SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background: There is a shortage of validated autism screening tests in the 11 official languages of South Africa. The Modified Checklist for Autism in Toddlers, Revised with Follow-Up (M-CHAT-R/FTM), a validated and well-known screening test, had already been adapted (in English) and translated into Northern Sotho for use in South Africa.

Objectives: The aim was to collect pilot data to determine the preliminary reliability and feasibility of the two tests to confirm the equivalence of the adaptation and translation.

Method: The study was conducted in a peri-urban community in South Africa. Twenty-one first-language Northern Sotho caregivers of children aged between 18 and 48 months were recruited by employing snowball sampling. The participants were asked to complete the Northern Sotho and the culturally adapted English M-CHAT-R/F, which were presented in random order.

Results: The preliminary content validity and equivalence were evident, with no difference at the 5% interval of the Wilcoxon signed rank test. All 21 toddlers screened presented with a low risk for autism following the recommended execution of the Follow-Up section for the toddlers in the medium risk category. All participants completed the two screening tests, with none indicating unfamiliar words or constructs. A higher preference for the English adapted version was found but a need for the Northern Sotho screening test was also evidentConclusion: The Northern Sotho translation of the M-CHAT-R/F, as well as the adapted English version, appears feasible and is ready for comprehensive validation.

Background: The bedside assessment is often seen as a screener because of its high variability in sensitivity and specificity, whilst the instrumental measures are viewed as gold standards because of the ability of speech-language therapist (SLT) to visualise the swallow more objectively.

Objectives: This research article explores how the value needs to be placed on the decision-making abilities of the SLT rather than on the assessment measure itself.

Method: A mixed methodology concurrent triangulation design was employed to collect data in two phases: the first phase included observing seven SLTs conducting assessments using a standardised bedside measure together with pulse oximetry and cervical auscultation. The second phase was a focus group discussion based on the findings from the first phase. Data were analysed thematically using a bottom-up approach.

Results: The following factors were found to influence the decision-making process at the bedside: bedside assessment data sets, patient, multidisciplinary team, context and then SLT. The availability of more data from the assessment from different data sets improved the confidence of the SLT at the bedside when needing to make clinical decisions. Clinical instincts are developed through experience and observation of those more experienced. These skills need to be developed from junior years.

Conclusion: This research study showed that a bedside assessment can provide valuable information that will allow for diagnostic decisions to be made at the bedside. This study also highlighted the importance of critical thinking using clinical instincts, and that these are the factors that need to be valued and emphasised rather than the assessment measures themselves.

Background: Various fields of study have alluded to food textural, and its associated acoustic, properties (i.e. food textural acoustics). However, because of the challenging nature of the inclusion of acoustic properties in diet textural modifications in dysphagia (swallowing disorders), this construct has not been sufficiently considered in the field.

Objective: To investigate the sensibility of food textural acoustics as a construct to understand eating for individuals with dysphagia.

Method: The study design was based on qualitative evidence synthesis methodologies. This involved revised scoping review methods (peer-reviewed published articles from 1980 to 2020 over seven databases), with an adapted consultation phase through online focus group discussions with six world experts. The data was analysed using frequency and thematic analysis, and ideology critique.

Results: A total of 11 articles were included in the revised scoping review analysis (seven research studies and four review articles). The analysis of these articles revealed a lack of diversity in geography, discipline and perspective exploring the construct of food textural acoustics. A total of three themes with three associated core arguments emerged from the revised scoping review and the consultation phase. These arguments highlighted (1) the need to study food textural acoustics because of its salience and pleasure responses, (2) possible methodological dilemmas in studying food textural acoustics due to the complexity of eating, and (3) considerations with regard to the approach and positioning adopted when studying the construct.

Conclusion: Food textural acoustics may be a sensible construct to understand eating for individuals with dysphagia. As eating is a complex process, there is a need to challenge the methods we use when studying this construct of food textural acoustics. We hope that this article inspires researchers and practitioners to think differently by using textural, and its associated acoustic, properties as a way to reimagine dysphagia practice, especially for those from low- to middle-income contexts such as South Africa and Brazil.

Background: Limited research exists regarding South African audiologists' practice with acoustic immittance. This study was part of a bigger study titled 'Wideband acoustic immittance in adults living with human immunodeficiency virus'.

Objectives: The purpose of the study was to explore current practice of South African audiologists regarding acoustic immittance measures, and to explore their perceived knowledge and views on acoustic immittance advancements.

