Oral-diadochokinesis between Parkinson's disease and neurotypical elderly among Malaysian-Malay speakers.

BACKGROUND: Parkinson's disease (PD) has an impact on speech production, manifesting in various ways including alterations in voice quality, challenges in articulating sounds and a decrease in speech rate. Numerous investigations have been conducted to ascertain the oral-diadochokinesis (O-DDK) rate in individuals with PD. However, the existing literature lacks exploration of such O-DDK rates in Malaysia and does not provide consistent evidence regarding the advantage of real-word repetition. AIMS: To explore the effect of gender, stimuli type and PD status and their interactions on the O-DDK rates among Malaysian-Malay speakers. METHODS & PROCEDURES: O-DDK performance of 62 participants (29 individuals with PD and 33 healthy elderly) using a non-word ('pataka'), a Malay real-word ('patahkan') and an English real-word ('buttercake') was audio recorded. The number of syllables produced in 8 s was counted. A hierarchical linear modelling was performed to investigate the effects of stimuli type (non-word, Malay real-word, English real-word), PD status (yes, no), gender (male, female) and their interactions on the O-DDK rate. The model accounted for participants' age as well as the nesting of repeated measurements within participants, thereby providing unbiased estimates of the effects. OUTCOMES & RESULTS: The stimuli effect was significant (p < 0.0001). Malay real-word showed the lowest O-DDK rate (5.03 ± 0.11 syllables/s), followed by English real-word (5.25 ± 0.11 syllables/s) and non-word (5.42 ± 0.11 syllables/s). Individuals with PD showed a significantly lower O-DDK rate compared to healthy elderly (4.73 ± 0.15 syllables/s vs. 5.74 ± 0.14 syllables/s, adjusted p < 0.001). A subsequent analysis indicated that the O-DDK rate declined in a quadratic pattern. However, neither gender nor age effects were observed. Additionally, no significant two-way interactions were found between stimuli type, PD status and gender (all p > 0.05). Therefore, the choice of stimuli type has no or only limited effect considering the use of O-DDK tests in clinical practice for diagnostic purposes. CONCLUSIONS & IMPLICATIONS: The observed slowness in O-DDK among individuals with PD can be attributed to the impact of the movement disorder, specifically bradykinesia, on the physiological aspects of speech production. Speech-language pathologists can gain insights into the impact of PD on speech production and tailor appropriate intervention strategies to address the specific needs of individuals with PD according to disease stages. WHAT THIS PAPER ADDS: What is already known on this subject The observed slowness in O-DDK rates among individuals with PD may stem from the movement disorder's effects on the physiological aspects of speech production, particularly bradykinesia. However, there is a lack of consistent evidence regarding the influence of real-word repetition and how O-DDK rates vary across different PD stages. What this study adds to existing knowledge The O-DDK rates decline in a quadratic pattern as the PD progresses. The research provides insights into the advantage of real-word repetition in assessing O-DDK rates, with Malay real-word showing the lowest O-DDK rate, followed by English real-word and non-word. What are the potential or actual clinical implications of this work? Speech-language pathologists can better understand the evolving nature of speech motor impairments as PD progresses. This insight enables them to design targeted intervention strategies that are sensitive to the specific needs and challenges associated with each PD stage. This finding can guide clinicians in selecting appropriate assessment tools for evaluating speech motor function in PD patients.

Orthotic intervention options to non-surgically manage adult and pediatric trigger finger: A systematic review.

