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  1. Naufal, N., Narayanasamy S., Ahmad, M., Hairol, M.I., Sharanjeet K., Kadar, M., et al.
    Medicine & Health, 2020;15(1):225-236.
    MyJurnal
    Penilaian status visual kanak-kanak prasekolah adalah penting kerana ia adalah salah satu faktor yang menentukan ketersediaan mereka untuk bersekolah. Walau bagaimanapun, tidak semua kanak-kanak prasekolah mendapat peluang untuk mengikuti program saringan penglihatan. Dalam kajian ini, akuiti visual jauh dan dekat serta tahap stereoakuiti diukur di kalangan kanak-kanak berumur enam tahun (n=385). Parameter tersebut kemudiannya dibandingkan di antara kanak-kanak prasekolah swasta bandar dan prasekolah KEMAS daripada keluarga berpendapatan rendah di luar bandar. Tujuh peratus kanak-kanak prasekolah KEMAS adalah gagal dalam ujian saringan penglihatan jauh berbanding dengan 6% kanak-kanak prasekolah swasta. Untuk ujian penglihatan dekat, kadar kegagalan adalah masing-masing 8.7% dan 4.9% bagi kanak-kanak prasekolah swasta dan KEMAS masing-masing. Untuk ujian stereoakuiti, seramai 3.3% kanak-kanak prasekolah swasta dan 2.5% kanak-kanak prasekolah KEMAS dikategorikan sebagai lemah stereopsis. Semua perbezaan tersebut adalah tidak signifikan secara statistik (semua p>0.05). Peratusan kanak-kanak yang gagal ujian saringan penglihatan adalah serupa untuk kedua-dua jenis prasekolah. Oleh itu, program saringan penglihatan perlu dijalankan di semua jenis prasekolah untuk memastikan sebarang masalah penglihatan dapat dikesan, didiagnos, dirawat dan dicegah.


  2. Ooi HK, Chai SC, Kadar M
    Clin Rehabil, 2020 Apr;34(4):515-523.
    PMID: 32037862 DOI: 10.1177/0269215520905050
    OBJECTIVE: To investigate the effects of pressure (Lycra) garment on the spasticity and function of the arm in the early stages after stroke.

    DESIGN: A randomized controlled trial.

    SETTING: Occupational therapy unit of a public hospital.

    SUBJECTS: A total of 46 adults with stroke.

    INTERVENTION: After random assignment, for six weeks, both intervention group and control group received a 2 hour/week conventional occupational therapy program, with the intervention group receiving an extra 6 hour/day pressure garment application (long glove).

    MAIN MEASURES: Modified Modified Ashworth Scale, Disabilities of Arm, Shoulder and Hand Outcome Measure, and Jebsen-Taylor Hand Function Test. Eligibility measures: Mini Mental State Examination and Modified Modified Ashworth Scale. Assessments were performed at baseline and six weeks postintervention.

    RESULTS: There were 21 participants with the mean age of 51.19 (8.28) years in the intervention group and 22 participants with the mean (SD) age of 52.82 (8.71) years in the control group. The intervention group had median (interquartile range (IQR)) post-stroke duration of 1 (1) month, while for the control group, they were 2 (2) months. There was no difference in spasticity, and both perceived and actual arm functions between the groups at six weeks after baseline.

    CONCLUSION: Wearing a pressure garment on the arm for 6 hours daily had no effect in controlling spasticity or on improving arm function in the early stages after stroke.

  3. Baharudin NS, Harun D, Kadar M
    Malays J Med Sci, 2020 Mar;27(2):21-36.
    PMID: 32788838 MyJurnal DOI: 10.21315/mjms2020.27.2.3
    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.
  4. Abd Aziz N, Kadar M, Harun D, Mohd Rasdi HF
    Occup Ther Health Care, 2021 Apr;35(2):227-244.
    PMID: 33511894 DOI: 10.1080/07380577.2021.1876967
    This scoping review explores the implementation of video modeling (VM) by occupational therapists during the intervention process for children and adolescents with special needs. Four primary electronic databases were used to conduct the scoping review: PubMed, Scopus, CINAHL, and Proquest (Nursing and Allied Health). Research methodologies by Arksey and O'Malley were used as a framework to perform the review process. From the review, two themes emerged: (1) implementing VM by occupational therapists during the intervention process can successfully improve a client's desired skills; (2) VM can be applied through several types of technologies. The findings support occupational therapists' use of VM during interventions to positively enhance and promote desired skills among children and adolescents with special needs. Also, it can be incorporated into technological devices to suit a client's specific needs.
  5. Chai SC, Teoh RF, Razaob NA, Kadar M
    Hong Kong J Occup Ther, 2017 Dec;30(1):42-48.
    PMID: 30186079 DOI: 10.1016/j.hkjot.2017.05.002
    Objective/Background: Occupational therapy that focuses on servicing clients demands motivated workers for quality service delivery. The objectives of this study were: (a) to determine the level of work motivation among occupational therapy graduates in Malaysia and (b) to determine if there is a difference in work motivation among these graduates based on work sector, job position, length of work experience, and gender.

