Browsing by Subject "Speech-Language Pathology"

Now showing 1 - 20 of 49
  • Thumbnail Image
    Item
    Open Access
    A case study of emerging practice in speech-language therapy in a community practice context
    (2019) Abrahams, Kristen; Kathard, Harsha; Pillay, Mershen; Harty, Michal
    Background: The profession of speech-language therapy (SLT) continues to struggle with challenges around equity and service delivery. The dominant medical model, characterised by one-on-one, individualised health care, is struggling to serve the large population in need of services. As such, there is a need to reconceptualise SLT practices toward a social justice focus. The study used clinical education as the entry point of exploration into how emerging professional practices (EPPs) may be developed. Aims/Objectives: The study aimed to describe and analyse a case study of an emerging professional practice in SLT as part of a university-school partnership in a peri-urban settlement in South Africa. The objectives were: 1. To describe and analyse the practice methods of the EPP, 2. To describe and analyse the educational and knowledge bases which support the EPP, and 3. To describe and analyse the underlying epistemology, ontology and methodology underpinnings shaping the EPP. Method: A qualitative case study methodology, guided by critical theory and decoloniality, was used. Final year SLT students were the primary participants for the study. Data were collected in the form of document analyses, participant observations, interviews, photovoice, and experiential drawings from a number of stakeholders (including SLT students, a school principal, a project coordinator, a library assistant and a clinical educator) from January to December 2017. The data were analysed using reflexive interpretation (Alvesson & Sköldberg, 2009) as a guiding frame. Findings: The three-level analysis process was used to generate the thesis offering. The first level of analysis was the construction of the overall case narrative - documenting the practice methods of the EPP through the experiences of the SLT students. The second level of analysis used thematic analysis approach to identify key themes emerging from the case narrative. Four key themes were explored in the form of narratives, collages and paintings. The third level of analysis used decoloniality (i.e. coloniality of power, knowledge and being) and the Relationship of Labouring Affinities (RoLA) as critical lenses to deepen my understanding of the case. Through using both RoLA and decoloniality, dialogue emerged as a critical form of engagement toward developing EPPs. The study specifically puts forward the concept of critical dialoguing as a necessary process for conscientisation and change. Conclusion: The findings of the study illuminated how SLT students navigated through their experiences of disruption of their traditional practice. The findings weave together participant narratives, drawings and collages to engage the reader in the EPP. The findings showed how critical engagement with political, historical, social and linguistic influences underlying their work in communication, facilitated new learning and insight into SLT practice. The thesis offering discusses the role of critical dialoguing in opening up space for critical discussions about the profession. In conclusion, supported disruption provided students with a platform to interrogate current SLT practices, re-examine the viability of practices to serve populations, and reflect on how the SLT profession can adapt and change with the changing needs of the population.
  • No Thumbnail Available
    Item
    Open Access
    A case study of how a centre-based preschool programme for children who are blind/visually impaired supports early multilingual communication development
    (2023) Kamedien, Layla; Kathard, H
    Communication development is an essential part of a child's development – socially, academically, and vocationally. For children with visual impairment/blindness (VI/B), the literature indicates that opportunities supporting early communication development can benefit a child with VI/B. Speech-language therapists' (SLTs) core focus on communication is instrumental in supporting children to develop their communication. However, little is known about the practices which support the communication development of children with VI/B. The study therefore aimed to explore and describe how the centre-based preschool programme at the League of the Friends of the Blind (LOFOB) in Cape Town supported early multilingual communication development. A qualitative case study design was used to explore and describe the programme's knowledge, values, principles, skills, and practices. Semi-structured interviews were conducted with key stakeholders, along with classroom observations and document reviews of key government policies, principles and standards. Thematic analysis was used to analyse and interpret findings. During this process a key informant with VI was used to assist with the interpretation of the data. The findings are presented as a narrative and accompanying individual vignettes. The narrative explores the activities and opportunities available for multilingual communication support. While the individual vignettes describe the knowledge, values, principles and skills that inform the practices of the programme. Key themes that emerged from thematic analysis of the data include an inclusive approach to encourage multilingual engagements and support, a structured programme that focussed on capabilities, and a committed team offering support. The study argued that there is an opportunity for the SLT profession to rethink how communication is typically supported and shifting from a focus on pathology to communication supports that explore capabilities and inclusion.