BACKGROUND: The design and efficacy of orthotic intervention to non-surgically manage adult and pediatric trigger finger vary widely. PURPOSE: To identify types of orthoses (including relative motion), effectiveness, and outcome measurements used to non-surgically manage adult and pediatric trigger finger. STUDY DESIGN: Systematic review. METHODS: The study was undertaken according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement and registered with the International Prospective Register of Systematic Reviews Registry, number CRD42022322515. Two independent authors electronically and manually searched, and screened 4 databases; selected articles following pre-set eligibility criteria; assessed the quality of the evidence using the Structured Effectiveness for Quality Evaluation of Study; and extracted the data. RESULTS: Of the 11 articles included, 2 involved pediatric trigger finger and 9 adult trigger finger. Orthoses for pediatric trigger finger positioned finger(s), hand, and/or wrist of children in neutral extension. In adults, a single joint was immobilized by the orthosis, blocking either the metacarpophalangeal joint or the proximal or distal interphalangeal joint. All studies reported positive results with statistically significant improvements and medium to large effect size to almost every outcome measure, including the Number of Triggering Events in Ten Active Fist 1.37, Frequency of Triggering from 2.07 to 2.54, Quick Disabilities of the Arm, Shoulder and Hand Outcome Measure from 0.46 to 1.88, Visual Analogue Pain Scale from 0.92 to 2.00, and Numeric Rating Pain Scale from 0.49 to 1.31. Severity tools and patient-rated outcome measures were used with the validity and reliability of some unknown. CONCLUSIONS: Orthoses are effective for non-surgical management of pediatric and adult trigger finger using various orthotic options. Although used in practice, evidence for the use of relative motion orthosis is absent. High-quality studies based on sound research questions and design using reliable and valid outcome measures are needed.

Effects of pressure garment on spasticity and function of the arm in the early stages after stroke: a randomized controlled trial.

OBJECTIVE: To investigate the effects of pressure (Lycra) garment on the spasticity and function of the arm in the early stages after stroke. DESIGN: A randomized controlled trial. SETTING: Occupational therapy unit of a public hospital. SUBJECTS: A total of 46 adults with stroke. INTERVENTION: After random assignment, for six weeks, both intervention group and control group received a 2 hour/week conventional occupational therapy program, with the intervention group receiving an extra 6 hour/day pressure garment application (long glove). MAIN MEASURES: Modified Modified Ashworth Scale, Disabilities of Arm, Shoulder and Hand Outcome Measure, and Jebsen-Taylor Hand Function Test. Eligibility measures: Mini Mental State Examination and Modified Modified Ashworth Scale. Assessments were performed at baseline and six weeks postintervention. RESULTS: There were 21 participants with the mean age of 51.19 (8.28) years in the intervention group and 22 participants with the mean (SD) age of 52.82 (8.71) years in the control group. The intervention group had median (interquartile range (IQR)) post-stroke duration of 1 (1) month, while for the control group, they were 2 (2) months. There was no difference in spasticity, and both perceived and actual arm functions between the groups at six weeks after baseline. CONCLUSION: Wearing a pressure garment on the arm for 6 hours daily had no effect in controlling spasticity or on improving arm function in the early stages after stroke.

Standardized translated instruction versus spontaneously translated instruction: Test-retest and interrater reliability of a hand function test.

STUDY DESIGN: Cross-sectional study. INTRODUCTION: Adhering to test administration and standardized instructions is important for attainment of accurate and reliable results in performance-based tests. PURPOSE OF THE STUDY: To determine test-retest and interrater reliability of standardized translated instruction (St-TI) and spontaneously translated instruction (Sp-TI) of a hand function test. METHODS: Four raters and seventy-two subjects were divided into 2 groups: St-TI group, direct administration of the Hong Kong Chinese version of the Jebsen Hand Function Test to subjects by raters; and Sp-TI group, spontaneously translating the Jebsen-Taylor Hand Function Test from English into Chinese by raters. Test-retest and interrater reliability were calculated based on instruction time by the rater and performance time by the subject. RESULTS: Test-retest and interrater reliability of instruction time by rater for St-TI has intraclass correlation coefficient of 0.35 to 0.70 and 0.24 to 0.55, respectively, whereas that for Sp-TI was -0.50 to 0.18 and -0.09 to 0.51, respectively. Test-retest and interrater reliability of performance time by subject for St-TI was 0.56 to 0.84 and 0.33 to 0.78, respectively, whereas that for Sp-TI was 0.54 to 0.87 and 0.35 to 0.77, respectively. Sp-TI had two test-retest minimal detectable change percent values that fell within the acceptable range (subtest 3 = 21.9% and subtest 6 = 25.7%). CONCLUSION: Instruction time by rater for Jebsen-Taylor Hand Function Test subtests had generally poor to moderate test-retest and interrater reliability for both St-TI and Sp-TI. Performance time by subject generally had moderate to good reliability, except for St-TI with poor to good interrater reliability.

