SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS最新文献

Background:  Early classroom communication supports are critical in influencing oral language development and emergent literacy skills. It is both support from peers and adults, as well as the environment that impacts the quality and efficacy of language learning. Schools in particular play a key role in communication development, which will be further explored in this article.

Objectives:  To describe how communication was being supported in the classroom by teachers in the areas of language-learning environment (LLE), language-learning interactions (LLIs) and language-learning opportunities (LLOs) to focus on classroom communication supports to strengthen literacy outcomes for Grade R learners.

Method:  A cross-sectional descriptive survey of classrooms was conducted using a structured observation method in 136 classrooms. The Communication Supporting Classroom Observation Tool was used to make 223 observations across classrooms of LLE (19 items), LLI (20 items) and LLO (5 items). A descriptive analysis of frequency of occurrence of items was conducted for each domain.

Results:  Language-learning environment had more frequently occurring observations, with 12 out of 19 items being observed with a frequency of occurrence greater than 65%, indicating that the environment had adequate basic resources (e.g. good light). Language-learning interactions scores indicated that 3 out of 20 items were observed frequently, while 17 out of 20 items were observed less frequently (56.5%), including interactive strategies (e.g. turn-taking). Language Learning Opportunities scores indicated that teacher-led behaviours (e.g. including children in small group activities) were infrequently observed on all items.

Conclusion:  While the physical environment was generally supportive, the behaviours in the interactive domains of LLI and LLO were observed less frequently. There is potential for speech-language therapists to work collaboratively with teachers to develop communication supporting classrooms as a critical primary-level intervention for language-literacy learning.

Background:  Universities across the world experienced lockdown and closure of all learning institutions around March 2020 because of the advent of the coronavirus disease 2019 (COVID-19). This lockdown and closure presented challenges to the traditional pedagogical approaches in the health sciences, which typically include both campus-based and clinical site-focused activities involving face-to-face interactions and work integrated learning. The onset of the COVID-19 pandemic resulted in a shift to emergency remote teaching (ERT) and learning.

Objectives:  This study aimed to explore speech-language pathology (SLP) educators' experiences of the planning and implementation of ERT and learning during the COVID-19 pandemic.

Method:  A qualitative, descriptive narrative design was adopted to meet the objectives of the study. Seven SLP educators from a single university in South Africa participated in this study by constructing narratives on their experiences. The narratives were analysed using thematic analysis.

Results:  Five themes emerged from the data analysis, and these included (1) uncertainty, (2) educator feelings, (3) capacity development, (4) influence of circumstances on teaching, learning and assessment and (5) troubleshooting. Current findings provide insight into the challenges encountered and strategies utilised by educators in planning and implementing ERT and learning.

Conclusion:  Beyond the COVID-19 pandemic, most educators believe that a hybrid model would address some concerns identified, such as that of missing face-to-face contact, but that it would still allow for the full exploitation of online activities for teaching, learning and assessment required during clinical training.

Background:  Counselling plays an integral part in the management of presbycusis and tinnitus. Counselling can be conducted by implementing patient-centred care (PCC), showing improved patient outcomes; however, it has been poorly implemented in healthcare in South Africa (SA), particularly in the field of audiology for this condition.

Objectives:  This study aimed to report on audiologists' presbycusis and tinnitus counselling practices as guided by the PCC framework within KwaZulu-Natal (KZN).

Method:  Quantitative semi-structured online surveys were conducted using purposive sampling of 41 audiologists practising in both the public and private sectors within KZN.

Results:  This study revealed that 7.3% (n = 3) of participants provided only compensation for hearing loss without counselling, and only 2.4% (n = 1) of participants offered group counselling. Apart from this, 7.9% (n = 3) reported that tools and resources in counselling were not useful, whilst 12.5% (n = 5) reported that counselling was not multiculturally sensitive. Furthermore, a p = 0.044 suggests the public sector reported a dire need for improved training in counselling as compared with the private sector.

Conclusion:  Audiologists have been providing services within PCC to the best of their capabilities and their environments; however, there is still room to better implement PCC for improved patient outcomes. PCC has not been fully implemented into counselling practices in terms of patient preferences, emotional support, involvement of significant others, integrated care and education.

