Browsing by Author "Shabalala, Nokuthula"
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- ItemOpen AccessA systematic assessment of an early Autism intervention(2014) Gauntlett, Graham Leonard; Shabalala, Nokuthula
- ItemOpen AccessBarriers and Facilitators to Implementing a Caregiver-Coaching Early ASD Intervention in South Africa(2019) Makombe, Chipo Belindah Theodorah; Shabalala, Nokuthula; Franz, LaurenSub-Saharan Africa (SSA) has a scarcity of research on autism spectrum disorder (ASD) and available early interventions, as most of what is known about the disorder is from highincome countries. Early detection and intervention methods were found to have positive effects on developmental delays and to alleviate symptom severity in children with ASD or at risk of it. There is a need for scalable interventions in low-resource settings, which are characterised by a lack of highly-trained specialists, infrastructure and funding. This study explored the barriers and facilitators to implementing and sustaining a caregiver-coaching ASD early intervention, informed by the principles of the Early Start Denver Model (ESDM), adapted for South Africa and for delivery by non-specialists. The study also identified some changes that could be made to improve intervention adoption and sustainability. Nine multilevel stakeholders involved in the implementation of the caregiver-coaching intervention were purposively sampled, individual in-depth interviews were conducted, transcribed verbatim and thematically analysed. Major implementation facilitators included: ECD worker baseline ASD knowledge and experience; skills gained from the training received and coaching; clear in-session caregiver-coaching structure; value of strong team relationships; clear video illustration of intervention concepts; and the mastery and generalisation of skills by the ECD workers, ECD supervisors and caregivers. Implementation barriers included: the complexity of the intervention and coaching concepts; misalignment of ECD teacher training with the caregiver-coaching approach; logistical challenges; and mismatch of the video content with the South African context. Facilitators to sustain the intervention included: child outcomes; caregiver ‘buy-in;’ and competence; and the need for ongoing live supervision. Barriers to sustaining the intervention included: structural issues of poverty, transportation and unemployment. Positive child and caregiver outcomes could be offset by larger contextual and system-level issues such as poverty and the need for ongoing support, supervision and local coaching materials in South African languages. The results will inform tailoring of the intervention training and supervision approach for a larger pilot study.
- ItemOpen AccessBehavioural challenges in people with intellectual disability : a comparison between those with a history of sexual assault and those without(2009) Kwendakwema, Mwendalubi Nolianga; Shabalala, NokuthulaLiterature suggests that challenging behaviour is one of the most common problems associated with intellectual disability. The aim of this research was to compare the behaviour of two groups of people with intellectual disabilities, depending on whether they had a history of a sexual assault or not, to determine whether there was a difference in their presentation and severity of challenging behaviours. Following a review of relevant literature, the study had a one-directional hypothesis that people who had experienced a sexual assault would present with increased and more severe challenging behaviours than those with no sexual assault history. 54 participants who are carers for people with intellectual disability were interviewed using the Aberrant Behaviour Checklist-Community (ABC-C). All participants were identified and accessed through Cape mental health Society, a nongovernmental organisation that supports psychiatric patients and people with intellectual disability. 27 of the people with intellectual disability had a history of sexual assault and the other 27 had no known history of sexual assault. The ABC-C, a questionnaire with five subscales, namely Irritability, Lethargy, Stereotypical behaviour, Hyperactivity, and Inappropriate speech, was used to assess the presence of challenging behaviours in the intellectually disabled people they were caring for. The ABC-C has been used in previous studies and has a well-established validity and reliability. The performance of the two groups was quantitatively analysed using the Mann-Whitney U statistical test. The results showed that intellectually disabled people who had been sexually assaulted had more challenging behaviours, and these challenging behaviours were more severe than those who did not have a sexual assault history. This was specifically so on three of the subscales: Irritability, Lethargy and Hyperactivity. There were no significant differences between the two groups in their presentation and severity of aberrant behaviour on the Stereotypy and Inappropriate speech subscales. The findings suggest that a history of sexual assault is associated with an increase in, and the presence of more severe challenging behaviours, in people with intellectual disabilities. This supports the argument that intellectually disabled people do react to trauma, and that sexual assault may have adverse effects on their well-being and particularly on their behaviour. The results will hopefully help caregivers of intellectually disabled people to recognise that challenging behaviours may be an expression of trauma.