A systematic review of occupational therapy intervention for handwriting skills in 4-6 year old children.

INTRODUCTION: Handwriting skills play a significant role in all stages of an individual's life. Writing interventions should be considered at a younger age to ensure proper development of writing skills. Hence, the aims of this study is to evaluate the current evidence of occupational therapy interventions in handwriting skills for 4-6 year old children. METHODS: Published literature was systematically searched according to PRISMA guidelines using specific key terms. Initial search identified 785 studies; however only seven met the inclusion criteria and were assessed for final review. Studies were methodologically appraised using the McMaster Critical Review Form-Quantitative Studies. RESULTS: The review found no randomised control trial study design pertaining to the reviewed area. However, it can be seen that occupational therapy interventions for writing skills in 4-6 year old children managed to increase the targeted skills. The results were similar across samples with or without disabilities. An effective integration of occupational therapy interventions into educational curriculum was found to save both time and cost. CONCLUSION: The long-term benefit from these interventions and the effects of these interventions on a broader spectrum of fine motor abilities need to be explored further with stronger research designs. However, the lack of studies adopting high level study designs, i.e., RCT designs means, results need to be approached with caution by occupational therapists when implementing handwriting skills intervention in practice.

Validity and reliability of a Malay version of the Lawton instrumental activities of daily living scale among the Malay speaking elderly in Malaysia.

BACKGROUND/AIM: The Lawton Instrumental Activities of Daily Living Scale is a tool often used to assess independence among elderly at home. Its suitability to be used with the elderly population in Malaysia has not been validated. This current study aimed to assess the validity and reliability of the Lawton Instrumental Activities of Daily Living Scale - Malay Version to Malay speaking elderly in Malaysia. METHODS: This study was divided into three phases: (1) translation and linguistic validity involving both forward and backward translations; (2) establishment of face validity and content validity; and (3) establishment of reliability involving inter-rater, test-retest and internal consistency analyses. Data used for these analyses were obtained by interviewing 65 elderly respondents. RESULTS: Percentages of Content Validity Index for 4 criteria were from 88.89 to 100.0. The Cronbach α coefficient for internal consistency was 0.838. Intra-class Correlation Coefficient of inter-rater reliability and test-retest reliability was 0.957 and 0.950 respectively. CONCLUSIONS: The result shows that the Lawton Instrumental Activities of Daily Living Scale - Malay Version has excellent reliability and validity for use with the Malay speaking elderly people in Malaysia. This scale could be used by professionals to assess functional ability of elderly who live independently in community.

The effectiveness of therapeutic craft-making activities in treating lower-third forearm fracture: study protocol for a randomized controlled trial.

