Face and Content Validity of a Handwriting Program for Children With Handwriting Difficulties

@#Introduction: Occupational therapists have been developing various handwriting intervention that has fundamental occupational goals with known validity to guide professional practice in the treatment of children with handwriting difficulties. This study aimed to explore the development and content validation of a developed handwriting intervention programme for children with handwriting difficulties. Methods: This study employed a combination of qualitative and quantitative methodology based on the sequential exploratory design in two main stages. The first stage is the focus group discussion and followed by a validation procedure using face and content validity scored by the expert reviewers. A total of thirteen experts participated in this study. Results: The findings were analyzed thematically according to physical appearance, language used, and content in the developed programme. The face and content validity report a convincing value, ranging from 0.99 to 1.00 of S-CVI values on four aspects, relevancy, clarity, simplicity, and ambiguity in the developed programme. Conclusion: This study provided preliminary approval for the development and validation of a handwriting intervention programme for children with handwriting difficulties to support the demand in the Malaysian school curriculum.

Adherence to the Ayres Sensory Integration® Fidelity Measures: Malaysian Occupational Therapists’ Practices

@#Introduction: A popular intervention for paediatric clients, Ayres Sensory Integration® (ASI) must adhere to sensory integration (SI) fidelity. This study describes fidelity adherence in ASI intervention by occupational therapy practitioners in Malaysia. Methods: A questionnaire on ASI fidelity was developed before being tested for its validity by seven experts and for its internal consistency and test-retest reliability by 30 occupational therapists. The questionnaire was then used nationally to collect data on ASI practitioners. Data were collected from 161 occupational therapists working in various settings. Results: The mean of the sub-scales I-CVI was excellent, ranging between 0.97 and 1.00. The total S-CVI/Ave of the form was also reported as excellent, at 0.98, with subscales S-CVI ranging between 0.75 and 1.00. Cronbach’s alpha was 0.80 for the questionnaire’s internal consistency and the ICC for test-retest reliability ranged from 0.80 to 0.95. The survey received 161 responses, indicating that most respondents perceived themselves as having ‘moderate competence’ and showing ‘high interest’ in ASI implementation. Most fidelity aspects were addressed in their practices. Majority of the respondents adhered to the process elements. It was indicated that three aspects of physical space under the structural elements could not be provided by most occupational therapists in the study. Conclusion: To implement evidence-based practice, adherence to fidelity when providing ASI is important to ascertain its effectiveness. Improvements to ensure optimal space, ASI certification, and more related training are the first steps that can be taken by the related agencies to ensure effective ASI intervention could be delivered.

Ayres Sensory Integration ® Implementation in Malaysian Occupational Therapists: Challenges and Limitations (Perlaksanaan Ayres Sensory Integration ® Terhadap Terapis Carakerja di Malaysia: Cabaran dan Limitasi) / Jurnal Sains Kesihatan Malaysia

@#One of the most popular interventions provided by occupational therapists for pediatric clients is Ayres Sensory Integration® (ASI). Strict fidelity measures consisting of procedural and structural elements must be adhered to when using it. These fidelity measures distinguish Ayres Sensory Integration® from other sensory-based interventions. This study involved the development of a survey instrument and outlined the challenges that Malaysian occupational therapists face when using Ayres sensory integration® (ASI). The questionnaire development involved the processes of assessing its validity and reliability. A total of 161 occupational therapists working in various healthcare settings responded to the survey by answering a self-administered questionnaire. The results identified eight themes or issues: (1) Inadequate Training, (2) Resource Issues, (3) Physical Constraints, (4) Time Constraints, (5) Limited Information/ Support Provided By Family, (6) Limited Support From Management, (7) Limited Information/Support Provided By Suppliers, and (8) Issues in Implementing Evidence-Based Practice. Identifying the challenges of implementing ASI is an important aspect of improving occupational therapy assessments and interventions, which would establish the effectiveness of the interventions provided.

The Effectiveness of Occupational Therapy Handwriting Intervention for Children with Motor Coordination Issues: A Systematic Review (Keberkesanan Terapi Cara Kerja Bagi Intervensi Tulisan Tangan Terhadap Kanak-kanak Dengan Masalah Koordinasi Motor: Tinjauan Literatur Sistematik) / Jurnal Sains Kesihatan Malaysia

@#Handwriting difficulty is one of the main issues among school children, especially for those with motor coordination issues. The aim of this systematic review is to evaluate the effectiveness of occupational therapy interventions in handwriting components for children with motor coordination issues. Current research articles were systematically searched according to the PRISMA guidelines. Two hundred and sixty-eight (n=268) research articles were identified; however, only ten (n=10) were eligible to be evaluated for this study. Studies were appraised by using McMaster Critical Review Form-Quantitative Studies. Descriptive synthesis was executed due to the heterogeneity of included studies. The review found various types of intervention conducted by occupational therapists to have a positive effect on handwriting performance components among children with motor coordination issues. Types of intervention used were visual, motor, perceptual, sensory, activity of daily living skills, training device and assistive technology and specific handwriting programs. Most handwriting intervention showed effectiveness to improve handwriting performance in motor function, visual and perceptual components. Future research should focus on homogeneity of Occupational Therapy (OT) intervention to improve handwriting performance by using specific handwriting programmes and similar standardised evaluation instruments. Practitioners of OT intervention should consider collaboration with teachers, parents and other health professionals to expedite effectiveness of intervention in handwriting performance components.

