OpenUCT :: Browsing by Department "Division of Communication Sciences and Disorders"

Browsing by Department "Division of Communication Sciences and Disorders"

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Open Access
A South African perspective: audiologists' and otologists' orientation to, and use of evidence-based practice with reference to benign paroxysmal positional vertigo
(2021) Naidoo, Tanaya Ellen Ravi; Rogers, Christine
Evidence-based practice, whose roots emanate from the mid-1960s, aims to provide fair, high-quality, and soundly researched health care with patients' best interests as a priority. Clinical practice guidelines are evidence-based and designed to assist clinicians with sound decision making. Despite the importance of evidence-based practice and the efforts invested into its development and dissemination, its uptake and implementation are poor. The disconnect between evidence-based practice and its translation into clinical practice was previously reported in low-to-middle income countries. This study investigated South African audiologists' and otorhinolaryngologists' (ear, nose and throat specialists') self-reported orientation to evidence-based practice. Second, adherence to evidence-based clinical practice guidelines was assessed with reference to the diagnosis and management of benign paroxysmal positional vertigo, a common vestibular condition for which a firm evidence base supporting treatment exists. A two-part quantitative approach was adopted. Part one surveyed South African audiologists and otorhinolaryngologists with the Evidence-Based Practice Profile Questionnaire and an additional researcher-developed questionnaire pertaining to the diagnosis and management of benign paroxysmal positional vertigo. A total of 130 survey responses were included in this study. Independent sample t-tests, one-way ANOVAs and Fisher's Exact tests were used to analyse the survey data. Part two used a retrospective record review at a tertiary academic hospital in the Western Cape of South Africa. Medical folders of patients diagnosed with benign paroxysmal positional vertigo, between 2010 – 2018 (n = 80), were analysed. The diagnosis and management strategies were recorded and compared against a gold standard evidence based guideline for congruence. Descriptive statistics were used to analyse and understand the data. Survey scores showed a positive association between increased years of experience and healthcare professionals' knowledge (p = .008) and confidence (p = .003) in evidence-based practice. Otorhinolaryngologists might be more knowledgeable than audiologists in evidence-based practice due to their increased training and exposure to evidence-based practice in their specialising years. Findings from the retrospective record review suggested adherence to the clinical practice guidelines in the diagnosis and management of posterior semi circular canal benign paroxysmal positional vertigo. The study outcomes propose that evidence-based clinical practice guidelines developed in the Global North may not be appropriate for the different health contexts that exist in low-to-middle income South Africa (e.g., rural settings). However, the benign paroxysmal positional vertigo clinical practice guidelines were adhered to at a tertiary, academic hospital in Cape Town. The results also support the notion that increased exposure to evidence-based practice reinforces its approach. Outcomes from this study raise implications for the development and dissemination of context-appropriate, evidence-based clinical practice guidelines.
Open Access
The acquisition of Setswana phonology in children aged 3;0 – 6;0 years : a cross-sectional study
(2014) Mahura, Olebeng; Pascoe, Michelle; Smouse, Mantoa
This study aimed to describe the typical development of speech in first language Setswana speaking children. Thirty-six children, aged 3;0 – 6;0 years, attending preschools in Hebron in the North-West Province of South Africa, participated in the study. The objectives of the study were documenting the children’s ability to produce consonants and vowels, different syllable structures, as well as the nature of phonological processes occurring at various ages. The study followed a cross-sectional design with six children grouped into each six month age band. Due to the preliminary and exploratory nature of the project, an assessment tool was developed and used to document speech development in Setswana-speaking children. This was done as none is currently available. Words and pictures selected for this assessment tool were culturally and linguistically appropriate for the study population, and an expert panel was used to ensure this. Assessments were transcribed online by a first language Setswana speaker using the IPA convention and were audio-recorded and re-transcribed by the same Setswana speaker to ensure reliability. Findings of this study indicate that the majority of Setswana consonants are acquired by 3;0 years. The rounded alveolar trill /rw/ is among the phonemes which continue to develop after 6;0 years, particularly in the penultimate syllable. Phonological processes found in the speech of younger children mainly occur in multisyllabic words and include deletion of marked and unmarked syllables, gliding of liquids, assimilation, as well as the simplification of -Cw- digraphs and words with five syllables. Older children (5;6 – 5;11 years) present with fewer phonological processes than the younger group of children (3;0 – 5;5 years). Findings of the study are discussed in relation to normative data from other languages, and in particular to those belonging to the same language group such as Sesotho. Knowledge of Setswana speech development will better equip Speech-Language Therapists working in Southern Africa to assess and manage speech difficulties in Setswana-speaking children. Future research may focus on developing a standardised Setswana speech assessment tool. The results contribute to an increasing body of locally relevant information about the typical development of children’s speech.
