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  1. Fadzillah AJ, Lee JAC
    MyJurnal
    Parental involvement during early childhood development is important especially when the child has learning disabilities. This research aims to study the effectiveness of parental-based speech training programs for preschoolers with Speech Language Impairments (SLI) in a localized setting. The method used was qualitative and data was collected from selected preschoolers (N = 5) with different types of SLI symptoms. Each participant was assessed using a standardized assessment protocol to measure his/her language scale. The participants were given the intervention program by their own parents using the Hanen’s It Takes Two to Talk program. The progress of each subject and observations from these sessions were documented. The participants were assessed again once the intervention had been implemented. Substantial results were achieved when all subjects showed improvements in language comprehension and production skills. These results highlight the importance of parental involvement as first teachers in the early intervention of children with SLI.
  2. Lee JAC, Otaiba SA
    Read Writ Q, 2017;33(3):226-238.
    PMID: 28706433 DOI: 10.1080/10573569.2016.1165639
    In this article, the authors examined the spelling performance of 430 kindergarteners, which included a high risk sample, to determine the relations between end of kindergarten reading and spelling in a high quality language arts setting. The spelling outcomes including the spelling errors between the good and the poor readers were described, analyzed, and compared. The findings suggest that not all the children have acquired the desired standard as outlined by the Common Core State Standards. In addition, not every good reader is a good speller and that not every poor speller is a poor reader. The study shows that spelling tasks that are accompanied by spelling errors analysis provide a powerful window for making instructional sense of children's spelling errors and for individualizing spelling instructional strategies.
  3. Lee JAC, Lee S, Yusoff NFM, Ong PH, Nordin ZS, Winskel H
    Front Psychol, 2020;11:1700.
    PMID: 32754104 DOI: 10.3389/fpsyg.2020.01700
    The aim of the study was to develop a new comprehensive reading assessment battery for multi-ethnic and multilingual learners in Malaysia. Using this assessment battery, we examined the reliability, validity, and dimensionality of the factors associated with reading difficulties/disabilities in the Malay language, a highly transparent alphabetic orthography. In order to further evaluate the reading assessment battery, we compared results from the assessment battery with those obtained from the Malaysian national screening instrument. In the study, 866 Grade 1 children from multi-ethnic and multilingual backgrounds from 11 government primary schools participated. The reading assessment battery comprised 13 assessments, namely, reading comprehension, spelling, listening comprehension, letter name knowledge, letter name fluency, rapid automatized naming, word reading accuracy, word reading efficiency, oral reading fluency, expressive vocabulary, receptive vocabulary, elision, and phonological memory. High reliability and validity were found for the assessments. An exploratory factor analysis yielded three main constructs: phonological-decoding, sublexical-fluency, and vocabulary-memory. Phonological-decoding was found to be the most reliable construct that distinguished between at-risk and non-at-risk children. Identifying these underlying factors will be useful for detecting children at-risk for developing reading difficulties in the Malay language. In addition, these results highlight the importance of including a range of reading and reading-related measures for the early diagnosis of reading difficulties in this highly transparent orthography.
  4. Cheah WL, Poh BK, Ruzita AT, Lee JAC, Koh D, Reeves S, et al.
    BMC Public Health, 2023 Jun 06;23(1):1082.
    PMID: 37280555 DOI: 10.1186/s12889-023-16023-w
    BACKGROUND: Toybox is a kindergarten-based intervention program that targets sedentary behavior, snacking and drinking habits, as well as promoting physical activity in an effort to improve healthy energy balance-related behaviors among children attending kindergartens in Malaysia. The pilot of this program was conducted as a randomized controlled trial (RCT) involving 837 children from 22 intervention kindergartens and 26 control kindergartens respectively. This paper outlines the process evaluation of this intervention.

