SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background:  Learners who are hard of hearing (HoH) in the Eastern Cape typically attend special schools for the deaf. Failures in mainstream schools result in learners being placed at a special school where South African Sign Language (SASL) is used as the medium of instruction. This is despite learners having residual hearing compared to their d/Deaf peers. This scenario is common in South Africa and often poses a dilemma for professionals in the field.

Objectives:  The objectives of this study were to describe the contextual factors of the audiological history (cause of hearing loss, age of diagnosis and use of amplification) and the communicative function of learners, to explore the school experiences of HoH learners in terms of their classroom and social experiences and to describe learners' views on self-identity.

Method:  The study participants consisted of two groups, learners (eight) and their parents or caregivers (six). A case study design was used. The data sources for the study included participant interviews, direct observations and a review of records. Thematic analysis and descriptive statistics were used for data analysis.

Results:  The learners used SASL and had positive school experiences. They could communicate effectively in SASL and identified with the school community and Deaf Culture. Learners used speech-reading and some oral language. Parents and caregivers could not communicate in SASL with their children.

Conclusion:  Learners who are HoH had a sense of belonging in a school for the deaf where SASL is used as a medium of instruction.Contribution: The findings contribute to the understanding of learners who are HoH in the South African Special Needs Education context where research of this nature is lacking.

Background:  South African Speech-Language Therapy and Audiology (SLH) programmes historically followed Western frameworks, often lacking in cultural and linguistic relevance to the local context. SLH curricula and clinical training continue to face challenges in aligning with South Africa's diverse population and healthcare needs.

Objectives:  To investigate South African undergraduate SLH students' experiences of transformation in the curriculum and clinical service provision.

Method:  A cross-sectional survey design was employed on students from four South African universities. Data were collected through an online questionnaire. Quantitative data were analysed using descriptive and inferential statistics, while thematic analysis was conducted on qualitative responses.

Results:  Findings revealed that most students perceived limited cultural and linguistic relevance in the SLH curriculum, with 60% indicating insufficient Afrocentric content and South African language integration. Students reported feeling underprepared for working with diverse linguistic groups, citing a lack of appropriate resources and limited training in cultural competence. Students proficient in an indigenous language reported higher confidence levels in clinical interactions. Qualitative themes included lack of representation in curriculum content, insufficient cultural competence training and desire for indigenous knowledge and Afrocentric approaches.

Conclusion:  The study highlights critical gaps in SLH education in South Africa, particularly in the inclusion of culturally and linguistically relevant training. Recommendations include integrating Afrocentric content, indigenous language modules and practical training for working in diverse clinical settings.Contribution: This study contributes to the discourse on decolonising SLH education in South Africa, offering evidence-based recommendations to align training with the country's diverse sociocultural and linguistic realities.

Hearing loss in children born to human immunodeficiency virus (HIV)-positive mothers is an emerging public health concern in South Africa. These children, particularly those exposed to antiretroviral therapy (ART) in utero, face heightened risks of auditory impairment predominantly linked to ototoxic ART regimens, prematurity, maternal health comorbidities such as diabetes, and socioeconomic vulnerabilities. While ART has been effective in reducing mother-to-child HIV transmission, evidence suggests that it can also contribute to auditory impairments, impacting early childhood development, language acquisition, and cognitive skills. Audiologists play a crucial role in mitigating these risks through early hearing detection and intervention (EHDI). However, audiologists remain underutilised by both the public and the National Health Department in public healthcare settings with capacity versus demand challenges, and routine audiological screenings for high-risk children, such as HIV-exposed but uninfected infants, are limited.Contribution: This article advocates for the integration of routine audiological assessments within maternal and paediatric HIV healthcare services, highlighting the need for structural changes in policy to support preventive audiological care. By establishing comprehensive, multidisciplinary EHDI programmes, South Africa can reduce the long-term developmental and socioeconomic impacts of hearing loss in this vulnerable population, enhancing both individual and public health outcomes.

Background:  The growing ageing population requires effective management of complex medical diagnoses and healthy ageing support within residential care facilities. However, limited access to guidelines on monitoring residents' eating and swallowing abilities has been reported. Recent research is critical for future policy development.

Objectives:  This study aimed to compare self-perceived and clinical presentation of eating and swallowing abilities among a portion of elderly residents to enhance management of the residential care population within the South African context.