  • Thumbnail Image
    Item
    Open Access
    A study of the collaborative process of volunteers in a literacy intervention programme in support of vulnerable children in South Africa
    (2019) Zoetmulder, Amy; Kathard, Harsha; Pillay, Mershen
    The development of early literacy skills is critical for all children in South Africa. Children receive language and literacy development support in the home, school, and community environments. Vulnerable children, such as orphans, may receive this support from volunteers in their home environments. Additional language development support systems in the form of programmes run by volunteers are important. This study describes and analyses the process of collaboration between six volunteers who are involved in languageliteracy programmes by examining how volunteers negotiate collaboration in promoting literacy development. This qualitative research study used a participatory action cycle design to investigate collaboration. A range of research methods such as focus groups, interviews, reflections and observations were used. Findings from this study provided insight into the identity of volunteers. They were people who had strong values in respect of literacy, a positive experience of volunteering, a sense of civic responsibility and an empathetic personality. The collaborative process was established through the presence of a strong common cause, vulnerability and trust among volunteers, a structured and well-led action cycle process, the development of self-reflection, and a passion to be change agents. Volunteers were able to problem solve and act to make changes to the intervention programme which included actions at a programme and volunteer level. The speechlanguage therapist (SLT’s) role was critical in a literacy-related intervention as a support for volunteers. The expertise of SLTs, namely knowledge in language and literacy development, was valued in streamlining the process of taking appropriate actions to enrich the literacy programme.
  • Thumbnail Image
    Item
    Open Access
    Affirming marginal voices : a study of a group of primary school children in an asymmetrical multilingual setting
    (2008) Jardine, Aziezah; Hutchings, Cathy
    The aim of my teaching intervention, dialogue journal writing, was to counter these deficit perceptions by affirming the marginal home language at school. More importantly, I aimed to give children who do not often get the opportunity to do so, the space to voice themselves in writing. My research, therefore, aimed at investigating the dialogue journal writing process as a means of raising the status of Xhosa at school, as well as to affirm the voices of children in asymmetrical multilingual settings.
  • Thumbnail Image
    Item
    Open Access
    An exploration of the facilitators and barriers experienced by Rehabilitation Care Workers in the provision of Speech-Language Therapy related services
    (2018) Higgs, Salma; Harty, Michal; Norman, Vivienne
    Background: South Africa experiences a severe shortage of speech-language therapists (SLTs) which results in individuals requiring Speech-Language Therapy (SLT) services having to travel long distances or being placed on long waiting lists to access services. Rehabilitation Care Workers can assist with bringing this service closer to the communities they serve. It is important to explore the experiences of these individuals to ensure that they are adequately supported and skilled. The University of Cape Town (UCT) has been training Rehabilitation Care Workers (RCWs) since 2012, however to there is currently no empirical data documenting the facilitators and barriers experienced by RCWs in their work. Aim: To explore RCWs (in the Mitchells Plain/Klipfontein sub-structure) perceptions of the facilitators and barriers in providing SLT related activities in their work context. Methods: A descriptive exploratory study was conducted. Eighteen RCWs were approached and 13 participated in 2 focus groups. Data was transcribed and analysed using thematic analysis. An inductive approach was used to develop meaningful themes and sub-themes. Results: The plot of “vital role players” best synthesized the 3 main themes namely scope of practice, RCW position and value as an intrinsic motivator and challenges. : The scope of practice theme included 4 sub-themes namely, RCW activities; awareness of broad scope; understanding family needs; including family as stakeholders in patient management. RCW position and value as an intrinsic motivator - included 4 sub-themes namely, integral members of the team; agents for change; community servants; go between formal structures and the community. Finally the theme challenges –included 4 sub-themes namely, training gaps; safety; lack of resources; feeling undervalued. The facilitators and barriers identified by the RCW’s aligned with perceptions of other mid-level health care workers as reported in the literature. Implications: RCWs work within a family centred care approach and see themselves as community servants who bring vital rehabilitation services into homes by transferring their skills to families and communities through education, support and advocacy. Despite their value and passion, RCWs feel undervalued by those around them, including management structures and the Department of Health (DOH). Conclusion: RCWs can bring much needed rehabilitation services into the homes of communities in Cape Town. For this reason, it is imperative to consider the facilitators and barriers experienced by these individuals in order to harness their natural skills and strengthen the current RCW service and solidify their roles within the Multidisciplinary Team (MDT).