    Methods: This cross-sectional study recruited occupational therapy bachelor's degree graduates using an online survey. The Work Extrinsic and Intrinsic Motivation Scale (WEIMS) was used to measure level of work motivation.

    Results: Responses from 82 (60.3%) graduates (male: 26.8%; female: 73.2%) were analysed. Sixty-two (75.6%) graduates worked locally and 20 (24.4%) worked in foreign countries. The average Work Self-Determination Index (W-SDI) score for WEIMS is +11.38 with 78 (95.1%) of graduates demonstrated a self-determined motivational profile and 4 (4.9%) demonstrated a nonself-determined profile. Graduates in the private sector (13.10 ± 6.47) show significantly higher W-SDI score compared to those in the public sector (9.40 ± 6.06), p = 0.01. W-SDI scores appeared higher among clinician (11.67 ± 6.40), case manager (13.33), and others (14.90 ± 8.23); and those with work experience of 5-6 years (13.11 ± 6.90) and less than one year (12.65 ± 7.12). Male (10.29 ± 6.86) and female (11.79 ± 6.39) graduates shared equally high score. There is no significant difference in W-SDI score based on job position, length of work experience, and gender.

    Conclusion: Occupational therapy graduates have high work motivation as evident by their self-determined profile. Only work sector imposes difference in work motivation among these graduates. Copyright © 2017, Hong Kong Occupational Therapy Association. Published by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

  6. Kadar M, Ibrahim S, Razaob NA, Chai SC, Harun D
    Aust Occup Ther J, 2018 02;65(1):63-68.
    PMID: 29315609 DOI: 10.1111/1440-1630.12441
    BACKGROUND/AIM: The Lawton Instrumental Activities of Daily Living Scale is a tool often used to assess independence among elderly at home. Its suitability to be used with the elderly population in Malaysia has not been validated. This current study aimed to assess the validity and reliability of the Lawton Instrumental Activities of Daily Living Scale - Malay Version to Malay speaking elderly in Malaysia.

    METHODS: This study was divided into three phases: (1) translation and linguistic validity involving both forward and backward translations; (2) establishment of face validity and content validity; and (3) establishment of reliability involving inter-rater, test-retest and internal consistency analyses. Data used for these analyses were obtained by interviewing 65 elderly respondents.

    RESULTS: Percentages of Content Validity Index for 4 criteria were from 88.89 to 100.0. The Cronbach α coefficient for internal consistency was 0.838. Intra-class Correlation Coefficient of inter-rater reliability and test-retest reliability was 0.957 and 0.950 respectively.

    CONCLUSIONS: The result shows that the Lawton Instrumental Activities of Daily Living Scale - Malay Version has excellent reliability and validity for use with the Malay speaking elderly people in Malaysia. This scale could be used by professionals to assess functional ability of elderly who live independently in community.

  7. Alias NA, Kadar M, Wan Yunus F, Cremin K
    Malays J Med Sci, 2024 Aug;31(4):78-90.
    PMID: 39247118 DOI: 10.21315/mjms2024.31.4.6
    Difficulties with self-care skills are frequently observed in children with developmental delays. Given the scarcity of robust evidence backing self-care interventions for this group, this scoping review is designed to aggregate existing literature on the implementation of such interventions. Therefore, this scoping review aims to collate literature on the nature of self-care intervention implementation to increase understanding of the current practice and inform future research directions. This scoping review endeavoured to explore the body of literature concerning the existence of self-care interventions and their implementation strategies in children who have developmental delays. Relevant studies were identified by searching through the following databases: Web of Science (W0S), Scopus, ASEAN Citation Index (ACI), CINAHL EBSCO and PubMed. Six types of interventions using various approaches were identified. Occupational therapists mainly manage intervention providers with multidisciplinary co-facilitator and parents' involvement. Whilst session information varied, some evidence suggests that at least 30 min per session, minimum once per week up to twice per week, ranging from 10 to 23 sessions, may be sufficient. Intervention plans should be tailored to each child's unique needs, taking into account the variety of available interventions. Collaboration among occupational therapists, parents, educators and health professionals in home programmes enhances self-care intervention outcomes. These results are set to inform future research and practice, paving the way for enhanced support and improved outcomes for children with developmental delays.
  8. Suhaili I, Harun D, Kadar M, Hanif Farhan MR, Nur Sakinah B, Evelyn Jong TH
    Med J Malaysia, 2019 02;74(1):34-39.
    PMID: 30846660
    INTRODUCTION: 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.

