Improving Self-Care in Children with Down Syndrome: A Pilot Study Of Combined Intervention
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Abstract
Background: Children with Down syndrome (DS) often experience delays in developing self-care skills, which are essential for independence and participation in daily life. This pilot study aimed to examine preliminary changes in self-care independence following a combined direct self-care intervention and animation-based home program.
Methods: A pre-experimental one-group pre-test and post-test design was used. Sixteen children with DS were recruited purposively from two occupational therapy services in Yogyakarta and Sukoharjo, Indonesia. The intervention combined therapist-led self-care training with a daily animation-based home program supported by caregivers for one month. Self-care independence was assessed using a 63-item Self-Care Ability Questionnaire. Data were analyzed using the Shapiro–Wilk test and paired sample t-test.
Results: Self-care scores increased following the intervention, with a statistically significant pre-test to post-test difference (t = −9.970, p < 0.001). The mean difference was −13.500 (SD = 5.416), with a 95% confidence interval of −16.386 to −10.614. The standardized effect size was large (Cohen’s d = 1.34).
Conclusion: The combined intervention demonstrated promising preliminary improvement in self-care independence among children with DS. Integrating therapist-led training, animation-based home practice, and caregiver involvement may provide a feasible approach for supporting self-care development. Given the pilot design and small sample, larger controlled studies are warranted to confirm these preliminary findings.
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Aisah, S., Ismail, S., & Margawati, A. (2021). Edukasi Kesehatan dengan Media Video Animasi: Scoping Review. Jurnal Perawat Indonesia/Jurnal Perawat Indonesia, 5(1), 641–655. https://doi.org/10.32584/jpi.v5i1.926
Aladwan, S. Q. A. (2024). Behavioural Training and Self-Care Skill Development in Early Childhood Down Syndrome in Jordan. International Journal of Educational Sciences, 44(1-3). https://doi.org/10.31901/24566322.2024/44.1-3.1319
Alnahdi, G. H. (2020). The effectiveness of video modeling in teaching daily living skills. International Journal of Developmental Disabilities, 66(3), 183–193. https://hdl.handle.net/11274/12915
Amanullah, A. (2022). Mengenal Anak Berkebutuhan Khusus: Tuna Grahita, Down Syndrom dan Autisme. Jurnal Almurtaja: Jurnal Pendidikan Islam Anak Usia Dini, 1(1), 1–14. http://ejournal.iaitabah. ac.id/index.php/almurtaja/article/view/1793
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2). https://doi.org/10.5014/ajot.2020.74S2001
Argueta Dheming, K. G., Silva, L. O., da Silva, M. C. V., Gomes, C. M. S., Cavalcante, F. S. Z., Parreira, F. V., & Magalhães, R. C. (2026). Home-based occupational therapy early intervention programs in children with Down syndrome: A randomized clinical trial. Physical & Occupational Therapy in Pediatrics.
Advance online publication. https://doi.org/10.1080/01942638.2026.2667359
Athorp, S. M., Stuart, S. K., & Collins, J. C. (2022). Building daily living skills through portable video modeling. Education and Treatment of Children, 45(3), 293–297. https://doi.org/10.1007/s43494-022-00077-3
Bull, M. J. (2020). Down syndrome. New England Journal of Medicine, 382(24), 2344–2352. https://doi.org/10.1056/NEJMra1706537
Camden, C., & Silva, M. (2021). Pediatric telehealth and family-centered care. Physical & Occupational Therapy in Pediatrics, 41(1), 1–14. https://doi.org/10.1080/01942638.2020.1825032
Case-Smith, J., Weaver, L. L., & Fristad, M. A. (2021). Interventions for children with developmental disabilities. American Journal of Occupational Therapy, 75(1). https://doi.org/10.1177/1362361313517762
Chen, M., Dutt, A. S., & Nair, R. (2022). Systematic review of reviews on Activities of Daily Living measures for children with developmental disabilities. Heliyon, 8(6), e09698. https://doi.org/10.1016/j.heliyon.2022.e09698
Cochran, E., Breithaupt, K., Williams, L., & Atkins, K. (2022). Parent experiences in children with Down syndrome. Physical & Occupational Therapy in Pediatrics, 42(3), 333–349. https://doi.org/10.1080/01942638.2021.1981514
Daunhauer, L. A., & Fidler, D. J. (2021). Executive functioning and adaptive behavior in Down syndrome. Journal of Neurodevelopmental Disorders, 13(1), 1–12. https://doi.org/10.1111/jir.12897
Domínguez-Lucio, S., Compañ-Gabucio, L. M., & García de la Hera, M. (2022). Occupational therapy interventions using new technologies in children and adolescents. International Journal of Environmental Research and Public Health, 19(3), 1234. https://doi.org/10.1007/s10803-022-05431-3
Down Syndrome Resource Foundation. (2022). Learning Strategies for Increasing Independence - Down Syndrome Resource Foundation. Diakses dari https://www.dsrf.org/resources/blog/learning-strategies-for increasingindependence/ pada tanggal 14 Januari 2024.
