Friday, August 16, 2019
Malaysian Speech Language Pathologists Practices Education Essay
1.0 IntroductionThe best indicant to find the local prevalence of kids with developmental disablement is from international surveies which have suggested that more than 10 % of all kids in the universe have developmental disablement ( Amar 2008 ) . Using this rate to local population under 15 old ages old with the figure of 9.2 million ( Department of Statistics Malaysia 2011 ) , approximative 920,000 kids with disablement would be found in Malaysia. Speech Language Pathologists ( SLPs ) play a important function in assisting the communicating development of individuals ( ASHA 2005 ) so that they are able to populate inclusively in society as stated in Persons with Disabilities Act 2008 ( Government of Malaysia 2008 ) . In the mid-1990, merely less than five Speech Language Diagnosticians who trained overseas were working locally in Malaysia which ensuing of amazing 1: 2.5 million Speech Language Pathologist to people ratio ( Ahmad 2010 ) . Finally, formal local Speech Language Pathologist preparation started in the late 1990 ( Sharma 2008 ) . Universiti Kebangsaan Malaysia ( UKM ) is the innovator to offer Bachelor of Speech Science with Honors while Universiti Sains Malaysia ( USM ) began offering their Speech Pathology plan in 2004-2005. By 2011, more than 175 Speech Language Pathologists had graduated from the universities ( Aishah 2012- unpublished ) and are functioning to the community in different scenes. Lian & A ; Abdullah ( 2001 ) found that the profession of Speech Language Pathologist is still in its babyhood phase in Malaysia. The profession still needs old ages to turn and maturate ( Kosta 2005 ) . Indeed, many Malayan Speech Language Diagnosticians have indicated that they face great challenges to keep good profession patterns. The challenges are unfavourable working environment, deficit of Speech Language Pathologists, high caseload, small chances for go oning instruction and other factors ( Ahmad 2010 ; Sharma 2008 ) . Despite many challenges that affect Malayan Speech Language Pathologists patterns when pull offing instances, the balance between pragmatism and professionalism should be achieved in order to supply equity and quality of service proviso ( Ahmad 2010 ; Taylor-Goh 2005 ) . American Speech-Language-Hearing Association ( ASHA ) and Centers for Disease Control and Prevention ( CDC ) define Developmental Disability ( DD ) as terrible chronic conditions that occur in an single due to physical and or mental damage. Examples of developmental disablement are rational disablement such as Down Ã¢â¬Ës syndrome, neuromuscular upsets such as intellectual paralysis, sightlessness, hearing damage, larning disablements, epilepsy, and Autism Spectrum Disorder ( ASD ) ( Decoufle et al. 1994 ) . The oncoming of the conditions is before 22 old ages of age and will normally stay throughout the person Ã¢â¬Ës life-time. Peoples with developmental disablement have restrictions and jobs in his or her major functional life activities such as acquisition, working, walking, speech production and other countries ( ASHA 2005 & A ; CDC 2011 ) . Paul ( 2001 ) described kids in the Developing Language Stage ( DLS ) as group of kids who are still at the period of larning to unite words into sentences and they have expressive vocabularies larger than 50 words. Developing Language Phase occurs between 2 and 5 old ages of age for typical developing kids. Another manner to depict Developing Language Stage is that it refers to linguistic communication degree in Brown Ã¢â¬Ës Stage II-V. This indicated average lengths of vocalization ( MLU ) of more than two but less than five morphemes. The type of sentence produced by them are at the scope of additive simple sentences with outgrowth of grammatical morphemes, like Ã¢â¬Å" my cat Ã¢â¬Ës feeding Ã¢â¬ to intensify sentences, like Ã¢â¬Å" I drink milk and daddy drink java Ã¢â¬ ( Shipley & A ; McAfee 2009 ) . Developing Language Phase is the most explosive phase of linguistic communication development for kindergartner to develop from telegraphic vocalizations to basic sentence constructions ( Paul 2001 ) . For kids with developmental disablement, they needs appropriate intercession to travel through this phase ( Paul 2001 ; International Centre for Allied Health Evidence 2007 ; Law et al. 2010 ) . Hence, this is an of import passage gate for them to either remain at the same phase or to turn and come in the Language for Learning Stage. Malayan Speech Language