Method:  This comparative, within-subject research study assessed 44 participants using an oropharyngeal dysphagia protocol including a medical history review, the Eating Assessment Tool - 10 (EAT-10), the Mann Assessment of Swallowing Abilities (MASA), and the three-ounce water test of the Yale Swallow Protocol (YSP). A brief cognitive screener was used when cognitive impairment was unknown.

Results:  Of the participants, 21 out of 44 (48%) self-reported concerns for oropharyngeal dysphagia. Evidence of compensatory eating behaviours, without therapeutic intervention, was found. A negative, low correlation was present between the EAT-10 and the MASA (r = -0.306, p  0.05) scores.

Conclusion:  Individuals who self-reported eating and swallowing difficulties demonstrated fewer clinical symptoms, potentially due to compensatory techniques. The disparity between patient-reported outcome measures and clinical assessment tools highlights the need for robust screening and assessment policies within this context.Contribution: This study highlights the importance of holistic assessment practices by integrating self-perception with clinical findings to address oropharyngeal dysphagia incidence within this complex population.

In South Africa, the integration of research into clinical practice within the fields of speech therapy and audiology remains a pivotal, yet underexplored challenge. This opinion piece discusses the critical need for a structured research agenda to drive meaningful changes in clinical practice in South Africa. With healthcare realities such as limited resources, linguistic and cultural diversity, and access to services, it is essential that practitioners, policymakers and researchers collaboratively define and prioritise research topics that address the unique needs of South African patients. Through identifying gaps in current practice, engaging with communities and overcoming barriers to change, the South African healthcare system can adapt to evidence-based, patient-centred models of care. By building a culture of research and innovation, fostering multidisciplinary collaboration and ensuring continuous professional development, South Africa can align its speech therapy and audiology practices with global standards, ultimately improving outcomes for individuals with communication and hearing disorders.Contribution: This article highlights the steps needed to establish a research-driven framework for clinical practice change, positioning research as a cornerstone of future healthcare delivery.

Background:  The development of a Digit Triplet Test in the Swahili language is an essential step towards providing accurate hearing assessment for Swahili-speaking populations.

Objectives:  This study aimed to develop a Digit Triplet Test in Swahili through a two-part procedure consisting of an optimisation phase and an evaluation phase using normal hearing participants.

Method:  A total of 34 subjects participated in the study. During the optimisation phase, a psychometric intelligibility function was determined for each recorded digit, allowing for volume adjustments to standardise the threshold across all digits. This resulted in a lower threshold and a steeper psychometric function for both the triplets and the test lists. Using the optimised speech material, four test lists were created, each containing 27 triplets composed of digits between 1 and 9. The finalised material was then evaluated.

Results:  In the final version, the mean Speech Reception Threshold (SRT) for the participants was -8.9 ± 0.6 dB Signal-to-Noise Ratio (SNR), and the mean slope was 24.7 ± 3.5%/dB using triplet scoring.

Conclusion:  The psychometric function for normal listeners shows a steep slope with little variation between subjects and across test lists.Contribution: The test results are comparable to those of Digit Triplet Tests developed in other languages, indicating the effectiveness and reliability of the Swahili Digit Triplet Test for hearing assessments.

Background:  Challenges associated with language assessment in multilingual people with aphasia include the lack of linguistically and culturally appropriate assessment tools. Moreover, most multilingual people with aphasia are assessed in each of their languages separately. However, many multilingual people use elements from their complete linguistic repertoire rather than communicate in one language at a given conversation.

Objectives:  We aimed to examine language production in multilingual speakers with aphasia within a translanguaging approach to assessment, that is, without specifying a single target language. Our four research questions inquired about the characteristics of translanguaging in elicited language production and about the influence of task, topic and individual variables on translanguaging patterns.

Method:  We elicited individual monologues and group conversations from seven people with aphasia living in the Johannesburg Metropolitan Municipality in South Africa. We coded their language output in terms of the number of words used and the languages selected.

Results:  Participants used translanguaging to varying degrees. Five participants used both isiZulu and English in their responses; two participants each used only one language (isiZulu or English). Topic and context of conversation did not seem to affect the pattern of language use.

Conclusion:  Seven multilingual people with aphasia demonstrated the use of translanguaging during elicited language testing. An assessment procedure that allows for the use of multiple languages without restricting the conversation to one language is a feasible approach to assessing people from multilingual communities.Contribution: The study introduces an alternative approach to assessing multilingual people with aphasia and demonstrates its feasibility.