Open Access
Aminoglycoside-induced balance deficits: a review of vestibulotoxicity
(South African Academy of Family Physicians, 2011) Rogers, C; Petersen, L
This article aims to inform clinicians about the current knowledge on aminoglycoside-induced vestibulotoxicity through a review of the literature. The effects of vestibulotoxicity are irreversible and may be profoundly disabling. It would appear that the sooner vestibular rehabilitation therapy is instituted, the more favourable the prognosis is. Thus, early referral and management are essential. Vestibulotoxicity is a commonly overlooked aetiology when assessing dizzy patients. This could be due to the difficulty that patients have in describing vestibular symptoms in general, as well as the absence of vertigo as a presenting complaint. Discussion includes the clinical presentation of vestibulotoxicity and its sequelae, as well as strategies to assess and monitor patients.
Open Access
App-based intervention for children with reading difficulties : a description of five cases
(2014) Kaplan, Gaby; Pascoe, Michelle; Harty, Michal
This descriptive single subject intervention study aimed to describe the outcomes of an application (app)-based intervention for five children with reading difficulties. All participants were required to have a grade one reading level. Each participant’s language and literacy profiles are detailed in accordance with developmental and information processing models, and intervention was designed based on each child’s specific level of difficulty. Following a baseline control period, each child received approximately six weeks of intervention using the Reading TherAppy and/or Comprehension TherAppy app (Tactus Therapy Solutions) on an iPad ® mini, which was mediated by the researcher on a 1:1 basis. Treated and untreated probe items were administered at three points in the study (baseline, pre, post) in order to determine the effects of intervention on treated and untreated, matched items. Each child’s reading on standardized literacy measures was re-evaluated post intervention. This was followed by an interview with each participant to obtain information about his or her experience of the intervention. Results show that all participants improved their reading of items treated in the intervention. In addition, some of the participants’ standardized reading and spelling scores improved in relation to typically developing peers from pre to post intervention testing. Changes are detailed for each participant using the theoretical models. Child interviews indicated that all children enjoyed a positive experience of intervention. This study aimed to explore and contribute to the limited knowledge base on efficacy, optimal dosage and outcomes of app-based intervention for children with reading difficulties. The implications of the study are discussed in relation to Speech Language Therapists working in educational settings, the functional application of models of reading, and the reading intervention literature.
Open Access
The application and review processes of disability grants for deaf adults in the Western Cape : an exploratory study
(2006) Mestern, Carol
Includes bibliographical references (leaves 153-165).
Open Access
The association between frontal lisping and an anterior open bite, a tongue thrust swallow, the concurrence of an anterior open bite and a tongue thrust swallow and slow diadochokinetic rate
(2006) Thompson, Linda; Singh, Shajila
Includes bibliographical references (leaves 97-111).