    METHODS: A cross-sectional study was conducted among 148 children with SLD and their caregivers. The evaluation consisted of the Movement Assessment Battery for Children-2 (MABC-2) and the Functional Mobility domain from Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT). The level of motor performances and functional mobility were determined. A linear regression was then conducted to assess the influence of motor performances that could be accounted for functional mobility scores.

    RESULTS: More than half of the children with SLD showed motor performance difficulty in manual dexterity subscale (54.7%). For functional mobility, the mean standard T-score indicated an average level of capability (49.49±15.96). A regression analysis revealed that both manual dexterity and balance were significant predictors for functional mobility. According to the regression coefficients, manual dexterity (B=1.37, β=0.303, sr2=0.077) was found to be a stronger predictor compared to balance (B=0.85, β=0.178, sr2=0.028).

    CONCLUSION: Manual dexterity was found to influence functional mobility among children with SLD. Therefore, fine motor skills intervention for children with SLD should emphasize on manual dexterity training. Future studies that involve dual tasks and inclusion of typical children would give useful additional information on motor performances issues in children with SLD.

  9. Hairol MI, Nordin N, P'ng J, Sharanjeet-Kaur S, Narayanasamy S, Mohd-Ali M, et al.
    PLoS One, 2021;16(3):e0246846.
    PMID: 33657109 DOI: 10.1371/journal.pone.0246846
    Visual-motor integration (VMI) is related to children's academic performance and school readiness. VMI scores measured using the Beery-Bucktenicka Developmental Test of Visual-Motor Integration (Beery-VMI) can differ due to differences in cultural and socioeconomic backgrounds. This study compared the VMI scores of Malaysian preschoolers with the corresponding US norms and determined the association between their VMI scores and socioeconomic factors. A cross-sectional study was conducted among 435 preschoolers (mean age: 5.95±0.47 years; age range: 5.08-6.83 years) from randomly selected public and private preschools. VMI scores were measured using Beery-VMI in the preschools' classrooms. Information on the socioeconomic characteristics of the preschoolers was obtained using a parent-report questionnaire. One sample t-test was used to compare their VMI scores with the corresponding US norms. Multivariate logistic regression models were used to explore the influence of socioeconomic factors on the preschoolers' VMI scores. Overall, Malaysian preschoolers' VMI performance was similar to the US standardized norms (p>0.05). Children from low-income families were twice likely to obtain lower than average VMI scores than those from higher-income families (OR = 2.47, 95%CI 1.05, 5.86). Children enrolled at public preschools were more likely to obtain a lower than average VMI score than those who enrolled at private preschools (OR = 2.60, 95%CI 1.12, 6.06). Children who started preschool at the age of six were more likely to obtain lower than average VMI scores than those who started at an earlier age (OR = 4.66, 95%CI 1.97, 11.04). Low maternal education level was also associated with lower than average VMI score (OR = 2.60, 95%CI 1.12, 6.06). Malaysian preschoolers' Beery-VMI performance compared well to their US counterparts. Some socioeconomic factors were associated with reduced VMI scores. Those from disadvantaged socioeconomic backgrounds are more likely to have reduced VMI performance, potentially adversely affecting their school readiness, cognitive performance, and future academic achievements.
  10. Wan Yunus F, Bissett M, Penkala S, Kadar M, Liu KPY
    Res Dev Disabil, 2021 Jul;114:103986.
    PMID: 33965876 DOI: 10.1016/j.ridd.2021.103986
    BACKGROUND: Self-regulated learning is an active learning cognitive approach which helps individuals to be aware of their own ability and environment and control their own learning.

    AIM: This study examined the therapeutic effects of self-regulated learning on reducing challenging behaviors and enhancing school-related function in children with autism spectrum disorders.

    METHODS: Forty children (aged 6-12) were randomized into a 12-week Self-Regulated Learning or Activity-Based intervention control group. Three outcome measures, assessing the behavior and school-related function of the children in both groups, were administered before and after the intervention and at one-month follow-up. The results between the two groups were also compared.