Video Modelling to Improve Hand Dexterity in Students with Learning Disabilities: Special Education Teachers' Perspectives (Permodelan Video Bagi Meningkatkan Kecekatan Tangan Murid Dengan Masalah Pembelajaran: Persepsi Guru Pendidikan Khas) / Jurnal Sains Kesihatan Malaysia

@#Proficient hand dexterity (HD) may help students with learning disabilities (LDs) perform various hand tasks efficiently. Video modelling (VM) is a strategy that uses a model to improve desired skills. However, the limited study focuses on VM to improve HD among students with LDs. Therefore, this study explores VM implementation in the learning and teaching process to improve the HD of students with LDs. Five Special Education (SE) teachers who taught the Hand Manipulative Component lessons in two different states were purposefully selected and invited to participate in this study. A one-toone interview was conducted with individual SE teachers. The interview sessions were audio-recorded and transcribed verbatim, and the data was analysed through thematic analysis. Rigorous approaches were performed to ensure the findings' trustworthiness, such as triangulation, member checking, and an audit trail. Four key themes emerged: conventional learning and teaching methods, challenges faced by students with LDs in improving HD, and the advantages of implementing VM in learning and teaching to improve HD and develop a video module. This study suggests SE teachers can implement VM in their learning and teaching processes to improve the HD performance of students with LDs. This current study concludes that VM can be a supportive strategy in the teaching process to improve HD performance among students with LDs.

Self-Care Skills between Institutionalised and Home Dwelling Older Adults: A Preliminary Study Kajian Rintis Kemahiran Penjagaan Diri Warga Tua di antara institusi dan rumah kediaman / Jurnal Sains Kesihatan Malaysia

@#Self-care is defined as activities performed by individuals, families, and communities to enhance their health, prevent diseases, limit illnesses, and restore health. Previous research has mainly focused on self-care skills of older adults in either institution or residential homes separately but limited studies have compared between both these settings. This study aimed to compare the self-care skills between institutionalised and home dwelling older adults at selected area in Malaysia. A total of 43 participants aged 60 years old and above were recruited in our study; (23 participants were home-dwelled older adults and 19 participants were recruited from institutionalised older adults located in Kuala Lumpur). The Malay Version of Performance Assessment of Self-Care Skills (M-PASS-HOME) 4.0 was used focusing on four main subtests of self-skills; oral hygiene, trimming toenails, house mobility and shower mobility. The differences in self-care skills between institutionalised and home dwelling older adults are statistically significant (p<0.01) in the aspects of independency for all self-care activities. The results of this study revealed that home dwelling older adults group are more independent in self-care activities of oral hygiene, trimming toenails, house mobility and shower mobility compared to institutionalised group.

Cultural Adaptation and Validation of the Performance Assessment of Self-care Skills among Older People in Community (Adaptasi Budaya dan Kesahan Penilaian Prestasi Kemahiran Penjagaan Diri dalam Kalangan Warga Emas di Komuniti) / Jurnal Sains Kesihatan Malaysia

@#The Performance Assessment of Self-care Skills (PASS-Home) is a client-centered, performance-based, criterionreference, observational form designed to capture client’s performance skills in completing daily task activities. The aim of the study was to describe the process of translating, adapting and validating the PASS-Home from English language version into a Malay language version. The development of the translated Malay version of the PASS-Home consisted of two stages. Stage one involved the exclusion of the items that were not culturally relevant to the Malaysian culture. Stage two involved the translation process. The five steps of the cross-cultural adaptation process were followed: (1) initial forward version; (2) a summary of recommendations by the expert panels; (3) the back-translation; (4) modifications of the translated Malay version of PASS and a summary of problems found during the pre-testing, and (5) the final version of the PASS Malay Version (M-PASS). A total of five items from the PASS-Home were omitted in the Malay version (M-PASS) and another five items that were considered as suitable in Malaysian context were added in the M-PASS. The Content Validation Index (CVI) showed perfect agreement with an average of I-CVI was reported at 0.99 and S-CVI/universal agreement (S-CVI/UA) was at 0.93. Test-retest reliabilty showed that the M-PASS were highly reliable reported of its three main constructs of Independence (ICC=0.706), Safety (ICC=0.906) and Adequacy (ICC=0.950). M-PASS showed strong evidence as a valid and reliable assessment in evaluating the functional level of older people who live independently in community.

