SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background: One of the interventions for dysphagia is diet modifications, involving a variety of resources and consumables. In South Africa, where 49% of the population live below the poverty line, the necessities for it are not always feasible for the patient and their family. This coupled with the responsibility of caring for a loved one with disability can culminate into caregivers experiencing third-party disability (TPD).

Objective: To describe the experiences of TPD of caregivers when implementing dysphagia management strategies at home within an economically developing country context.

Methods: This was a qualitative study using phenomenological principles. Data were collected using a semi-structured self-developed interview tool at three tertiary level public sector hospitals. Seven participants and six caregivers were interviewed. Rigour was obtained through credibility, triangulation, transferability, dependability and confirmability. The data were analysed using a thematic content analysis technique following a top-down approach to coding.

Results: The use of diet modification is an appropriate management strategy if the patients' access and contextual limitations have been taken into consideration. It was evident that the caregivers had multiple International Classification of Functioning, Disability and Health domains affected, which restricted their daily functioning including activities, participation and environmental and personal factors.

Conclusion: The management of dysphagia needs to be family centred and the caregiver's role and needs have to be considered by all team members when determining long-term management plans. The specific area of how the caregiver's quality of life was experienced also required further exploration.

Background: This study used local resources- community members, photographer and speech therapists to develop a new test for screening receptive language skills and sought to determine its feasibility for use with a larger population in KwaZulu-Natal province, South Africa.

Objectives: The aim of this study was to develop a one-word receptive vocabulary test appropriate for screening and diagnosis of isiZulu-speaking preschool-aged children. The objectives were (1) to determine sensitivity and specificity of the Ingwavuma Receptive Vocabulary Test (IRVT) and (2) to determine the relationship of IRVT scores with age, gender, time and the confounding variables of stunting and school.

Method: The study was quantitative, cross-sectional and descriptive in nature. The IRVT was piloted before being administered to 51 children (4-6 years old). Statistical analysis of test item prevalence, correlations to confounding variables and validity measurements were conducted using Statistical Package for Social Scientists version 25 (SPSS 25).

Results: The IRVT was able to profile the receptive skills for the preschool children in Ingwavuma. The mean raw score for boys was 35, and 32 for girls. There was a significant Pearson correlation between test scores and age (0.028, p 0.05) with a high effect size (Cohen's d = 0. 949), gender (r = -0.032, p 0.05) with a medium effect size (Cohen's d = 0.521) and school (r = 0.033, p 0.05) with a small effect size (Cohen's d = 0.353). The sensitivity and specificity values were 66.7% and 33%, respectively. The test reliability (Cronbach's alpha) was 0.739, with a good test-retest reliability.

Conclusion: The IRVT has potential as a screening test for isiZulu receptive vocabulary skills amongst preschool children. This study contributes to a development of clinical and research resources for assessing language abilities.

Background: This study continued the development of an isiZulu speech reception threshold (zSRT) test for use with first language, adult speakers of isiZulu.

Objectives: The objective of this study was to determine the convergent and concurrent validity of the zSRT test.

Methods: One hundred adult isiZulu first-language speakers with normal hearing and 76 first-language, adult isiZulu speakers with conductive or sensorineural hearing losses ranging from mild to severe were assessed on pure tone audiometry and a newly developed isiZulu SRT test. Convergent validity was established through agreement of the zSRT scores with pure tone average (PTA) scores. Concurrent validity was assessed by examining the steepness of the psychometric curve for each word in the zSRT test for each type and degree of hearing loss.

Results: Intraclass correlation coefficient analyses showed zSRT scores were in substantial to very high agreement with PTA scores for the normal hearing and hearing loss groups (NH - right ear ICC consistency = 0.78, left ear ICC = 0.67; HL - right ear ICC consistency = 0.97, left ear ICC consistency = 0.95). The mean psychometric slope (%/dB) at 50% correct perception for all words in the zSRT test was 4.92%/dB for the mild conductive hearing loss group, 5.26%/dB for the moderate conductive hearing loss group, 2.85%/dB for the moderately severe sensorineural hearing loss group and 2.47%/dB for the severe sensorineural hearing loss group. These slopes were appropriate for the degree of hearing loss observed in each group.

Conclusion: The zSRT test showed convergent and concurrent validity for assessing SRT in first language, adult speakers of isiZulu.

Background: Individuals with Down syndrome (DS) have more difficulties with the structural aspects of language, including morphology (concatenation and non-concatenation) and syntax (word order and grammatical/concord rules), than with other language components (e.g. vocabulary, phonetics and pragmatics).

Objectives: This study investigates the accuracy of grammatical number inflection produced by Jordanian Arabic-speaking children and young adults with DS. The work also examines the correlation between age and the correct production of singular, dual and plural numbers.