Open Access
Auditory characteristics and balance function of diabetic patients
(2017) Hlayisi, Vera-Genevey; Ramma, Lebogang; Petersen, Lucretia; Rogers, Christine
Aims and Objectives. This study aimed to describe auditory characteristics and balance function in patients with diabetes between 18-55 years of age as well as determine the association between patients' auditory and balance function with diabetes characteristics (type, duration and control). Background. Diabetes is one of the most prevalent non-communicable diseases worldwide with approximately 422 million people diagnosed globally. This number is projected to rise to 642 million by 2040 if no appropriate interventions are implemented to reverse the rise in the number of people with diabetes. South Africa has the second highest diabetes prevalence in Africa (after Nigeria) with 2.6 million cases. A rise in diabetes prevalence should be a concern for audiologists with increasing literature linking diabetes with the risk of acquiring hearing and balance disorders. However, there is currently a lack of research done in South Africa to investigate auditory and balance disorders in patients with diabetes. Therefore, the current study sought to investigate auditory characteristics and balance function in South African patients diagnosed with diabetes. It is anticipated that the study findings will yield evidence that will highlight the role of an audiologist in the clinical management of patients with diabetes. Research Design. The study utilised an observational cross-sectional matched groups design with a cohort (patients with diabetes) and control (volunteers without diabetes) group of participants. Participants were recruited from a Primary Health Care clinic in Polokwane, Limpopo using purposive and convenience sampling for the cohort and control group respectively. Methodology. Several methods were used to collect data pertinent to this study. These included case history interview and a medical folder review to obtain information related to participants' diabetes status. Furthermore, all participants underwent the following assessments: otoscopy, pure tone audiometry, diagnostic distortion product otoacoustic emissions (DPOAE), vision screening, peripheral neuropathy screening, Dynamic Gait Index test (DGI) and the Modified Clinical Test of Sensory Integration (MCTSIB). Data were analyzed using both descriptive and inferential statistical tests. Results. A total of 192 participants took part in this study; 110 in the cohort and 82 in the control group. There were similar distributions of gender in both groups with the following age distributions (in years) for each group; cohort; median =46, range =20-55, control; median =43, range =21-55. Pure tone audiometry assessments showed a significantly higher prevalence of hearing loss in the cohort (55%) when compared to the control (20%) group (p < .001). Participant age, gender and diabetes duration were associated with the likelihood of having hearing loss (age: odds ratio=2.90, 95% CI: 1.19-7.08, p=0.019; gender (male): odds ratio=.266, 95% CI: .104-.677, p=0.005; diabetes duration: odds ratio=1.12, 95% CI: 1.02-1.22, p=0.013). DPOAE assessments showed significantly higher percentages of abnormalities with signal to noise ratio (p < 0.01) and DPOAE level (p < 0.01) in the cohort compared to the control group. A significantly higher proportion (38%) of participants in the cohort group reported tinnitus when compared to 15% in the control (p < .001). Balance screening assessments with the DGI and the MCTSIB, showed significantly poorer performance in the cohort group than the control (DGI:, p < .001; MCTSIB: p < .001). Conclusion. Overall findings of this study showed that participants who were diagnosed with diabetes had a higher proportion of auditory and balance abnormalities when compared to those in the control group. Older age, male gender and longer duration since diabetes diagnosis were associated with a higher likelihood of having hearing loss. The findings of this study therefore suggest that auditory and balance dysfunction should be considered as comorbidities associated with diabetes. This study also highlighted the role of an audiologist in the managment of patients with diabetes with respect to early identification and management of auditory and balance dysfunctions amongst these patients.
Open Access
Caregivers' experiences with the diagnosis of hearing loss
(2015) Hagedorn, Elfriede; Kathard, Harsha; Taljaard, Dunay
Knowledge of the impact of a diagnosis of hearing loss in children on their caregivers and the nature of their relationships with professionals during this process is inadequate in South Africa. The purpose of this study was to understand the experiences and perceptions of caregivers of diagnosis of hearing loss in their children. A qualitative, retrospective, narrative inquiry research design was used. Participants who were purposefully selected included one couple and 12 caregivers in the Tshwane Metropolitan area. They were interviewed using an in-depth interview method. The narrative data was subjected to in-depth thematic analysis. Three themes emerged from the data: 1) The catastrophic emotional impact of diagnosis, 2) The good and the bad of professional interaction, 3) Imbalanced relationships, strained resources and resulting identity threats. The discussion focused on the deeply emotional nature of the participants' experiences and the changes that ensued during and following the diagnosis of hearing loss in their relationship with their child and the wider community and how this impacted on their sense of identity. The study concluded that diagnosis has extensive, pervasive and disruptive effects on caregivers and that the professional plays an important role in shaping that experience. It thus makes recommendations for a humanistic, family-centred, paediatric audiology practice.
