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JURNAL
JURNAL SOSIAL DAN SAINS
VOLUME 3 NOMOR 10 2023
P-ISSN 2774-7018, E-ISSN 2774-700X
Parent Education Program about Dental Health Education for
Intellectual Disability Children in Wetland
Renie Kumala Dewi
*
, Beta Widya Oktiani, Anugrah Qatrunnada Hakim, Ika Kusuma
Wardani
Faculty of Dental Medicine, Universitas Lambung Mangkurat, Indonesia
Email: renie.dewi@ulm.ac.id*
Keywords:
Intellectual
disabilities
children;
animated video;
parent education
program;
Wetland
ABSTRACT
Background: Wetlands are swamps with a water pH of 3.5-4.5. There are also cariogenic
bacteria, including Streptococcus sp. Parents living in wetlands have a habit of using wetland
water for their daily routine, such as for gargling after toothbrushing. Oral health problems
in intellectual disabilities children include gingivitis, periodontitis, and rapid dental caries.
Dental Health Education can increase the awareness of people in wetlands.
Purpose: to analyse the effectivity of parent education program about dental health
education for intellectual disability children in Wetland
Methods: A quasi-experiment study with pretest and posttest without control design that
used a simple random sampling technique.
Results: Thirty-eight parents of intellectual disabilities children filled questionnaires for
pretest, then asked to watch an animated video of Dental Health Education for moderate
intellectual disabilities children living in wetlands concerning dental caries prevention. As
for the posttest, the samples were asked to fill the same questionnaire after 20 days. Data
were analyzed using Wilcoxon statistical test. The results of the Wilcoxon test prove value =
0.000 (p < 0.05).
Conclusion: There is an effect of the parent education program through Dental Health
Education video for intellectual disabilities children in wetlands on dental caries prevention.
This video can be applied to parents of children with intellectual disabilities as promotive
action for dental health education.
INTRODUCTION
The American Association of Mental Deficiency (AAMD) defined intellectual
disability as a disorder with general intelligence below average (IQ < 70), which is seen
before 18 years old and is related to adaptive behavioral disorder or lack of intelligence,
thus having difficulties in performing daily activities. Intellectual disability is classified
into four categories in relation to intelligence level (IQ), i.e.; Mild (IQ 50-70), moderate
(IQ 35-50), severe (IQ 20-35), and profound (IQ below 20-25) (Özgül et al., 2014).
Based on the National Census (2012), intellectual disabilities children placed
highest, with 66,610 compared to children with other disorders and approximately 57% had
a mild or moderate intellectual disability. Oral health problems in intellectual disabilities
children include gingivitis, periodontitis, and rapid dental caries. The oral health in
intellectual disabilities children is poorer than normal children because of their limitations.
Lower intelligence level causes a high level of dental caries, calculus, and debris. The
Association for Education and Communication Technology (AECT) stated that media is a
tool to channel information. Media act to express learning messages from the sender to the
Parent Education Program about Dental Health Education
for Intellectual Disability Children in Wetland
2023
Renie Kumala Dewi, Beta Widya Oktiani, Anugrah Qatrunnada Hakim, Ika Kusuma
Wardani 1048
receiver to stimulate the mind, feeling, awareness, and interest of students (Motto et al.,
2017) (Anjasti, 2017).
South Kalimantan is one of the regions with wetlands. Wetlands are swamps with a
water pH of 3.5-4.5. The water in South Kalimantan wetlands cariogenic bacteria, including
Streptococcus sp. Most parents living in wetlands have a habit of using wetland water for
their daily routine, such as gargling after toothbrushing. Learnings about self-development
for intellectual disabilities children are generally delivered through the lecture method.
Therefore, some information concerning personal hygiene did not reach children and
children tend to be bored to follow the learning. Another method of learning is needed to
improve independence in personal hygiene in intellectual disabilities children by providing
interactive video (Dewi et al., n.d.; Firdaus & Hakim, 2020; Suyami et al., 2019).
Intellectual disabilities children have low intelligence levels. Therefore, they require
special service or help to learn on development, especially for education and guidance.
Parents have a very important role in their children’s oral hygiene. The roles of parents
include giving an example of oral hygiene, motivating in oral hygiene. Parents affect the
development and independence of children. Parents with intellectual disabilities children
have a role in educating and training their children in the process of development.
Intellectual disabilities children mostly experienced physical and motor limitations, which
cause problems in fulfilling personal hygiene needs. Personal hygiene is required to
maintain health, both physical and psychological. One of the activities of personal hygiene
is oral hygiene. Only listening has a different level of understanding compared to seeing
and listening. Therefore, a good education medium for intellectual disabilities children is
an interactive video. The steps of oral hygiene are given in an interactive video so that the
children can observe and practice these steps after they understood the activities in the
video (Sandy, 2018).
