The use of augmentative and alternative communication by children with developmental disability in the classroom: a case study.

PURPOSE: Augmentative and alternative communication (AAC) systems are often introduced to children with disabilities who demonstrate complex communication needs. As attending school is an essential part of these children's lives, it is important that they use their AAC system to communicate in the classroom. This study aimed to describe the nature of the use of AAC by students with developmental disabilities in the classroom. MATERIALS AND METHOD: This study was conducted in Malaysia. Six students were observed twice each in their classroom and their classroom interactions were video recorded. The video recordings were transcribed and coded for the presence of a communication event, the student's mode of communication and communication function, the communication partner involved, and access to the AAC system. RESULTS: Contrary to past studies, most students in this study spontaneously initiated interaction almost as many times as they responded. They primarily communicated with gestures and verbalizations/vocalizations despite having been introduced to an AAC system. When students communicated using their AAC system, they mainly interacted with the teachers, and for the function of either behavioral regulation or joint attention. It was found that for 39% of communicative events, the student's aided AAC system was not within arm's reach. CONCLUSION: The findings highlight the need for efforts to encourage students with complex communication needs to use AAC more frequently in their classroom to be able to communicate more effectively and for a wider range of communicative functions. Speech-language pathologists can work closely with teachers to provide the necessary support to these students.

Speech-language pathologists (SLPs) can provide ongoing support to school teachers to equip them with the necessary knowledge and skills to support the use of augmentative and alternative communication (AAC) in the classroom.SLPs can also focus on teaching students to use AAC for a variety of communication functions and with various partners rather than only adult communication partners.

Parents' perception on the use of augmentative and alternative communication by children with complex communication needs in Malaysia.

PURPOSE: Children with developmental disabilities who have complex communication needs (CCN) frequently need to use augmentative and alternative communication (AAC) to communicate effectively and efficiently. Speech-language pathologists (SLPs) often work closely with parents and other professionals when deciding on the best AAC system to introduce to these children. This study aimed to describe the use of AAC by children with CCN in Malaysia as reported by their parents. MATERIALS AND METHOD: An online survey distributed for this study was completed by 235 parents. RESULTS: Most of the parents of children with CCN who participated in this study reported that their children used low-tech AAC systems. A majority of respondents were satisfied with their child's AAC system. Parental satisfaction was positively associated with the frequency of use and whether the use of AAC helped parents understand the child better. Challenges reported by parents when using AAC and the reason some families abandoned the use of AAC were similar. Examples of challenges include parents having limited time and the child lacking the motivation to use the AAC system. CONCLUSION: The findings of this study suggest the importance of SLPs actively involving parents in the selection of their children's AAC system so they are agreeable with the system introduced and continuously supporting children and their families to encourage and sustain the use of AAC. Implications for rehabilitationSpeech-language pathologists (SLPs) can create communication opportunities for the child to use augmentative and alternative communication (AAC) and experience success, teach parents how to incorporate AAC into the family's daily routine and activities, and reduce the demands on parents by preparing the AAC materials and programming the AAC system where possible.SLPs can provide ongoing support to school teachers to equip them with the necessary knowledge and skills to support the use of AAC in the classroom.

The relationship between affiliate stigma, stress, and quality of life for parents of individuals with cerebral palsy in Malaysia.

OBJECTIVE: To examine the relationship between affiliate stigma, stress, and perceived quality of life among parents of children with cerebral palsy (CP). METHOD: Surveys (Study 1) and semi-structured interviews (Study 2) were used to collect data. Thirty-eight respondents completed the Affiliate Stigma Scale (ASS), Caregiver Burden Inventory (CBI), and Care-related Quality of Life (CarerQol) scales (GMFCS). Eleven respondents took part in semi-structured interviews, which were then thematically evaluated. RESULTS: Parents did not feel stigmatized because they had a child with CP. However, parents needed some form of short-term relief from caregiving. After controlling for demographics, high stress respondents experienced high affiliate stigma whereas low stress respondents had better quality of life. Although the respondents with less stigma had a better quality of life, this effect was moderate. Three major themes emerged from the interviews. CONCLUSION: Counseling, support groups, and helper services should be offered to parents. Also, healthcare professionals participating in CP rehabilitation, community-based rehabilitation, and health institutions should be educated on how to better help parents of children with CP.

