Displaying all 14 publications

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  1. Ooi CC, Wong AM
    Int J Speech Lang Pathol, 2012 Dec;14(6):499-508.
    PMID: 23039126 DOI: 10.3109/17549507.2012.712159
    One reason why specific language impairment (SLI) is grossly under-identified in Malaysia is the absence of locally- developed norm-referenced language assessment tools for its multilingual and multicultural population. Spontaneous language samples provide quantitative information for language assessment, and useful descriptive information on child language development in complex language and cultural environments. This research consisted of two studies and investigated the use of measures obtained from English conversational samples among bilingual Chinese-English Malaysian preschoolers. The research found that the language sample measures were sensitive to developmental changes in this population and could identify SLI. The first study examined the relationship between age and mean length of utterance (MLU(w)), lexical diversity (D), and the index of productive syntax (IPSyn) among 52 typically-developing (TD) children aged between 3;4-6;9. Analyses showed a significant linear relationship between age and D (r = .450), the IPsyn (r = .441), and MLU(w) (r = .318). The second study compared the same measures obtained from 10 children with SLI, aged between 3;8-5;11, and their age-matched controls. The children with SLI had significantly shorter MLU(w) and lower IPSyn scores than the TD children. These findings suggest that utterance length and syntax production can be potential clinical markers of SLI in Chinese-English Malaysian children.
  2. Phoon HS, Abdullah AC, Maclagan M
    Int J Speech Lang Pathol, 2012 Dec;14(6):487-98.
    PMID: 23039125 DOI: 10.3109/17549507.2012.719549
    This study investigates the effect of dialect on phonological analyses in Chinese-influenced Malaysian English (ChME) speaking children. A total of 264 typically-developing ChME speaking children aged 3-7 years participated in this cross-sectional study. A single word naming task consisting of 195 words was used to elicit speech from the children. The samples obtained were transcribed phonetically and analysed descriptively and statistically. Phonological analyses were completed for speech sound accuracy, age of consonant acquisition, percentage of phonological process occurrence, and age of suppression for phonological processes. All these measurements differed based on whether or not ChME dialectal features were considered correct, with children gaining higher scores when ChME dialect features were considered correct. The findings of the present study provide guidelines for Malaysian speech-language pathologists and stress the need to appropriately consider ChME dialectal features in the phonological analysis of ChME speaking children. They also highlight the issues in accurate differential diagnosis of speech impairment for speech-language pathologists working with children from any linguistically diverse background.
  3. Kamal RM, Ward E, Cornwell P
    Int J Speech Lang Pathol, 2012 Dec;14(6):569-76.
    PMID: 22974073 DOI: 10.3109/17549507.2012.713394
    There are competency standards available in countries with established speech-language pathology services to guide basic dysphagia training with ongoing workplace mentoring for advanced skills development. Such training processes, however, are not as well established in countries where speech-language pathology training and practice is relatively new, such as Malaysia. The current study examines the extent of dysphagia training and workplace support available to speech-language pathologists (SLPs) in Malaysia and Queensland, Australia, and explores clinicians' perceptions of the training and support provided, and of their knowledge, skills, and confidence. Using a matched cohort cross-sectional design, a purpose-built survey was administered to 30 SLPs working in Malaysian government hospitals and 30 SLPs working in Queensland Health settings in Australia. Malaysian clinicians were found to have received significantly less university training, less mentoring in the workplace, and were lacking key infrastructure needed to support professional development in dysphagia management. Over 90% of Queensland clinicians were confident and felt they had adequate skills in dysphagia management; in contrast, significantly lower levels of knowledge, skills, and confidence were observed in the Malaysian cohort. The findings identify a need for improved university training and increased opportunities for workplace mentoring, training, and support for Malaysian SLPs.
  4. Joginder Singh S, Iacono T, Gray KM
    Int J Speech Lang Pathol, 2011 Oct;13(5):389-98.
    PMID: 21888557 DOI: 10.3109/17549507.2011.603429
    The aim of this study was to explore the assessment, intervention, and family-centred practices of Malaysian and Australian speech-language pathologists (SLPs) when working with children with developmental disabilities who are pre-symbolic. A questionnaire was developed for the study, which was completed by 65 SLPs from Malaysia and 157 SLPs from Australia. Data reduction techniques were used prior to comparison of responses across questionnaire items. Results indicated that SLPs relied mostly on informal assessments. Malaysian and Australian SLPs differed significantly in terms of obtaining information from outside the clinic to inform assessment. When providing intervention, SLPs focused mostly on improving children's pre-verbal skills. A third of Australian SLPs listed the introduction of some form of symbolic communication as an early intervention goal, compared to only a small percentage of Malaysian SLPs. Regarding family involvement, SLPs most often involved mothers, with fathers and siblings being involved to a lesser extent. Overall, it appeared that practices of Malaysian SLPs had been influenced by developments in research, although there were some areas of service delivery that continued to rely on traditional models. Factors leading to similarities and differences in practice of SLPs from both countries as well as clinical and research implications of the study are discussed.