- ItemOpen AccessCultural variations in the presentation of depression in female patients at Valkenberg Hospital(2008) Khumalo, Nokwanda; Shabalala, NokuthulaDepression is a significant problem for both developed and developing countries. Local and international literature indicates that there are culturally mediated differences in presentation that contribute to more women being diagnosed with depression than men and to the predominance of particualar features of the illness in different settings. The aim of this archival study was to explore the presentation of depression across race groups in female patients at Valkenberg Hospital in the Western Cape. The narratives of patients' presenting complaints were obtained from the history taking notes in 46 hospital files, comprised of three sets of 15 files belonging to Black, White and Coloured patients, and one file belonging to a patient of Asian origin. Thematic analysis was used to analyze the narratives. Findings revealed that patients across race groups viewed depression as occurring in and resulting from interpersonal problems. However, White and Coloured patients also related their main problem to emotional distress, which was the main trigger for seeking help. Black patients reported difficulties in coping with life stressors as their main complaint, and frequently cited experiences of gender based violence. Distress seems to be tolerated until it manifests in behavioural disturbances. It was found that Black patients sought help only when their behaviour became distruptive for those around them. It was also observed that depression with psychotic featues and a co-morbid HIV diagnosis were reported most frequently among Black patients. There were thus similarities and differences in the presentation of depression across race groups. Patients' understandings of depression are mediated by various socio-cultural factors.
- ItemOpen AccessAn evaluation of a brief psycho-educational intervention for exam stress with extended degree programme students(2010) Schultz, Hannah; Shabalala, NokuthulaOverseas research has shown that minority university students are at special risk for stress. South Africa’s race-based history of educational discrimination means that black students are multiply disadvantaged at formerly white universities. Many interventions around disadvantaged students have been reframed in terms of retention difficulties. In 2009, a psycho- educational support group was run with first year humanities Extended Degree Programme students. This study was a qualitative evaluation of the group. We found that the group was successful in giving students social support. Students also felt that it had been useful academically. Issues that should be addressed include clear avenues for referral and improving student/facilitator interaction. The stress and the academic demotivation that they experience suggest that the whole support programme should be evaluated and improved.
- ItemOpen AccessAn exploration of clinicians' experiences in the diagnosis and management of patients with borderline personality disorder [patients] at Valkenberg hospital in the Western Cape region(2007) Gqiba, Nobuntu; Shabalala, NokuthulaDisorders of personality are conceptualized along a continuum of severity. Among all diagnosed with a cluster B personality disorder, patients with Borderline Personality Disorder illness are believed to experience the greatest suffering. Always in a state of crisis, these patients are so name by different writers because they were believed to stand between a neurotic and psychotic personality organization. This complex diagnostic picture together with the illness's tendency to co-exist with some of Axis I psychiatric disorders has made the illness to be perceived as both difficult to diagnose and manage. Previous research indicates that many professionals are turned off by working with people with this illness because it draws on many negative feelings from the clinician. This study sought to explore factors which assist clinicians in making the BPD diagnosis. It focuses at diagnostic processes utilized other than the DSM-IV -TR. Explanatory theories are also put forward in an effort to try and understand some of the issues experienced by the individual in the development of the illness. Participants' attitudes held towards these patients are also examined to see whether these have shifted. An understanding of these factors and recommendations are offered at the end. Semi-structured interviews were conducted with seven white clinicians from Valkenberg hospital in the Western Cape region. The research design was qualitative and a phenomenological framework was used to inform the study. The interviews were taped, transcribed and typed. The data was then analysed according to broad themes emerging from the interviews. A number of different factors impacted on the decision regarding in both making the diagnosis and management of BPD illness. These factors were discussed according to the following broad themes: Diagnostic challenges; Demographic patterns in BPD diagnosis; Management issues.
