Indria Laksmi Gamayanti

Dampak Stimulasi Kognitif Disertai Pemberian Garam Beriodium Tiga Bulan terhadap Kecukupan Iodium, Kualitas Lingkungan Pengasuhan dan Perkembangan Kognitif Balita di Daerah Endemik GAKI

ABSTRACT International Child Development Steering Group stated that inadequate cognitive stimulation and IDD were two of four risk factors of child developmental failure in developing countries. There were no research found on the impact of cognitive stimulation combined with iodine intervention on child development status. The aim of this study is measuring the effect of parenting based cognitive stimulation combined with low dose salt intervention (30 ± 5 ppm) on child iodine status, home quality of care, and child cognitive development. This was a quasi experimental research, pre test post test with controlled group design, conducted in Pituruh, Purworejo district. The subjects was 76 children 4-5 years old with his mother. Home quality of care data taken with HOME questionnaire, iodine intake indicator taken with Urinary Iodine Excretion, and child cognitive development measured with WPPSI (Weschler Primary and Preschool Scale of Intelligent). Intervention was done in three months.There was no difference on UIE level between intervention and control group before and after the intervention (p>0.05), with the UIE mean in the level of above requirement (254 μg ± 130 μg/L). There was no significant difference in prevalence of insufficient and excessive iodine status before and after the intervention. Result of the analysis on quality of care showed that intervention group showed higher score in home quality of care in the aspects of language stimulation (p 0.05). Three months low dose iodized salt intervention (30 ± 5 ppm) had not changed iodine intake status in under five years old children. Parenting based cognitive stimulation enhanced the aspects in maternal quality of care related to quality of home stimulation relevance with child non verbal cognitive development. It was suggested to optimized maternal parenting quality to enhance child cognitive development in IDD areas. Future research should extend the time of intervention to evaluate the impact of the intervention on child verbal cognitive development, iodine intake and also thyroid status. Keywords : cognitive stimulation, iodized salt, iodine status, cognitive development, under five years children. ABSTRAK International Child Development Steering Group menyebutkan stimulasi kognitif tidak memadai dan GAKI sebagai dua dari empat faktor risiko utama kegagalan perkembangan anak di negara berkembang. Belum diketahui dampak kombinasi intervensi gizi iodium dan stimulasi perkembangan. Penelitian ini bertujuan untuk mengetahui dampak stimulasi kognitif berbasis pengasuhan disertai intervensi garam beriodium 30 ± 5 ppm terhadap peningkatan status iodium, kualitas lingkungan pengasuhan, dan perkembangan kognitif anak. Penelitian dilakukan di Kecamatan Pituruh, Kabupaten Purworejo terhadap 76 anak 4-5 tahun beserta ibunya. Penelitian ini menggunakan rancangan kuasi eksperimental pre test post test with control group design . Pengambilan data kualitas lingkungan pengasuhan dengan HOME, kecukupan iodium dengan EIU, dan kemampuan kognitif anak diukur dengan WPPSI ( Weschler Primary and Preschool Scale of Intelligent ). Intervensi dilakukan selama 3 bulan. Tidak ada perbedaan tingkat EIU kelompok intervensi dan kelompok kontrol sebelum dan sesudah intervensi (p>0.05), dengan rerata EIU lebih (254 μg ± 130 μg/L). Perubahan proporsi status defisien dan ekses iodium belum menunjukkan perubahan signifikan. Hasil analisis kelompok intervensi menunjukkan skor lebih tinggi dalam kualitas lingkungan pengasuhan pada aspek: stimulasi bahasa (p 0.05). Intervensi garam beriodium 30 ± 5 ppm tiga bulan belum mengubah status kecukupan iodium balita. Stimulasi kognitif pengasuhan meningkatkan aspek-aspek kualitas pengasuhan ibu yang relevan dengan peningkatan kemampuan kognitif anak. Disarankan untuk mengoptimalkan program peningkatan kualitas pengasuhan sebagai daya ungkit kemampuan kognitif anak di daerah endemik GAKI, memperpanjang waktu intervensi untuk mengevaluasi pengaruh intervensi pada kemampuan kognitif verbal dan status iodium anak dengan mengukur indikator kadar hormon tiroid. Kata kunci : stimulasi kognitif, HOME, garam beriodium, balita, kemampuan kognitif.