Fahlevi, R., & Basaria, D. (2022). Penerapan Teknik Modifikasi Perilaku untuk Meningkatkan Kemampuan Bina Diri pada Anak dengan Down Syndrome. Jurnal Kesehatan Mental Indonesia, 1, 38, 1–45 https://journal.binawan.ac.id/jkmi/article/view/592/281
Febriyanti, T., Setiana, W., & Rahman, E. T. (2024). Pengaruh Bimbingan Selfcare Terhadap Kemandirian Anak Berkebutuhan Khusus. Irsyad: Jurnal Bimbingan, Penyuluhan, Konseling, Dan Psikoterapi Islam, 11(1), 41–62. https://digilib.uinsgd.ac.id/id/eprint/84363
Fernández-Alcaraz C, Carvajal F. Neuropsychological profile of adults with Down syndrome and moderate intellectual disability (2020). Research in Developmental Disabilities.;107:103781. doi: 10.1016/j.ridd.2020.103781
Fidler, D. J., Most, D. E., & Guiberson, M. (2020). Neuropsychological profile of individuals with Down syndrome. Current Developmental Disorders Reports, 7(1), 1–9. https://doi.org/10.1016/j.ridd.2020.103781
Fitriyah, Q. F. (2020). Intervensi Guru dalam Mengajarkan Daily Living Skills pada Anak Down Syndrome. Al-Althfal: Jurnal Pendidikan Anak, 6(1), 41–54. https://doi.org/10.14421/al-athfal.2020.61-04
Franceschetti, M., et al. (2024). Combined intervention approaches in pediatric rehabilitation. Journal of Pediatric Rehabilitation Medicine, 17(2), 123–135. https://doi.org/10.1080/09638288.2023.2229731
Franceschetti, S., Tofani, M., Mazzafoglia, S., Pizza, F., Capuano, E., Raponi, M., Gessica Della Bella, & Antonella Cerchiari. (2024). Assessment and Rehabilitation Intervention of Feeding and Swallowing Skills in Children with Down Syndrome Using the Global Intensive Feeding Therapy (GIFT). Children, 11(7), 847–847. https://doi.org/10.3390/children11070847
Gardner, R., & Wolfe, P. (2023). Video modeling interventions for developmental disabilities. Journal of Autism and Developmental Disorders, 53(4), 1456–1470. https://eric.ed.gov/?id=EJ1045100
Hielscher, L., Irvine, K., Ludlow, A. K., Rogers, S., & Mengoni, S. E. (2023). Feeding and early development in children with Down syndrome. Journal of Pediatric Psychology, 48(11), 914–930. https://doi.org/10.32524/jksp.v3i2.86
Idhartono, N. a. R., Sambira, N., & Rafikayati, N. A. (2021). Peran Terapi Okupasi bagi Kemandirian Anak Down Syndrome. Special and Inclusive Education Journal, 2(2), 119–124. https://doi.org/10.36456/special.vol2.no2.a5178
Ismail, N. K., Hosshan, H., Abd Aziz, N., Masnan, A. H., Rozubi, N. C., Zalli, M. M. M., & Arifin, S. R. M. (2024). The use of video-based interventions to teach activity of daily living to children with autism spectrum disorder–scoping review. International Journal of Public Health, 13(3), 1136-1144. DOI: 10.11591/ijphs.v13i3.23707
Kartika, Y. E., Nurhidayah, I., & Hendrawati. (2020). Dukungan Keluarga dalam Kemandirian Perawatan Diri Anak Retardasi Mental Ringan di SLB-C YKB Garut. Jurnal Kesehatan Saelmakers Perdana (JKSP), 3(2), 214–221. https://journal.ukmc.ac.id/index.php/joh/article/view/86/88
Kementerian Kesehatan Republik Indonesia. (2023). Survei Kesehatan Indonesia 2023.