Method: A quantitative survey with a cross sectional design was employed. An electronic questionnaire was distributed to participants via professional associations of audiologists. Data was analysed through descriptive and inferential statistics.

Results: Most audiologists worked in private practice and conducted tympanometry with 226Hz probe tone and ipsilateral acoustic reflexes. There was no association between clinical setting, levels of qualification, and the use of tympanometry. None of the participants included multifrequency and multicomponent tympanometry (MFT) and/or wideband acoustic immittance (WAI) in their test battery. Most of the participants were not familiar with MFT and WAI. Familiarity with MFT and WAI were only associated with the level of qualification. Limited training and lack of equipment were major barriers to conducting some of the acoustic immittance measures. Most participants believed that they would include MFT and/or WAI in their test battery if they had access to the equipment.

Conclusion: Current findings raise training and clinical implications for the South African audiologists, including training institutions. These findings provide motivation for strategic resource allocation, planning and distribution of audiology clinics in the country if positive preventive audiology outcomes are to be achieved.

South African speech-language and hearing (SLH) professions are facing significant challenges in the provision of clinical services to patients from a context that is culturally and linguistically diverse (CLD) due to historic exclusions in higher education training programmes. Over 20 years postapartheid, little has changed in training, research, as well as clinical service provision in these professions. In line with the Health Professions Council of South Africa's (HPCSA) SLH Professional Board's quest to transform SLH curriculum and in adherence to its recently published Guidelines for Practice in a CLD South Africa, in this review article, the authors deliberate on re-imagining practice within the African context. They do this within a known demand versus capacity challenge, as well as an existing clinician versus patients CLD incongruence, where even the clinical educators, a majority of whom are not African, are facing the challenge of an ever more diverse student cohort. The authors systematically deliberate on this in undergraduate clinical curriculum, challenging the professions to interrogate their clinical orientation with respect to African contextual relevance and contextual responsiveness (and responsibility); identifying gaps within clinical training and training platforms; highlighting the influencing factors with regard to the provision of linguistically and culturally appropriate SLH clinical training services and, lastly, making recommendations about what needs to happen. The Afrocentric Batho Pele principles, framed around the concept of ubuntu, which guide clinical intervention within the South African Healthcare sector, frame the deliberations in this article.

Background: Cape Town Minstrel Carnival is one of the oldest and most authentic indigenous New Year's customs in South Africa. Musicians who perform at this carnival are exposed to excessively loud music and therefore at a risk of acquiring noise-induced hearing loss (NIHL).

Objectives: This study aimed to determine patterns of exposure to loud music and prevalence of hearing loss amongst Cape Town Minstrel Carnival musicians.

Method: A descriptive, observational exploratory survey design was used and 43 participants (21 males and 22 females; mean age, 21 ± 9 years) took part in this study. Sound level measurements were conducted to assess musicians' sound exposure during rehearsals and performances. All participants underwent the following audiological test battery at least 2 h before music exposure: Case history, otoscopic examination, tympanometry, pure tone audiometry and distortion products otoacoustic emission (DPOAE).

Results: Average noise levels recorded were 86 dBA during rehearsals and 98.7 dBA at performances and average durations of exposure were 240 and 10 min at rehearsals and performances, respectively. One out of 43 (1/43) participants presented with sensorineural hearing loss. Audiometric results of the remaining participants were normal and did not show a pattern suggestive of NIHL. A high proportion of participants (21/43) reported experiencing tinnitus.

Conclusion: Despite being exposed to high levels of noise, there was a low prevalence of hearing loss amongst these musicians. However, a high proportion of them reported tinnitus, which could be an indication that they were at a high risk of NIHL from the music that they played.

Background: The absence of best practice guidelines on informational counselling, has caused lack of clarity regarding the information audiologists should provide to parents and caregivers following the diagnosis of a hearing loss. Research shows that informational counselling provided by audiologists is limited and often biased, with little evidence of how parents experience this service.

Objectives: To explore the nature and practice of informational counselling by audiologists.

Method: This study was descriptive in nature and adopted a survey design to obtain information on the current practices of informational counselling from the perspective of parents and primary caregivers. Ninety-seven face-to-face semi-structured interviews were conducted across KwaZulu-Natal province of South Africa. Descriptive statistics and thematic analysis using Nvivo software were conducted.

Results: The majority of the parents reported receiving some form of informational counselling. However, the information provided by audiologists was considered to be biased as it included a favoured communication option, school and rehabilitative technology. There was a lack of information related to aural rehabilitation and family-centred intervention. The provision of all communication options, school options and rehabilitative technology were identified as gaps that contribute to an unfavourable decision-making process.