BACKGROUND: Occupational Therapists use craft-making activities as therapeutic interventions to improve physical and psychological functioning of injured people. Despite the therapeutic effects, craft-making is not routinely used in hand rehabilitation as an intervention for patients with upper limb fractures. These patients often experience physical and psychosocial issues; however, without supportive evidence, therapists hesitate to integrate craft-making into upper limb rehabilitation. PURPOSE: This study aims to determine the effect of a conventional therapy combined with therapeutic craft-making on disability, post-traumatic stress, and physical performance in patients with lower-third forearm fractures. METHODS: Priori analysis determined that 38 patients will be needed for this superiority randomized controlled trial to be conducted in a hand and upper limb rehabilitation center. Eligible participants must comprehend English, be diagnosed with lower-third forearm fracture(s) stabilized by open reduction internal fixation, and referred to therapy within 2-4 weeks of surgery. Following the CONSORT guidelines, participants will be randomly assigned to a Control (conventional therapy) group or an Intervention (conventional therapy and craft) group. Twice weekly for 6 weeks, Therapist A will provide both groups with 1-h of conventional therapy while the Intervention group will also receive 15 min of craft-making supervised by the Researcher. The primary outcome of disability will be measured with the Quick-Disabilities of Arm, Shoulder and Hand. The secondary outcome measurements include the Patient-Rated-Wrist-Evaluation; Impact of Event Scale-revised and physical performance, i.e., the Purdue Pegboard Test, AROM, and grip strength. All outcome measures will be obtained by Therapist B prior to the 1st therapy visit and after the 12th visit. Descriptive analysis will be done for the categorical and continuous data and a mixed model ANOVA for analysis of the initial and final assessment scores within and between groups. RESULTS: This study is ongoing. DISCUSSION: The intent of this study is to determine if therapeutic crafts have value as an intervention when used in combination with conventional therapy for patients with lower-third forearm fractures. If the value of crafts is supported, this evidence may reduce hesitancy of therapists to implement craft-making with patients referred to hand therapy after upper limb fracture. CONCLUSION: This study is ongoing. TRIAL REGISTRATION: ANZCTR, ACTRN12622000150741. Retrospectively registered on 28 January 2022 https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=382676&isReview=true ..

The standardised Malay version of purdue pegboard test: Content validity and test-retest reliability testing.

Introduction: Purdue Pegboard Test (PPT) is a valid and reliable instrument for measuring hand dexterity among individuals with or without medical conditions. In the Southeast Asia region where Malay is widely spoken, there is a need to have a Malay translation of Purdue Pegboard Test. This study aimed to translate the PPT into the Malay version (PPT-M) and to determine the content validity and test-retest reliability of this translated version. Methods: This study involved: (1) four English teachers (translators) for forward and backward translation procedures; (2) 10 experts in the field of occupational therapy (expert reviewers) for content validity testing; and (3) 60 undergraduate students (participants) for test-retest reliability testing. Results: PPT-M had excellent content validity with Item-Content Validity Index = 0.9-1.0, Scale-Content Validity Index/Average = 0.93-0.95, and a slightly lower Scale-Content Validity Index/Universal Agreement = 0.25-0.75. Test-retest reliability for 3-trial administration (n = 30; Intraclass Correlation Coefficients, ICCs = 0.76-0.85; good) was higher compared to 1-trial administration (n = 30; ICCs = 0.34-0.46; poor) for all subtests. Both trial administrations were mostly affected by systematic errors, especially practice effect as the retests gave higher scores. Random errors mostly affected Subtest 3 of 1-trial administration, evident by its Minimal Detectable Change Percent values = 30.84% that fell beyond the acceptable range. Conclusion: PPT-M has the potential to be a valuable instrument for measuring hand dexterity among Malay speaking individuals especially when the 3-trial administration is used.

Postoperative management of zones V-VI extensor tendon repairs: A survey of practice in Malaysia and comparison to IFSHT member countries.