METHODS
Reseach Desain and Sample
This study is a quasi-experimental with non-equivalent without control group (non-
randomized without control group pretest-posttest) design. The samples were parents of
moderate intellectual disabilities children in South Kalimantan PIK POTADS foundation
in Banjarmasin, South Kalimantan. Thirty-eight samples of parents were chosen with
criteria including parents who care for intellectual disabilities children for 24 hours, had
children with moderate intellectual disability (IQ 55-40) and could communicate well,
parents with intellectual disabilities children without congenital disorder or other diseases,
parents with intellectual disabilities children aged 5-15 years old, parents with intellectual
disabilities children living in South Kalimantan wetlands with inclusion criteria: Parents
who care for intellectual disabilities children for ± 24 hours, Children with moderate
intellectual disabilities (IQ 55-40) and can communicate well, Children with intellectual
disabilities do not have congenital abnormalities or other diseases, Children with
intellectual disabilities aged 5-15 years, Parents and children with intellectual disabilities
living in wetland areas. Exclusion Criteria Children who are sick, children with physical
disabilities, children who refuse to practice, parents and children who cannot participate in
the research until it is completed.
Research Prosess
The first step of the study was obtaining ethical clearance number 08/KEPKG-
FKGULM/EC/VIII/2021 before starting to make a dental health education video for
parents of intellectual disabilities children living in wetlands to prevent dental caries using
an animated video modified with the Makaton method. The content of the animated video
for intellectual disabilities children modified with the Makaton method was the addition of
children songs in the form of symbols on the correct choice of toothbrush and toothpaste,
the proper way of toothbrushing, types of foods and drinks that are good and bad for teeth,
Volume 3, Nomor 10, Oktober 2023
p-ISSN 2774-7018 ; e-ISSN 2774-700X
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the choice of good gargle water after toothbrushing in children living in wetlands, the use
of safe mouthwash for intellectual disabilities children, how to maintain oral health and
routinely visit the dentist to check for oral health.
The parents were asked to fill a questionnaire containing 25 items concerning Dental
Health Education as a pretest, where is the content of the question in the Dental Health
Education video. Then, they were instructed to watch a 10-minute animated video of Dental
Health Education on intellectual disabilities children living in wetlands concerning dental
caries prevention. Video content consists of choosing a child's toothbrush, fluoridated
toothpaste, using toothpaste sizes, choosing mouthwash when brushing your teeth, how to
brush your teeth, types of food and drink that are good for oral health (vegetables & fruit),
bad types of food and drink. for dental and oral health (food contains a lot of sugar),
prevention of transmission of Covid through the oral cavity.
The final assessment was observation. Measuring the knowledge of parents of
moderately mentally retarded children about DHE through animated videos using a
questionnaire with the resulting answers being Very Good, Good, Enough and Less. After
20 days of education to the parents and children with intellectual disabilities, the author
resent the link to the google form as a posttest for parents via online meeting. Data were
analyzed using the IBM SPSS Statistics software version 16.01 for Windows. This study
used numerical data of ratio, thus the hypothesis test used to test mean difference from two
measurement results of pretest and posttest was the Wilcoxon non-parametric test and a
conclusion was produced.
RESULTS AND DISCUSSION
Results
The study conducted on 38 parents of intellectual disabilities children in South
Kalimantan POTADS Foundation showed that there was an effect of parent education
program through a Dental Health Education (DHE) video for moderate intellectual
disabilities children living in wetlands on dental caries prevention.
Figure 1. The pretest result of the parent education program
The pretest result of the parent education program before using the animated video
of Dental Health Education showed in Figure 1 revealed that 11 parents (28.9%) had poor
understanding concerning dental caries prevention, 13 parents (34.2%) had medium
understanding concerning dental caries prevention, 8 parents (21.1%) had average
understanding concerning dental caries prevention, and 3 parents (7.9%) had a good
understanding concerning dental caries prevention 3 parent (7.9%) had excellent
concerning dental caries prevention.
0
5
10
15
Kurang Cukup Sedang Baik Sangat Baik
Parent education program before Dental Health
Education
Jumlah
Total
Poor Medium Average Good
Excellent
Parent Education Program about Dental Health Education
for Intellectual Disability Children in Wetland
2023
Renie Kumala Dewi, Beta Widya Oktiani, Anugrah Qatrunnada Hakim, Ika Kusuma
Wardani 1050
Figure 2. The posttest result of the parent education program after being given a
DHE animated video
The posttest result of the parent education program tested 20 days after being given
the Dental Health Education video shown in Figure 2 indicated an increase of
understanding compared to before being given an animated video of Dental Health
Education, which was expressed by 25 parents (65.8%) who had an excellent understanding
on dental caries prevention, 8 parents (21.1%) had a good understanding, 5 parents (13.2%)
had average understanding, and no more parents with fine or poor understanding
concerning dental caries prevention in children.