  • No Thumbnail Available
    Item
    Open Access
    An exploration of the occurrence of speech sound disorders in children with autism spectrum disorder aged 4;0 ? 7;11 years
    (2023) Kapoutsis, Stefania; Harty, Michal
    Language development in children with autism spectrum disorder (ASD) is an area of study that has received a lot of attention, however there is limited research available on speech development in this population. There is especially limited research that has investigated speech sound disorders (SSDs) in children with ASD in South Africa. This study aimed to describe the type of SSDs children with Autism Spectrum Disorders (ASD) aged 4;0 – 7;11 years present with. The study employed a descriptive, exploratory research design. Twentyfive children aged 4;0 – 7;11 years with a diagnosis of ASD, attending English-medium schools in the Southern Suburbs of Cape Town, South Africa, participated in the study. The findings were described based on the classifications of SSDs (using Dodd's (2005) differential diagnostic framework), intelligibility ratings, production of phonemes and phonotactic structures, the occurrence of phonological processes, oro-motor ability, and prosody. Phonological delays were the most commonly occurring SSDs, this was followed by articulation disorders, phonological disorders and inconsistent phonological disorders. No participants in the sample were diagnosed with childhood apraxia of speech (CAS). The findings suggested that children with ASD appear to acquire vowels, consonants and phonotactic structures at the same trajectory as typically developing children. Variations in the acquisition of fricatives, affricates and liquids were observed. Substitution, syllable and atypical phonological processes were observed across the sample. A higher prevalence of delayed and atypical phonological processes were observed in the sample of children with ASD, compared to the norms available for typically developing children. The results of this study have indicated that while children with ASD acquire phonemes at the same rate as their typically developing peers, children with ASD may be more likely to present with SSDs. These findings highlight the need for SLTs to ensure that accurate speech assessments are carried out among this population, rather than focusing solely on language. This study is a starting point for further research to be carried out on speech development and SSDs in children with ASD.
  • Thumbnail Image
    Item
    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).
  • Thumbnail Image
    Item
    Open Access
  • No Thumbnail Available
    Item
    Open Access
    Caregivers? perceptions of caregiver burden, quality of life and support needs in caring for a child with cerebral palsy with feeding and/or swallowing difficulties within the context of the Western Cape, South Africa
    (2023) Le Roux, Raquel; Norman, Vivienne; Harty Michal
    Background: Children with cerebral palsy often present with feeding and/or swallowing difficulties and are reliant on family caregivers for long-term care, particularly in resource-constrained countries like South Africa. This can result in caregiver burden and decreased quality of life for both caregiver and child. The planning and implementation of supportive services and interventions depend on the availability of knowledge relating to caregivers' perceptions of burden and the impact on their quality of life, as well as their specific support needs. Research Aim: To describe caregivers' perceptions of caregiver burden, quality of life and support needs in caring for a child with cerebral palsy who has feeding and/or swallowing difficulties, in the context of the Western Cape, South Africa. Methods: A qualitative, descriptive, case study design was utilised to describe the perceptions of eight mothers caring for children with cerebral palsy who have feeding and/or swallowing difficulties, who were between the ages of two and eight years (mean=4.63). Participants, aged between 25 and 42 years (mean = 29.25), were recruited from a hospital's cerebral palsy clinic. Semi-structured telephonic interviews, using an interview guide of seven open-ended questions and probes, were conducted and recorded. Four interviews were conducted in English and the remaining four were conducted in isiXhosa. To ensure trustworthiness and rigor, the study used various measures such as pilot testing, informal member checking, verbatim transcription, re- evaluation of data, triangulation of analysts and sources, debriefing and reflexivity. The data were analysed using thematic analysis to generate themes and sub-themes. Results: Caregiver perceptions were captured in seven key themes, namely: ‘Worry'; ‘Feeding is everything'; ‘Identified support needs'; ‘What helps me cope?'; ‘Cost of caregiving'; ‘Hopeful caregiving'; and ‘Shortfalls of healthcare system and society'. The themes reflect the stress and anxiety of caregiving, the centrality of feeding, specific needs for support, resilience and coping, multifaceted strain, hope and positivity, and failures of healthcare and society in supporting caregivers. Conclusions: The results of this study give voice to caregivers of children with cerebral palsy who have feeding and/or swallowing difficulties, in South Africa. The caregivers highlighted challenges they face in terms of the burden of caregiving and the impact on their quality of life. These caregivers also described the support that was helpful and support that is needed. This knowledge contributes to a broader knowledge base and informs the development of contextually relevant support services for caregivers of children with cerebral palsy who have feeding and/or swallowing difficulties in the Western Cape – and similar contexts – to improve the caregiving experience and quality of life outcomes for caregivers and their children.