Background:  Counselling manages the psychosocial effects of presbycusis and associated tinnitus, which is best conducted through patient-centred care (PCC). However, there is a paucity of research on implementing PCC within audiology and on patients' perceptions of counselling practice, making the focus on patient benefit and satisfaction crucial. Furthermore, PCC has been documented to be suitable in addressing the psychosocial effects of hearing loss and associated tinnitus, as it focuses on the adult patient playing an integral part of the management processes, providing improved patient outcomes.

Objectives:  This study aimed to explore patients' perceptions of presbycusis and associated tinnitus counselling practices by audiologists within KwaZulu-Natal (KZN).

Method:  Qualitative phenomenological semi-structured telephonic interviews were conducted through purposive sampling, consisting of seven patients with presbycusis and associated tinnitus who were recruited from private and public facilities in KZN. Data were analysed through hybrid thematic analysis following Braun and Clark's steps.

Results:  Six categories were identified: perceptions on counselling methods, efficacy and tools, audiological rehabilitative training, multicultural sensitivity, patient satisfaction and recommendations on improving counselling practices as PCC adaptation. Themes were then extracted from these categories. The overall outcome of the study found that patients had positive perceptions of methods and tools, and audiologists were viewed as adequately trained. Furthermore, they were satisfied and benefitted from counselling practices and found clinicians to be culturally sensitive in their practice. However, recommendations were made towards linguistic sensitivity and satisfaction evaluations.

Conclusion:  Therefore, implementing PCC into counselling practice may achieve positive patient perceptions, thus highlighting the need to identify barriers and improve the implementation of PCC into practice, especially in resource-constrained contexts.

Background:  There has been an increased emergence of the use of telerehabilitation by speech-language therapists (SLTs) in South Africa since the COVID-19 pandemic in 2020.

Objectives:  To explore the criteria that SLTs use when recommending telerehabilitation for children with autism spectrum disorder (ASD), the technical skills required, strategies used by SLTs, the restrictions encountered when conducting telerehabilitation and the views of SLTs on telerehabilitation in comparison to face-to-face therapy for children with ASD.

Method:  A descriptive, phenomenological, qualitative study design was utilised. Purposive and snowball sampling techniques were employed. Six SLTs from the private sector, who had experience providing telerehabilitation to children with ASD, were recruited from three provinces in South Africa. Data were gathered via semistructured online interviews and analysed using thematic analysis.

Results:  Two out of five themes that emerged from this study are presented in this paper, i.e. approaches to telerehabilitation and the benefits of telerehabilitation. Results revealed that telerehabilitation was used to provide assessment and therapy during the COVID-19 pandemic lockdowns as an alternative method of service delivery. Assessment and treatment strategies included synchronous and asynchronous methods, family collaboration, social stories, frequent breaks and interactive sessions. Telerehabilitation reduced the client's and SLT's travel costs and increased caregiver and clinician satisfaction. Client progress and increased awareness of SLT were viewed as further benefits.

Conclusion:  Telerehabilitation was found to be beneficial to most children with ASD, and in most cases, the benefits far outweighed the challenges encountered. Clinical implications included the need for caregiver support in facilitating effective carryover, an increase in SLTs' knowledge and the opportunity to provide services to a broader geographical range. Limitations of the study are included.

Background:  Coronavirus disease 2019 (COVID-19) and the subsequent lockdown altered traditional clinical training for speech language pathology students, thus forcing training institutions to implement innovative and responsive clinical training strategies in the midst of the pandemic. As such, a writing-intense programme was piloted in an online clinical training programme with second-year speech language pathology students.

Objectives:  This study explored speech language pathology students' experiences with a writing programme used during an online clinical training programme implemented during the COVID-19 pandemic.

Method:  The study used a qualitative survey design. Purposive convenient sampling was used to recruit 29 second-year speech language pathology students. Online student reflections guided by 10 open-ended questions were used to elicit responses from students. Data were analysed using deductive thematic analysis.

Results:  Findings revealed that the written component of the programme facilitated the acquisition of clinical knowledge and improved clinical processes of writing among students. Feedback that students received on their written tasks improved learning. The clinical component of the course enabled students to learn in a less stressful environment and helped them gain confidence in their knowledge and clinical skills. Connectivity challenges and the lack of motivation from some students negatively impacted the programme.