This study concludes that there is an effect of parent education program through a
DHE video for moderate intellectual disabilities children living in wetlands on dental caries
prevention with a p-value of 0.000 < 0.05.
Table 1. Wilcoxon test on the parent education program
Test Statistics
After the Video
Before the Video
Z
-3.837
b
Asymp.Sig (2-tiled)
.000
a. Wilcoxon Signed Ranks Test
b. Based on Negative Ranks
998
Description: statistical results before and after watching videos with Wilcoxon test
The results showed that there was an effect of parent education program through the
DHE video for moderate intellectual disabilities children living in wetlands. This was in
line with Fithriyana (2019) concerning the role of parents on children’s independence on
personal hygiene before given intervention with an average value of 2.73. Independence is
not a skill that appeared suddenly, but it must be taught and trained to intellectual
disabilities children to not hinder their development tasks (10).
Discussion
Animated video can deliver information in the form of audio (sound) and visual
(image). This type of medium has a better ability to motivate and direct parents’ and
children’s concentration to the learning material. If the child is motivated to learn, then the
result can also be improved. Audiovisual is highly beneficial in the learning process
because it can focus children’s attention to a clearer and more direct meaning of a
vocabulary to make the learning process more alive. Other than that, it can also attract
attention to the learning process because it is interesting to hear or see (PASARIBU, n.d.).
0
5
10
15
20
25
30
Kurang Cukup Sedang Baik Sangat Baik
Parent education program after Dental Health Education
Jumlah
Poor Fine Average Good Excellent
Total
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p-ISSN 2774-7018 ; e-ISSN 2774-700X
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This was also in line with Fajarwati & Sujarwanto (2010), who stated that there was
a significant effect of interactive video in improving the ability to start reading in children
with moderate intellectual disability in Gedangan Harmoni Special School Sidoarjo. Using
learning media with interactive video, children and parents can improve their ability
concerning personal hygiene, so that the children are independent to perform personal
hygiene as seen and heard from the media and help reduce the burden of parents in taking
care of children with moderate intellectual disability. Parents also have a role in their
children’s behavior in maintaining health, including maintaining oral health (Denis, 2020;
Rosmaya et al., 2019).
The increase of mean before and after the education occurred because oral health
education concerning toothbrushing with modified Makaton method used symbols on how
to brush teeth properly, which is expressed in the form of an interactive video. Interactive
video is a learning medium in the form of a moving story accompanied by sound. This
medium contains knowledge and skills that are packaged simply and attractively.
Therefore, the children are not bored with the content. This was in line with Fajarwati &
Sujarwanto (2010) who indicated a significant effect of interactive video in improving the
ability to read in children with mild-moderate intellectual disability in Gedangan Harmoni
Special School Sidoarjo (Martins et al., 2023; Ribek et al., 2023).
The use of animated video as a learning medium can improve the knowledge on oral
health in intellectual disabilities children. Azhar (2007) stated that animated video could
also fulfill basic skills, instill attitude, and illustrate clear images that can be repeated as
needed for intellectual disabilities children. These children have intellectual barriers, thus
require guidance to be able to accept learning materials. Based on Perwiradananta (2016),
animated video used as a learning medium is a solution to overcome the limitation in
intellectual disabilities children in receiving learning materials. The results of the study
revealed that there was a significant increase of oral health knowledge in intellectual
disabilities children before and after being given learning using animated video (Zhafirah
et al., 2014).
Intellectual disabilities children can only be trained to take care of themselves
concerning daily activities and perform social community functions according to their
ability. One of the examples of important self-care to be taught to children is maintaining
oral health. Therefore, the role of a parent is needed for the oral hygiene of intellectual
disabilities children (8).
The role of parents in educating children includes providing basic education,
behavior, character, and basic skills such as religion, manners, esthetics, affection, sense of
security, and inculcate good habit and discipline. According to Notoatmodjo (2003),
parents are the foundation of children's behavior because they are the main target for public
health promotion. The role of a parent is a form of actions and attitudes given by the parents
to develop the children’s personality. Parents actively participate in caring for children for
optimal growth and development of the children (8,9).
CONCLUSION
There is an effect of parent education program through the dental health education
video for intellectual disabilities children living in wetlands on dental caries prevention.
The content of the materials in the dental health education animated video made by the
authors can be used as counseling media concerning oral health for intellectual disabilities
children living in wetlands. Further studies are needed concerning the overview of oral
health and dental caries of children with mild intellectual disability living in wetlands after
dental health education counseling using the animated video used in this study.
Parent Education Program about Dental Health Education
for Intellectual Disability Children in Wetland
2023
Renie Kumala Dewi, Beta Widya Oktiani, Anugrah Qatrunnada Hakim, Ika Kusuma
Wardani 1052
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