The Effect Of Baby Solus Per Aqua (Baby Spa) To Sensory Skill, Fine Motor Skill And Gross Motor Skill In Children Aged 6-24 Months Di Wawa Holistic Care Mojokerto

Supporting of baby growth must be done in a comprehensive and quality manner that can be done through stimulation activities. Stimulation that is easily given actively to infants can be through tactile stimulation in the form of massages. Massage therapy can be combined with water therapy, which is a baby spa. Baby spas can be used to support the success of sensory skills, fi ne motor skills and gross motor skills.The study was to determine the effectiveness of Baby Spa on sensory skills, fi ne motor skills and gross motor skills in children aged 6-24 months.The design used in this study was a pre-experimental design with a two-group pre-post-test approach. The variables in this study are the baby spa, sensory skills, fi ne motor skills and gross motor skills. Respondents were children aged 6 to 24 months totaling 29 children for the treatment group and 29 children for the control group. The treatment group will be treated eight times (2 times baby spa and six times massage). Previously conducted a pre-test, then after eight treatments carried out a post-test with an observation of sensory skills, fi ne motor skills and gross motor skills data analysis using the Mann-Whitney test.The results of data analysis on the sensory skill ISSN 2354-7642 (Print), ISSN 2503-1856 (Online) Jurnal Ners dan Kebidanan Indonesia Tersedia online pada: http://ejournal.almaata.ac.id/index.php/JNKI INDONESIAN JOURNAL OF NURSING AND MIDWIFERY


INTRODUCTION
Early childhood is a group of children who are in a process of growth and development that is uniquely important to have a pattern of growth and physical development, intelligence, social emotional, language and communication (1).
Supporting of growth and development of infants must be done in a comprehensive and quality manner that can be done through stimulation or stimulation activities. Perform adequate early stimulation means to stimulate the baby's brain so that fi ne motor function, gross motor and sensory function in infants take place optimally according to the child's age. Lack of stimulation provided to infants can cause delays in growth and development (2).
According to the World Health Organization (WHO) explained that 5-25% of preschool-aged children suffer from minor brain dysfunction, including impaired fi ne motor development. In Indonesia the number of babies is 23.7 million, 10.4% of the total population of Indonesia and obtained 16% of children under fi ve years of age (toddlers) Indonesia experience neurological and brain development disorders ranging from mild to severe, impaired gross and fi ne motor development, hearing impairment, lack of intelligence and late speech (3). Based on the data above the importance of providing obtained p-value = 0.962 indicates that the baby spa is less effective against increasing sensory skills, while the fi ne motor skill p-value = 0,000 and gross motor skill obtained p-value = 0,000 means that the baby spa is effective against increasing fi ne motor skills and gross motor skills in children aged 6  affects the gross motor delay in children.In this study the treatment group will be treated 8 times (2 times baby spa and 6 times massage).
Children will be observed according to age and analyzed the effectiveness of baby spason their growthanddevelopment.
The stimulation provided can be given in the form of visual, verbal and tactile stimulation.
Stimulations are easily given actively to infant scan be through tactile stimulation in the formof massages (6). Baby massage is a therapy in the form of touch massage that provides a stimulus to hormones in the body. One substance regulates functions such as appetite, sleep, sensory function, muscle contraction, metabolism and growth and development (7).Massage therapy can be combined with water therapy which is called a baby spa. The baby spa is a body therapy using water as a medium; its activities consist of swimming, bathing and massage. Babies treated with a spa will look fresher, healthier and more vibrant. Other benefits obtained by spas in infants are increasing the gross and fi ne motor movements of the baby, increasing the ability of the fi ve senses, increasing appetite, improving the quality of sleep of the baby and increasing the baby's immunity (8).
One of the benefits of a baby spa is to improve the ability of the fi ve senses including smell, sight, touch, hearing. For this reason, baby spas can be used to support the success of a sensory play. Sensory play is a sensory game or sensory responses of children. If a child can play the sensory game according to his age, the child is said to have successfully carried out a sensory play (9). In addition to the success of the sensory play, baby spas are also useful for enhancing development in children including gross motor skills and fi ne motor skills. Gross motor skill or gross motor ability is the ability to make movements that involve large muscles and form a posture such as raising the head, while fi ne motor skills or fi ne motor skills to make movements smoother and involve the fl exibility of small muscles such as to pick up objects with radius(10).