  5. Ahmad K
    Int J Speech Lang Pathol, 2010 Aug;12(4):317-9; discussion 329-32.
    PMID: 20590514 DOI: 10.3109/17549507.2010.483017
    Speech-language pathologists (SLPs) practising in Malaysia face similar dilemmas as their counterparts in more developed countries when it comes to deciding on discharge/termination of services for their patients. Furthermore, discharge dilemmas appear to be a frequent and inevitable part of their everyday practice. In an interview conducted for the purpose of this paper, it was clear that many SLPs found it difficult to articulate or justify the process they took to reach a decision on whether or not to terminate their services or discharge their patients. Much of the difficulty is anchored on the need to be realistic and function within the confines of limited resources. Malaysian SLPs were aware of the ideals that had to be abandoned along the way but had not allowed guilt to dissuade or discourage them from providing what they perceived as the next best available service. The not-so ideal decisions made by these SLPs may be frowned upon by international standards but must be examined within the local historical perspective of the development of the SLP profession in Malaysia. The dilemma will continue until the country produces SLPs in sufficient numbers but the profession is reminded that less-than-ideal practices may perpetuate over time into unhealthy traditions that will require major efforts to be undone.
  6. Van Dort S, Coyle J, Wilson L, Ibrahim HM
    Int J Speech Lang Pathol, 2013 Feb;15(1):90-5.
    PMID: 23323823 DOI: 10.3109/17549507.2012.757707
    The lead article by Wylie, McAllister, Davidson, and Marshall (2013) puts forward pertinent issues facing the speech-language pathology profession raised by the World Report on Disability. This paper continues the discussion by reporting on a capacity building action research study on the development, implementation, and evaluation of a new approach to early intervention speech-language pathology through clinical education in Malaysia. This research evaluated a student-led service in community-based rehabilitation that supplemented existing and more typical institution-based services. A Malaysian community-based rehabilitation project was chosen due to its emphasis on increasing the equitability and accessibility of services for people with disabilities which was a catalyst for this research. Also, expanding awareness-building, education, and training activities about communication disability was important. The intention was to provide students with experience of working in such settings, and facilitate their development as advocates for broadening the scope of practice of speech-language pathology services in Malaysia. This article focuses on the findings pertaining to the collaborative process and the learning experiences of the adult participants. Through reflection on the positive achievements, as well as some failures, it aims to provide deeper understanding of the use of such a model.
  7. Ahmad K, Ibrahim H, Othman BF, Vong E
    Int J Speech Lang Pathol, 2013 Feb;15(1):37-41.
    PMID: 23323816 DOI: 10.3109/17549507.2012.757709
    The current paper is a response to the Wiley, McAllister, Davidson, and Marshall lead article regarding the application of the World Report on Disability (WRD) to people with communication disorders. The current paper directly addresses recommendation 5 (improvement of human resource capacity) and indirectly addresses recommendations 7, 8, and 9 (related to improving local knowledge and data on communicative disabilities) indirectly. The paper describes Malaysia's initiatives in the early 1990s, in developing its local professional capacity to provide services for people with communication disorders (PWCD). It charts the history of development of a local undergraduate entry-level degree program for speech-language pathology (SLP) from the point of conceptualization to full execution. The article provides glimpses to the processes and challenges faced by Universiti Kebangsaan Malaysia as the pioneer university in the South East Asia region to undertake the training and education of the SLP profession and highlights relevant issues faced by newly introduced professions in a country where resources and practice traditions were previously unavailable. It underscores the important role played by government institutions and an international professional network in driving forward-looking policies to implement and sustain the program.
  8. Joginder Singh S, Chan MY, Ahmad Rusli Y
    Int J Speech Lang Pathol, 2016 12;18(6):560-570.
    PMID: 27063683
    PURPOSE: Children with speech and language delay/disorder (SLD) in the developing language stage (DLS) are one of the largest populations served by speech-language pathologists (SLPs) working in paediatric settings. The aim of this study was to investigate the practise patterns adopted by Malaysian SLPs when managing these children.

