen*/-/ 3eng/n /n/+ *e*/. 3i -um/h) Ji+/ /n/+ *e-bu+*i

3i/b/i+/n6 *e-/ni/1/ se0/-/ em2si2n/l m/u.un ,isi+ h/-us sege-/ 3il/.2-+/n +e./3/

 .ih/+ hu+um 3/n l/1/n/n .e-lin3ung/n /n/+ 3i 3/e-/h *e-sebu*)

Ke/3//n ,isi+ 3/n em2si2n/l /n/+ 3/n *ing+/* .eng/suh/n 1/ng s/l/h

menen*u+/n s*-/*egi *e-/.i) Su/*u .enen*u/n h/-us 3il/+u+/n mengen/i s*/*us gi

8/18/2019 REFERAT F94)

17/19

in*e-ensi +linis /3/l/h mel/lui +e-5/ in3ii3u 3eng/n /n/+) 9e+e-5/ 3eng/n /n/+ 3/n

 .eng/suh be-s/m/4s/m/ se-ing lebih e,e+*i, 3/l/m mem.-23u+si .e-*u+/-/n

em2si2n/l 1/ng lebih be-m/+n/)

[F94.2] GANGGUAN KELEKATAN TAKTERKENDALI MASA KANAK 

Kel/in/n ,ungsi s2si/l 1/ng *imbul ./3/ m/s/ & */hun .e-*/m/ +ehi3u./n

/n/+ menun5u++/n +e0en3e-ung/n un*u+ mene*/. se+/li .un *e-5/3i .e-ub/h/n bes/-

 ./3/ ling+ung/n) P/3/ usi/ +i-/4+i-/ % */hun bi/s/n1/ */m./+ .e-il/+u 1/ng mele+/*

3/n +/bu-6 *e*/.i *i3/+ *e-,2+us se0/-/ sele+*i,) P/3/ usi/ ( */hun +ele+/*/n 1/ng

+/bu- *e-sebu* /+/n mene*/. *e*/.i si+/ mele+/* 3ig/n*i 3eng/n si+/. men/-i+

 .e-h/*i/n 3/n si+/. -/m/h 1/ng *i3/+ ./n3/ng bulu)

P/3/ .e-*eng/h/n 3/n b/gi/n /+hi- m/s/ +/n/+6 /n/+ 1/ng be-s/ng+u*/n

mung+in mengemb/ng+/n +ele+/*/nn1/ se0/-/ sele+*i, /*/u *i3/+6 n/mun si+/.

men0/-i .e-h/*i/nn1/ /+/n *e*/. be-l/n5u* 3/n in*e-/+si 3eng/n /n/+ seb/1/n1/ /+/n

men5/3i +u-/ng *e-/-/hB *e-g/n*ung ./3/ +e/3//n 3/n mung+in *e-5/3i g/nggu/n

em2si2n/l /*/u .e-il/+u)G/nggu/n ini se0/-/ n1/*/ *el/h 3ii3en*i,i+/si ./3/ /n/+ 1/ng 3i/suh 3i ./n*i

se5/+ m/sih b/1i n/mun 3/./* .ul/ *e-5/3i ./3/ si*u/si l/in) G/nggu/n ini seb/gi/n

 bes/- 3iseb/b+/n +/-en/ *i3/+ /3/n1/ +esem./*/n un*u+ membin/ +ele+/*/n sele+*i,

seb/g/i /+ib/* 2leh be-g/n*i4g/n*in1/ .eng/suh) Ke-/g/m/n +2nse.*u/l 3/-i g/nggu/n

ini 3i*en*u+/n 2leh 2nse* 3ini 3/-i +ele+/*/n 1/ng +/bu-6 in*e-/+si s2si/l 1/ng +u-/ng

3/n *e-5/3in1/ +e+h/s/n si*u/si)

%+$a* +a*#!' a*"a* '%&%'a!a* !a'!%'%*!+a& $a#a 'a*a' 

Di/gn2sis h/-us 3i3/s/-+/n ./3/ +en1/*//n b/h=/ /n/+ menun5u++/n

+ele+/*/n sele+*i, 1/ng +/bu- sel/m/ & */hun .e-*/m/ 3/n umumn1/ be-hubung/n

3eng/n .e-il/+u mele+/* se=/+*u m/sih b/1i6 3/n .e-il/+u m/n-i+ .e-h/*i/n ./3/

m/s/ 3ini /*/u .e-*eng/h/n +/n/+) 9i/s/n1/ /n/+ 3eng/n g/nggu/n ini /+/n

meng/l/mi +esuli*/n 3/l/m membin/ hubung/n /+-/b 3/n -/s/ .e-0/1/ 3eng/n

$@

8/18/2019 REFERAT F94)

18/19

+el2m.2+ *em/n seb/1/n1/) Mung+in 5ug/ 3/./* */m./+ g/nggu/n em2si2n/l /*/u

 .e-il/+u 1/ng men1e-*/i) Keb/n1/+/n +/sus memili+i -i=/1/* .eng/suh 1/ng

 be-g/n*i4g/n*i /*/u 3/-i s/*u +elu/-g/ /suh .in3/h +e +elu/-g/ /suh 1/ng l/in)

[F94.8] GANGGUAN FUNGSI SOSIAL MASAKANAK LAINNYA

Termasuk: &an&&uan fun&si sosial den&an "ena!i#an di!i dan si#a" malu-malu

a#iat #u!an&na #emam"uan untu# e!sosialisasi.

[F94.9] GANGGUAN FUNGSI SOSIAL MASAKANAN YANG TIDAK TERGOLONGKAN

$"

8/18/2019 REFERAT F94)

19/19

/*(/ PS(/K/

• W2-l3 He/l*h O-/ni