METHODS AND MATERIALS
The research design used in this study was pre-experimental design with a two-group pre-post design approach. The study population was children aged 6 months to 24 months who came to Wawa Holistic Care Mojokerto in good health from August until November 2019 The accidental sampling technique was 58 children. 29 children in the treatment group and 29 children in the control group. The treatment group will be treated 8 times in 1 month (2 times baby spa and 6 times massage). In this study, the treatment group will be treated 8 times in 1 month, namely 1 week 2 treatments (2 times baby spa in the fi rst week and fi rst treatment in the third week and 6 massages in the second, three, four, six treatment, seven and eight).

RESULTS AND DISCUSSION
Based on table 1 shows that the majority of respondents aged 13-18 months in the control group were 18 respondents (62.1%) while in the experimental group were 17 respondents (58.6%). The sex of the majority of women in the control group was 19 respondents (65.5%) while in the experimental group were 17 respondents (58.6%). Maternal age is more than half the age of healthy reproduction (20-30 years) both the control group and the experimental group.
The age of the mother is more than half the age of 20-30years both the control group and the experimental group.   The development of children in terms of learning, not only comes from genetic factors but also from the stimulus provided by the surrounding environment. When the stimulus enters the child's brain, the nervous system will then process it by producing a sensation that encourages the child's senses to move (stimulusresponse) in accordance with (11). The more stimulus provided, the more children will have a pleasant experience. Certainly, each stimulus will produce a different response, and it is the parents' job to facilitate their children to gain a lot of experience so that the brain's data bank is increasingly diverse.   Source: Primary data groups. Fine motor skills where the child's ability to make movements that involve certain parts of the body and are carried out by small muscles, but require careful coordination, such as observing something, pinch, write, etc. This is in accordance with opinions, (12). The development of fi ne motor skills requires stimulation of the role of parents in order to achieve optimal child development.
Fine motor skills where the child's ability to make movements that involve certain parts of the body and are carried out by small muscles but require careful coordination, such as observing something, pinching, writing, etc. This is in accordance with opinions (12).The In accordance with. The development of children in terms of learning, not only comes from genetic factors but also from the stimulus provided by the surrounding environment. When the stimulus enters the child's brain, the nervous system will then processit by producing a sensation that encourages the child's senses to move (stimulus response). The more stimulus provided, the more children will have a pleasant experience.
Certainly, each stimulus will produce a different response, andit's the parents' job to facilitate their children to gain a lot of experience so that the brain's data bank is increasingly diverse.
Gross motor skills are developments related to the child's ability to make movements and postures involving large muscles, such as sitting, standing, walking, and so on (13). explained when the baby is experiencing rapid brain development certainly affects the gross motor and fine motor because touch stimulation is gradual and continuously stimulates the cerebral cymbals, the part of the brain that acts as the center of muscle movement and balance of the body so that it can optimize development. Based on the results of the mann-Whitney test obtained the probability value of fi ne motot skills (p value) of 0,000 and gross motor skills (p value) of 0,000 that the development of fi ne motor skills and gross motor skills obtained p value <0.005 means that the baby spa is very effective against increasing fi ne development motor skills (p = 0,000) and gross motor skills (p = 0,000).
From the statement, it means that the baby spa is very effective in increasing the development of fi ne motor skills and gross motor skills in children aged 6-24 months, which is conducted twice a week for 1 month.

CONCLUSION AND RECOMMENDATION
Baby spas are very effective for enhancing the development of fi ne motor skills and gross motor skills and gross motor skills. Parental stimulation is also important for optimal child growth and development in an effort to reduce the incidence of stunting in children.
For the development of sensory skills, a combination of baby spa stimulation needs to be combined with other methods to be more effective in improving children's development, and research into sensory skills has not been widely developed in Indonesia.