LEARNING and developmental disabilities are quite common among children in Malaysia.
They include global developmental delay (GDD), intellectual disability, autism, Down Syndrome and attention deficit hyperactivity disorder (ADHD).
There are also specific learning disorders like dyscalculia (severe difficulty in making arithmetic calculations), dysgraphia (unable to write coherently) and dyslexia (difficulty in reading or interpreting words, letters and other symbols).
According to the Welfare Department, there were 82,447 children registered with these disorders in 2016, which account for about 71 per cent of the total children with disabilities.
Universiti Kebangsaan Malaysia (UKM) Faculty of Medicine lecturer and family medicine specialist Dr Ezura Madiana Md Monoto said as public awareness on autism, ADHD, dyslexia and other learning disabilities increased, more parents are seeking help when they notice that their children are not developing as well as their peers.
“There are long queues at government hospitals and primary care clinics for consultation on learning and developmental disabilities.
“Private hospitals, learning centres and non-governmental organisations are also providing therapies for special needs children.
“In our (UKM) setting, other than referring patients to our colleagues in the psychiatric and paediatric departments, we also offer rehabilitation services, such as occupational therapy, physiotherapy and speech therapy.
“We also work hand-in-hand with NGOs such as SOLS Health to provide assessment and intervention to our patients.
“Obviously, we need more specialists and facilities that are easily accessible to detect, diagnose and provide early intervention for special needs children at an affordable cost,” she said.
To provide exposure to medical students and, at the same time produce more experts, Dr Ezura said students at UKM Medical (UKMMC) will get the opportunity to work with such patients during their clinical years.
“We have the Child Development Centre under the paediatrics department, Child Psychiatry Clinic under the psychiatric department, and Child and Adolescents Clinic under UKMMC’s primary care clinic, where students will work in rotations.
“When they are posted to other teaching hospitals, too, they have the opportunity to see these cases as their prevalence is high in our communities.
“They have ample opportunity to see and discuss such cases with specialists and doctors, in which they gain valuable experience to handle these cases in future,” she said.
Dr Ezura said final-year medical students at UKM undergo their family medicine posting for five weeks, and they will be posted to UKMMC’s primary care clinic in Kuala Lumpur, and Klinik Kesihatan Batu 9 Cheras and Klinik Kesihatan Batu 14 Hulu Langat in Selangor, to allow them to work in the community.
She said they will learn to practice patient-centered consultation and apply the continuity of care concept in managing patients. They will be exposed to personalised healthcare that has cost-effective and quality features.
Being a public university that trains specialists in family medicine, UKM’s Family Medicine Department also runs a Child and Adolescent Clinic.
It is open in UKMMC every Tuesday, and the clinic provides therapy for patients under 18 with learning difficulties, and developmental and behavioural disorders.
Special needs youngsters are referred to the Child and Adolescent Clinic from schools, government clinics and private practitioners.
“With increasing awareness, sometimes parents themselves walk in to consult on their children’s problems. We work hand in hand with UKMMC’s Child Development Clinic and Child Psychiatry Clinic to diagnose and coordinate care for these children and adolescents.
“Students attached here have the opportunity to serve at the clinic under the supervision of lecturers and family medicine specialists.
“With increased prevalence of such disabilities in Malaysia, they will be the frontliners in the community to detect, manage and coordinate care for patients after they graduate.
“We also provide continuous education for medical practitioners who like to learn about this subject,” said Dr Ezura, adding that the clinic also conducts awareness programmes for the public.
Recently, the UKMMC Child and Adolescent Clinic carried out a programme to mark autism and Down Syndrome. It was officiated by Faculty of Medicine assistant dean (learning & CITRA) Professor Datuk Dr Harlina Halizah Siraj.
Dr Harlina said not everybody is capable of going through the challenges of raising children with special needs.
Therefore, society needs to be empathic, accepting and willing to lend full support to these families.
“Hence, that is why we organise this awareness programme today — to educate society on what Down Syndrome and autism are all about, how people with different abilities live their life.
“Typical people like us need to create an inclusive environment for them to thrive and achieve their full potential alongside with us,” she said.
Twenty-three UKM medical graduates and students volunteered to help out in the event.
“We are grateful for the opportunity to work with children and adolescents with autism and Down Syndrome as it gives us the chance to understand them better and learn how to support them and their family,” said Nur Nazira Safani, 25, who graduated last year and is waiting for her housemanship posting.
Dr Ezura, who headed the organising committee, said it took two weeks to secure funding and put the event together.
“Within a short period, we managed to bring Andi Miranti, a teenager with autism who published his comic Ned Dickens; Amira Daniea, an autistic but talented young artist who has her own line of tudung and art pieces; and Yan Wei Xing, eight, a boy with Down Syndrome who helps his parents plant and sell hydrangea flowers.
“We also engaged SOLS Health to provide psychological assessment for visitors and Nuha Kids Care Centre to do gross motor circuit activities for the children.
“We held an exhibition on what early intervention is all about. Speech language pathologists and dietitians from UKM were also at hand to provide advice and hands-on demonstration to parents,” said Dr Ezura.
“This was a good initiative to show the community what people with autism and Down Syndrome can do if early intervention is initiated to minimise gaps in developmental milestones and social functions,” said Florence Lim Tze Teng, who is the mother of Yan Wei Xing.
“Although there are prevailing negative perception and attitude from the community, we need to help our special needs children to prepare themselves for the future — to be independent and, hopefully, integrate successfully with their peers and the community,” she added.
The event received tremendous support from parents and teachers of children with special needs, who brought their children to participate in the activities. UKMMC will be holding a seminar on paediatric learning disabilities for primary healthcare providers in UKMMC on July 30.