Methods: The study involved 60 monolingual Arabic children and young adults with DS, 30 males and 30 females, enrolled at the Nazik Al Hariri Welfare Centre for Special Education, Amman. The participants were divided into three groups: KG2 (7.1-12.5 years old), school (13.10-17.6) and vocational training (18.3-27.3). The participants' data were collected from a picture elicitation task and free speech, and the answers were recorded using a smartphone. Tokens were classified into correctly used, incorrectly used or not recognised. Proficiency percentage in using the correct number in correlation with age was calculated adopting Jia's (2003) composite score of proficiency. The one-way analysis of variance was used to trace the impact of age on the correct performance of number. Post hoc comparisons (guided by the Scheffe test) were calculated for the cumulative results of the scale as a whole to examine the difference in the arithmetic mean between the three groups.

Results: The singular form was the most used by all age groups (83.3%), followed by the plural (27%); the most delayed was dual (10.3%). Intriguingly, the dual form is the most difficult plural pattern because it was the least frequently used pattern in everyday language. Results were in line with other research on morphological markers in individuals with DS (e.g. Penke, 2018). The cumulative results statistically prove the influence of age on the correct use of grammatical number, in favour of the older two groups (total F = 29.865, at the level of significance P = 0.000), with a higher arithmetic mean of all categories (AM: KG2 = 9.00, school = 15.10, VT = 16.25). Hence, sensitivity to the correct number option increases with age although children and young adults with DS do not reach adult-like performance. The non-recognition cases of the proper number category significantly mark language delay in participants with DS.

Conclusion: The study concluded that inflection for grammatical number is evidently delayed in individuals with DS. Linguistic teaching and training of children with DS (involving families, caregivers and educators) should start from childhood and continue to adulthood to improve their use of dual and plural numbers.

Background: Evidence suggests that caregivers of children with autism spectrum disorder (ASD) and associated feeding difficulties have specific mealtime challenges in the home environment because of the limited interventions that are appropriate and responsive to the needs of the child as well as the family.

Objectives: To describe: (1) common feeding difficulties in children with ASD, (2) mealtime challenges for the caregiver and (3) mealtime strategies used by the caregiver.

Method: Forty caregivers were purposively sampled to participate in the study. Participants were recruited through ASD-specific schools in Johannesburg, South Africa. Participants completed an online questionnaire focusing on their mealtime experiences with their child with ASD.

Results: Findings from the data after thematic analysis indicated the multitude of challenges caregivers have when feeding their child with ASD as well as their individualised way of dealing with these difficulties.

Conclusion: The findings emphasised the importance of incorporating the family's beliefs, values and needs into feeding management and highlight the importance of a holistic approach to intervention. The study also provided information about mealtime strategies that are being used in the home environment to support the child as well as the caregiver. This information can be used to inform management to improve therapeutic outcomes and feeding challenges in the home environment.

Background: Literature has shown that there is limited compliance amongst nurses with the dysphagia recommendations made by speech-language therapists (SLTs). Poor compliance could have a significant impact on the health outcomes of patients with dysphagia.

Objectives: This study aimed to determine the specific barriers to compliance with dysphagia recommendations experienced by South African nurses, with the goal of identifying viable strategies to overcome these barriers.

Method: This cross-sectional study made use of a self-administered questionnaire to obtain quantitative data on nurses' perceptions of barriers to the implementation of SLT dysphagia recommendations. Eighty-one nurses were recruited from two tertiary hospitals in two South African provinces. Descriptive statistics were used to analyse the reported barriers to compliance.

Results: Three main barriers to compliance were identified, namely a lack of knowledge regarding dysphagia, patient-related barriers and workplace concerns. Knowledge barriers included poor familiarity with the role of the SLT in dysphagia management, lack of knowledge regarding SLT terminology, disagreement with dysphagia recommendations and insufficient dysphagia training. Workplace concerns included staff shortages, heavy workloads and time constraints. Poor patient cooperation was emphasised as a patient-related barrier.

Conclusion: For dysphagia recommendations to be followed by nurses, SLTs need to be aware of the barriers experienced by nurses within the relevant facility. Speech-language therapists need to consider the provision of appropriate in-service dysphagia training and include nurses in the decision-making process when recommendations are made. Speech-language therapists need to consider their role in both clear communication with the nurses and the development of supporting material, such as glossaries and visual aids.

Background: Specific language impairment (SLI) is difficult to identify because it is a subtle linguistic difficulty, and there are a few measures available to differentiate between typical and atypical language development in bilinguals. Sentence repetition (SR) has strong theoretical foundations and research evidence as a valid tool for the identification of SLI in bilinguals.