There is a need in Malaysia to offer counseling, support groups, and assistance programs for parents of children with cerebral palsy.Healthcare professionals, who offer rehabilitation services to children with cerebral palsy, need greater awareness of the needs of families and caregivers and should be educated about how to best support them.There should be greater recognition of the importance of respite and relief from caregiving among Malaysian parents of children with cerebral palsy.

Malaysian speech-language pathology students' reflections about their participation in an AAC training program.

Most speech-language pathologists (SLPs) in Malaysia practice with an undergraduate degree, which provides them with limited knowledge about and training in augmentative and alternative communication (AAC). This limited knowledge and training may affect their confidence and competence when introducing and using AAC with individuals for whom it is required. This study aimed to obtain feedback, via semi-structured interviews, from a group of 11 Malaysian university students who participated in an AAC training program about their experiences participating in and the effectiveness of the training program. Three themes were derived from qualitative content analysis of the interviews: (a)Time Demands, (b) Generalizing the use of AAC, and (c) Learning Required When Introducing AAC. The participants reported that they obtained better insights into the role of SLPs and communication partners with regards to AAC, as well as the struggles they faced. Students also reported increased confidence when working with individuals who use AAC after participating in the training program, thus supporting the need for similar training programs in the future.

Association Between Symbolic Play and Language: A Comparison Between Typically Developing Children and Children with Down Syndrome.

OBJECTIVE: Language and symbolic play require the same underlying symbolic ability and develop parallel to one another. The aim of this study was to determine the association between symbolic play and vocabulary in typically developing children and children with Down syndrome in Malaysia. METHODS: Twenty-five typically developing children and 25 children with Down syndrome aged between 12 and 36 months were involved in this study. They were recruited from an early intervention center and various kindergartens from the West Coast of Peninsular Malaysia. Their play skills were assessed using the Symbolic Play Test Second Edition, and information about their vocabulary was obtained through the MacArthur Bates Communicative Development Inventories that was filled out by their parents. RESULTS: There was a significant difference in the vocabulary and symbolic play scores of children with Down syndrome compared with typically developing children. There was also a positive correlation between symbolic play scores and receptive and expressive vocabulary scores for both groups of children. CONCLUSION: When providing intervention, speech-language pathologists need to promote the development of symbolic play in addition to language, given the association between the two. They should also look into introducing an augmentative and alternative communication system to the children who demonstrate age-appropriate symbolic play skills but have trouble with symbolic language production.

Malaysian teachers' experience using augmentative and alternative communication with students.

Teachers play an important role in the successful implementation of augmentative and alternative communication (AAC) for students with complex communication needs. The goal of this two-phase, mixed-methods study was to explore Malaysian teachers' use of, experience with, and perceptions about AAC. Phase 1 involved 252 teachers who completed a questionnaire that was aimed at collecting nationwide data about their use and overall perceptions of AAC. Phase 2 involved semi-structured interviews with 13 teachers who had experience supporting students who used AAC. Approximately half of the participants who completed the questionnaire knew about AAC and had used AAC with their students. Almost all of the participants had positive views of AAC though some misconceptions were reported. Most participants had limited knowledge about AAC that led them to experience difficulties supporting their students. Teachers were motivated to receive AAC-related training to enable them to use AAC more successfully with their students given the small number of SLPs in the country.

Reflections of Malaysian parents of children with developmental disabilities on their experiences with AAC.

Parents play an important role in the successful implementation of AAC. Previous research has indicated that parents in different countries have varying perceptions about the use of AAC and face different challenges in its implementation. To date, there is limited information about the use of AAC by children in Malaysia or parents' views about its use. The aim of this study was to explore Malaysian parents' perception of AAC and their experience when supporting their children who use AAC. For this study, 12 parents of children with autism spectrum disorder and cerebral palsy were involved in semi-structured individual interviews. Qualitative content analysis was used to analyze interview data. Following analysis, three themes were identified: (a) impact of the use of AAC, (b) challenges faced, and (c) hopes and expectations. Participants reported that the use of AAC had a positive impact on their children, but that they faced challenges related to the child, the settings, and the system itself, as well as a lack of time and support. Findings from this study provide an insight for Malaysian speech therapists about the challenges faced by parents when supporting their children who use AAC, and how important it is to overcome these challenges to ensure successful implementation of AAC.

Practise patterns of Malaysian speech-language pathologists in managing children with speech and language delay/disorder.

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.

A comparison of Malaysian and Australian speech-language pathologists' practices with children with developmental disabilities who are pre-symbolic.

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.