- ItemOpen AccessAn exploration of nursing professionals’ understanding of Autism Spectrum Disorder(2014) Matenge, Batetshi; Shabalala, NokuthulaThe number of children diagnosed with autism spectrum disorder is increasing at an alarming rate. Research indicates that early identification and diagnosis is key in terms of children receiving early intervention. However, many children are not being identified as early as possible by their primary health care providers. This research investigated nursing professional’s experiences of working with autism spectrum disorder in a clinic setting. Using phenomenology theory as the epistemological framework, thematic analysis was conducted on ten in-depth interviews with nursing professionals working in the public sector. Three main groupings for the findings emerged from the interpretative analysis: 1) nursing professionals’ knowledge, understanding and awareness of autism spectrum disorder, 2) screening practices of nursing professionals; and 3) identified challenges in screening for autism spectrum disorder. Although the majority of the nursing professionals showed a good understanding of some aspects of the condition, there was some confusion about some key facts concerning the disorder, the characteristics of ASD and scientific terminology, and an inaccurate understanding of early intervention treatments. Nursing professionals’ screening efforts remain poor despite the diagnostic value of routine screening for early childhood developmental delays. Limited services and resources, a lack of communication between primary and secondary systems, time restrictions, work pressure and inadequate training are all barriers that prevent nursing professionals from conducting routine screening during child wellness visits, resulting in missed opportunities for detecting autism spectrum disorders in the early months or years. This research highlights the urgent need to look into strategies that would improve and support efforts for conducting early screening in primary health care clinics. Implications for future research in this area are also addressed.
- ItemOpen AccessAn exploratory study of psychiatric symptoms in intellectually disabled people with and without a known history of sexual abuse(2010) Linden, Alannah; Shabalala, NokuthulaCurrent research shows that people with intellectual disabilities display psychiatric symptoms which are often similar to those found in the general population. Furthermore, some literature has found that psychiatric difficulties in the intellectually disabled population can manifest in atypical forms which differ from those exhibited in the general population. The aim of this study was to explore the prevalence of psychiatric symptoms in the intellectually disabled population in South Africa. This particular study formed part of a larger project looking at trauma in a sample of intellectually disabled people. The PAS-ADD Checklist, which consists of two sections, was administered to a sample of caregivers of intellectually disabled people with and without a known history of sexual abuse. The data was analysed using non-parametric statistical tests. The first section of the instrument focused on the potentially traumatic life events that were reported by the caregivers and it was found that the group of individuals with a history of sexual assault had experienced more of these in comparison with the control group. The second section consisted of statements which were designed to elicit psychiatric symptoms on three subscales namely, possible organic condition, affective or neurotic disorder and psychotic disorder. The results showed that the total sample had a fairly high overall prevalence rate of psychiatric symptoms. In particular, the group with a History of Sexual Abuse obtained significantly higher scores on the affective/neurotic subscale when compared with the control group. There were also significant differences between the groups on the organic condition with the History of Sexual Abuse Group showing a higher prevalence of symptoms. The groups also differed on the psychotic disorder with the group who had a History of Sexual Abuse obtaining a higher score, although this was not statistically significant. The implications of the findings suggest that people with an intellectual disability who have a History of Sexual Abuse display an increased rate of psychiatric symptoms, particularly on the affective/neurotic spectrum. Whilst the findings generated from this study are in line with much of the international literature around the relationship between potentially traumatic life events and a high prevalence of affective symptoms in the intellectually disabled population, there is still a dearth of research in this area in South Africa.
