The effects of the pop-up book "Aku dan Gigiku" on salivary alpha amylase levels in hearing impaired children

Children who have hearing impairments often experience feelings of anxiety because of both their limitations in understanding language through their auditory senses and the barriers of limitations they encounter when communicating. The anxiety experienced by children with hearing impairments becomes an obstacle for them when they receiving dental treatments. This pop-up book is a form of three-dimensional interactive literature that allows children to become involved in the story. The book has grown into a genre that delights and educates children of all ages. The aim of this study is to assess and compare the anxiety levels of hearing impaired children who were educated by using the pop-up book "Aku dan Gigiku" before receiving dental treatments to the levels of children who were not educated with the book before receiving dental treatments. The assessment and comparison were done by measuring the children's salivary alpha amylase (SAA) levels. The SAA levels were measured in 42 seven-to-nine-year-old children who had hearing impairments. The children were divided into two groups: the intervention group, which used the pop-up book "Aku dan Gigiku," and the control group, which did not. This study used the experimental design for clinical research. The Mann-Whitney U test was used to compare measurements of any decreases in SAA levels between the two groups. Statistical comparison of how much the SAA levels changed indicated significant differences between the intervention group that used pop-up book "Aku dan Gigiku" and the control group, p = 0.001 (p < 0.05). Analysis of the changes in the SAA levels showed that the pop-up book was effective in reducing anxiety among hearing impaired children.