Open Access
Challenges facing primary school educators of English Second (or other) Language learners in the Western Cape
(2009) O'ConnorI, Julie; GeigerII, Martha
We were prompted by the prevalence of English Second or Other Language (ESOL) learners identified by educators as having language disorders and being referred for Speech-Language Therapy. We describe challenges faced by Grade 1, 2 and 3 educators at government schools in the Cape Metropolitan area who were working with such learners. Applying a mixed-methods descriptive design, a self-administered questionnaire and three focus groups were used for data collection. Educator perceptions and experiences regarding ESOL learners were described. Some participant educators at schools that were not former Model C schools had large classes, including large proportions of ESOL learners. Furthermore, there was a shortage of educators who were able to speak isiXhosa, the most frequently occurring first (or home) language of the region's ESOL learners. Challenges faced by educators when teaching ESOL learners included learners' academic and socio-emotional difficulties and a lack of parent involvement in their children's education. Participant educators indicated a need for departmental, professional and parental support, and additional training and resources. Implications and recommendations for speech-language therapist and educator collaborations and speech-language therapists' participation in educator training were identified.
Open Access
Children with speech difficulties: An exploratory survey of clincial practice in the Western Cape
(2010) Pascoe, Michelle; Maphalala, Zinhle; Ebrahim, Aeysha; Hime, Daneil; Mdladla, Bathobile; Mohamed, Nerosha; Skinner, Mandy
This paper is based on a study by Joffe and Pring (2008) which investigated assessment and therapy methods used by Speech Language Therapists (SLTs) in the United Kingdom for children with phonological difficulties. Joffe and Pring reported SLTs’ most favoured assessments and therapy approaches in that context. Children with speech difficulties are likely to form a considerable part of SLT caseloads in South Africa, but the choice of assessments may not be so clearcut given the linguistic diversity of the region and the fact that few assessments have been developed specifically for the SA population. Linked to difficulties with assessment, selection of intervention approaches may also pose challenges. This study aimed to investigate the methods of assessment and intervention used by SLTs in the Western Cape when working with children with speech difficulties. A questionnaire was sent to SLTs working with pre and/ or primary school- aged children. Twenty-nine clinicians of varying experience responded. The majority of SLTs (89%) use informal assessment tools in combination with formal assessment. When using formal assessments, more than 50% of SLTs make modifications to better suit the population. Participants use a variety of intervention approaches, often in combination, and based on a child’s individual profile of difficulties and available resources. Forty-six percent of SLTs felt unsure about the selection of assessments and intervention for bi/multilingual children with speech difficulties. SLTs suggested that guidelines about accepted / typical speech development in the region would be helpful for their clinical practice. Clinical implications of the findings are discussed together with some suggestions for developing knowledge of children’s speech difficulties in the South African context.
Open Access
Clinical educators' expectations and experiences of supervising audiology students in South Africa a focus on race and language
(2013) Keeton, Nicola; Singh, Shajila
Includes abstract. Includes bibliographical references.