    RESULTS: The Self-Regulated Learning group showed significantly better results in reducing concerning behaviors and enhancing the school-related function than the activity-based group post-intervention and at one-month follow-up.

    CONCLUSIONS: The Self-Regulated Learning intervention was more effective compared to the Activity-Based intervention with particular benefits for on-going learning and improvements.

  11. Kadar M, Wan Yunus F, Tan E, Chai SC, Razaob Razab NA, Mohamat Kasim DH
    Aust Occup Ther J, 2020 02;67(1):3-12.
    PMID: 31799722 DOI: 10.1111/1440-1630.12626
    INTRODUCTION: Handwriting skills play a significant role in all stages of an individual's life. Writing interventions should be considered at a younger age to ensure proper development of writing skills. Hence, the aims of this study is to evaluate the current evidence of occupational therapy interventions in handwriting skills for 4-6 year old children.

    METHODS: Published literature was systematically searched according to PRISMA guidelines using specific key terms. Initial search identified 785 studies; however only seven met the inclusion criteria and were assessed for final review. Studies were methodologically appraised using the McMaster Critical Review Form-Quantitative Studies.

    RESULTS: The review found no randomised control trial study design pertaining to the reviewed area. However, it can be seen that occupational therapy interventions for writing skills in 4-6 year old children managed to increase the targeted skills. The results were similar across samples with or without disabilities. An effective integration of occupational therapy interventions into educational curriculum was found to save both time and cost.

    CONCLUSION: The long-term benefit from these interventions and the effects of these interventions on a broader spectrum of fine motor abilities need to be explored further with stronger research designs. However, the lack of studies adopting high level study designs, i.e., RCT designs means, results need to be approached with caution by occupational therapists when implementing handwriting skills intervention in practice.

  12. Razaob NA, Tham SY, Mohd Rasdi HF, Wan Yunus F, Kadar M
    Occup Ther Health Care, 2020 Jan;34(1):32-47.
    PMID: 31920126 DOI: 10.1080/07380577.2020.1712632
    The Community Integration Questionnaire-Revised (CIQ-R) is a self-report standardized instrument designed to assess an individual's degree of community integration. The aim of this study was to translate, validate and conduct a reliability test of the CIQ-R Malay version. The development involved the three phases of translation, content validation and cognitive interviewing, test-retest reliability and internal consistency of the CIQ-R Malay version. The Content Validity Index (CVI) showed perfect agreement between the panel experts. The Intra-class Correlation Coefficient (ICC) demonstrated a moderate to excellent level of test-retest agreement (ICC 0.72 to 0.93). The Total CIQ-R Malay version and Home Integration subscale showed good internal consistency, with values of Cronbach's alpha ranging from 0.81 to 0.90. The findings from the present study provided preliminary support for the psychometric properties of the CIQ-R Malay version as a valid and reliable instrument to be used in Malaysia.
  13. Wan Yunus F, Romli MH, Mohd Rasdi HF, Harun D, Kadar M
    Front Med (Lausanne), 2022;9:967511.
    PMID: 36341254 DOI: 10.3389/fmed.2022.967511
    The COVID-19 pandemic altered the health profession's education. Educational activities were shifted to online, and clinical placements were compromised in certain countries. A mixed-methods study included 17 undergraduates undergoing a mental health placement. The first 3 weeks of clinical placement applied online case-based learning in written and in video format. The last 2 weeks involved hybrid remote and physical onsite clinical placement. SPICES model utilizing various active learning activities, case studies and client attendance, facilitator engagement, discussion and feedback were implemented. A self-administered System Usability Scale (SUS), e-learning preference level, focus group discussion, and reflective writing was conducted at the end of each week and the students' final marks were compared with the past cohort who attended conventional physical clinical placement. Two-way mixed ANOVA indicates no significant interaction was found on the SUS (p = 0.062, η p 2 = 0.062) and preference scores (p = 0.285, η p 2 = 0.079) according to week and practical site. There was no significant difference in the final mark among the online and onsite placement of the current cohort (p = 0.350, d = 0.47). The current cohort reported better marks than the previous cohort who attended conventional placement (p = 0.006, d = 0.99). Qualitative findings show positive responses where online activities have minimal restriction on the learning process. This innovative approach is acceptable for substituting conventional clinical learning during this restricted situation.
  14. Kamarudin MS, Shahril MR, Haron H, Kadar M, Safii NS, Hamzaid NH
    Nutrients, 2023 Jan 03;15(1).
    PMID: 36615899 DOI: 10.3390/nu15010242
    Picky eating in children is often a major source of concern for many parents and caregivers. Picky eaters (PEs) consume limited foods, demonstrate food aversion, and have a limited food repertoire, which hinders their growth and health. These behaviours are common in children with special health care needs despite the rise in typically developing children. This leads to less attention being given to intervention programmes for typically developing children. Therefore, this scoping review aims to investigate the key concept of an existing intervention programme for PE among typically developing children, primarily on the types and approaches selected. A thorough literature search was conducted on three primary databases (PubMed, Emerald In-sight, and Web of Science) using predefined keywords. The literature was then appraised using the Joanna Briggs Institute's guidelines and protocols, and the PRISMScR checklist. Inclusion and exclusion criteria were also specified in the screening procedure. Results showed that the majority of the interventions in these studies were single-component interventions, with the sensory approach being the type that was most frequently utilised, followed by the nutrition approach and parenting approach. Single and multiple intervention components improved the assessed outcome, with a note that other components may or may not show a similar outcome, as they were not assessed in the single-component intervention. Given the evidence that picky eating is influenced by various factors, a multi-component intervention can provide a substantial impact on future programmes. In addition, defining picky eaters using standardised tools is also essential for a more inclusive subject selection.
  15. Poo YS, Chai SC, Goh PI, Kadar M, Razaob Razab NA
    Hong Kong J Occup Ther, 2023 Dec;36(2):84-91.
    PMID: 38027054 DOI: 10.1177/15691861231179012
    INTRODUCTION: Purdue Pegboard Test (PPT) is a valid and reliable instrument for measuring hand dexterity among individuals with or without medical conditions. In the Southeast Asia region where Malay is widely spoken, there is a need to have a Malay translation of Purdue Pegboard Test. This study aimed to translate the PPT into the Malay version (PPT-M) and to determine the content validity and test-retest reliability of this translated version.