Introduction: A survey of International Federation of Societies for Hand Therapy (IFSHT) member countries identified relative motion extension as the preferred approach to management of zones V-VI extensor tendon repairs. The aims of this survey were to identify and compare hand therapy practice patterns in Malaysia (a non-IFSHT member country) with findings of the IFSHT survey including an IFSHT subset of Asia-Pacific therapists and to investigate if membership status of the Malaysian Society for Hand Therapists (MSHT) influenced therapy practice patterns. Methods: An online English-language survey was distributed to 90 occupational therapists and physiotherapists including MSHT members and non-members. Participation required management of at least one extensor tendon repair in the preceding year. Five approaches were surveyed: immobilisation, early passive motion (EPM) with dynamic splinting, and early active motion (EAM) delivered by resting hand (RH), palmar resting interphalangeal joints free (PR), and relative motion extension (RME) splints. Results: Thirty-seven of the 53 therapists (68%) who commenced the survey completed it. The most used approach was dynamic/EPM (28%), followed by RH/immobilisation (22%) and RH/EAM (22%). A preference for RME/EAM was identified with implementation barriers being surgeon preference and hand therapist confidence. Discussion: Approach selection for Malaysian therapists differed from the combined IFSHT and Asia-Pacific respondents, with the former using dynamic/EPM and RH/immobilisation compared to IFSHT respondents who predominately used RME/EAM and PR/EAM. This survey provides valuable insights into Malaysian hand therapists' practices. If implementation barriers and therapist confidence are addressed, Malaysian practice patterns may change to better align with current evidence.

Work Motivation among Occupational Therapy Graduates in Malaysia.

OBJECTIVE/BACKGROUND: Occupational therapy that focuses on servicing clients demands motivated workers for quality service delivery. The objectives of this study were: (a) to determine the level of work motivation among occupational therapy graduates in Malaysia and (b) to determine if there is a difference in work motivation among these graduates based on work sector, job position, length of work experience, and gender. METHODS: This cross-sectional study recruited occupational therapy bachelor's degree graduates using an online survey. The Work Extrinsic and Intrinsic Motivation Scale (WEIMS) was used to measure level of work motivation. RESULTS: Responses from 82 (60.3%) graduates (male: 26.8%; female: 73.2%) were analysed. Sixty-two (75.6%) graduates worked locally and 20 (24.4%) worked in foreign countries. The average Work Self-Determination Index (W-SDI) score for WEIMS is +11.38 with 78 (95.1%) of graduates demonstrated a self-determined motivational profile and 4 (4.9%) demonstrated a nonself-determined profile. Graduates in the private sector (13.10 ± 6.47) show significantly higher W-SDI score compared to those in the public sector (9.40 ± 6.06), p = 0.01. W-SDI scores appeared higher among clinician (11.67 ± 6.40), case manager (13.33), and others (14.90 ± 8.23); and those with work experience of 5-6 years (13.11 ± 6.90) and less than one year (12.65 ± 7.12). Male (10.29 ± 6.86) and female (11.79 ± 6.39) graduates shared equally high score. There is no significant difference in W-SDI score based on job position, length of work experience, and gender. CONCLUSION: Occupational therapy graduates have high work motivation as evident by their self-determined profile. Only work sector imposes difference in work motivation among these graduates. Copyright © 2017, Hong Kong Occupational Therapy Association. Published by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Self-Care Skills between Institutionalised and Home Dwelling Older Adults: A Preliminary Study Kajian Rintis Kemahiran Penjagaan Diri Warga Tua di antara institusi dan rumah kediaman / Jurnal Sains Kesihatan Malaysia

@#Self-care is defined as activities performed by individuals, families, and communities to enhance their health, prevent diseases, limit illnesses, and restore health. Previous research has mainly focused on self-care skills of older adults in either institution or residential homes separately but limited studies have compared between both these settings. This study aimed to compare the self-care skills between institutionalised and home dwelling older adults at selected area in Malaysia. A total of 43 participants aged 60 years old and above were recruited in our study; (23 participants were home-dwelled older adults and 19 participants were recruited from institutionalised older adults located in Kuala Lumpur). The Malay Version of Performance Assessment of Self-Care Skills (M-PASS-HOME) 4.0 was used focusing on four main subtests of self-skills; oral hygiene, trimming toenails, house mobility and shower mobility. The differences in self-care skills between institutionalised and home dwelling older adults are statistically significant (p<0.01) in the aspects of independency for all self-care activities. The results of this study revealed that home dwelling older adults group are more independent in self-care activities of oral hygiene, trimming toenails, house mobility and shower mobility compared to institutionalised group.