Open Access
Clinical Outcomes Associated with Speech, Language and Swallowing Difficulties Post-Stroke – A Prospective Cohort Study
(2022) Kaylor, Stephanie Anne; Singh, Shajila
Background: Due to a lack of prospective research in South Africa's Speech-Language Therapy (SLT) private healthcare sector, this prospective cohort study investigated associations between speech, language, and swallowing conditions (i.e. dysarthria, apraxia of speech, aphasia, dysphagia), risk factors, and outcomes post-stroke (i.e. length of hospital stay, degree of physical disability according to the Modified Rankin Scale [mRS], functional level of oral intake according to the Functional Oral Intake Scale [FOIS], dehydration, weight loss, aspiration pneumonia, mortality). Methods: Adults with a new incident of stroke without pre-existing speech, language or swallowing difficulties (N=68) were recruited. Convenience sampling was used to select participants. A prospective design was used to determine the incidence of speech, language, and swallowing conditions poststroke and association with outcomes from admission to discharge. Results: Co-occurring speech, language, and swallowing conditions frequently occurred post-stroke (88%). Participants who were referred to SLT greater than 24 hours post-admission (52.94%) stayed in hospital for a median of three days longer than those who were referred within 24 hours (p=.042). Dysphagia was significantly associated with moderate to severe physical disability. Dysphagia with aspiration was significantly associated with poor functional level of oral intake (i.e. altered consistency diets and enteral nutrition), at admission and at discharge (p<. 01). Dysphagia had a higher likelihood of mortality (OR=2.86) (p=.319). At discharge, aspiration pneumonia was significantly associated with severe physical disability (p< .01, r=0.70). Risk factors; poor oral hygiene (p=1.00), low level of consciousness (p=1.00), dependent for oral intake (p=.040), and enteral nutrition (p=.257); were not associated with aspiration pneumonia. Conclusion: In South Africa's private sector, cooccurring speech, language, and swallowing conditions commonly occurred post-stroke, and dysphagia was strongly associated with physical disability and poor functional level of oral intake. Length of hospital stay was increased by delayed SLT referrals.
Open Access
Cochleo-vestibular clinical findings among drug resistant Tuberculosis Patients on therapy-a pilot study
(BioMed Central Ltd, 2012) Ramma, Lebogang; Ibekwe, Titus
ABSTRACTS:BACKGROUND: To investigate the Cochleo-vestibular clinical and audiometric findings in Multi and Extreme Drug Resistance(MDR and XDR) tuberculosis(TB) patients on treatment and make recommendations. METHODS: A cross-sectional study of adult MDR and XDR-TB patients was conducted in a general hospital in Cape-Town-South-Africa. Ethical approval was secured and all consenting patients administered with pretested and validated questionnaire under the guidance of International Classification of Functioning, Disability and Health(ICF) Checklist-version-2.1a. Audiometric evaluation included: Otoscopy, Diagnostic Audiometry and Tympanometry. The data analyses were done with SPSS version 16, Chi-square and StatCalc-7. RESULTS: Fifty-three adults, ages 18-60 (mean-33 years) comprising 26 males and 27 females participated in the study. Hospital stay duration varied from 1-18 months (mean-6 months) and all were on anti-Koch's second line drugs (regimen 2). MDR TB group were 45(85%) and XDR 8(15%). Vertigo was the most common vestibular symptoms, 24(45%) whereas, tinnitus 23(42%) and hearing loss 13(25%) were most frequent auditory complaints. Bilateral sensorineural hearing losses of varying degrees were confirmed in 23(47%).There was no association between gender and age with hearing loss [chi2 (P = 0.16, alpha = 0.05) and (p = 0.13, alpha = 0.05)]. Furthermore, MDR and XTR TB groups [20/42 Vs 3/8; Z = 0.46 and P = 0.64], showed no difference in pattern of the hearing losses. CONCLUSIONS: A multi-disciplinary close surveillance of MDR and XDR TB patients on therapy is imperative. Finally, researches into therapeutic trials on antidotes and potent safer substitutes for aminoglycosides in the management are recommended.
Open Access
The communication between low-risk low birth weight premature infants and their mothers in the first year of life a description of four cases
(2012) Bissessur, Divya; Pascoe, Michelle
There has been a global increase in survival rates of premature infants due to advances in medical technology. Premature infants are known to be at risk for developmental problems including communication delays and disorders. Speech- Language Pathologists have an important role to play in the assessment and management of premature infants, especially due to the high prevalence of premature births in South Africa. The bonding and attachment experiences of premature infants and their mothers are often challenged, further placing these infants at risk for communication difficulties. This study aimed to explore the communication between low-risk low birth weight premature infants and their mothers at three points in the first year of life. A longitudinal study was conducted where four mother-infant dyads were investigated.
Open Access
Communication in health within the South African context : current practices employed across three levels of health care
(2004) Schwartz, Taryn
Bibliography: leaves 130-145.