Objective: This study assessed the value of SR using peer group comparisons to identify Sepedi-English bilingual children at the risk of SLI.

Method: One hundred and two Grade 3 learners in three different contexts of education were assessed on equivalent English and Sepedi SR measures.

Results: Eleven participants who scored between 1 and 2 standard deviations (SD) below the peer group means on both the English and Sepedi SR tests were identified with possible SLI. Learners in the English language of learning and teaching (LoLT) - Sepedi additional language (SAL) context obtained similar scores in both languages, a higher score in English than the English LoLT group and a higher score in Sepedi than the Sepedi LoLT - EAL group. The English LoLT group obtained a significantly higher score in English than in Sepedi and a significantly lower score than the other two groups in Sepedi. The Sepedi LoLT group obtained a significantly higher score in Sepedi than in English, their additional language, in which they obtained a significantly lower score than the other two groups.

Conclusion: Sentence repetition tasks are valid screening tools to identify bilingual children with SLI by comparing them to peer groups. The SR tests were sensitive to language practices in different educational contexts. It was observed that a bilingual approach that uses both English and the home language as academic languages leads to better language outcomes.

Background: Early identification of stroke-related oropharyngeal dysphagia (OPD) using screening by nurses can prevent adverse patient outcomes in lower middle-income countries. Nurses are essential in the OPD management team and should ideally be able to screen and prioritise dysphagia management in stroke patients.

Objective: The aim of this research was to describe nurses' practices related to identification and management of patients with stroke-related OPD.

Methods: Qualified nurses from various healthcare levels in the Eastern Cape, South Africa were invited to complete a previously published hard copy survey on the signs and symptoms, complications and management of stroke-related OPD. A sample of 130 participants completed the survey.

Results: The mean scores of correct responses for each section were: 8.7/13 (66.7%) for signs and symptoms, 4.7/10 (47.3%) for complications and 3.8/7 (54.2%) for management practices. Statistically, there were no differences between the levels of healthcare for the signs and symptoms section and the complications section. Regarding management of OPD, secondary-level (S) nurses demonstrated significantly better knowledge than primary-level (P) and tertiary-level (T) nurses (S-P: p = 0.022; S-T: p = 0.010). Secondary-level nurses also scored significantly higher across all three sections (S-P: p = 0.044; S-T: p = 0.025) than those at the other levels.

Conclusions: The study found that nurses across all levels of healthcare had only moderate knowledge regarding identification and management of stroke-related OPD. Interdisciplinary collaboration between nurses and speech-language therapists may improve nurses' knowledge in identification and management of stroke-related OPD in lower middle-income settings such as South Africa.

Background: Speech care of cleft lip and/or palate (CLP) and craniofacial deformities (CFD) is complex and lengthy and requires collaboration amongst different disciplines. Consequently, it is important to provide academic educational models that include didactics, online learning and clinical exposure in CLP and CFD treatment, and participation in established cleft palate multidisciplinary team management.

Objectives: To obtain information regarding: (1) the perceived adequacy of CLP and CFD academic education of speech-language therapists (SLTs); (2) the professional services that SLTs offer to CLP and CFD patients; and (3) the educational needs of SLTs in this field.

Method: A 54-item online survey to collect quantitative data was conducted by telephone and email using a randomised sample of SLTs in different areas of South Africa.

Results: The questionnaire was completed by 123 SLTs, 70% of whom had more than 10 years of professional experience. Of the respondents, 81% acknowledged their limited clinical exposure during their academic education. Only 42% of the professionals offer treatment for CLP and CFD patients. Of the respondents, 96% agreed on the need to improve CLP and CFD academic education, and the majority recommended certified courses, continued-education workshops and online resources.

Conclusion: The findings indicate that SLTs academic training is perceived to be significantly limited in the cleft palate and craniofacial fields. Thus, there is a strong need at the undergraduate level for clinical training and exposure to multidisciplinary management. At post-graduate level there is a need to establish an educational strategy to meet the needs of SLTs providing CLP and CFD care. Participants suggested that programmes for continuing professional education, degree courses and online resources be designed to provide practising clinicians with updated information and guidance in management of CLP and CFD patients.

In the era of coronavirus disease 2019 (COVID-19), many healthcare professionals are being faced with the question of what is considered to be an essential service. This opinion paper has attempted to answer this complex question by understanding the potential relationship between dysphagia and COVID-19 and how speech-language therapists (SLTs) in South Africa should tackle this. It also aims to answer the question through the lens of a risk-benefit discussion based around practices and decision-making. Important gaps in the field relating to how SLT practices need to move forward during this challenging time have also been highlighted. Reflective questions that can assist SLTs when seeing dysphagia cases have been provided.