Cultural Adaptation and Validation of the Performance Assessment of Self-care Skills among Older People in Community (Adaptasi Budaya dan Kesahan Penilaian Prestasi Kemahiran Penjagaan Diri dalam Kalangan Warga Emas di Komuniti) / Jurnal Sains Kesihatan Malaysia

@#The Performance Assessment of Self-care Skills (PASS-Home) is a client-centered, performance-based, criterionreference, observational form designed to capture client’s performance skills in completing daily task activities. The aim of the study was to describe the process of translating, adapting and validating the PASS-Home from English language version into a Malay language version. The development of the translated Malay version of the PASS-Home consisted of two stages. Stage one involved the exclusion of the items that were not culturally relevant to the Malaysian culture. Stage two involved the translation process. The five steps of the cross-cultural adaptation process were followed: (1) initial forward version; (2) a summary of recommendations by the expert panels; (3) the back-translation; (4) modifications of the translated Malay version of PASS and a summary of problems found during the pre-testing, and (5) the final version of the PASS Malay Version (M-PASS). A total of five items from the PASS-Home were omitted in the Malay version (M-PASS) and another five items that were considered as suitable in Malaysian context were added in the M-PASS. The Content Validation Index (CVI) showed perfect agreement with an average of I-CVI was reported at 0.99 and S-CVI/universal agreement (S-CVI/UA) was at 0.93. Test-retest reliabilty showed that the M-PASS were highly reliable reported of its three main constructs of Independence (ICC=0.706), Safety (ICC=0.906) and Adequacy (ICC=0.950). M-PASS showed strong evidence as a valid and reliable assessment in evaluating the functional level of older people who live independently in community.

Functionality among stroke survivors with upper limb impairment attending community-based rehabilitation

@#Introduction: There is scarcity of research information on upper limb (UL) functionality among Malaysian post-stroke population despite the increasing number of stroke survivors. This study intends to evaluate functionality among stroke survivors residing in the community, with a specific focus on the UL. Methods: This cross-sectional study involved 65 stroke survivors with UL dysfunction (mean (SD) age = 64.83 (8.05) years, mean (SD) post-stroke duration 41.62 (35.24) months) who attended community-based rehabilitation program. Upper limb functionality was assessed using the UL items of Stroke Specific Quality of Life Scale (SSQOL), the Lawton Instrumental Activities of Daily Living (IADL) Scale and the Jebsen-Taylor Hand Function Test (JTHFT). The stroke survivors’ performance in completing JTHFT using their affected dominant hand was compared with standard norms. Results: The three most affected UL daily living tasks were writing (64.7%, n=42), opening a jar (63.1%, n=41) and putting on socks (58.5%, n=38). As for IADL, the mean (SD) score of Lawton scale was 3.26 (2.41), with more than 50% unable to handle finance, do the laundry and prepare meals for themselves. Performances of stroke survivors were much slower than normal population in all tasks of JTHFT (p<0.05), with largest speed difference demonstrated for ‘stacking objects’ task (mean difference 43.24 secs (p=0.003) and 24.57 (p<0.001) in males and females, respectively. Conclusion: UL functions are significantly impaired among stroke survivors despite undergoing rehabilitation. Rehabilitation professionals should prioritize highly problematic tasks when retraining UL for greater post-stroke functionality

Adaptation, Validation and Reliability Testing of Sensory Processing Measure Home Form Malay version for Children with Autism (Adaptasi, Kesahan dan Kebolehpercayaan Borang Sensory Processing Measure Home Form versi Bahasa Melayu untuk Digunakan terhadap Kanak-kanak dengan Autisme) / Jurnal Sains Kesihatan Malaysia

