ABSTRACT
@#Speech and language skills are among the crucial components in determining cochlear implant habilitation outcomes. The purpose of this study was to investigate speech and language skills of Malay cochlear implant children using a developmental scale questionnaire and to identify the demographic factors that contribute to their performance. This study involved 26 children recruited from the National Cochlear Implant Program under the Malaysian Ministry of Health with chronological ages between 33 to 99 months (mean=72, SD=18.9), implant ages between 18 to 71 months (mean=40, SD=13.5) and hearing ages between 13 to 48 months (mean=30, SD=10.5). The instrument used was The Integrated Scale of Development-Malay version 2 (ISD-Mv2). The questionnaires were given to the parents or caregivers followed with by a phone call interview later. Results from the study showed that only 9 subjects (35%) were able score on the ISD-Mv2 equally or higher than their hearing age. From the six components in the ISD-Mv2, cognitive was scored the highest with 96.79% meanwhile expressive language was the lowest with 76.21%. Pearson correlation test revealed strong positive correlation between audition-receptive language (r=0.554, p<0.05) and cognitive–social communication/ pragmatic (r= 0.625, p<0.05). Speech and language performance of children with demographic factors did not show significant differences. The findings suggests that majority of the Malay cochlear implant children demonstrated delayed speech and language performance as compared to normal hearing children.
ABSTRACT
@#Background & Objectives: The National Institute of Health Stroke Scale (NIHSS) provides a valid and quick assessment of stroke severity in hyperacute stroke management. Stroke patients who are eligible for reperfusion therapy require prompt assessment. There is no validated Bahasa Malaysia (BM) version of the NIHSS that allows easier assessment by BM-speaking health professionals. This study aimed to translate and validate a BM version of the NIHSS. Methods: The English NIHSS was translated to BM, then back translated to ensure linguistic accuracy. We also adapted the language assessment of the NIHSS to be more culturally appropriate. Training and certification videos were downloaded from the NIH website and dubbed into BM. We determined intra-class correlation and unweighted kappa as the best measure of reliability. Median scores were used in the analysis for language items. Results: One hundred and one raters participated in the test-retest reliability study. Agreement between the original NIHSS and our translated version of the BM-NIHSS was good (ICC = 0.738, 95% CI: 0.611 to 0.823). Fair to moderate agreement was found on item-by-item analysis (unweighted κ=0.20-0.50) despite high observed agreement. Fifty patients participated in the language assessment arm. Scores were better in BM for reading, naming objects and repetition (Mdn = 100, p < 0.001). There was no difference in the median scores for the description component. Conclusions: The BM-NIHSS is a valid translation of the NIHSS, and may be used in clinical practice by BM-speaking healthcare professionals.
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@#The paper describes the validation of the Malay Preschool Language Assessment Tool (MPLAT), a standardized normed referenced language assessment tool for Malay preschoolers within the ages of 4;0-6;11 and whose native language is Malay. The MPLAT (A Razak et al. 2010) is an assessment tool which is designed to assess the areas of receptive language, expressive language and early literacy skills. The MPLAT contains six subtests i.e. picture vocabulary, grammatical understanding, sentence repetition, referential meaning, relational meaning and early literacy skills. This paper is divided into 2 studies. Study 1 tested the psychometric properties and normative data of the diagnostic version of MPLAT on 300 participants recruited from preschools in the rural area of Gua Musang and the urban area of Kota Bahru located in the East Coast state of Kelantan. The construct validity is high with a strong correlation (r = 0.942) between test scores and age, validating the developmental nature of the test. There was also moderate to strong positive correlation between each subtest and the test total, as well as between subtests. It also has high test-retest reliability (r = 0.998 (p < 0.01) and inter-rater reliability (rho = 1.000). The second study looked at the psychometrics properties of the MPLAT short version (screening) compared to the full version diagnostic. The short version of MPLAT is about a quarter of the full (diagnostic) version. About 108 subjects in the urban area of the the Klang Valley, consisting of Kuala Lumpur and Selangor, were administered both versions of the MPLAT. The Pearson correlation revealed a strong positive correlation between the total scores and age (r = 0.718, p<.01), and strong positive correlation for the test-retest reliability (r = 0.881, n=12) for the short MPLAT version. For the full version, the Spearman correlation revealed a strong positive correlation between total scores and age (r = 0.791, p<.01) and a very strong positive Pearson correlation for test-retest reliability (r = 0.943). Cronbach's Alpha values demonstrated the internal consistency of the full version (0.972) and short version (0.929). In summary, both versions of the MPLAT were found to be valid tools to screen and diagnose language problems among Malay preschool children in Malaysia. MPLAT also has the potential to be a useful research tool to delineate language development of the preschool Malay children.
ABSTRACT
Applied Behavior Analysis (ABA) is a technique used to teach children with autisme a variety of skills. In ABA, children with autisme often do not receive reinforcers because they have difficulty performing their targeted behaviors, which consequently leads to challenging behaviors. Objectives of this study are to increase spontaneous request and decrease challenging behavior among children with autisme by introducing a secondary reinforcer during therapy based on ABA model. Secondary reinforcer has lower reinforcing value than the primary reinforcer. When the children tried but were unable to produce their targeted behavior, they were given the secondary reinforcer. The children were divided into two groups, five children in the intervention group and four children in the control group, and they were taught specific target requesting behavior (TRB) to request for a preferred item. Three children in the intervention group recorded an increase in spontaneous request and a reduction in challenging behaviors. Only two children from the control group recorded an increase in spontaneous request and a decrease in challenging behaviors. However, only children from the intervention group were able to maintain their performance during the generalization sessions. The results suggest that children respond differently to specific prompts and interventions. Future studies should focus on how prompts affect children’s performance and also on reinforcer selection. Bigger scale studies are still needed to further determine the effectiveness of a secondary reinforcer in assisting the learning of requesting skill and in reducing challenging behaviors among children with autisme during therapy based on ABA model.
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Introduction: Little is known about the treatment outcomes of children with cleft lip and/or palate (CLP) receiving surgical care for primary lip and palate closure in Malaysia. Objectives: This study examined the speech and hearing status of Malay-speaking children with CLP residing in Kuala Lumpur. Methods: Parents whose children were between the age of 5 and 7 years were recruited via the Cleft Lip and Palate Association of Malaysia (CLAPAM) registry. Parents completed a survey and the children completed a speech and hearing assessment at the Audiology and Speech Sciences Clinic, Universiti Kebangsaan Malaysia. Outcomes: Speech measures include nasality rating, nasalance scores, articulation errors and speech intelligibility rating, while hearing measures include hearing thresholds and tympanometry results for each child. Results: Out of 118 registered members who fulfilled the inclusion criteria, 21 agreed to participate in the study. The overall speech and hearing status of children in this sample were poor. Only four (19%) participants had normal speech intelligibility rating and normal hearing bilaterally. In terms of overall cleft management, only four (19%) participants were seen by a cleft team while seven (33%) had never had their hearing tested prior to this study. Conclusion: Participants in this sample had poor outcomes in speech and hearing and received uncoordinated and fragmented cleft care. This finding calls for further large scale research and collaborative efforts into improving and providing centralised, multidisciplinary care for children born with CLP.