  • Thumbnail Image
    Item
    Open Access
    Classroom intervention to change peers' attitudes towards children who stutter: a pilot study six months post-intervention
    (2015) Badroodien, Rizwana; Kathard, Harsha
    The Classroom Communication Resource (CCR) intervention was developed to improve peer attitudes towards children who stutter (CWS). This pilot study will inform the feasibility of a Randomised Control Trial (RCT) through the following aims: 1. To analyse selected procedural aspects including recruitment, participation and re tention rates and questionnaire-questionnaire completion trends. 2. To observe treatment and cluster effect of the CCR intervention at one and six months post-intervention. An experimental, quantitative cluster randomised trial design was used. Pre-intervention - post-intervention data was collected from control and intervention groups. The sample comprised 273 mixed-gender Grade 7 participants in the Western Cape (WC) Metro urban area in classrooms across quintiles. Data was collected and analysed at pre-intervention, one and six months post-intervention. The Stuttering Resource Outcomes Measure (SROM) was used to measure attitude changes. Descriptive and inferential statistics were used to describe the procedural aspects and treatment effect. A positive school-recruitment rate (90, 91%) was observed while the participation (59.6%) and retention rates (44.8%) decrease d over time. Participants were excluded due to poorly completed questionnaires, consent, assent, absenteeism and administrative errors. Questionnaire completion trends at six months post-intervention showed that errors were noted on all items. These procedural challenges could be reduced in future studies through rigorous planning. The positive treatment effect was minimal at one month post-intervention, while more evident in magnitude and direction of change in attitude scores on the SROM at six months post-intervention. A constant group effect was noted at pre-intervention, one and six months post-intervention. This study therefore concluded that a future RCT is feasible with several recommendations.
  • Thumbnail Image
    Item
    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.
  • Thumbnail Image
    Item
    Open Access
  • Thumbnail Image
    Item
    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.
  • Thumbnail Image
    Item
    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.
  • Thumbnail Image
    Item
    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.
  • Thumbnail Image
    Item
    Open Access
    Dysphagia in children (0-12 years) recovering from tuberculosis meningitis (TBM)
    (2015) Makanza, Wadzanai Michel; Norman, Vivienne; Singh, Shajila
    Background information: Tuberculous meningitis (TBM) is the most severe extra-pulmonary complication of tuberculosis (TB) and also the most common bacterial meningitis in the Western Cape. The consequences of childhood TBM include poor motor and neurological outcomes which could lead to dysphagia. Aims: The aim of the study was to describe dysphagia in children (0-12 years) recovering from TBM at Red Cross War Memorial Children's Hospital (RCWMCH) in the Western Cape, South Africa. The purpose of the study was to determine the occurrence and describe the nature of dysphagia as well as to investigate whether any associations existed between dysphagia and the severity of TBM, neurological sequelae, age, and radiological findings.
  • Thumbnail Image
    Item
    Open Access
    The effectiveness of a multi-sensory phonological awareness and letter knowledge training programme for disadvantaged first graders
    (1997) Nadler-Nir, Elizabeth Francis; Tuomi, Seppo K
    The study aimed to determine the effectiveness of a multi-sensory phonological awareness and letter knowledge programme for disadvantaged first graders. One control group and one experimental group, each consisting of 20 children, were matched for age, gender, school readiness, socio-economic status and phonological awareness. Twenty-nine sessions of phonological awareness and letter knowledge training were administered to the experimental group while the control group received vocabulary stimulation activities for the same length of time. Results indicated that the programme was highly effective in improving phonological awareness, letter knowledge, reading and spelling skills. The experimental group scored significantly higher than the control group on simple phonological awareness tasks such as segmenting the sounds in a word, letter knowledge and in their ability to read and spell real and pseudowords. The results are discussed in terms of the importance of both phonological awareness and letter knowledge in the process of literacy acquisition.
