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THE EFFECTIVENESS OF ORAL HEALTH AND NUTRITION MODULE FOR
PARENTS/GUARDIANS OF CHILDREN WITH LEARNING DISABILITIES (ON-LD MODULE) IN
PASIR PUTEH, KELANTAN: A PILOT INTERVENTION STUDY
NMRR-18-2992-44125

Rosnani N, Ruhaya H, Normastura AR
Introduction: Maintaining oral health and nutrition status in children with learning
disabilities or LD may be challenging, as failure to do this will result in poor oral health and
nutrition status. Children with LD are dependant and need special care from
parents/guardians. Parents/guardians play an important role in ensuring the children’s
oral health and nutrition at the optimum level. Objective: To assess the effectiveness of
ON-LD Module in improving oral health KAP and cariogenic foods intake of
parents/guardians, as well as dental plaque maturity, nutritional status and cariogenic
foods intake of children with LD. The ON-LD Module was an integrated oral health and
nutrition education module specially designed for children with LD and delivered through
an organised training of trainer (TOT) programme, reinforcement sessions and periodic
reminders. Materials and Methods: A community intervention study using ON-LD Module
was done on parents/guardians and children with LD aged 7-14 years enrolled in Special
Education Integration Program (SEIP) of primary schools of Pasir Puteh and Bachok
Districts in Kelantan. About 286 pairs of parents/guardians and children with LD recruited;
145 pairs from Pasir Puteh as intervention group (IG), and 141 pairs from Bachok as
control group (CG). The oral health KAP and cariogenic food intake of the
parents/guardians were assessed using M-OHKAPQ (Malay - Oral Health Knowledge,
Attitude and Practice Questionnaire) and M-CFFQ (Malay - Cariogenic Food Frequency
Questionnaire) questionnaires. Meanwhile, the children were assessed on dental plaque
maturity score (DPMS) using GC Tri Plaque ID Gel®, nutritional status on height-for-age Z-
score (HAZ), Weight-for-age Z-score (WAZ), and body mass index-for-age Z-score (BAZ) as
well as cariogenic food intake using M-CFFQ questionnaire. The assessments were done
for three times; at the baseline/pre-intervention, after three months (Post intervention 1
or Post -1) and after six months (Post intervention 2 or Post -2) of intervention in both IG
and CG groups. No intervention received by CG group, however existing oral health and
nutrition services provided by government was allowed. Statistical analysis was done
using IBM SPSS version 26.0. Descriptive analysis and repeated measures ANCOVA were
used. Significant level was set at P<0.05. Results: A total of 286 pairs of parents/guardians
and children with LD participated in baseline/pre-intervention. The mean (SD) age of the
parents/guardians and children with LD were 43.1(8.16) and 10.2(1.67) years old
respectively. Majority (99.7%) of the children and parents/caregivers were Malays. More
than three fifth of the children were from Intellectual Deficit (ID) category (64.0%),
followed by Global Developmental Delay (GDD) (8.4%), Autistic Spectrum Disorder (ASD)
(6.6%), Specific Learning Disorder (SLD) and multiple LD categories (5.6 %) respectively, as
well as Down Syndrome (DS) and Attention Deficit and Hyperactivity Disorder (ADHD)
(4.9%) respectively. More than two fifth of the total parents/guardians has Sijil Pelajaran
Malaysia (SPM)/upper secondary school education level (42.3%) the median (IQR)
monthly income in the IG and CG were RM800 (465) and RM800 (900), respectively.

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