    METHODS: We assessed five process indicators: recruitment, retention, dosage, fidelity, and satisfaction for the Toybox program. Data collection was conducted via teachers' monthly logbooks, post-intervention feedback through questionnaires, and focus group discussions (FGD) with teachers, parents, and children. Data were analyzed using quantitative and qualitative data analysis methods.

    RESULTS: A total of 1072 children were invited. Out of the 1001 children whose parents consented to join, only 837 completed the program (Retention rate: 88.4%). As high as 91% of the 44 teachers and their assistants engaged positively in one or more of the process evaluation data collection methods. In terms of dosage and fidelity, 76% of parents had received newsletters, tip cards, and posters at the appropriate times. All teachers and their assistants felt satisfied with the intervention program. However, they also mentioned some barriers to its implementation, including the lack of suitable indoor environments to conduct activities and the need to make kangaroo stories more interesting to captivate the children's attention. As for parents, 88% of them were satisfied with the family-based activities and enjoyed them. They also felt that the materials provided were easy to understand and managed to improve their knowledge. Lastly, the children showed positive behaviors in consuming more water, fruits, and vegetables.

    CONCLUSIONS: The Toybox program was deemed acceptable and feasible to implement by the parents and teachers. However, several factors need to be improved before it can be expanded and embedded as a routine practice across Malaysia.

  5. Reeves S, Poh BK, Chong YT, Lee JAC, Cheah WL, Hafizah YN, et al.
    Int J Environ Res Public Health, 2023 Aug 20;20(16).
    PMID: 37623197 DOI: 10.3390/ijerph20166614
    Prevention and treatment of childhood obesity is a global concern, and in Malaysia, it is considered a national public health priority. Determinants of childhood obesity are multifactorial and include factors that directly and indirectly influence energy balance-related behaviours, including energy intake and energy expenditure. Interventions to address childhood obesity that have multiple components at different levels have been shown to be the most influential. The ToyBox-study is a childhood obesity intervention aimed at preschool-aged children and their families that had been shown to be effective in several European countries and so was chosen for adaption for the Malaysian setting. Materials were translated and adjusted for the Malaysian context and audience and implemented in kindergartens in Peninsular Malaysia and Sarawak. However, during the COVID-19 pandemic and lockdown, teaching transitioned to being online. This brought an opportunity to reach a wider audience and consider the long-term sustainability of the intervention, and thus eToybox was born. eToybox aims to bring support for healthy energy balance behaviours directly to the teachers, into kindergartens and homes, to encourage families to be active and eat healthily, and prevent or reduce obesity. Through online innovation, the Toybox Study Malaysia programme has been expanded to enhance its potential to impact the promotion of healthy lifestyles among preschoolers and their families, highlighting the importance of a holistic approach to preventing and treating childhood obesity in Malaysia.
  6. Noor Hafizah Y, Ang LC, Yap F, Nurul Najwa W, Cheah WL, Ruzita AT, et al.
    PMID: 31783477 DOI: 10.3390/ijerph16234722
    As there are few food frequency questionnaires (FFQ) to assess the dietary intake of preschool children, this study examined the validity and reliability of an FFQ for this purpose. A total of 210 preschoolers aged 4 to 6 years participated in the validation study, while a subsample of 66 participants joined the reliability study. The FFQ is modified from the ToyBox-study and South East Asian Nutrition Surveys (SEANUTS), and comprised 108 food items from 13 food groups. A three-day estimated dietary record (3DR) was used as reference and reliability was assessed through a second administration of the FFQ (FFQ2), four weeks after the first administration (FFQ1). For the validation study, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ and 3DR. Cross-classification of quartile analysis showed moderate agreement between the two methods. As for reliability, Spearman's correlation coefficients showed moderate to high correlations (p < 0.001) between FFQ1 and FFQ2. Cronbach's alpha values (0.708 to 0.824) and intraclass correlation coefficients (0.710 to 0.826) showed good agreement between repeated FFQs. The results suggest that the FFQ has acceptable validity and good reliability. Hence, the FFQ can be used to assess preschool children's food intake.
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