African Journal of Disability最新文献

Background: The South African Constitution asserts that persons with disabilities must have equal access to opportunities in society; however, the realisation of this mandate has remained a challenge. There is a need to create contextually relevant, inclusive structures that support equal access to opportunities for persons with disabilities in society.

Objectives: This article reflects on and highlights key considerations for an inclusive framework that facilitates access to opportunities for youth with disabilities in South Africa, which emanated from a study that explored how ongoing interaction with the performing arts can facilitate social and economic inclusion of youths with disabilities.

Method: The study adopted a qualitative research approach, using critical ethnography. Primary data were obtained from three focus groups with a total of 20 youth with disabilities who have attended performance events, as well as an in-depth interview with a disabled performer.

Results: The facilitation of access to equal opportunities for youth with disabilities must occur at a multidimensional level, involving both personal and systemic changes and levels of support. Complex barriers linked to the apartheid legacy also exist, some of which include access to resources and reduced self-determination, whilst positive factors such as internal resilience and skills development function as promising predictors of inclusion.

Conclusion: Contextually relevant, disability-inclusive structures in South Africa must confront and address how youths with disabilities are uniquely impacted in present times by South Africa's history.

Contribution: The voices of youths with disabilities make a key contribution as their experiences must inform these inclusive structures which have the potential to enhance access to equal opportunities for them at both personal and systemic levels.

Background: Hearing is essential for learning in school, and untreated hearing loss may hinder quality education and equal opportunities. Detection of children with hearing loss is the first step in improving the learning situation, but effective interventions must also be provided. Hearing aids can provide great benefit for children with hearing impairment, but this may not be a realistic alternative in many low- and middle-income countries because of the shortage of hearing aids and hearing care service providers.

Objective: In this study, alternative solutions were tested to investigate the potential to improve the learning situation for children with hearing impairment.

Method: Two technical solutions (a personal amplifier with and without remote microphone) were tested, in addition to an approach where the children with hearing impairment were moved closer to the teacher. A Swahili speech-in-noise test was developed and used to assess the effect of the interventions.

Results: The personal sound amplifier with wireless transmission of sound from the teacher to the child gave the best results in the speech-in-noise test. The amplifier with directive microphone had limited effect and was outperformed by the intervention where the child was moved closer to the teacher.

Conclusion: This study, although small in sample size, showed that personal amplification with directive microphones did little to assist children with hearing impairment. It also indicated that simple actions can be used to improve the learning situation for children with hearing impairment but that the context (e.g. room acoustical parameters) must be taken into account when implementing interventions.

Contribution: The study gives insight into how to improve the learning situation for school children with hearing impairment and raises concerns about some of the known technical solutions currently being used.

Background: The large South African population of people with disabilities presents unique challenges for training organisations because there is no training model that accommodates the demands of all disabilities. The site of the research was a private, nonprofit training institution with disability-friendly infrastructure which did not adequately prepare students for employment.

Objectives: The intention was to interrogate training models used at the institution, from the perspectives of students, facilitators and prospective employers. As there was no suitable assessment instrument, one that was fit for purpose was developed. The Adaptable Component-based Assessment Model (ACA Model) was the result.

Method: A case study using mixed methods was employed. The interpretive research paradigm allowed for purposive sampling. This article reports on the qualitative first phase of the study. The ACA Model was developed, and iterative applications provided information about areas that needed improvement before the second phase was initiated.

Results: The results all indicated that the existing programmes needed to be evaluated with the view for improvement. Various training models can be used to train students with disabilities, but they need to be assessed to ensure that they are integrated, holistic and student centred. Because different accommodations need to be taken into account for various disabilities, the ideal assessment model needs to be adaptable.

Conclusion: The ACA Model is an appropriate assessment model as it is based on individual learner affordances, workplace affordances, the holistic development of students and workplace absorption.

Contribution: The research contributes to knowledge and practice as the resultant ACA Model can be used to the benefit of students and education institutions. The model can be tailored to the needs of all groups of students, especially those with disabilities.

Background: Appropriate provision of assistive technology services (ATS) and products are a global health issue and essential for achieving the Sustainable Development Goals (SDGs). The Sixth African Network for Evidence-to-Action on Disability (AfriNEAD) conference included a workshop on collaboration, cohesion and coherence in ATS delivery in Africa.

Objective: This article aimed to summarise the workshop proceedings and to provide some recommendations on how coherence and cohesion can be facilitated in assistive technology services in Africa.

Method: A round table and small group discussions on assistive technology were facilitated in the virtual space of the AfriNEAD conference. Organisations and role players in ATS and products in Africa participated as keynote speakers, round table members and in small group discussions.

Results: There was consensus amongst participants that cohesive collaboration must be facilitated. They further agreed that users must be central to future action. There are local, national and regional initiatives, but none of these have grown into an African assistive technology platform. World Health Organization (WHO) Africa can bring partners together and facilitate creation, officialisation and operationalising of a continental assistive technology platform, through building on the existing initiatives. The AfriNEAD disability research country working groups can act as in-country coordinating bodies for ATS and afford a possibility of a structured approach to assistive technology research.

Conclusion: It is time to break away from Western institutionalised biomedical ways of providing ATS in Africa. Africans must develop coherent, cohesive ATS driven by empowered users who build on Africa's strengths and addresses the continents' unique needs.

Background: Little is known about the educational experiences of children diagnosed with autism spectrum disorders (ASDs) in the Kenyan Coastal context.

Objectives: We examined the diagnostic and placement procedures used in education on the Kenyan coastal region. In addition, we investigated the education-related challenges faced by children with ASD.

Methods: We conducted focus group discussions and in-depth interviews with 21 participants, including teachers, clinicians and educational administrators. Data were analysed using an inductive thematic framework on qualitative data analysis software, NVIVO 10.

