Sunday December 16, 2012
By DR LOW HUI MIN
The authorities should be serious if they want to move towards advocating inclusive education especially for children with learning disabilities.
MANY children with special learning needs require speech and language therapy from an early age. They generally receive this service from speech-language pathologists, either in hospitals or in private practices.
Although the provision of speech-language services in schools is common in most developed countries, this service, unfortunately, has yet to be made available in Malaysian schools.
Therefore, this area of remediation, though crucial, remains inaccessible to many children in need of it.
Developmental and learning disabilities in children are common. Evidence from worldwide reports show that about 16% to 33% of children have at least one form of special learning needs.
McLeod and McKinnon from Charles Sturt University in Australia compared the prevalence of communication disorders with other learning needs in 14,500 primary and secondary school students.
They found that the majority of students with special learning needs are struggling in the area of speech, language and communication.
Their statistics show that 19% of the students have dyslexia, 12% have communication impairment and 6% have difficulties learning English or other languages as their second language.
Altogether, these figures yield an alarming 37% of students with speech, language and communication difficulties.
This figure is compelling, as compared to the other forms of special learning requirements: behavioural/emotional difficulty (6%), early achiever/advanced achiever (6%), physical/medical disability (1%), intellectual disability (1%), hearing impairment (1%) and visual impairment (0.5%).
Besides that, the prevalence of developmental and learning disabilities has been reported as “increasing” over the years. According to an American national report released in a prominent scientific journal,Pediatrics (2011), the prevalence of development disabilities has increased from 12.84% to 15.04% over the past 12 years.
In the past 10 years, Malaysia has also experienced a notable shift in the prevalence for students with special educational needs.
The Special Education Department in the Education Ministry reported that in 1999, there were 6,433 students who received special education services in primary schools and 2,627 students in secondary schools.
In 2009, the number had increased six-fold to 21,775 special education students in primary schools and 13,864 students in secondary schools.
Given this alarming shift, there is an urgent need to critically assess the current special education situation in Malaysia especially its capabilities and potential to serve the increasing population of students with special needs.
This is particularly for those who struggle to use speech, language and communication on a daily basis.
Speech and language therapy
Studies have shown that children with learning difficulties could benefit substantially from early identification and remediation of their learning difficulties.
One aspect of remediation that is essentially required by them is speech and language therapy.
Others include occupational therapy, behavioural intervention and medical treatment according to individual needs.
Speech and language therapy is crucial as many children with learning difficulties experience delay in speech and language development.
Some of them, such as those with Autism Spectrum Disorders (ASD) also experience atypical use of gestural communication, lack of eye contact and turn-taking skills, echolalia (repetition of words without accessing to the meanings), hyperlexic (intense fascination with letters and numbers) and use of idiosyncratic language (unusual word choices or sentence structures).
Furthermore, many children remain mute or non-verbal, and they need to be trained to use alternative methods to communicate, such as pictures, symbols or gestures.
Speech and language therapy is therefore important to help these children to acquire language and communication skills in the presence of the individual learning challenges that they have.
In Malaysia and many other countries, speech and language therapy is provided by clinically trained professionals, known as speech-language pathologists or speech-language therapists.
This group of professionals is trained at either the undergraduate or postgraduate level to diagnose speech and language delay or disorders and to provide remedial services to those with such difficulties.
Universiti Sains Malaysia and Universiti Kebangsaan Malaysia are the two universities in Malaysia that have produced graduates in this area.
These graduates work predominantly in general hospitals, private medical centres, early intervention centres or in their own private practices.
So far, very few graduates have worked in schools or with the Education Ministry.
One primary reason is that previously there were no permanent positions available for this profession in schools or in the ministry.
Furthermore, the biggest setback is a special requirement set by the ministry, where the graduates are required to obtain a one-year diploma course in teaching in order to qualify as speech-language pathologists in schools.
This requirement is almost similar to requesting an electrical engineer who applies to this position in a hospital to do a one-year medical diploma.
This working package obviously becomes less attractive to graduates who had just completed an intensive four-year coursework and clinical undergraduate programme in university and who are eager to start serving the community.
The question raised here is whether there could have been other strategies to make speech-language therapy services more accessible to students in schools?
First, it is important to recognise that speech-language pathologists play specialised roles in schools and they are not there to replace the teachers. Speech-language pathologists are needed in schools to assist students with difficulties in speech, language and communication to deal with their deficit areas so that they have better school learning experiences.
Their responsibilities will be to identify the students’ issues in these areas, help teachers to develop a mode for the students to communicate in the classes, provide periodical assessment to monitor the students’ progresses and provide direct speech and language remediation as a way to work on their deficit areas.
Speech language therapy services in schools function to address the students’ special needs, which teachers would not be able to specifically focus on due to their whole-class teaching responsibilities.
Thus, speech-language therapy services need to be made available in schools to students with special needs to fill up their learning gaps.
Second, it is equally important to understand that speech-language pathologists would not be able to replace any regular teacher or to take over their roles, and vice versa.
This is in line with point one that speech-language pathologists are trained with highly fine-grained skills which they are qualified with, and the services provided by them are specific for the prevention, diagnosis, remediation and consultation of speech, language and communication difficulties.
Similarly, speech-language pathologists should not be called to perform the duty of teachers, just like office administrators in schools would not be allowed to teach in classes.
Course on teaching
These two points challenge the criterion of having speech-language pathologists to take a one-year course in teaching prior to job entry.
Nevertheless, it is also important to maintain the idea that speech-language pathologists who wish to work in schools should have sound knowledge of the education principles in Malaysia.
Such knowledge would help them to adapt to the school systems and to deliver effective speech therapy services in school environments.
A clear understanding of their roles in schools would also help them to establish positive working relationships with the teachers, headmasters, and parents.
This healthy relationship potentially leads to productive collaborations that would benefit all involved, particularly the special-need students.
Therefore, instead of an additional teaching diploma, it is suggested speech-language pathologists have to attend an orientation course of a shorter duration conducted by the relevant experts in education.
Such orientation courses should be opened to all graduates in the area of speech-language pathology regardless of their future career directions. The graduates can choose to participate in this course voluntarily.
Perhaps sponsorships could be offered to graduates with good grades as a way to encourage them to consider the option of working in school settings.
Completion of this orientation course provides a ticket for them to apply for the relevant posts in schools or at the ministry. Alternatively, this course can also be introduced as part of speech-therapy training at the university level.
The knowledge learnt could then be reinforced via a supervision and mentoring system established by the ministry in schools, with relevant continual professional development programmes. This practice is common in Australia.
As a whole, there is a call for more efforts from the ministry and all personnel involved in providing high-quality educational care to the students with special needs in Malaysia, in order to improve their learning environment and experiences.
Perhaps one way to start with is to make certain professional services, such as speech and language therapy available and accessible to the students in schools.
In line with the concept of Education For All, our country should move towards advocating inclusive education for all students, including those with special needs.
The idea is that all students, regardless of their conditions, should be given equal learning opportunities, and should not be isolated from the mainstream education system.
Along with this line, support services, such as speech and language therapy are crucial to help students with special needs to adapt to and to cope with regular classroom teaching and learning, and at the same time, to address their specific needs.
Such a system has been long established in many developed countries for at least half a decade. It is therefore time for us to move forward.
>The writer is an expert on Special Education from the School of Educational Studies, Universiti Sains Malaysia, Penang.