@#Inappropriate responses towards sensory input received from the environment, also known as sensory processing difficulties (SPD) may affect daily living activities of the children with Autism Spectrum Disorder (ASD). Sensory Processing Measure Home Form (SPM Home Form) as a parent report measure for SPD is available in English and other foreign languages. To enhance the applicability and meaningfulness of SPM Home Form for the Malay speaking population, a study that focuses on translating, adapting, and validating the SPM Home Form into the Malay language was conducted. The development of the Malay version of the SPM Home Form (SPM-MV Home Form) involved three steps: 1) Item evaluation, 2) Forward and backward translation, and 3) Expert review and content validity. The process of translation and adaptation of the form was performed according to standard guidelines. No item was excluded from the original SPM Home Form as all the items were considered by the expert panel as appropriate and relevance to evaluate the activity and social participation among children in Malaysia. Content validity as measured by 10 experts in occupational therapy is high. The mean of sub-scales I-CVI is between 0.96 and 1.00. The total S-CVI of the form is 0.95 with sub-scales S-CVI range between 0.82 and 1.00. Cronbach’s alpha for internal consistency was reported at 0.80 and ICC for test-retest reliability ranged from 0.80 to 0.97. The SPM-MV Home Form has high potential to be used for assessing SPD among children ages 5-12 years in Malaysia.

Does Neurophobia Exist Among Rehabilitation Sciences Students? A Survey At Universiti Kebangsaan Malaysia / Jurnal Sains Kesihatan Malaysia

Neurophobia, defined as ‘the fear of neural sciences and neurology’ is reported among medical students, which threatenedtheir performance in neurology course. This phenomenon has not been studied among rehabilitation sciences studentsdespite the significance of neurology as an area for rehabilitation. In this study we aim to assess the perceptions of neurologycourse and the possibility of neurophobia existence among rehabilitation sciences students of Universiti KebangsaanMalaysia (UKM). We also aimed to identify learning methods which are regarded as useful among the students. A surveyusing self-administered questionnaires was conducted among 73 students from School of Rehabilitation Sciences of theuniversity. Questions in the questionnaire were adapted from previous studies, in which neurophobia was indicated by poorknowledge and low confidence level in managing neurology course. Results showed that the percentage of participantswho perceived having good knowledge of neurology was significantly higher than the percentage who claimed of havingpoor knowledge level (90.4% versus 9.6%, p < 0.01). Similarly, the percentage of participants who claimed having highconfidence to handle neurology cases was higher than the percentage who expressed lack of confidence (79.2% versus20.8%, p = 0.03). However, neurology course was perceived as difficult by majority of the participants (78.1%) whencompared to other courses. Majority of the participants (97.3%) perceived clinical teaching as a useful method of learningrehabilitation science courses including neurology followed by problem-based learning (90.4%). While limited exposureto neurology cases was claimed as the main reason to why neurology is difficult. In conclusion, although neurology isperceived as a difficult course among rehabilitation sciences students, the students did not report lack of knowledge andconfidence in the course. This implies that neurophobia does not exist among UKM rehabilitation students. Enhancementof learning methods may assist in reducing the level of difficulty of neurology course among the students.

Reframing Services for Malaysian Students in Schools: Time to Bring Occupational Therapy into the Classroom / Jurnal Sains Kesihatan Malaysia

Autism spectrum disorder is a developmental disability that has gained increasing attention in Malaysia. Much effort is now being taken to include children with autism spectrum disorder in the school system, either in inclusive settings or in special educational settings. However, this endeavor raises many challenges for the children with autism spectrum disorder, their families and for service providers. The current study uses a qualitative approach to investigate parents’ perceptions of problems faced by their children with autism spectrum disorder in issues related to academic skills. A face-to-face interview was performed with parents of children with autism spectrum disorders who were receiving occupational therapy services for their difficulties in academic related skills. Findings indicate that most of the difficulties faced by these children are related to skills needed to be accepted at school, such as ability to communicate and socialize and this often limit their performance at school. These findings not only raise and discuss important implications for service providers such as teachers, health care professionals and policy makers, but also lead to suggestions for future research.