Results: The findings from this study indicate that there were no systematic approaches to diagnosing children as having ASD. Teachers reported experiencing many challenges, including a lack of specialised training, inadequate resources and difficulty in managing children with different functional abilities in one class.

Conclusion: There is an urgent need for contextually relevant evidence-based identification, placement and management services to be put in place to meet the educational needs of children with ASD.

Background: Cerebral palsy (CP) can cause motor, sensory, perceptual, cognitive, communication and behavioural disorders. The complexity of this condition justifies measuring the quality of life (QOL) of children with CP. This measurement depends on personal and socio-economic factors, hence the relevance of performing it in our cultural context of Tunisia.

Objectives: The objectives of this study were to assess the QOL of Tunisian children with CP and to identify predictive factors for QOL.

Method: A cross-sectional study using a self-administered questionnaire (the CP QOL-Child) was employed. It included 68 children with CP and their parents who consulted the outpatient clinics of Physical Medicine and Rehabilitation of the University Hospital of Sahloul Sousse.

Results: The QOL of children with CP was altered, and the mean total score for the CP QOL-Child was 59.3 (± 14). All domains were affected by this alteration. Six predictive factors for lowered QOL in children with CP were identified, namely age older than 6 years, swallowing disorders, more intense chronic pain, greater level of motor impairment, the use of botulinum toxin injection and the absence of verbal communication.

Conclusion: Intervention with children with CP must be mindful of their altered QOL. Five out of the six predictive factors of QOL are modifiable through a multidisciplinary approach within the framework of the International Classification of Functioning, Disability and Health (ICF).

Contribution: The multiplicity of the factors associated with QOL revealed by this study incites clinicians to adopt the ICF approach by displaying its practical implications on the efficiency of the medical intervention.

Background: Youth with disabilities encounter multiple barriers to livelihood opportunities and socio-economic inclusion. Research focusing on identifying and evaluating evidence-based strategies that may facilitate their transition into socio-economic participation is limited.

Objectives: The study undertook to contribute knowledge and evidence to inform inclusive socio-economic development of youth with disabilities and capacitation of community-based workers engaged in implementing the livelihood component of community-based rehabilitation programmes advocating for inclusive development.

Method: This qualitative exploratory case study used the International Classification of Functioning, Disability and Health: Children & Youth Version to analyse community-based workers' knowledge and experience of the rural and peri-urban communities in which they worked in Botswana. It further analysed their activities, strategies and recommendations in response to environmental factors impacting the livelihood opportunities of youth with disabilities. Data were generated through semi-structured interviews, following a life history and phenomenological approach. Data were analysed inductively using thematic content analysis.

Results: Community-based workers showed sufficient knowledge and experience of barriers and enablers in health, education and training, social development, employment and governance that facilitated or obstructed access to livelihood opportunities for youth with disability. Identifying more barriers than enablers, community-based workers adopted innovative strategies to sustain and strengthen their practices and activities in the livelihoods domain. They contributed recommendations, mainly aimed at government.

Conclusion: Community-based workers have the capacity to provide valuable evidence and design strategy to facilitate the socio-economic inclusion of youth with disabilities. They are particularly adept at intervening at local levels but do not have sufficient confidence or capacity to mobilise supportive community structures or to exert influence at the level of policy formulation, decision-making and implementation.

Background: Lack of support systems in the management of health and rehabilitation related problems, including the stigma of giving birth to a child with disability, results in some parents ignoring the doctor's prognosis of lifelong disability.

Objectives: The study was conducted in the Eastern Cape province (ECP) of South Africa (SA) on parents' views in caring for children with disability in an area with minimal health facilities in a rural setting.

Method: Data was collected using exploratory descriptive qualitative methods. A Xhosa-speaking researcher facilitated six focus group discussions and conducted one individual in-depth interview with 37 parents or caregivers of children with disability residing at Happy home. Only one father was interviewed. Thematic analysis was used in interpreting data obtained from interviews.

Results: The findings revealed themes indicating key concerns of parents, which were as follows: challenges with disability diagnosis, negative attitudes of health professionals, health and rehabilitation related problems, and lack of support from families and community.

Conclusion: Caring for children with disability in a rural setting where services are minimal or not available to the poorest people who mostly need such services is not easy. Thus, to respond appropriately to the health and support needs of children with disability, it is crucial to understand the social context and needs of their families and caregivers. Due to size of the study, findings cannot be generalised. Recommendations are made for further studies to explore the vital issues affecting parents of children with disabilities.

Background: Stroke survivors often experience permanent or temporal physical and psychological stroke impairments. As a result, stroke survivors are often discharged to recover in their home environments and are cared for mostly by family members. Additionally, caregiving roles are often assumed without any formal training or preparation whatsoever. This can transform the family's functional patterns due to adjustments that are made to accommodate the caregiving needs.

Objectives: To explore the experiences and influence of stroke on families and on family functioning.

Method: Explorative descriptive qualitative research design through the use of in-depth interviews were employed as the means of data collection. The sample size was eight (8) family members and was guided by the saturation point. Data was thematically analysed.

Results: Four themes emerged from the analysis: 1) reduced interactions with family members due to communication barriers, 2) the influence of stroke on family relationships, 3) emotional engagement in caring for a family member with a stroke and 4) financial implications of stroke on family functioning. This study found that stroke can influence the family functioning negatively as family members may be forced to change their functional patterns. However, some family members reported positive experiences, they developed a supportive structure to accommodate the new life of the stroke survivor.

Conclusion: Using the McMaster's model of family functioning, this study found that stroke is a threat to the six dimensions of family functioning: 1) problem-solving, 2) communication, 3) roles, 4) affective responsiveness, 5) affective involvement, and 6) behaviour control.