Conclusion: There are inefficiencies experienced by families of deaf and hard of hearing children during informational counselling. However, this understanding, together with the identified gaps by parents, can help address the professional response to caring for families with deaf and hard of hearing children.

Background: Factors that influence various professionals to pursue postgraduate studies have been investigated. However, there is a dearth of evidence of factors that influence South African speech language pathologists (SLPs) and audiologists (As) to pursue their postgraduate studies.

Objective: Therefore, this study aimed to determine factors that influence the decision of South African SLPs and As to pursue postgraduate studies and potential barriers to this pursuit.

Method: A quantitative survey research methodology with a cross-sectional research design was adopted, where a 21-item web-based survey was used to survey 127 speech therapists, As and speech therapists and As from across the country. All participants were qualified and registered with the Health Professionals Council of South Africa (HPCSA). Ethical clearance and permission from relevant stakeholders were obtained. Data were analysed descriptively.

Results: The findings suggested that over half of the participants pursued their postgraduate studies to fulfil a personal goal and improve their knowledge, whilst others did it to develop expertise and for job opportunities. Participants highlighted that a lack of time and funding, heavy workloads and bad experiences during their undergraduate studies were the main barriers to pursuing postgraduate studies. Whilst community service was not a barrier per se, participants felt that it delayed them from beginning their postgraduate studies immediately.

Conclusion: The findings of this study highlighted the urgent need for institutions of higher learning, government and other stakeholders to provide the necessary support for SLPs and As in South Africa to pursue postgraduate studies.

Background: Children from under-served communities are at risk for delayed spoken language and literacy development. Under-served preschools frequently contend with lack of resources, especially with regard to access to age-appropriate storybooks and/or print resources. Environmental print is a cost-effective material that can be used to stimulate emergent literacy skills. In the context of under-served communities, a collaborative approach and mentorship between preschool teachers and Speech-Language Therapists (SLTs) promote language and literacy development.

Objectives: This article's purpose is two-fold; firstly, to discuss the use of environmental print as a stimulus material to promote emergent literacy in preschoolers in under-served preschools. Secondly, to promote the SLT's involvement in such education initiatives.

Method: A mixed-method, comparative intervention research design, was reported in this article. A pre- and post-test design was employed, with data collected before and after a teacher-based intervention.

Results: Participants in the intervention group displayed increased scores on the Concepts About Print (CAP) assessment, participants in the comparison group showed no change in scores using the same assessment over the same time period.

Conclusion: A short-term, teacher-based intervention using environmental print with SLT mentoring and collaboration promoted preschool children's emergent literacy skills. Implications include the value of using environmental print as a teaching material and the positive impact of collaboration between SLTs and teachers to promote emergent literacy in preschool children.

Background: Age-Related Hearing Loss (ARHL) is the most widespread sensory disorder in the elderly. Poor audiological support within retirement homes is one of the fundamental issues impacting the Quality of Life (QoL).

Objectives: The objectives of this study were to: (1) Identify the presence of hearing impairment through a hearing screening test battery in a sample of elderly participants residing in three retirement homes. (2) Determine the psychological, communication-related and social impact of the hearing impairment on the QoL in a sample of elderly participants residing in retirement homes.

Method: A prospective cross-sectional research design with quantitative methods of data analysis was used to obtain data from 70 elderly participants (mean age = 79 years, 79% were female). Ten of them used hearing aids. Hearing screening was conducted using otoscopy, tympanometry and air conduction screening (500 Hz-4 kHz). The World Health Organization Quality of Life (WHOQoL) questionnaire was adapted and utilised for the present study.

Results: Findings revealed that 77% of the sample obtained a refer result from the hearing screening protocol indicating a high presence of hearing impairment. Twenty-nine per cent (n = 16) of the participants felt depressed, worried and anxious because of their hearing loss and 20% of participants felt unaccepted by their significant others as a result of their hearing impairment. Hearing difficulties were significantly associated with a reduced QoL (p = 0.045). Eight of the 10 participants who wore hearing aids reported an overall improvement in QoL since receiving and utilising their hearing aids and 20% (n = 2) of hearing aid users reported challenges with maintaining their hearing aids.

Conclusion: The findings of this study emphasised the need for an increased role for audiological services provided by audiologists within retirement homes, thereby contributing to an improved QoL.