The applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives

dc.contributor.advisorHarty, Michal
dc.contributor.advisorHampton, Lauren H
dc.contributor.authordu Plessis, Chevonne
dc.date.accessioned2020-02-26T14:11:35Z
dc.date.available2020-02-26T14:11:35Z
dc.date.issued2019
dc.date.updated2020-02-26T13:17:21Z
dc.description.abstractBackground: Enhanced Milieu Teaching (EMT) is an evidence-based naturalistic developmental behavioural intervention (NDBI) to improve expressive communication. EMT produces favourable long-term results in both vocabulary growth and linguistic structure after a relatively short intervention period. However, very little research has been conducted to prove its effectiveness in culturally and linguistically diverse populations. Furthermore, before interventions can be implemented in different contexts, there is a need to determine if any adaptations are needed to maximize the fit of the intervention to the novel context. Tension exists between the need for implementation fidelity and the flexibility or fit of an intervention into novel settings, populations and contexts. A single proof of concept study exists which indicates that a trained therapist can implement EMT to fidelity in a South African special school context with English-speaking children. However, very little research exists which documents stakeholder perspectives of the perceived fit of naturalistic developmental behavioural interventions in the South African context. This study adds to this important body of literature by documenting the perceptions of bilingual Speech and Language Therapists, as well as bilingual parents of children with developmental disabilities, regarding the applicability of EMT within the South African context. Aim: To determine bilingual parents’ and Speech and Language Therapists’ perceptions regarding the acceptability and appropriateness of implementing EMT with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or isiXhosa at home. Methods: A descriptive exploratory study was conducted using two qualitative methods. Five bilingual SLT’s were interviewed, and two focus groups with eleven bilingual parents of children with developmental disabilities was conducted thereafter. Data was transcribed and analysed using thematic analysis according to the approach suggested by Braun & Clarke, (2006). The findings of the thematic analysis were then merged as subthemes within the adaptome framework (Chambers & Norton, 2016) in order to present diverse parent and SLT perspectives adequately. The adaptome framework comprises four sources of adaptations, namely: service setting, mode of delivery, target audience and cultural adaptations. vi Results: The barriers and facilitators to implementing EMT, together with the areas for potential adaptation within a multilingual and/or multicultural context, were reported in this study. Both parent and professional stakeholders reported that the core components of EMT are appropriate within their contexts and would not require adaptations. The data obtained from both parent and professional participants pertaining to potential adaptations were grouped into ten subthemes which were assigned within the four sources of adaptation. Bilingual SLTs highlighted aspects such as limited resources and limited parent-professional collaborations as barriers to sustained implementation across diverse service settings. Parents expressed concerns regarding the resources and the mode of intervention delivery used during EMT implementation. The facilitators and barriers, together with the areas for potential adaptation identified by the participants, align with perceptions of parents and professionals as reported in previous literature. Implications: Bilingual parent and professional stakeholder participants found that the core components of EMT would be appropriate in the South African context. However, participants suggested that adaptations to the peripheral elements of EMT would be required, with the majority of the adaptations relating to preferred service delivery settings and the mode of intervention delivery. Conclusion: Bilingual parents and Speech and Language Therapists view EMT as an appropriate and potentially valuable intervention in the South African context.
dc.identifier.apacitationdu Plessis, C. (2019). <i>The applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives</i>. (). ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders. Retrieved from http://hdl.handle.net/11427/31343en_ZA
dc.identifier.chicagocitationdu Plessis, Chevonne. <i>"The applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives."</i> ., ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders, 2019. http://hdl.handle.net/11427/31343en_ZA
dc.identifier.citationdu Plessis, C. 2019. The applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - du Plessis, Chevonne AB - Background: Enhanced Milieu Teaching (EMT) is an evidence-based naturalistic developmental behavioural intervention (NDBI) to improve expressive communication. EMT produces favourable long-term results in both vocabulary growth and linguistic structure after a relatively short intervention period. However, very little research has been conducted to prove its effectiveness in culturally and linguistically diverse populations. Furthermore, before interventions can be implemented in different contexts, there is a need to determine if any adaptations are needed to maximize the fit of the intervention to the novel context. Tension exists between the need for implementation fidelity and the flexibility or fit of an intervention into novel settings, populations and contexts. A single proof of concept study exists which indicates that a trained therapist can implement EMT to fidelity in a South African special school context with English-speaking children. However, very little research exists which documents stakeholder perspectives of the perceived fit of naturalistic developmental behavioural interventions in the South African context. This study adds to this important body of literature by documenting the perceptions of bilingual Speech and Language Therapists, as well as bilingual parents of children with developmental disabilities, regarding the applicability of EMT within the South African context. Aim: To determine bilingual parents’ and Speech and Language Therapists’ perceptions regarding the acceptability and appropriateness of implementing EMT with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or isiXhosa at home. Methods: A descriptive exploratory study was conducted using two qualitative methods. Five bilingual SLT’s were interviewed, and two focus groups with eleven bilingual parents of children with developmental disabilities was conducted thereafter. Data was transcribed and analysed using thematic analysis according to the approach suggested by Braun &amp; Clarke, (2006). The findings of the thematic analysis were then merged as subthemes within the adaptome framework (Chambers &amp; Norton, 2016) in order to present diverse parent and SLT perspectives adequately. The adaptome framework comprises four sources of adaptations, namely: service setting, mode of delivery, target audience and cultural adaptations. vi Results: The barriers and facilitators to implementing EMT, together with the areas for potential adaptation within a multilingual and/or multicultural context, were reported in this study. Both parent and professional stakeholders reported that the core components of EMT are appropriate within their contexts and would not require adaptations. The data obtained from both parent and professional participants pertaining to potential adaptations were grouped into ten subthemes which were assigned within the four sources of adaptation. Bilingual SLTs highlighted aspects such as limited resources and limited parent-professional collaborations as barriers to sustained implementation across diverse service settings. Parents expressed concerns regarding the resources and the mode of intervention delivery used during EMT implementation. The facilitators and barriers, together with the areas for potential adaptation identified by the participants, align with perceptions of parents and professionals as reported in previous literature. Implications: Bilingual parent and professional stakeholder participants found that the core components of EMT would be appropriate in the South African context. However, participants suggested that adaptations to the peripheral elements of EMT would be required, with the majority of the adaptations relating to preferred service delivery settings and the mode of intervention delivery. Conclusion: Bilingual parents and Speech and Language Therapists view EMT as an appropriate and potentially valuable intervention in the South African context. DA - 2019 DB - OpenUCT DP - University of Cape Town KW - Speech-Language Pathology LK - https://open.uct.ac.za PY - 2019 T1 - The applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives TI - The applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives UR - http://hdl.handle.net/11427/31343 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/31343
dc.identifier.vancouvercitationdu Plessis C. The applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives. []. ,Faculty of Health Sciences ,Division of Communication Sciences and Disorders, 2019 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/31343en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDivision of Communication Sciences and Disorders
dc.publisher.facultyFaculty of Health Sciences
dc.subjectSpeech-Language Pathology
dc.titleThe applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMSc
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