Background:  Tele-intervention gained popularity, during the coronavirus disease 2019 (COVID-19) pandemic, prompting healthcare providers to adapt to remote service delivery. Research about stuttering treatment via tele-intervention in South Africa is limited. Speech-language therapists (SLTs) require further insights to deliver a well-supported approach for treatment of stuttering using tele-intervention, despite limitations such as technological disruptions, including loadshedding, that impact service reliability.

Objectives:  The study aims to explore clients' experiences with tele-intervention for stuttering therapy, and to provide recommendations to improve service delivery.

Method:  Semi-structured interviews were conducted with 11 persons who stutter (PWS) recruited through purposive sampling. Written informed consent was obtained from all participants with experience in both tele-intervention and in-person treatment. Inductive thematic analysis supplemented by descriptive statistics was used to identify patterns and trends.

Results:  Four main themes emerged: (1) User experiences and factors shaping perceptions of tele-intervention; (2) technical infrastructure: barriers and facilitators; (3) financial and access considerations and (4) in-person treatment experience compared to tele-intervention user experience. Likert scale ratings indicated no considerable difference in preferences between tele-intervention and in-person treatment.

Conclusion:  Participants' diverse experiences highlighted tele-intervention's benefits and challenges for stuttering therapy. While limitations exist, findings inform service enhancement in South Africa, emphasising the importance of users' perspectives in tele-intervention design.Contribution: Insights from PWS can be used in informing clinical practice, aiding SLTs in meeting the needs of PWS and guiding best practice. Tele-intervention should be integrated into a hybrid intervention model that PWS prefer.

Background:  Management of oropharyngeal dysphagia within the first few days of an infant's life results in favourable breastfeeding outcomes, indicating the importance of investigating the breastfeeding management practices of speech-language therapists (SLTs) working within this field.

Objectives:  Little has been published about SLTs' management of breastfeeding in low- and middle-income settings. This study explores the perspectives of a group of experienced South African SLTs on their approach to breastfeeding management.

Method:  Qualitative data were gathered through semi-structured online interviews with 12 experienced SLTs and were subjected to thematic analysis.

Results:  Three main themes emerged: (1) Approach to breastfeeding management; (2) Exposure, skills and knowledge related to breastfeeding management and (3) Perspectives and attitudes towards breastfeeding management. Participants demonstrated a clear understanding of their roles within the scope of breastfeeding management, which aligns with established literature. Their approaches appeared to be influenced by their perspectives and attitudes towards breastfeeding, as well as their exposure, skills and knowledge in this area. The study underscores the need for breastfeeding training in undergraduate programmes and highlights the demand for continuous professional development opportunities.

Conclusion:  While the findings are drawn from a small sample of experienced clinicians, they offer valuable insights for speech-language pathology clinical educators and professional organisations.Contribution: This study suggests a re-evaluation of university curricula to enhance exposure to breastfeeding management.

Background:  Hearing aid verification is required to objectively measure hearing aid outputs by ensuring that the amplified speech spectrum closely approximates the prescription goals.

Objectives:  This study aimed to determine audiologists' perceptions and practices regarding hearing aid verification and identify facilitators and barriers to its use.

Method:  A cross-sectional national e-survey included questions related to demographics, perceptions of verification, verification practices and two open-ended questions regarding the facilitators and barriers to conducting hearing aid verification in South Africa.

Results:  Seventy-eight South African audiologists, with experience ranging from less than a year to 34 years, completed the online survey. Of these, 76.3% conduct hearing aid verification, while 23.7% seldom or never perform this verification. Among the audiologists who conducted verification, 81.0% reported performing it on both adults and children. More than three-quarters (86.6%) indicated that they conduct verification only during the initial fitting, while half (53.8%) do so only when a problem arises. Thematic analysis revealed the following barriers to verification: improper equipment, a lack of equipment, non-standard clinical practices and time constraints.

Conclusion:  There are several challenges faced by South African audiologists in performing verification. It may be feasible to address these barriers by raising awareness about the value of verification, offering training, and advocating for the purchase and utilisation of verification equipment.Contribution: This study's findings provide information on the current practices of hearing aid verification in a socioeconomically diverse setting. Furthermore, it highlights important challenges such as a lack of equipment as well as time constraints.