An Assessment of the Movement and Function of Children with Specific Learning Disabilities: A Review of Five Standardised Assessment Tools

@#ract Various standardised assessment tools have been used to evaluate children with disabilities. However, assessment tools that provide information on the movement and function of children with specific learning disabilities (SLD) are still limited. This article provides a narrative review of the characteristics of five movement and/or function assessment tools. The strengths and limitations of the tools will be highlighted. Empirical studies on the assessment tools used are reviewed based on three criteria: (i) standardised tools; (ii) assessment of movement and/or function; (iii) applicability to children with SLD ranging from 4–17 years of age and widely used in practice. The following instruments have been included as they have been found to fulfil the criteria: (i) the Bruininks-Oseretsky test of motor proficiency-2 (BOT-2); (ii) the movement assessment battery for children-2 (MABC-2); (iii) the pediatric balance scale (PBS); (iv) the Vineland adaptive behaviour scale-II (VABS-II) and (v) the pediatric evaluation of disability inventory-computerised adaptive test (PEDI-CAT). The article presents the characteristics, strengths and limitations of five standardised assessment tools that are currently in use, which measure the movement and/or function of children with SLD. This article concludes with a discussion of recommendations for the best approaches to evaluating the movement and functional abilities of children with SLD.

Development and Validation of a Personal Care Modules for Older Adults with More Significant Disabilities Pembangunan dan Kesahan Modul Penjagaan Peribadi Warga Tua yang Mempunyai Pelbagai Ketidakupayaan / Jurnal Sains Kesihatan Malaysia

@#Older adults residing in community, as well as those who are residing in institutional or care home may experience various cognitive, health and physical impairments that may affect their independence. Continuous supports are needed to manage most of their personal care activities which are usually managed by their family members, often without proper training or guidance. To date, there is no personal care module that can be used as a guideline by family members and paid caretakers. Therefore, this study aims to develop and validate a personal care module as a guideline in assisting older adults with more significant disabilities. This study was a three-phase study, involving (1) development of the personal care module, (2) focus group discussion with healthcare experts and (3) face and content validity by the expert reviewers. A total of 10 older adults participated in semi structured interview in phase one and 13 occupational therapists were involved as experts in evaluating the module in phase two and three, having between 5 to 25 years of working experiences. The finding reported a high content validity in the developed module ranging from 0.88 to 1.00 on six domains of personal hygiene, bathing, dressing, feeding, bed mobility and stairs climbing. This study provides a preliminary support for the developed personal care module as a valid instrument to be used as a guideline in managing personal care activities of older adults with more significant disabilities.

Adaptation, Validation and Reliability Testing of Sensory Processing Measure Home Form Malay version for Children with Autism (Adaptasi, Kesahan dan Kebolehpercayaan Borang Sensory Processing Measure Home Form versi Bahasa Melayu untuk Digunakan terhadap Kanak-kanak dengan Autisme) / Jurnal Sains Kesihatan Malaysia

@#Inappropriate responses towards sensory input received from the environment, also known as sensory processing difficulties (SPD) may affect daily living activities of the children with Autism Spectrum Disorder (ASD). Sensory Processing Measure Home Form (SPM Home Form) as a parent report measure for SPD is available in English and other foreign languages. To enhance the applicability and meaningfulness of SPM Home Form for the Malay speaking population, a study that focuses on translating, adapting, and validating the SPM Home Form into the Malay language was conducted. The development of the Malay version of the SPM Home Form (SPM-MV Home Form) involved three steps: 1) Item evaluation, 2) Forward and backward translation, and 3) Expert review and content validity. The process of translation and adaptation of the form was performed according to standard guidelines. No item was excluded from the original SPM Home Form as all the items were considered by the expert panel as appropriate and relevance to evaluate the activity and social participation among children in Malaysia. Content validity as measured by 10 experts in occupational therapy is high. The mean of sub-scales I-CVI is between 0.96 and 1.00. The total S-CVI of the form is 0.95 with sub-scales S-CVI range between 0.82 and 1.00. Cronbach’s alpha for internal consistency was reported at 0.80 and ICC for test-retest reliability ranged from 0.80 to 0.97. The SPM-MV Home Form has high potential to be used for assessing SPD among children ages 5-12 years in Malaysia.

Motor performance and functional mobility in children with specific learning disabilities

@#Limitations in motor performances among children with specific learning disabilities (SLD) can lead to impaired functional skills. Thus, this study aimed to determine the level of motor performances and functional mobility, and the influence of motor performances on the functional mobility in children with SLD.