  • Thumbnail Image
    Item
    Open Access
    Effectiveness of the classroom communication resource in changing primary school learners' attitudes towards children who stutter after one month: A feasibility study
    (2015) Walters, Freda Aletta; Kathard, Harsha; Norman, Vivienne
    Children who stutter are bullied and teased by their peers, especially in the primary schooling years. The Classroom Communication resource (CCR) was developed as a teacher-administered classroom-based education programme aiming to improve peers' attitudes towards CWS. The focus of this feasibility study was to determine the initial treatment effect of the CCR to improve peers' attitudes towards CWS and the feasibility for a larger scale cluster randomised trial (CRT) in future. Peer attitudes were determined via a Likert scale questionnaire, the Stuttering Resource Outcomes Measure (SROM), completed by primary school learners. Aim one was to establish if the SROM was a valid and reliable outcomes measure. Aim two utilized a quantitative, CRT design with a control group to describe the direction and magnitude of changes in 196 Grade 7 peers' attitudes towards CWS following the administration of the CCR. It also determined whether the changes were linked to gender or having exposure to a person who stutters. The evidence confirmed that the SROM was a valid and reliable outcomes measure. Attitude changes after the administration of the CCR were analysed through inferential statistics. A significant positive change in SROM scores was found in the experimental group (p=0.005) when compared to the control group (p=0.41). Females had a greater magnitude of change in SROM scores after the administration of the CCR compared to males. Participants with prior exposure to a person who stutters held more positive attitudes towards CWS at pre-test. The magnitude of positive change in SROM was greater in participants who did not have prior exposure to a person who stutters (p=0.007). The study indicated initial positive treatment effect of the CCR and implications for the feasibility of a larger CRT is discussed.
  • Thumbnail Image
    Item
    Open Access
  • Thumbnail Image
    Item
    Open Access
    An evaluation of a communicative intervention programme for hearing caregivers and their deaf children in a developing context
    (2005) Hurt, Sharon; Ogilvy, Dale
    This study set out to evaluate the effectiveness of an intervention programme, in a developing context within an ecological framework that involves parents througp parent training adopting a parent-child interaction approach to intervention. This short-term, group intervention programme was developed specifically for hearing primary caregivers of profo,undly deaf signing children from low socio-economic backgrounds. A naturalistic approach to .intervention that followed a conversational model was applied. The programme was deSigned to enhance dyadic communicative interaction and to empower the caregivers as effective change agents, primarily through the programme components of communication skills and sign language, information and knowledge, educational advocacy and support. A broader perspective was adopted through addressing socio-economic factors and adapting to cultural differences. A team of people was involved in programme development, implementation and evaluation and included professionals from a range of disciplines, Deaf signing adults, and an English-isiXhosa interpreter. A shortterm longitudinal, before-and-after group design was used in programme implementation and evaluation. This design encompassed constructivist-interpretive and positivist/post-positivist research paradigms. The group of sixteen caregiver-child dyads reported on in this study was its own control, constituting a quasi-experimental design. An estimate of the effect of the programme was determined by analysing pre-post-intervention comparisons of videotaped dyadic interactions during play and storytelling, and the post-intervention evaluation questionnaire and focus group interview data. A coding system was compiled for the investigation of communication and sign language parameters that were not part of an occurrence of communication breakdown. Investigation of breakdown and repair as well as aspects of caregiver sign production constituted a separate analysis. Both quantitative and qualitative analyses were Icarried out in the evaluation process and certain procedures were adopted to enhance the reliability and validity of the findings. It is believed that the aims I of this study and the specific goals/objectives of the programme were met. The analyses carried out indicated positive change and that this change was most likely due to the programme. In particular, it is believed that the style of caregiver-child interaction changed over the course of the intervention and so the programme was effective to the degree that it improved caregiver-child communicative interaction. More so, it is believed that the programme resulted in empowerment of the caregivers. Numerous aspects are believed to contribute towards the uniqueness of this study and of the communicative intervention programme. The numerous clinical and theoretical implications and implications for future research arising from this study are discussed in detail.