Original Research
Paediatric Health & Neurodevelopment

Phonological Awareness and Global Visual Spatial Ability Among Malay Speaking Children with Specific Learning Disorder with Dyslexia

Background and Context

Specific Learning Disorder (SLD), particularly dyslexia, represents one of the most common neurodevelopmental conditions affecting school-age children worldwide. Children with SLD face significant challenges in academic areas and are frequently subject to negative labelling by peers and educators. While the phonological deficit theory has long been the dominant framework for understanding reading difficulties in dyslexia, the contribution of visuospatial difficulties to learning problems in SLD children remains inadequately understood, particularly in non-Western populations.

The Malaysian education system serves a linguistically diverse student population, with Bahasa Melayu (Malay) as the primary medium of instruction in national schools. Research on SLD in Malay-speaking children has been limited, creating a critical gap in understanding how phonological processing and visual-spatial abilities interact in this linguistic context. The Malay language has a relatively transparent orthography compared to English, meaning there is a more consistent correspondence between letters and sounds. This characteristic may influence the manifestation and severity of phonological processing difficulties.

Study Design and Methodology

This study employed a cross-sectional comparative design to investigate the relationship between phonological awareness skills and global visual-spatial abilities among Malay-speaking children with SLD. Participants were recruited over a period from June 2016 to January 2017. The study received ethical approval from the Research Ethics Committee of Universiti Kebangsaan Malaysia, followed by approval from the selected school (National School of Jalan Raja Muda).

Two groups of children were compared: those diagnosed with Specific Learning Disorder (the SLD group) and typically developing readers (the control group). Data were coded and analysed using multiple statistical approaches, including Kendall’s Tau-b correlation coefficient, independent samples t-test, and Mann-Whitney U test, providing both parametric and non-parametric assessments of group differences.

Phonological awareness was assessed using validated instruments appropriate for Malay-speaking children, measuring abilities such as phoneme identification, phoneme manipulation, and rhyme awareness. Global visual-spatial ability was evaluated through standardised measures including the Block Design subtest, which assesses the ability to analyse and synthesise abstract visual stimuli.

Principal Findings

The analysis revealed a strong negative correlation between phonological skills and global visual-spatial ability (r = 0.55). This finding suggests an inverse relationship where children with stronger phonological processing tended to rely less on visual-spatial strategies, while those with weaker phonological skills showed greater engagement of visual-spatial processing pathways.

Independent samples t-tests demonstrated that typical readers had significantly higher IQ scores, better phonological skills, and superior global visual-spatial skills compared to the group with SLD. The magnitude of these differences was clinically meaningful, indicating that children with SLD exhibited deficits across multiple cognitive domains rather than isolated phonological impairment.

However, the researchers noted that there was no conclusive evidence regarding the specificity of the relationship due to the fact that more than one area was measured by the assessment tools used. This important caveat acknowledges the complexity of cognitive assessment in neurodevelopmental conditions and the difficulty of isolating specific cognitive processes.

Theoretical and Clinical Implications

The phonological deficit theory of dyslexia posits that the primary cause of reading difficulties lies in impaired processing of the sound structure of language. However, this study’s findings add to a growing body of evidence suggesting that visual-spatial processing also plays a significant role. The strong negative correlation between phonological and visual-spatial abilities supports the dual-deficit hypothesis, which suggests that some children with SLD may have difficulties in both domains.

For clinical practice in Malaysia, these findings have important implications for assessment and intervention. Occupational therapists, educational psychologists, and special education teachers working with Malay-speaking children with SLD should consider evaluating both phonological awareness and visual-spatial abilities as part of comprehensive assessment batteries. Intervention programmes that address only phonological deficits may be insufficient for children who also experience visuospatial difficulties.

The results also highlight the creative thinking often associated with SLD. Research has noted that individuals with SLD are frequently perceived as creative thinkers, and the visual-spatial processing patterns observed in this study may reflect alternative cognitive strategies that could be harnessed in educational settings.

Context Within Malaysian Education

Malaysia has made significant strides in inclusive education policy, with the Education Act providing frameworks for supporting children with special educational needs. However, the identification and support of children with SLD remains a challenge, particularly in government schools where class sizes are large and specialist assessment resources are limited.

This study contributes valuable data on the cognitive profiles of Malay-speaking children with SLD, information that can inform the development of culturally and linguistically appropriate screening tools and intervention programmes. Given that the Malay orthography differs substantially from English in its transparency, findings from English-language research on dyslexia cannot be directly applied to the Malaysian context.

Limitations

The study faced difficulties in recruiting suitable participants, a challenge common to SLD research. The sample was drawn from a single school in Kuala Lumpur, which may limit generalisability to rural populations or other states in Malaysia. Additionally, the cross-sectional design precludes conclusions about causality or developmental trajectories. Multi-ethnic factors in Malaysia—where Malay, Chinese, Indian, and indigenous populations coexist—may introduce cultural and linguistic variations that were not fully captured in this single-language study.

Future research should employ longitudinal designs, larger samples with representation from multiple regions and ethnic groups, and neuroimaging techniques to better elucidate the neural substrates of the phonological-visuospatial relationship in Malay-speaking children with SLD.

Significance and Future Directions

This study provides an important foundation for future research examining global visual-spatial aspects of SLD in addition to the long-standing phonological deficit theory. By demonstrating that Malay-speaking children with SLD show deficits in both phonological and visual-spatial domains, the research opens new avenues for understanding the multifaceted nature of learning disorders and developing more comprehensive, evidence-based educational interventions tailored to the Malaysian context.

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