Missed Appointments at a Child Development Centre and Barriers to Access Special Needs Services for Children in Klang Valley, Malaysia: A Mixed Methods Study

Attending appointments is vital for children with special needs, as such appointments involve long-term interdisciplinary care to ensure continuity of care and improve health and well-being. This study was performed to determine the prevalence of missed clinic appointments and identify the factors among those who have ever missed appointments and barriers of access to children’s special needs services at the Child Development Centre (CDC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Moreover, suggestions for improvement from the caregivers’ perspectives were explored. This is an explanatory sequential mixed methods study among caregivers of children with developmental disabilities aged up to 17 years old. Of 197 caregivers, 62 (31.5%) had missed clinic appointments. Forgetfulness was the most frequently cited reason. The bi-variable analysis showed significant differences in missed appointment rates by gender of caregivers and duration of follow-up. The final logistic regression model demonstrated that, when combined with the effect of being a male caregiver as an independent variable, follow-up duration of more than 6 years increased 2.67 times the risk of missing an appointment. Caregivers’ perceived barriers were transportation, caregiver, child and healthcare services factors. Policies and strategic plans should be focused on key findings from these factors to improve appointment adherence and accessibility to services for children with special needs.

Evaluation of Child Development Centre Based Intervention for Children with Multiple Disability

Background: Children with multiple disabilities usually have more than one significant disability that may include speech, physical mobility, learning, mental retardation, visual, hearing, and possibly others. Objective: The purpose of the present study was to evaluate the types of multiple disabilities in children with cerebral palsy and epilepsy and their fate after the intervention. Methodology: This retrospective observational study was conducted at Dhaka Shishu hospital from January 2011 to Decemberb2011.Children with multiple disabilities were referred to the child development center of Dhaka Shishu Hospital and were assessed for impairments and appropriate intervention done in special clinics. Result: Out of 540 children 66% were male. 43% of children were age group from 12-23 months. 58% had tetraplegic cerebral palsy (CP) with epilepsy and the second-highest group was diplegic CP with epilepsy 75(14.0%). Among 72 selected children who came in regular follow up, all children had motor disabilities. Cognitive delay, speech delay, vision and hearing impairment were found in 50%, 79%, 58% and 54% respectively. After intervention more improvement was found in motor function (92%). Conclusion: Intervention in specialized clinics improved the quality of life of children with multiple disability. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 38-41

Rancang Bangun Aplikasi Terapi Wicara Grow SCDC (Special Child Development Centre) Berbasis Android

Klinik Tumbuh Kembang Anak Grow SCDC (Special Child Development Centre) merupakan salah satu pusat terapi untuk perkembangan kesehatan anak, dimana kegiatan yang ada di dalamnya terdapat beberapa fasilitas terapi untuk perkembangan anak yang mengalami gangguan kesehatan. Salah satu gangguan adalah berbahasa atau bicara. Aplikasi terapi wicara dibangun dengan berbasis android menggunakan metode Extreme Programming. Aplikasi terapi wicara menggunakan metode perubahan teks menjadi suara (text to speech) dan metode suara menjadi teks (speech to text). Metode text to speech dilakukan dengan menyebutan nama kartu berisi gambar dan nama kartu. Pada saat kartu dipilih, aplikasi akan menyebutkan nama dari kartu tersebut. Metode text to speech dilakukan dalam fitur game tebak kartu. Game tebak kartu berisi daftar dari kartu yang dapat ditebak menggunakan tombol voice, pada saat tombol voice ditekan, suara yang dikeluarkan user akan direkam dan selanjutnya rekaman suara akan diubah menjadi teks. Hasil teks akan dicocokan dengan nama dari kartu yang dipilih, teks akan di periksa apakah jawaban bernilai benar atau salah. Aplikasi terapa wicara ini dirancang dan dibuat dengan beberapa bahasa pemrograman, yaitu Dart, PHP (Perl Hypertext Preprocessor), framework Flutter dan paket pendukung yaitu Cloud Speech API untuk penerapan metode text to speech dan speech to text. Sistem manajemen basis data menggunakan piranti lunak MySQL. Dapat disimpulkan pada penelitian ini fitur dan fungsi yang ada didalam aplikasi sudah sesuai dengan keinginan responden dikarenakan memiliki nilai rata-rata kuesioner yaitu 87%, dengan pernyataan aplikasi terapi wicara ini sudah stabil dan lancar bagi responden.