- ItemOpen AccessHIV/AIDS and men : a critical examination of tensions and challenges in establishing a support group for men(2006) Dawson-Squibb, John Joe; Shabalala, NokuthulaThe HIV/AIDS pandemic has introduced significant challenges to health care professionals, specifically the appropriate means of supporting those living with the virus. Little research, however, has critically investigated the difficulties involved in the creation of community interventions in this area. In addition, few men's only HIV/AIDS support groups exist and a relatively modest amount of literature surrounds the subject. This thesis, aims to investigate the struggles and tensions involved in the formation of men's only HIV/AIDS support groups.
- ItemOpen AccessThe holding environment : challenges in the containment of a patient with borderline personality disorder(2008) Vollenhoven-Brown, Tanya; Shabalala, NokuthulaThis qualitative study used a single case study method to explore the therapeutic relationship between the researcher and a client diagnosed with a borderline personality disorder. The aim of this study was to examine what it entailed to establish a foundation stable enough to support the client as she challenged the rules set up to protect the therapeutic space. A hermeneutic - psychoanalytic analysis of session notes taken over the course of the one year treatment was used to make sense of the symbolic enactments occurring between the researcher and her client. This contributed to a deeper understanding of what it meant to provide a therapeutic holding environment for someone with a pattern of instability of relating to others and viewing herself.
- ItemOpen AccessMental illness : negative perceptions of university students(2011) Hyde, Joy; Shabalala, NokuthulaThis study has sought to document the negative perceptions of mental illness in a sample of university students across four faculties at the University of Cape Town.
- ItemOpen AccessOutcomes of sexual assault court cases involving people with intellectual disabilities within the Western Cape: the association between conviction of the perpetrator and the complainants level of intellectual functioning(2023) Jantjies, Roslyn Rolien; Shabalala, Nokuthula; Wild, LaurenPeople with intellectual disabilities (PWID) are more likely to be survivors of sexual assault than people without intellectual disabilities (ID). Their cognitive, emotional, behavioral, and physical challenges increase their vulnerability and chances of being sexually assaulted. Despite this, individuals that disclose their sexual abuse face multiple barriers while seeking justice. This results in low prosecution and conviction rates of sexual offenders in cases involving complainants with ID. There is limited information available about specific factors that predict a court case outcome of sexual abuse cases involving PWID. This correlational study reviewed archival data of alleged survivors of sexual abuse with ID. The sample of 493 complainants had received assistance from Cape Mental Health (CMH) Sexual and Victim Empowered (SAVE) Program. This study showed that most of the complainants of sexual assault were female (86.8%), and 12.6% were male. Most complainants fell within the Mild ID range (54.6%), followed by Severe (20.3%) and Moderate ID (17%). More than half of the cases were withdrawn (58%), 22% of the perpetrators were found guilty, and 12% were acquitted of the charges. This study found that the ability to understand the consequences of sex and to refuse sexual advances increased the individual's ability to consent to sexual activity, while their ability to answer clarifying questions and take an oath significantly impacted their ability to testify in court. However, neither the ability to provide consent nor the ability to testify was significant in predicting the court case outcomes. This highlights the challenges complainants with ID face when seeking justice for sexual abuse. Sexuality education for PWID may mitigate their risk of sexual abuse and serve as a protective factor. Furthermore, the public's awareness regarding the rights of, and responsibilities towards, PWID may also decrease their vulnerability and protect PWID from injustice.
- ItemOpen AccessReported responses to sexual trauma in people with intellectual disability : an analysis of clinical psychologists' psycho-legal reports(2010) Mackenzie, Tania; Shabalala, NokuthulaWhile a large body of literature suggests that rape and sexual assault in the general population is pathogenic, there is a dearth of literature on its impact on people with intellectual disability (ID). Several studies have reported that individuals with ID may experience a range of psychopathology following rape that is similar to that experienced by adults and children in the general population (i.e. PTSD, Major Depression) but with stronger behavioural reactions. The main aim of this research was to identify the response of individuals with ID who had experienced sexual trauma. This was an archival study of the Sexual Abuse Victim Empowerment (SAVE) project's clinical psychologists' notes and psycho-legal reports from 2005 – 2009 on 295 female, child and adult, sexual assault/rape survivors with ID. It was hypothesised that in the different PTSD symptom criteria clusters there would be more symptoms of increased arousal than re-experiencing and avoidance, that there would be a difference in the number of reported symptoms between different levels of ID, and between the number of symptoms reported by the different psychologists who assessed the sample. Includes bibliographical references (pages 65-73).