Pathologists play great function to ease the acquisition of this group of kids. This is because mean caseload seen by Malayan Speech Language Pathologists particularly those who are working general infirmary consists of paediatric instances ( Aishah 2012- unpublished ; Sharma 2008 ) . From all the paediatric instance, Speech Language Disorder ( SLD ) is the most prevailing type of communicating damage seen by Speech Language Patholo gists in general infirmary ( Aishah 2012- unpublished ) . Therefore, this survey will function as a mention for the professionals in address and linguistic communication pathology about the pattern by Malayan Speech Language Pathologists in pull offing kids with Developmental Disability in the Developing Language Stage. Opinions and recommendations by Malayan Speech Language Pathologists sing the bing issues will besides be collected to give more in-depth apprehension about the pattern by Malayan Speech Language Pathologists. Besides, this survey will supply feedbacks to the professional associations & A ; universities about the development of Malayan Speech Language Pathologists. Clinical pattern guidelines related to communicating upset in kids are good documented by professional association from western states because they provide relevant statements sing clinical direction that are based on the available current groundss including adept clinical sentiments ( Hargrove et al. 2008 & A ; Taylor-Goh 2005 ) . The guidelines besides assist Speech Language Pathologists in clinical determination devising procedure and to supply high criterions of minimal best patterns services ( Hargrove et al. 2008 ; SPA 2001 ; Taylor-Goh 2005 ) . Looking back to Malaysia, guideline constitution for the profession of speech linguistic communication pathology in the local context is still developing due to limited resources and work force. Based on the guidelines documented by American Speech-Language-Hearing Association and Royal College of Speech Language Therapists ( RCSLP ) , few common chief clinical procedures are highlighted and overly discussed to guarantee minimal best pa ttern to be practiced by the Speech Language Pathologists. The procedures are attack used in direction, appraisal, planning and intervention ( ASHA 2005 ; Gerber & A ; Prizant 2008 ; Taylor-Goh 2005 ) . Approach used in speech linguistic communication pathology direction could be delivered utilizing different attacks harmonizing to the state of affairs by either working independently or in close partnership with squad members ( SPA 2001 ) . However, coaction that involves household centered, squad working and culturally appropriate services is able to guarantee effectual direction to the kids with Developmental Disability in the Developing Language Stage ( ASHA 2005 ; Diane 2011 ; SPA 2001 ; Taylor-Goh 2005 ) . Family-centered is a set of interrelated beliefs, rules and values that practiced by the facilitators including Speech Language Pathologists to back up and beef up the kid Ã¢â¬Ës household capacity to heighten and advance his development and acquisition ( Dunst 2002 ) . Through working in a multidisciplinary or interdisciplinary squad, Speech Language Diagnosticians do non provides services in isolation. Alternatively, this teaming establishes a joint intent and shared ends throughout the direction among the households, professionals and the kid ( ASHA 2005 ) . The cultural background of the households and the kid with Developmental Disability is really meaningful in service proviso particularly in Malaysia, a state which is good known by its multi-ethnicity, multi-cultures and multi-linguistics. Multicultural fluctuations that ever encountered by Speech Language Diagnosticians are values about acquisition, beliefs and perceptual experience about kid functions in the household, outlooks for child behaviour at different developmental degrees and household perceptual experiences and attitudes toward a Ã¢â¬Å" disablement Ã¢â¬ ( Diane & A ; Froma 2011 ) . Assessment involves roll uping relevant informations about the kid Ã¢â¬Ës conditions to make a diagnosing while diagnosing entails placing and understanding the jobs or shortages of the kid ( Paul 2001 ) . Both assessment and diagnosing are ongoing procedures because the diagnosing of the kid could alter over clip as the turning and development of him or her are besides ongoing ( Haynes & A ; Pindzola 2004 ) . The chief grounds for appraisal are to get at a good apprehension of the kid Ã¢â¬Ës job, to set up the baseline degree of operation, to ease