    METHODS: This study involved: (1) four English teachers (translators) for forward and backward translation procedures; (2) 10 experts in the field of occupational therapy (expert reviewers) for content validity testing; and (3) 60 undergraduate students (participants) for test-retest reliability testing.

    RESULTS: PPT-M had excellent content validity with Item-Content Validity Index = 0.9-1.0, Scale-Content Validity Index/Average = 0.93-0.95, and a slightly lower Scale-Content Validity Index/Universal Agreement = 0.25-0.75. Test-retest reliability for 3-trial administration (n = 30; Intraclass Correlation Coefficients, ICCs = 0.76-0.85; good) was higher compared to 1-trial administration (n = 30; ICCs = 0.34-0.46; poor) for all subtests. Both trial administrations were mostly affected by systematic errors, especially practice effect as the retests gave higher scores. Random errors mostly affected Subtest 3 of 1-trial administration, evident by its Minimal Detectable Change Percent values = 30.84% that fell beyond the acceptable range.

    CONCLUSION: PPT-M has the potential to be a valuable instrument for measuring hand dexterity among Malay speaking individuals especially when the 3-trial administration is used.

  16. Asmuri SN, Kadar M, Razaob NA, Chui CS, Mohd Rasdi HF
    PLoS One, 2024;19(4):e0301544.
    PMID: 38568914 DOI: 10.1371/journal.pone.0301544
    BACKGROUND: The Compeer Model, which was originally designed to match individuals recovering from mental illness with volunteers from their community, served as the basis for the development of the buddy program. However, limited research was available related to the buddy program among older adults in a Malaysian context.

    AIM: The study aimed to identify the effectiveness of the buddy program training module to enhance the daily living function, social participation and emotional status of older adults in residential aged care homes.

    METHODS: A quasi-experimental study was conducted with 30 pairs of buddies and older adults for both the experimental group and control group in two randomly selected residential aged care homes. The buddies in the experimental group received the buddy program training module related to activities of daily living (basic and instrumental) while the buddy-older adults pairs in the control group continued to perform their usual daily life activities in residential aged care homes. Baselines were performed before intervention and at eight weeks post-intervention.

    RESULTS: Over the eight weeks, for the older adults in the experimental group, there was a significant main effect of time after the intervention on BADL (p = 0.010). There were no significant interaction effects for the experiment group and control group on IADL and social participation. Also, there were no significant interaction effects for all domains in emotional status: depression, anxiety and stress. For buddies, there was a significant interaction effect for depression (p = 0.045) in the control group.

    CONCLUSIONS: The buddy program training module can be used as a guideline for older adults with more significant disabilities in residential aged care homes in managing activities of daily living. Future studies could be implemented to explore the intergenerational buddy program among older adults and young children in the community.

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