SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background:  Dysphagia is a common and serious condition in critically ill patients, often associated with complications such as aspiration pneumonia and prolonged hospital stays. In South Africa, limited access to instrumental assessments such as fibreoptic endoscopic evaluation of swallowing (FEES) hinders accurate diagnosis and management, particularly in public healthcare settings.

Objectives:  This study aimed to critically reflect on the process of implementing an interdisciplinary FEES service in a private South African hospital and to explore how these insights could inform dysphagia care across healthcare sectors.

Method:  A duoethnographic approach was used, involving structured reflection among four co-researchers (three speech-language therapists [SLTs] and one otolaryngologist) who co-developed the FEES service. Data were collected through a recorded focus group and analysed using Braun and Clarke's reflexive thematic analysis. Trustworthiness was ensured through triangulation, member checking, and peer debriefing.

Results:  Six themes were identified: (1) catalysts for change in dysphagia management, (2) cultivating interprofessional collaboration, (3) navigating logistical and resource constraints, (4) advocating for FEES, (5) enhancing clinical decision-making, and (6) translating FEES into broader contexts. These themes illustrated how FEES improved diagnostic accuracy, fostered interdisciplinary collaboration, and offered scalable potential for public health systems.

Conclusion:  Implementing an interdisciplinary FEES service in a private hospital revealed both challenges and solutions relevant to broader healthcare settings in the South African context.Contribution: Fibreoptic endoscopic evaluation of swallowing offers a cost-effective, accessible diagnostic option for dysphagia care and should be considered for wider adoption within South Africa's National Health Insurance framework.

No abstract available.

Background:  For decades, teaching and learning have relied primarily on oral communication. However, learners with little or no functional speech (LNFS) require augmentative and alternative communication (AAC) strategies to support learning and interaction.

Objectives:  This scoping review aims to map available survey instruments used to identify and describe learners who could benefit from AAC, and to highlight research gaps in this area.

Method:  The scoping review methodology, guided by the Johanna Briggs Institute was followed. A comprehensive search was conducted across nine databases: Academic Search Complete, Health Source: Science/Academic Edition Nursing, ERIC, Africa Wide Information, Scopus, PubMed, MEDLINE, CINAHL and PsycInfo. The search terms were combined using BOOLEAN operators. Studies were included if they: (1) involved learners aged 5-21 years with LNFS, (2) addressed any educational context, (3) report on any screening instrument (4) were published after 1985, (5) were written in English and (6) presented primary data in a peer-reviewed journal.

Results:  Following PRISMA-ScR guidelines, 890 articles were identified, 251 duplicates were removed. Of the remaining 639, 14 underwent full-text review, and seven met the inclusion criteria. No standardised survey instruments were found. Most clinicians adapted or created surveys to meet specific needs, although common variables were assessed, such as learner characteristics and AAC strategies.

Conclusion:  The absence of standardized tools to identify learners with LNFS reveals a significant research gap.Contribution: This review underscores the urgent need for standardised instruments to guide clinical ad educational practices.

Despite advancements in recognising the importance of early child language development and linguistic diversity in South Africa, culturally and linguistically appropriate assessment tools remain unevenly distributed across the official languages, posing considerable challenges for researchers and speech-language therapists. This study critically reviews the psychometric status of child language assessment tools in South Africa's official languages. The current state of tool development is analysed, evaluating language assessment tools available for clinical and research purposes in each language. Tools that assess speech sounds, phonological processing and (pre)literacy skills were excluded, as were untraceable tools reported in previous publications, and tools that do not assess language only but form part of larger developmental assessments. Considering each language version of a tool, 37 traceable language assessment tools (at least 1 per official language), in various states of readiness, are available for use with South Africans aged 0-12 years. Out of these 37 tools, 5 tools, with collectively 7 language versions, have been validated and the statistical results of the validation study published: 4 for isiZulu, 2 for English and 1 for Siswati. Despite advances in tool development, there is still a severe lack of validated standardised child language measurement tools in all official languages of South Africa.Contribution: This is the most recent critical review of the psychometric properties of tools developed for assessing South African children's language skills, and it highlights that past and current efforts in tool development are still insufficient.

Background:  Ensuring students who are deaf/Deaf (d/Deaf) or hard of hearing (d/DHH) have access to higher education goes beyond legal compliance but reflects an institution's commitment to creating educational environments where all learners can fully participate and develop.