    METHOD: A web-based questionnaire was developed to obtain information about SLPs' practises during assessment, planning and treatment.

    RESULT: A total of 53 SLPs completed the questionnaire. When assessing the children, participants either always or usually involved parents, suggesting that they understood the importance of family involvement in services provided. When planning goals, the SLPs relied mostly on their clinical experience and less on research evidence. Participants reported that, most often, they employed a one-to-one approach when providing treatment. There was, however, great variation in the frequency of treatment provided, reflecting the different workplaces of participants.

    CONCLUSION: Generally, findings from this study indicated that some practises employed by Malaysian SLPs when managing children with SLD in the DLS are on par with the best practise guidelines, but there is still room for improvement in certain areas such as team collaboration and evidence-based practise. Clinical and research implications are discussed.

  9. Mustaffa Kamal R, Ward EC, Cornwell P, Sharma S
    Int J Speech Lang Pathol, 2015 Dec;17(6):594-604.
    PMID: 25874970 DOI: 10.3109/17549507.2015.1026276
    PURPOSE: The purpose of the current study was to explore infrastructure issues that may be barriers to the establishment and improvement of dysphagia services in Malaysia compared to settings with established dysphagia management services (i.e. Queensland, Australia).

    METHOD: A mixed method design incorporating quantitative and qualitative data was used to increase credibility, validity and comprehensiveness of the results. Thirty-eight hospitals (Malaysia = 21, Queensland = 17) participated in Phase 1 (quantitative component) of the study involving completion of an infrastructure checklist by a speech-language pathologist from each hospital regarding availability of networking and communication, staffing and financial support, facilities and documentation of guidelines for dysphagia management. Subsequently, eight sub-samples from each cohort were then involved in Phase 2 (qualitative component) of the study involving a semi-structured interview on issues related to the impact of infrastructure availability or constraints on service provision.

    RESULT: The current study reveals that multiple challenges exist with regard to dysphagia services in Malaysian government hospitals compared to Queensland public hospitals.

    CONCLUSION: Overall, it was identified that service improvement in Malaysia requires change at a systems and structures level, but also, more importantly, at the individual/personal level, particularly focusing on the culture, behaviour and attitudes among the staff regarding dysphagia services.

  10. Chu SY, Barlow SM, Lee J, Wang J
    Int J Speech Lang Pathol, 2020 04;22(2):141-151.
    PMID: 31213093 DOI: 10.1080/17549507.2019.1622781
    Purpose: To characterise labial articulatory pattern variability using the spatiotemporal index (STI) in speakers with idiopathic Parkinson's disease (PD) across different speaking rates and syllable-sentence conditions compared to age- and sex-matched healthy controls.Method: Ten speakers with mild-severe idiopathic PD and 10 controls produced "pa" and the Rainbow Passage at slow, typical and fast speech rates. Upper lip and lower lip kinematics were digitised during a motion capture system. Data were analysed using linear mixed modelling.Result: Regardless of the participant group, a high STI value was observed in the fast speech rate for the "pa" syllable condition, particularly for movements of the lower lip. As utterance rate increased, the control group showed the highest variability, followed by PD OFF and PD ON conditions. Syllable "pa" showed a greater STI value compared to both the first and second utterance of Rainbow Passage.Conclusion: PD manifests sufficient residual capacity to achieve near-normal motor compensation to preserve the consistency of lower lip movements during speech production. The lack of a significant difference in lip STI values between ON-OFF medication states suggests that dopaminergic treatment does not influence stability of speech for individuals with mild-moderate stage PD.
  11. Altaher AM, Chu SY, Park HR, Khoong ESQ, Mustaffa Kamal R, Mcconnell G
    PMID: 34348530 DOI: 10.1080/17549507.2021.1958921
    Purpose: This study investigated the practice patterns used by Malaysian speech-language pathologists (SLPs) with patients with dysarthria, identified challenges perceived by SLPs and explored strategies to address perceived barriers for improving dysarthria management.Method: Two studies were conducted. Study 1 disseminated a 30-item survey questionnaire electronically via google link to SLPs in the Malaysian Speech-Language-Hearing Association through e-mail lists. Responses were analysed using descriptive statistics. In Study 2, semi-structured interviews of twelve SLPs who managed patients with dysarthria were conducted. Data were transcribed verbatim and analysed using the thematic analysis method.Result: Three major themes and ten sub-themes emerged from the interviews, including "assessment and treatment practices", "challenges", and "overcoming challenges". SLPs' practice of assessment and treatment of dysarthria were predominantly impairment-based. Respondents (64%) who never used standardised assessment tools valued textbooks more as sources of evidence and had a lower level of confidence in their knowledge about dysarthria compared to those who used standardised tools.Conclusion: Focus now needs to be on the education needs of our SLPs, on both the university training and continuing education levels, for direction of the development of professional training courses. Ongoing research and public awareness are required to guide clinical management decisions.
  12. Chu SY, Barlow SM, Lee J, Wang J
    Int J Speech Lang Pathol, 2017 12;19(6):616-627.
    PMID: 28425760 DOI: 10.1080/17549507.2016.1265587
    PURPOSE: This research characterised perioral muscle reciprocity and amplitude ratio in lower lip during bilabial syllable production [pa] at three rates to understand the neuromotor dynamics and scaling of motor speech patterns in individuals with Parkinson's disease (PD).