ends be aftering for intercession and to mensurate the advancement of the kid in intervention ( Haynes & A ; Pindzola 2004 ; Paul 2001 ) . Appraisal with kids with Developmental Disability in the Developing Language Stage is encouraged to see all relevant modes across different contexts utilizing appropriate appraisal tools ( Paul 2001 ; Taylor-Goh 2005 ; Haynes & A ; Pindzola 2004 ) . In add-on, appraisal of developmental age or menta l age is normally used by Speech Language Pathologists during diagnosing to qualify the kid Ã¢â¬Ës functional accomplishments. But, many Speech Language Pathologists excessively have been discouraged to trust entirely on the usage of developmental age appraisal during diagnosing because it could non reflect the high variableness among the kids ( DeVeney et al. 2012 ) . Based on the assessment findings, the planning of intercession plan specifies the ends and the procedure of intercession by sing the kid Ã¢â¬Ës damage, demands and outlooks ( Paul 2001 ; SPA 2001 ; Taylor-Goh 2005 ) . The planning aims to place and develop meaningful and contributing acquisition environment for the kids with Developmental Disability in the Developing Language Stage in functional day-to-day activities ( ASHA 2005 ) . Hence, relevant and possible schemes, contexts, issues, result and timeline should be documented to ease the service provided by Speech Language Pathologists is coordinated, comprehensive and holistic ( Diane 2011 ; Paul 2001 ; SPA 2001 ; Taylor-Goh 2005 ) . Besides, Speech Language Diagnosticians are strongly encouraged to follow Evidence-Based Practice ( EBP ) to help clinical determination ( ASHA 2005 ; Brankenbury 2008 ; Diane 2011 ; Johnson 2006 ; SPA 2001 ; Taylor-Goh 2005 ) . Evidence-Based Practice ( EBP ) encourages the Speech Language Patholog ists to take consideration of ( a ) current high-quality scientific research ; ( B ) Speech Language Pathologists expertness and experience ; and ( degree Celsius ) household Ã¢â¬Ës penchants, values, and involvements ( Diane 2011 ) . It is an of import portion of effectual and ethical directions as it guides Speech Language Pathologists to extinguish methods which appear no or minimal clinical effects ( Brankenbury 2008 ; Taylor-Goh 2005 ) . Besides, Evidence-Based Practice besides helps the profession of speech linguistic communication pathology to accomplish higher answerability and credibleness ( Johnson 2006 ) . Effective instruction techniques ( ASHA 2005 ; Dunst et Al. 2011 ; Law et al. 1999 ; Law 2003 ) are really of import to find the result of the intervention plan. There are three types Ã¢â¬Ë of intercession methods that are didactic, realistic, and combination of didactic & A ; realistic attacks ( Dunst et al. 2011 ; Law et al. 1999 ; Law 2003 ) . The classification of different type of intercession methods is non purposes for Speech Language Pathologists to take merely one method and utilize it systematically. In fact, it prepares a repertory of methods available for Speech Language Pathologists to fit the acquisition of the kid with the specific ends that have targeted ( Paul 2001 ) . In this manner, the efficiency of the intervention for the kid with Developmental Disability in the Developing Language Stage is maximized. Introduction of appropriate stuffs or activities ( ASHA 2005 ) , single acquisition environment ( ASHA 2005 ; Dunst et Al. 2011 ) , assistive engineerings ( Sand ra & A ; Sahoby 2006 ) and Augmentative and Alternative Communication ( AAC ) systems ( Millar et Al. 2006 ; Rose et Al. 1999 ) are all portion of duties of Speech Language Pathologists in giving intervention to the kids with Developmental Disability in the Developing Language Stage. These constituents facilitate the acquisition and growth of the kid in a familiar nature environment which is filled with synergistic communicating and societal routines/activities. Besides, the debut besides promotes the kid to generalise the new accomplishments to new state of affairs that would go on in mundane contexts. Back to Malaysia, Joginder Singh et Al. ( 2011 ) reported that Malayan Speech Language Pathologists demonstrated best pattern in many countries but fail to make in some other countries when supplying services to pre-symbolic kids. Approach used in speech linguistic communication pathology direction which consist the coaction of household centred, squad direction and culturally appropriate services is found barely practiced ( Lim 2008-unpublish ) ; Diane 2011 ; Joginder Singh et Al. 2011 ; Othman 2010 ) . Furthermore, Lian & A ; Abdullah ( 2001 ) found that Malayan Speech Language Pathologists were likely to trust on informal appraisals because formal appraisals are limited in the local market. When measuring pre-symbolic kids, Malayan Speech Language Pathologists showed low trust of roll uping communicating sample and roll uping informations out of clinic ( Joginder Singh et Al. 2011 ) . Looking into intercession pattern, Malayan Speech Language Pathologists demonstrate different int ercession attacks and techniques across different scenes ( Lian & A ; Abdullah 2001 ) . In other custodies, Augmentative and Alternative Communication ( AAC ) systems and assistive engineerings are non famously introduced by Malayan Speech Language Pathologists to better the efficiency of the intervention plan ( Joginder Singh et Al. 2011 ) .2.0 RESEARCH QUESTIONSHow Malayan Speech Language Pathologists holistically manage kids with Developmental Disability in the Developing Language Stage? What are the bing issues faced by Malayan Speech Language Pathologists when pull offing kids with Developmental Disability in the Developing Language Stage? What are the recommendations for better pattern suggested by Malayan Speech Language Pathologists when pull offing kids with Developmental Disability in the Developing Language Stage?3.0 RESEARCH OBJECTIVE3.1 General ObjectiveTo analyze Malayan Speech Language Pathologists Ã¢â¬Ë patterns in pull offing kids with Developmental Disability in the Developing Language Stage.3.2 Specific AimsTo find the specific clinical constituents practiced by Malayan Speech Language Pathologists in pull offing kids with Developmental Disability in the Developing Language Stage as are attacks used, assessment, planning and intervention. To find the bing issues faced by Malayan Speech Language Pathologists in pull offing kids with Developmental Disability in the Developing Language Stage. To depict the recommendations suggested by Malayan Speech Language Diagnosticians of better pattern in pull offing kids with Developmental Disability in the Developing Language Stage.4.0 METHODOLOGY4.1 Research DesignThis is a cross-sectional qualitative and quantitative survey via study.4.2 Sampling PopulationThe population of this survey covers all Malayan Speech Language Pathologists.4.3 Study SiteParticipants will be recruited from all 14 provinces in Malaysia.4.4 Sampling MethodPurposive sampling method is used for this survey. All participants who fulfill the inclusion standards ( Please refer to 4.6 ) will be recruited.4.5 Sampling FrameThe contact lists of Speech Language Pathologists who graduated from Universiti Kebangsaan Malaysia ( UKM ) and Universiti Sains Malaysia ( USM ) will be obtained in order to administer the study to all alumnas members. The study will be besides mailed or/and posted to all Speech Language Pathologists working with Ministry of Health and to all members listed in the directories of local professional organic structures ( i.e. Malayan Association of Speech-Language & A ; Hearing ( MASH ) and others ) .4.6 Sample Inclusion CriterionParticipants inclusion standards: Qualified Speech Language Pathologists and practising locally. However, Speech Language Pathologists who have non had experience in pull offing kids with Developmental Disability in the Developing Language Stage will be indicated in the study to return the study without farther responses ( Please refer Appendix A ) .4.7 Sample Size CalculationAishah ( 2012-unpublish ) reported that there are 175 SLPs registered in the UKM and USM alumni from local universities by the twelvemonth 2011. Besides Speech Language Pathologists who have obtained their makings locally, Speech Language Pathologists who graduated from overseas are besides included in the survey, with the status that they are presently practising locally. Hence, the population of Malayan Speech Language Pathologists is estimated to be between the scope of 175 to 250 Speech Language Pathologists. The mean of the scope of 210 Speech Language Pathologists will be used as N, in the undermentioned computation: IÃ¢â¬ ¡A?NP ( 1-P ) = 3.84 ten ( 210 ) ( 0.5 ) ( 1-0.5 ) dA? ( N-1 ) + IÃ¢â¬ ¡A?P ( 1-P ) 0.05A? ( 210-1 ) + 3.84 ( 0.5 ) ( 0.5 ) = 137 participants Happening of backdown and bead out of 10 % is farther considered in the sample size computation. Entire topics = nn__ 1-0.1 = _137_ 0.9 = 152 participantssubjects Therefore, a sum of 152 topics participants will be recruited in this survey.6.54.8 Data CollectionThe study utilized for this survey is adapted from several