Objectives:  This study explored instructional, psychosocial, and environmental factors influencing adjustment to the learning environment among d/DHH students at the University of KwaZulu-Natal (UKZN).

Method:  A qualitative design was employed, with semi-structured interviews conducted with 10 purposively sampled d/DHH students across four UKZN campuses (Westville, Pietermaritzburg, Howard College, and Edgewood). UKZN, one of South Africa's largest and most diverse universities, is recognised internationally for its focus on inclusive education and transformation.

Results:  Thematic analysis revealed eleven themes, including disclosure of disability, interpreter accessibility, classroom acoustics, and attitudinal barriers. Disclosure was vital for accessing support services, while interpreters were key enablers of participation, though mainly available during lectures. Poor classroom acoustics, lighting, noise, and rapid speech negatively affected interpretation. Attitudinal barriers, limited awareness of Deaf culture among peers, and inflexible teaching practices contributed to alienation and isolation. Nonetheless, supportive lecturers and peers facilitated better adjustment, highlighting the role of inclusive behaviours in enhancing learning experiences.

Conclusion:  While positive examples of accommodation were noted, significant challenges remain. The findings suggest the need for comprehensive strategies, including awareness, staff training, improved infrastructure, accessible technology, and strengthened disability support units, to foster inclusive environments that promote full participation of d/DHH students in higher education.Contribution: Addressing instructional, psychosocial and environmental barriers is essential for ensuring equitable access to higher education and academic success for d/DHH students. By examining the lived experiences of these students, this study provides valuable insights to inform more effective and inclusive institutional strategies.

Background:  The Joint Engagement Rating Inventory (JERI) can be used to measure response to early autism intervention. However, little is known about the utility of the JERI outside the United States, where it was developed. A South African study found the JERI to be a reliable and accurate measure of joint engagement and communication between young autistic children and their caregivers. The next step was to determine if the JERI could be used to detect changes in the behaviours of child and caregiver in response to intervention.

Objectives:  This proof-of-principle study aimed to evaluate whether the JERI could detect signals of change in the behaviours of child and caregiver in response to 12, 1-h naturalistic developmental behavioural intervention-informed caregiver coaching sessions.

Method:  A single-arm pre-post design was utilised. Standardised video-recorded caregiver-child interactions were completed before and after intervention. Two raters, blinded to intervention time-point, coded the JERI. Ten dyads completed coaching and video-recorded assessments. Data analysis included inter-rater reliability, Wilcoxon signed-rank test for paired samples and visual summaries.

Results:  Weighted Kappa values for 13 of the 16 JERI items indicated moderate to strong inter-rater agreement. Significant changes in symbol-infused joint engagement (z = -2.46, p = 0.01) and expressive language (z = -2.156, p = 0.03) were detected. Visual summaries showed change signals in 15 JERI ratings.

Conclusion:  Findings suggest that the JERI has the potential to detect change in the context of a caregiver-mediated intervention.Contribution: The JERI was shown here, for the first time in an African context, to be a potential outcome measure for early autism intervention research.

Background: The people of the Pedi culture place great value on, and take pride in, adhering to their culture, as reflected in the manner in which they communicate verbally and non-verbally. However, little is documented about the ways in which verbal and non-verbal language is used socially by the younger generations in the Pedi culture.

Objectives: This article examines how verbal and non-verbal social language skills and functions are used by the younger generations in Pedi families.

Method: A qualitative research design was employed, underpinned by the principles of direct participant observations and semi-structured interviews. A total of 22 participants from seven families were included, and the data were analysed through thematic analysis.

Results: The results showed how younger generations in Pedi families respectfully execute verbal and non-verbal social language skills and functions.

Conclusion: Understanding the cultural nuances of communication in the Pedi culture, including respect expressed through verbal and non-verbal cues, is critical for speech-language pathologists (SLPs). By recognising these cultural practices as differences rather than deficits, SLPs can provide more effective, respectful and culturally appropriate interventions.Contribution: The findings of this study contribute to a broader understanding of how language is used in the Pedi culture and offer valuable insights for practitioners working with clients from diverse cultural backgrounds. Moreover, these findings call for a more inclusive approach to pragmatics in speech-language pathology that acknowledges the rich diversity of communication practices worldwide.

Background:  Small infants face more developmental risks than their full-term peers, necessitating early intervention and long-term monitoring.