Conclusion:  Using a writing programme to clinically train students can have positive effects in applying theory to clinical application because it affords students time to consolidate and process theory with practice as the jump from first year to second year can be cognitively taxing. A writing-intense programme can also improve students' writing skills.

Background:  The emergence of the coronavirus disease 2019 (COVID-19) pandemic has resulted in communication being heightened as one of the critical aspects in the implementation of interventions. Delays in the relaying of vital information by policymakers have the potential to be detrimental, especially for the hearing impaired.

Objectives:  This study aims to conduct a scoping review on the application of artificial intelligence (AI) for real-time speech-to-text to sign language translation and consequently propose an AI-based real-time translation solution for South African languages from speech-to-text to sign language.

Methods:  Electronic bibliographic databases including ScienceDirect, PubMed, Scopus, MEDLINE and ProQuest were searched to identify peer-reviewed publications published in English between 2019 and 2021 that provided evidence on AI-based real-time speech-to-text to sign language translation as a solution for the hearing impaired. This review was done as a precursor to the proposed real-time South African translator.

Results:  The review revealed a dearth of evidence on the adoption and/or maximisation of AI and machine learning (ML) as possible solutions for the hearing impaired. There is a clear lag in clinical utilisation and investigation of these technological advances, particularly in the African continent.

Conclusion:  Assistive technology that caters specifically for the South African community is essential to ensuring a two-way communication between individuals who can hear clearly and individuals with hearing impairments, thus the proposed solution presented in this article.

Background:  The global coronavirus disease 2019 (COVID-19) pandemic has pushed many audiologists to incorporate remote service delivery methods to adhere to mandatory health and safety protocols. The use of tele-audiology for audiological rehabilitation may provide a sustainable, cost-effective modality to suit the existing need, particularly in low-resourced countries.

Objectives:  This study aimed to investigate the feasibility of implementing a hybrid tele-rehabilitation programme in a South African public health context. An online auditory training (AT) programme was used to determine (1) compliance, (2) clinical benefit, (3) participant experience and (4) costs.

Method:  A convergent mixed methods design with a feasibility approach was utilised. Data collection was done through questionnaires, in-booth assessments, online AT, and face-to-face interviewing. Participants undertook online AT over 4 weeks. For pre- and post-online AT, the Abbreviated Profile of Hearing Aid Benefit (APHAB), QuickSIN, entrance and exit questionnaires, interviews and a system usability scale were administered.

Results:  Key findings of this study included (1) a high compliance rate (84.82%) with minimal clinician contact time at 3 h 25 min over 5-6-weeks; (2) improvement in perceived hearing aid (HA) benefit, and improvement in listening skills; (3) reported positive experiences; and (4) minimal programme costs at an average of R1350.00 per participant.

Conclusion:  The results showed positive indicators that the use of hybrid tele-rehabilitative strategies may provide a viable alternative to the traditional face-to-face modality. The hybrid approach showed clinical benefits, cost-effectiveness, minimal contact time as well as COVID-19 compliance. Further large-scale research is still needed.

Background:  Vietnam's first speech and language therapy (SLT) degrees commenced in 2019 utilising international educators. Continuity of the degrees was impacted by travel restrictions during the coronavirus disease 2019 (COVID-19) pandemic.

Objectives:  This article presents a descriptive case report exploring the viability of online learning to continue clinical education (CE) of SLT students in Vietnam during the pandemic.

Method:  Students were scheduled for face to face placements throughout 2021. International SLT educators were to travel to Vietnam and work with interpreters and locally trained certificate level therapists to provide placement supervision. When travel became impossible, tele-supervision by international therapists working remotely and in partnership with local therapists and interpreters was arranged. The second wave of Covid-19 excluded students from healthcare settings early in their placements. To conclude these placements, tele-supervisors led online case-based discussions with students. For subsequent placements, Vietnamese and international therapists facilitated two to three weeks of online case-based group discussions for students, using cases with videos or avatars.

Results:  Learning outcomes for students, as evidenced in written and oral assessments demonstrated attainment of many of the learning objectives of the placements. Satisfaction for all participants (students, tele-supervisors, online group facilitators) was high. Students will undertake face to face placements in the future; however they will commence these placements with heightened clinical reasoning and planning skills.

Conclusion:  Online CE is possible in LMIC and, as part of a program which includes face to face placements, can support essential CE outcomes and enhance preparation for subsequent direct experiences with patients.