surveies that focus on happening similar results on SLP patterns ( Joginder Singh et Al. 2011 ; Mustaffa Kamal et Al. 2012 ; Othman 2010 ; Stuck 2012 ) . The study is constructed utilizing English because the participants involved in this survey are qualified Malayan Speech Language Pathologists who have English proficiency. The study contains the undermentioned subdivisions: Part A: Demographic Data Part B: Specific Clinical Components 7 parts that are Demographic informations, Approaches used, Assessment, Planning, Treatment, Opinions sing bing issue and Recommendations of better pattern. Close-ended inquiries utilizing 5 points LikertLikert grading and multiple picks are included in the study. Besides, and open-eopen-ended inquiries are besides included. nded inquiries are included. ( Please refer to Appendix A ) . Survey and information sheet will be distributed to the Speech Language Pathologists SLPs via electronic mail and/or gpost. QuestionPro Ã¢â¬Ës online study package will be used to administer the study via electronic mail. Meanwhile, Ffor Speech Language Pathologists SLPs who will have the study and information sheet via postmailing, a reply-paid envelope is included for them to return the study. SLPs will be informed that the returning of completed questionnaire study indicate consent to take part in this survey. A follow-up reminder electronic mail or phone call will be sent to Speech Language Pathologists SLP ten 10 yearss after the initial distribution. A 2nd reminder electronic mail or phone call will be sent 2 hebdomads subsequently.64..96 Validity and Reliability of SurveyThe study will be piloted on 10 participants. Concept, content and face cogency will be determined by modifying the points consequently ( following the pilot survey ) through feedback from the participants. To find how closely related the set of points are grouped in the study, internal dependability of the study constituents will be assessedachieved by ciphering Cronbach Ã¢â¬Ës Alpha Coefficientusing Cronbach Ã¢â¬Ës alpha. This will demo how closely related the set of points are as a group in the study.6.74.10 Statistical TrialThe quantitative informations obtained from closed-ended inquiries in the study will be analyzed utilizing descriptive statistics. From the study, 11 out of 20 closed-ended inquiries are far ther divided into sub-items. Hence, factor analysis via chief component analysis ( PCA ) is used as a information decrease technique. Items in the study that measured the same implicit in concept will be grouped together. Analysis method used by Mathers-Schmidt & A ; Kurlinski ( 2003 ) will be adopted in this survey. Descriptive statistics ( per centums ) of the grouped-items is calculated to look into the grade of which specific clinical constituents are used. First, to find which specific clinical constituents of Speech Language PathologistsSLPs Ã¢â¬Ë pattern are most normally used, the per centum of responses for each reply option ( ne'er, seldom, sometime, normally, or ever ) will be calculated. Percentages of response for option Ã¢â¬Å" normally Ã¢â¬ and Ã¢â¬Å" ever Ã¢â¬ are combined. The specific clinical constituents are so categorized into 3 groups: ( 1 ) constituents usually/always used by 90 % or more of the topics ; ( 2 ) constituents usually/always used by 50-90 % of the topics ; and ( 3 ) constituents usually/always used by less than 50 % of the topics. Second, consistence of the specific clinical constituents practiced by the topics will be determined. The information will be categorized as follows: ( 1 ) extremely consistent-75 % of topics indicated the same frequence of usage ; ( 2 ) reasonably consistent-50-75 % topics indicated the same frequence of usage ; ( 3 ) and inconsistent-less than 50 % of topics indicated the same frequence of usage for a peculiar clinical constituent.6.84.11 Research Procedure6.94.12 Gantt ChartYear/Month Undertaking Activities 2012 2013 July Aug Sept Oct Nov Dec Jan Feb Mac Apr May Literature Review Ten Ten Ten Ten Ten Ten Ten Ten Ten Ten Proposal Presentation Ten SurveyDevelopment Ten Ten Ten Application for Ethical motives Ten Ten Pilot Study Ten Ten Data Collection Ten Ten Ten Ten Datas Analysis Ten Ten Ten Ten Report Writing Ten Ten Ten Ten Ten Ten Ten Concluding Presentation Ten6.104.13 Information Sheet and Consent FormThe information sheet that will administer to the topics is attached in Appendix B. Meanwhile, the topics will be informed that the returning of completed questionnaire indicate their consent to take part in this survey.