Objectives:  This study examined the longitudinal developmental and hearing outcomes of small infants attending a high-risk clinic in a South African low-income community setting.

Method:  A short-term longitudinal within-subject descriptive study design was employed, where 28 participants underwent hearing and developmental screenings and assessments at two follow-up appointments (T1 and T2), at 6- and 12-month corrected age. Developmental outcomes, such as communication, motor and daily living skills, were evaluated using developmental screening tools (Parents Evaluation of Developmental Status [PEDS]), hearing screening (ABR MB11) and developmental assessments (Vineland-3).

Results:  All participants underwent hearing screening, with four (14.3%) failing twice (T1 and T2) and being referred for diagnostic evaluation. Developmental screening at T1 identified concerns in communication, gross motor and social-emotional skills (28.5%). Concerns persisted across T1 and T2 in the PEDS tool, with fine motor skills emerging as a key issue at T2. Vineland-3 assessments showed improvement from T1 to T2; initial concerns in daily living (M = 104.12; standard deviation [s.d.] = 38.99) and motor skills (M = 88.82; s.d. = 45.26) were no longer present at T2, where all participants had age-appropriate developmental scores.

Conclusion:  The findings highlight the need for comprehensive, routine developmental monitoring and early intervention to address delays in small infants. Continued follow-up care and support from birth to 12 months corrected age can improve outcomes and caregiver developmental literacy. Contribution: This study provides valuable insights for caregivers, healthcare policymakers and early intervention professionals by emphasising the importance of early screening, continuous monitoring and caregiver education in optimising developmental outcomes for small infants.

Background:  In South Africa (SA), congenital hearing loss (HL) is identified at around 30 months of age, which is later than local standards of identification by 6 weeks, mainly because of limited access to infant and newborn hearing screening (INHS). Thus, there is a critical need to explore other models of providing early detection such as nurse-administered INHS.

Objectives:  This study aimed to determine the reliability of nurse-administered INHS.

Method:  This was a repeated-measures study where 50 infants scheduled to receive their 6-week immunisation were independently screened by two nurses and an audiologist using distortion product otoacoustic emissions (DPOAE). Data were analysed using Cohen's kappa, using Stata v18 for Macintosh.

Results:  Thirteen (n = 13, 26%) infants failed DPOAE screening tests, of which four were male and nine (n = 9) were female. All participants who failed the screening were referred to the hospital for further evaluation and intervention as needed. Further analysis revealed an almost perfect agreement between audiologist- and nurse-administered screening (k = 0.81, p  0.001).

Conclusion:  Findings from this study demonstrate that nurses can consistently screen and identify babies with congenital HL using DPOAE screening tests. Furthermore, these findings pave the way for incorporating nurse-administered DPOAE screening into immunisation programmes, with the potential to increase access to INHS and reduce the age of identification of congenital HL to acceptable standards. Large-scale research is recommended to explore the implementation of this nurse-administered INHS in other contexts. Contribution: This study contributes to the growing body of evidence on INHS in SA.

Background:  Corporate speech and language therapy (CSALT) is an emerging field that extends the role of speech and language therapists (SALTs) into corporate environments, enhancing workplace communication and interpersonal skills. While internationally recognised, CSALT remains underexplored in South Africa, where linguistic and cultural diversity present challenges and opportunities for its integration.

Objectives:  This study aimed to explore South African SALTs' perceptions of CSALT.

Method:  A qualitative research approach was employed, grounded in a constructivist paradigm. Semi-structured interviews with seven SALTs were conducted and analysed using inductive thematic analysis. The study was conducted through remote interviews via Microsoft Teams.

Results:  Participants emphasised the relevance of CSALT in enhancing workplace communication, particularly in multilingual and culturally diverse corporate environments. Essential competencies for effective CSALT practice included business acumen, voice training and cultural competence, with a strong focus on understanding corporate communication styles. However, several barriers to CSALT were noted, such as limited public awareness, misconceptions about CSALT, accessibility challenges and insufficient academic preparation. Participants highlighted the need for greater recognition of CSALT and the development of more inclusive service delivery models to support its integration.

Conclusion:  CSALT can potentially improve workplace communication and inclusivity in South Africa. However, its growth is hindered by accessibility challenges and a lack of CSALT-specific training. Addressing these barriers could support its integration into national workforce development strategies.Contribution: This study highlights the potential to expand SALTs' scope of practice and contribute to the global discourse on speech and language therapy in corporate health.