Classroom Action Research-based Instruction: The Sustainable Teacher Professional Development Strategy

The purposes of this research were to study the current situation and to compare the consequences of the Child Development Centre teachers on classroom action research-based instruction. The sample was 81 teachers of the Child Development Centre of the Local Administrative Organisation, derived from multi-stage random sampling. The instruments were the semi-structured interview form, and the measurement form of learning management outcomes, which the validity was between 0.80-1.00 and reliability was 0.968. The data were analysed by percentage, mean, standard deviation, content analysis and independent t-test. The results showed that 1) most teachers conducted informal classroom research to solve children’s behaviour problems and to increase the development of children. They usually utilised their research than others, but still not much. 2) the consequences of the classroom action research-based instruction were significantly higher than the standard requirement instruction at the .05 level of significance. The outstanding results have been discussed.

Music therapy with couples and families in the United Kingdom: a review

A review of UK sources relating to the use of music therapy in work with couples and families revealed reports on family work with pre-school children in the context of a child development centre, with vulnerable young children in a child and family psychiatric unit, and with adolescents and their carers in clinical settings. There are no reports of music therapy being used in helping couples struggling with relational difficulties, or with managing their special needs children. There is also no mention of therapeutic help being extended to strengthening co-parenting with behaviourally challenging children. Music therapists do not appear to regard couple work as being distinct from family work and this could explain the scarcity of literature relating specifically to couples. It may also be that by limiting the definition of music therapy to rehabilitative work following physical injury the British Association of Music Therapy (BAMT) has limited publications on couple and family work in the UK.

Effect of remedial teaching on the scholastic performance of children with learning disability

Background: To assess the effectiveness of remedial teaching in children with learning disability and to find association between IQ score and age of the child with their improvement.Methods: An interventional study using pre-post study design, took place in Child Development Centre (CDC) of tertiary care Medical College hospital. Participants includes 45 school going children of age group of 6-15 years. After initial diagnosis and IQ assessment, remedial teaching was given in CDC for 12 months. Techniques are chosen on an individual basis by formulating individualised education program (IEP) by special educators. Diagnosis and pre- post assessment were done using tool, NIMHANS SLD battery. Effectiveness was evaluated as improvement in class levels of students. Definite improvement was decided in each student if improvement was observed in 4 or more domains. Relationship of IQ score and age with their improvement in was noted.Results: In pretest, poor results were found in attention and copying in 39 children, reading in 41, comprehension and spelling in 42, written expression in 43, and arithmetic in 44. In posttest, good results with statistical significance (p<0.05) were found in attention in 33, copying in 27, reading in 24, arithmetic in 15, and spelling in 12 children. Definite improvement was noticed for 33% of students with significant association with age and not IQ score of the child.Conclusions: This study shows that remedial teaching can bring about significant changes in academic skills namely attention, copying, reading, arithmetic, and spelling. 33% had definite improvement in 4 or more domains. The improvement in academic skills following remedial teaching was dependent on the child’s age and not on IQ score.

The Use of Modified Checklist for Autism in Toddlers (Malay Version) in Differentiating Between Autism Spectrum Disorders and Other Developmental Behavioural Disorders

Objective: The present study examined the sensitivity and specificity of M-CHAT-Malay version [M-CHAT(MV)] to discriminate ASD from other developmental-behavioural disorders. Methods: This study was carried out in the Child Development Centre at a tertiary referral centre. Parents of 130 children aged 18–60 months, referred for developmental-behavioural disorders were asked to complete M-CHAT(MV). A child was considered to have ASD if they failed any 3 of the 23 total items or 2 or more of the 6 critical items. Results: Looking at the total items, M-CHAT(MV) has a good sensitivity (88.9%) to differentiate between ASD and other developmental-behavioural disorders, although specificity was only 47.8%. However, the critical items only has sensitivity of 71.4% and specificity of 77.6%. Sensitivity for children aged 49–60 months old was lower (80.0%) compared to those in the younger age group (100.0% and 90.3% for those aged 25-36 months and 37–48 months respectively). Based on the ROC curve, the optimal criteria to detect ASD was failing 1 out of 6 critical items or 3 out of 23 total items. Conclusion: M-CHAT(MV) is a good screening tool in differentiating ASD from other developmental-behavioural disorders although the critical items’ criteria may need to be lowered to improve its sensitivity in selected cohorts.