SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background:  South Africa has the highest prevalence of human immunodeficiency virus (HIV) worldwide. Highly active antiretroviral therapy (HAART) is expected to improve the quality of life for these individuals but requires long-term medication intake. Poor pill adherence and related dysphagia are undocumented for individuals on HAART regimens living in South Africa.

Aim:  To conduct a scoping review describing the presentation of pill swallowing difficulties and dysphagia experiences of individuals with HIV and acquired immunodeficiency syndrome (AIDS) in South Africa.

Method:  This review describes the presentation of pill swallowing difficulties and dysphagia experiences of individuals with HIV and AIDS in South Africa using a modified version of the Arksey and O'Malley framework. Five search engines targeting published journal articles were reviewed. Two hundred and twenty-seven articles were retrieved; however, following the exclusion criteria based on PICO, only three articles were included. Qualitative analysis was completed.

Results:  The reviewed articles identified swallowing difficulties that adults with HIV and AIDS experienced and confirmed non-adherence to medical regimens. Barriers and facilitators of pill swallowing with dysphagia due to the side-effects of the pill itself were documented with physical properties of the pill not influencing adherence.

Conclusion:  The speech-language pathologists (SLPs) role with individuals with HIV/AIDS to facilitate improved pill adherence was lacking with limited research on the management of swallowing difficulties in this population. The review identified dysphagia and pill adherence management by the SLP in South Africa as caveats for further research.Contribution: Speech-language pathologists must monitor swallowing during mealtimes as well as pill swallowing in individuals with HIV/AIDS due to the compromise of their oral health and oral structures. Speech-language pathologists therefore have to advocate for their role in the team managing this population of patients. Their involvement may reduce the risk of nutritional compromise as well as patient non-compliance with medication stemming from pain and inability to swallow solid oral dosage forms of medication.

Background:  Early identification of dysphagia followed by intervention reduces, length of hospitalisation, degree of morbidity, hospital costs and risk of aspiration pneumonia. The emergency department offers an opportune space for triage. Triaging offers risk-based evaluation and early identification of dysphagia risk. A dysphagia triage protocol is not available in South Africa (SA). The current study aimed to address this gap.

Objectives:  To establish the reliability and validity of a researcher-developed dysphagia triage checklist.

Method:  A quantitative design was used. Sixteen doctors were recruited from a medical emergency unit at a public sector hospital in SA using non-probability sampling. Non-parametric statistics and correlation coefficients were used to determine the reliability, sensitivity and specificity of the checklist.

Results:  Poor reliability, high sensitivity and poor specificity of the developed dysphagia triage checklist was found. Importantly, the checklist was adequate in identifying patients as not being at risk for dysphagia. Completion time for dysphagia triage was 3 minutes.

Conclusion:  The checklist was highly sensitive but not reliable or valid for use in identifying patients at risk for dysphagia.Contribution: The study provides a platform for further research and modification of the newly developed triage checklist, which is not recommended for use in its current form. The merits of dysphagia triage cannot be ignored. Once a valid and reliable tool is confirmed, the feasibility of implementation of dysphagia triage must be considered. Evidence to confirm that dysphagia triage can be conducted, when considering the contextual, economic, technical and logistic aspects of the context, is necessary.

Untreated conductive and mixed hearing losses as a result of middle ear pathology or congenital ear malformations can lead to poor speech, language and academic outcomes in children. Lack of access to centralised hearing healthcare in resource-constrained environments limits opportunities for children with hearing loss. Red Cross War Memorial Children's Hospital (RCWMCH) is one of only two dedicated paediatric hospitals in sub-Saharan Africa. Between 2016 and 2021, 29 children received implanted bone conduction hearing devices, and 104 children were fitted with bone conduction devices on softbands. The authors' experience at RCWMCH suggests that bone-anchored hearing devices, either fitted on softbands or on implanted abutments, can provide solutions in settings where patients have limited access to hearing healthcare and optimal classroom environments. Hearing healthcare should be accessible and delivered at the appropriate level of care to mitigate the adverse effects of hearing loss in children.Contribution: This article describes strategies employed at RCWMCH such as fitting bone conduction hearing devices on a softband immediately after hearing loss diagnosis and conducting follow-up via remote technology to make hearing healthcare more accessible to vulnerable populations.

Background:  Many caregivers from low-middle income (LMI) households consider that preschool children are too young for shared book reading. Thus, many caregivers are unaware of their potentially powerful role in their children's emergent literacy and communication.

Objectives:  To describe (1) caregivers' perceptions of shared reading, (2) caregivers' perceptions of barriers to shared reading and (3) changes in these perceptions following a short intervention.

Method:  A qualitative methodology was used to understand the perceptions of 40 caregivers from a semi-rural South African township. Two semi-structured interviews were conducted before and after intervention. The intervention was a short training video about shared reading.