    METHOD: Electromyographic (EMG) signals of the orbicularis oris superior [OOS], orbicularis oris inferior [OOI] and depressor labii inferioris [DLI] were recorded during syllable production and expressed as polar-phase notations.

    RESULT: PD participants exhibited the general features of reciprocity between OOS, OOI and DLI muscles as reflected in the EMG during syllable production. The control group showed significantly higher integrated EMG amplitude ratio in the DLI:OOS muscle pairs than PD participants. No speech rate effects were found in EMG muscle reciprocity and amplitude magnitude across all muscle pairs.

    CONCLUSION: Similar patterns of muscle reciprocity in PD and controls suggest that corticomotoneuronal output to the facial nucleus and respective perioral muscles is relatively well-preserved in our cohort of mild idiopathic PD participants. Reduction of EMG amplitude ratio among PD participants is consistent with the putative reduction in the thalamocortical activation characteristic of this disease which limits motor cortex drive from generating appropriate commands which contributes to bradykinesia and hypokinesia of the orofacial mechanism.

  13. Chu SY, Lee J, Barlow SM, Ben-David B, Lim KX, Foong JH
    Int J Speech Lang Pathol, 2021 08;23(4):419-429.
    PMID: 33059474 DOI: 10.1080/17549507.2020.1808701
    PURPOSE: This study examined the effects of non-word versus real word, age, and gender on oral-DDK rates among healthy Malaysian-Mandarin speakers. Comparison between non-word of Malaysian-Mandarin and Hebrew speakers was examined.

    METHOD: One-hundred and seventeen speakers (18-83 years old, 46% men) were audio-recorded while performing non-word (repetition of "pataka") and real-word oral-DDK tasks ("butter cake" and " ([pha4tha1khan4])"). The number of syllables produced in 8 seconds was counted from the audio recording to derive the oral-DDK rates. A MANOVA was conducted to compare the rates between age groups (young = 18-40 years, n = 56; middle = 41-60 years, n = 39; older = 61-83 years, n = 22) and gender. In a second analysis, "pataka" results were compared between this study and previous findings with Hebrew speakers.

    RESULT: No gender effects were found. However, rates significantly decreased with age (p  non-words (5.29 ± 1.23) > Mandarin words (4.91 ± 1.13). Malaysian-Mandarin speakers performed slower than Hebrew speakers on "pataka" task.

    CONCLUSION: Aging has a large impact on oromotor functions, indicating that speech-language pathologists should consider using age-adjusted norms.

  14. Chu SY, Hara Y, Wong CH, Higashikawa M, McConnell GE, Lim A
    Int J Speech Lang Pathol, 2021 12;23(6):662-671.
    PMID: 33823717 DOI: 10.1080/17549507.2021.1877816
    Purpose: To investigate speech-language pathologists' current perceptions, previous training experiences, resources, barriers, and training needs in terms of evidence-based practices (EBPs) in two Asian countries.Method: Their knowledge and attitudes about EBP were explored using an online questionnaire. A descriptive analysis was conducted with consideration of the effect of demographic variables on knowledge and attitudes about EBP.Result: Malaysian speech-language pathologists (n = 98) displayed more positive attitudes toward EBPs, with a significantly higher (t (143) = 5.91, p < .01) total mean score (Mean = 120.7, SD = 11) compared to the Japanese speech-language pathologists (n = 47, Mean = 107.8, SD = 13.5). Malaysian practitioners who were female, worked full-time, and worked in government settings reported higher motivation to develop EBP skills. Japanese practitioners who worked in private sectors reported higher EBPs training needs than those in government settings. In both countries, speech-language pathologists with higher education levels tended to express fewer perceived barriers towards EBP.Conclusion: Findings could help local governance and speech-language pathologist associations to understand the current practices and professional development needs of speech-language pathologists, leading to more effective training programs and educating employers and managers who can reinforce EBP among practitioners.
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