Martínez, N., Connelly, C. D., Pérez, A., & Calero, P. (2021). Self-care: A concept analysis. International Journal of Nursing Sciences, 8(4), 418–425. https://doi.org/10.1016/j.ijnss.2021.08.007
Miranda-Duro, M. C., et al. (2021). Occupational therapy and the use of technology: A scoping review. International Journal of Environmental Research and Public Health, 18(2), 702. https://doi.org/10.3390/ijerph18020702
Mulyana, H., Ramdani, T., & Nugraha, B. (2023). Efektivitas Edukasi Perawatan Diri Pada Remaja Down Syndrome Dengan Media Video. Jurnal Keperawatan BSI, 11(2), 170–177. https://ejurnal.ars.ac.id/index.php/keperawatan/article/view/1408/815
Novak, I., & Honan, I. (2019). Effectiveness of pediatric occupational therapy interventions. American Journal of Occupational Therapy, 73(2). https://doi.org/10.1111/1440-1630.12573
Ozcan, D., & Merdan, F. (2020). The effectiveness of video modelling for teaching daily life skills to children with autism spectrum disorder. International Journal of Learning & Teaching, 12(1), 42–54. https://doi.org/10.18844/ijlt.v12i1.4560
Puspitosari, A. (2021). Sandsack physical activity increasing balance score in children with down syndrome. Jurnal Keterapian Fisik, 49-57. https://doi.org/10.37341/jkf.v0i0.254
Santoro, S. L., Hendrix, J., White, N., & Chandan, P. (2022). Caregivers evaluate independence in individuals with Down syndrome. American Journal of Medical Genetics Part A, 188(5), 1526–1537. https://doi.org/10.1002/ajmg.a.62680
Sari, D. Y., Ulfah, M., Rahayu, D., Khanafiyah, A., Asiyah, S., Baity, L. N., Purnomo, F. A., & Munawaroh, H. (2024). Analisis Pengaruh Penggunaan Media Pembelajaran Interaktif pada Anak Tunagrahita. Bhinneka: Jurnal Bintang Pendidikan Dan Bahasa, 3(1), 376–385. https://doi.org/10.59024/bhinneka.v3i1.1221
Sriasih, N. K., D, A. a. I. W. K., Rahyanti, N. M. S., & Dewi, N. W. E. P. (2023). Self-care agency pada anak berkebutuhan khusus di sekolah luar biasa. Jurnal Riset Kesehatan Nasional, 7(2), 156–162. https://doi.org/10.37294/jrkn.v7i2.524
Umuri, S. A., Rahmawati, A., & Sholeha, V. (2021). Analisis perkembangan selfhelp skills anak usia 5-6 tahun. Jurnal Pendidikan Anak/Jurnal Pendidikan Anak, 10(2), 137–143. https://doi.org/10.21831/jpa.v10i2.44170
World Health Organization. (2024). Self-care interventions for health.
Wulandari, U., & Linggardini, K. (2023). Pengaruh Pendidikan Kesehatan dengan Media Video Animasi terhadap Pengetahuan dan Keterampilan Anak dalam Menggosok Gigi. Jurnal Pendidikan Dan Konseling, 5, 40–46. https://journal.universitaspahlawan.ac.id/index.php/jpdk/article/view/12986
Yalçın, G., Kocaöz, O. E., & Arslantas, T. K. (2023). Effectiveness of animationbased video modeling on daily living skills teaching to individuals with intellectual disabilities. Education and Information Technologies, 28(12), 16233–16254. https://doi.org/10.1007/s10639-023-11863-w
Ying, X., Freedland, K. E., Powell, L. H., Stuart, E. A., Ehrhardt, S., & Mayo-Wilson, E. (2025). Determining sample size for pilot trials: A tutorial. BMJ, 390, e083405. https://doi.org/10.1136/bmj-2024-083405
Yulianasari, Lufianti, A., & Kusumaningrum, Y. (2023). Efektivitas Pengaruh Teknik Modelling dan Teknik Shaping Bina Diri terhadap Kemandirian Anak Tunagrahita di SLB. Journal of TSCS1Kep, 8(1), 44–51. https://doi.org/10.35720/