Results:  Caregivers described the unfamiliar reading culture and viewed reading as an educational activity that they knew little about. Barriers to shared reading included lack of time, few reading materials and low levels of literacy or lack of exposure to this type of activity. Following the intervention, they acknowledged the importance of shared reading, described growing confidence in their shared reading abilities and closer relationships with their children.

Conclusion:  Speech-language therapists (SLTs) have a pivotal role to play in caregiver training of emergent literacy skills and can make a marked impact in guiding caregivers' shared reading. A short video-based intervention can alter caregiver perceptions and practices, which may be the first step in changing behaviours.Contribution: The study provides an example of a simple and cost-effective intervention that changed caregiver perception and caregivers' reported shared reading practice.

No abstract available.

Background:  Studies related to tube feeding in people with dementia (PWD) remain a contested topic, neglecting the importance of speech-language therapists' (SLTs) role in dysphagia management. Furthermore, SLT practices and beliefs regarding tube feeding in people with advanced dementia in an upper-middle-income country, such as South Africa, are unexplored.

Objective:  This study aimed to determine the practices and beliefs of SLTs in South Africa regarding tube feeding placement in PWD.

Method:  A self-compiled online survey was distributed using social media platforms and was completed by 83 South African SLTs with experience in swallowing and feeding management of PWD.

Results:  Most SLTs (78.8%) strongly believed they play a vital role in the decision-making regarding feeding tube insertion in PWD. This role is often met with several challenges, such as limited support from other healthcare professionals. Speech-language therapists with more experience and increased involvement in palliative care appeared to be more confident in supporting and counselling families of PWD on tube feeding. Many SLTs still recommend tube feeding despite its known negative consequences for PWD.

Conclusion:  The findings indicate a need for continued professional development for South African SLTs on feeding decisions in advanced dementia to increase knowledge and confidence in clinical practice. Speech-language therapists require guidelines by professional bodies and further dialogue amongst healthcare professionals to guide difficult feeding decisions in people with advanced dementia.

Background:  Whilst otoacoustic emission (OAE) testing has proved to be valuable in revealing information about cochlear outer hair cell integrity, it does not provide insight into the afferent and efferent pathways once the stimulus has reached neural receptors. This information can be obtained objectively through contralateral acoustic stimulation (CAS) suppression. However, obtaining normative data is essential in the implementation of such tests.

Objectives:  The primary aim was to undertake a small pilot study to collect the CAS suppression across a predefined frequency range in order to provide a preliminary normative data set to be used with the newly developed transient evoked otoacoustic emission (TEOAE)-CAS module (PATH MEDICAL, Germering, Germany). Secondary aims included the analysis of the relationships between left and right CAS suppression, between male and female CAS suppression and between TEOAE signal-to-noise ratio (SNR) and CAS suppression.

Methods:  The purpose of this study was to determine preliminary normative data for contralateral TEOAE suppression from 40 normal ears of 20 healthy young adults (10 males and 10 females). Subjects were recruited using purposive sampling. The CAS suppression responses were obtained automatically by means of the data-collection protocol on the device used. From the data obtained, correlations between TEOAE SNR and CAS suppression were made using Pearson's correlation coefficient.

Results:  The data were statistically processed to form a normative database which possesses the potential of serving as a basis for further research aimed at determining the utility of CAS suppression testing when evaluating ear pathology. A mean CAS suppression of 0.8 decibels (dB) (0.61 SD) was obtained. There was no statistically significant relationship between TEOAE SNR and CAS suppression. There was no significant suppression difference in terms of laterality of ears or gender.

Conclusion:  Normative values for CAS suppression of TEOAEs in a group of normal-hearing individuals were obtained using the newly developed TEOAE-CAS module (PATH MEDICAL, Germering, Germany). The availability of normative data for contralateral TEOAE suppression using the studied module allows for it to become commercially available, which will enable researchers and audiologists to perform this measurement in different populations in the evaluation of ear pathology.

Providing equitable support for people experiencing communication disability (CD) globally is a historical and contemporary challenge for the speech-language therapy profession. A group of speech-language therapists (SLTs) with ongoing and sustained experiences in Majority and Minority World contexts participated in five virtual meetings in 2021. The aim of these meetings was to develop provocative statements that might spur a global discussion among individuals and organisations that support people experiencing CD. The following questions were discussed: What is our vision for the future of the profession globally? What are the global challenges around access to speech-language therapy services?Four main themes emerged: (1) the need to centre people experiencing CD as the focal point of services, (2) participation, (3) equity and (4) community. The themes relate to the need for a process of de-imperialism in the profession. Suggestions were made to develop more suitable terminology and to establish a global framework that promotes more equitable access to communication services. We seek the adoption of approaches that focus on reciprocal global engagement for capacity strengthening. Alternative models of culturally sustaining and equitable service delivery are needed to create impact for people experiencing CD, and their families worldwide.Contribution: Provocative statements were developed to prompt global conversations among speech-language therapy professionals and associations. We encourage readers to consider the questions posed, share their viewpoints and initiate positive change towards a global strategy.