Review on the Effect of Occupational Therapy Intervention in Improving Handwriting Skills among Preschool Children / Jurnal Sains Kesihatan Malaysia

@#The development of writing ability is not only important in building a child’s self-esteem, but also essential for academic success in school. Handwriting is an important skill that could affect students’ performance in most academic areas. This study aimed to review the effect of occupational therapy intervention in improving handwriting skills among preschool children. Relevant studies were systematically searched by using standardized keywords across three databases. The initial search identified 1,386 references. Of these studies, there were five quantitative studies that met the inclusion criteria and were methodologically appraised using the McMaster Critical Review Form–Quantitative Studies. All studies reported that preschool children with or without disabilities showed significant improvements in handwriting skills after receiving occupational therapy intervention. One study involved collaboration between teachers and occupational therapists in implementing intervention program to preschool students. Collaboration between teachers and occupational therapists was able to provide teachers with tools and skills that they can use to help students, with or without direct presence of occupational therapists. Overall, findings of this review indicated that preschool children could gain improvement in handwriting skills regardless of their conditions after receiving occupational therapy intervention programs.

Malaysian Parents’ Feedback On Three Proxy-Rated Assessments Used In Pediatric Rehabilitation

@#Assessing a child’s functional abilities and limitations can provide useful information for occupational therapists to develop individualised intervention plans. Usually paediatric assessments require parents to rate their child on different domains of health and functional performance. To do so, parents need to be able to understand the assessment content and instructions to rate their child accurately. The primary purpose of this study was to examine if parents in Malaysia understood the content and instructions of three assessments: the Sensory Profile Caregiver Questionnaire (SP), the Sensory Processing Measure Home Form (SPM) and the Behaviour Rating Inventory of Executive Function Parent Form (BRIEF). The secondary purpose was to examine perceptions about the clarity and relevancy of each of the items in each assessment. Thirty parents, recruited using convenience sampling, completed a survey about the assessments. In general, the parents indicated no problems or only minor problems in understanding the content and instructions of all three assessments. The parents also provided comments to improve the clarity of the assessment items. Comments were primarily related to the terms or jargon language used. Elaborations of the terms or jargon were later provided based on the parents’ comments. All three assessments were identified as relevant to be used in the Malaysian population. The results suggest that all three assessments can be used by parents and are suitable to be implemented by occupational therapists working with children in Malaysia.

Reframing Services for Malaysian Students in Schools: Time to Bring Occupational Therapy into the Classroom / Jurnal Sains Kesihatan Malaysia

Autism spectrum disorder is a developmental disability that has gained increasing attention in Malaysia. Much effort is now being taken to include children with autism spectrum disorder in the school system, either in inclusive settings or in special educational settings. However, this endeavor raises many challenges for the children with autism spectrum disorder, their families and for service providers. The current study uses a qualitative approach to investigate parents’ perceptions of problems faced by their children with autism spectrum disorder in issues related to academic skills. A face-to-face interview was performed with parents of children with autism spectrum disorders who were receiving occupational therapy services for their difficulties in academic related skills. Findings indicate that most of the difficulties faced by these children are related to skills needed to be accepted at school, such as ability to communicate and socialize and this often limit their performance at school. These findings not only raise and discuss important implications for service providers such as teachers, health care professionals and policy makers, but also lead to suggestions for future research.

The Reliability of Functional Mobility Assessment Tools Among the Elderly in Malaysia / Jurnal Sains Kesihatan Malaysia

Functional mobility among the older population is an important element for a meaningful quality of life. The implementation of functional mobility assessments among the older people is vital to ensure appropriate steps can be taken in order to detect changes in functional mobility. There are varieties of functional mobility assessments available however most of the reliability test are based on Western countries. Therefore this study was to determine the reliability of three types of functional mobility status assessment of physical activity, especially among the older person. Sixty older respondents with the average age of 76.32 years and standard deviation of 8.66 participated in this study performed three types of functional assessments; Six-Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Sit-to-Stand Test (STS). Two measurements were carried out with a week gap from the first measurement. Intraclass Correlation (ICC), Limits of Agreement (LOA) and Standard Error of Measurement (SEM) statistical tests followed by the combination of the three statistical analysis measurements were used for data analysis. The results showed all functional measurement tools using ICC, LOA, SEM and combination of three types analysis were highy reliable. The ICC value was exceeded 0.90 (ICC=0.94-0.99). The LOA graph for all activity measurement tools showed some degree of reliability while the SEM percentage recorded a value of less than 10% (SEM%=0.95%-9.95%). In conclusion, all three functional measurement tools are highly reliable and can be used as one of the functional test among the older people in Malaysia.