Open Access
Communication supporting environments of Grade R classrooms in a rural district of the Western Cape
(2016) Parusnath, Prianka; Kathard, Harsha; Harty, Michal; O'Carroll, Shelley
This study aims to describe the communication environment in Grade R classes in a rural district setting in the Western Cape in terms of language-learning environment; language-learning opportunities and language-learning interactions in order to identify areas of strengths and weaknesses. In addition to this, the study aims to explore the relationship between communication environments and school performance in a rural district in the Western Cape as well teacher and classroom variables. In order to do this, an observational tool, the Communication Supporting Classrooms Observational Tool, was used which allowed researchers to document what was happening in the classroom over the prescribed observation period (Dockrell, Bakopoulou, Law, & Spencer, 2010). Before this, the pilot phase of the study allowed researchers to train assistants to use the tool using video recordings as well as to ascertain the tool's applicability to South African classrooms with different languages of learning and teaching. A sample size of 60 classrooms was used in the main phase, consisting of 30 lower performing schools and 30 higher performing schools. The study included all regular learners and regular classroom teachers in the chosen Grade R classrooms in a rural/remote district. Overall, the outcomes of the pilot study were two-fold: (1) The researchers determined that the tool could be used reliably in classrooms where Afrikaans and isiXhosa were the language of instruction due to high inter-rater reliability measured by ICC; and (2) With sufficient training and practical examples, raters can be trained to use the tool effectively. In addition to these outcomes, the results of the pilot study allowed researchers to make useful choices for the main study. The study indicated that the tool was applicable in classrooms where Afrikaans and isiXhosa were the medium of instruction which allowed researchers to include these classrooms in the sample for the main study.
Open Access
A comparison of pure tone thresholds and distortion product otoacoustic emission measures in patients with Tuberculosis receiving aminoglycosides
(2005) Petersen, Lucretia; Singh, Shajila
Includes bibliographical references (leaves 116-131).
Open Access
Conversation between nurses and patients with aphasia : how to stay out of trouble
(2005) Hoffman, Kate; Van der Walt, Rina
This study aimed to investigate the conversational practices used by nursing staff interacting with patients with aphasia in a rehabilitation health care setting. Six dyads, each comprising of a qualified nurse and an adult with moderate to severe aphasia, were videotaped conversing in the hospital, yielding an hour of data. The conversations were transcribed in detail and subjected to conversation analysis (the ethnomethodological type), in order to identify the practices used by the partnership to negotiate meaning and achieve social satisfaction. An emphasis was placed during analysis on the strategies used by the nurses, in order to generate insights that could be applied to partner training. Analysis of the data revealed a pattern of nurses avoiding visible trouble in the conversations, which was accomplished by minimizing the interactive consequences of repair, glossing over potential sources of trouble, and managing the conversation in a manner that limited the potential for trouble to occur. The interactive advantages and disadvantages of this strategy of are discussed, along with theoretical and clinical implications.
Open Access
Developmental limb apraxia in deaf children : an objective assessment
(2001) Kinsella, Angela; Ogilvy, Dale
This study determines the presence of developmental limb apraxia in deaf signing children and in an oral hearing-impaired child who presents with oral apraxia. The VICON 370 Motion Analysis System was adapted to objecitvely assess the presence of this disorder and to illustrate differences in patterns of movement between the experimental and control subjects.The execution of motor performance of praxic functioning was analysed on a continuum of complexity across signs, gestures and meaningless movement sequence. Qualitative measures of kinematic abnormalities, spatial parapraxias, temporal qualities, quantitative elbow joint angles, resultant tractories of elbow position and wrist joint centre were obtained.
Open Access
Discourse characteristics of Creole-speaking Mauritian adults with mild to moderate aphasia
(2002) Nabeemeeah, Kauthar; Ogilvy-Foreman, Dale
With the shift away from evaluation of isolated aspects of linguistic performance, discourse assessment has become an important tool in assessing the communication competence of individuals following a neurological insult. The present research investigates the effects of mild to moderate aphasia on the dscourse performance of Creole speaking Mauritians. A control group was included so as to differentiate aspects of discourse from normal to pathological and with a view to discerning compensatory strategies of adults with aphasia in discourse.