- ItemOpen AccessSpeaking for ourselves: autism and barriers to early intervention services in Cape Town(2019) Bartlett, Kristin; De Wet, Jacques; Shabalala, NokuthulaThere is limited knowledge about autism as a disability in Africa: thus far, most autism research studies have been limited to families in high-income western countries, resulting in a gap in research regarding studies from low-income countries. Despite their vulnerability, people with disabilities have been largely unnoticed as a goal of development work despite disability’s economic impact on families and communities, and the associated discrimination, stigmatisation and exclusion. Education has been identified as an essential building block of human and economic development, yet children with disabilities face unequal barriers in accessing educational services and schooling. Focusing on early intervention services is vital for the growth and development of children with disabilities, as early human development services and programmes for young children and families play a critical role in alleviating poverty and achieving social and economic equity. The aim of this study was to identify the major barriers to accessing early intervention services for autistic individuals in Cape Town and achieving well-being. I drew on Sen’s capability approach to inform my theoretical framework. I used an embedded mixed methods design, with a quantitative questionnaire playing a supportive secondary role in this qualitative study, which included in-depth interviews and some documentary research. The sample consisted of ten participants: five parents of autistic children, and five autistic adults. Qualitative data for this study was analysed using thematic analysis, informed by Miles and Huberman’s (1994) process of first and second-level coding. The quantitative data for descriptive statistics was recorded and analysed using Statistical Package for the Social Sciences (SPSS). This study brought six themes into focus, namely services, financial constraints, practitioners, home environment, stigma, and lack of support services. A variety of recommendations were highlighted by the participants, including an adaptation of services; developing better trained practitioners in autism-specific strategies; making increased parent-training and support services available; together with creating a better system to help support, monitor and guide families and autistic individuals in navigating the field of services.
- ItemRestrictedWomen and authorship in post-apartheid psychology(SAGE, 2004) Shefer, Tamara; Shabalala, Nokuthula; Townsend, LoraineThis article addresses the issue of women's authorship in psychology. It reflects on the contributions of women authors to psychological knowledge production over the last 10 years through a quantitative assessment of authorship in the South African Journal of Psychology (SAJP). Key variables utilised include ‘race’, gender, university (i.e., historically black universities versus historically white universities), sole versus collective authorship, and the order of authors in multiple authored articles. The article highlights the historical silencing of women, particularly black women, in the broader realm of knowledge production, both internationally and in local context. Some of the debates arguing for the value of women's voice in research and publishing are highlighted before the findings of the small descriptive survey are reported. Findings are both predictable and disappointing. While women as a group appear to be publishing relatively well in relation to men as a group, and the overall trend shows a closing of the gap over the last ten years, the intersection of ‘race’ and gender foregrounds the continued marginalisation of black women as authors, as well as the relative stasis of this situation over the last ten years. Furthermore, when taking the numbers of registered psychologists in South Africa into account, women as a group are in the majority, yet are represented in inverse proportion to their numbers in the profession when it comes to publishing. Women also appear to be publishing more in collectives, while men are moving significantly more towards single authorship, reflecting gender stereotypes with respect to co-operative versus individualist modes. Differences between histirically black universities (HBUs) and historically white universities (HWUs) continue, with women publishing less in the former, which is argued to relate to continued areas of inequity and lack of institutional resources and support. The article concludes by emphasising the importance of women's role as producers of knowledge in the profession. It raises a number of material recommendations for ways to support women, especially younger and black authors, in facilitating a more equitable representation of authorship in South African psychology.