Masters Degrees (Speech-Language and Hearing Therapy)

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    The narrative thread : how narrative comprehension and production are intertwined with early learning indicators
    (Stellenbosch : Stellenbosch University, 2023-12) Smith, Annelien; Klop, Daleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Speech-Language and Hearing Therapy.
    ENGLISH SUMMARY: Background: Narrative development is a natural part of a child’s language and communication development and narrative abilities have also been shown to be foundational skills that are significant for later aspects to academic success such as reading comprehension. Integration of world knowledge, understanding of story structure and inferencing are aspects that oral narrative abilities and reading comprehension have in common. The Multilingual Assessment Instrument for Narratives (MAIN) has a strong focus on assessment of these aspects of story structure, causality and inferencing. In light of the national and international focus on early childhood development, and the plan to institute a compulsory pre grade R year – understanding the nature and scope of children’s oral narrative abilities and their competence in other aspects of early learning is extremely valuable. Objectives: The study investigated the relationships between narrative comprehension and production and early learning indicators as assessed by the Early Learning Outcomes Measure (ELOM) standardized South African instrument. The aims were to analyse participants’ performances in narrative development and early learning indicators, the relationships between these two factors and whether the MAIN could be used as a tool to identify children who are not achieving standards of early learning indicators. Participants: Study participants were 228 4-5-year-old Afrikaans (n= 108) and Xhosa-speaking (n=121) children from lower socio economic status backgrounds in Paarl and Khayelitsha in the Western Cape. Method: A quantitative, cross-sectional and correlational study design was followed to collect data in a randomised study population. Results: Participants’ narrative development patterns corresponded with previous research but MAIN scores were lower than reported in international studies. Half of the participants produced narratives that were not age appropriate. Narrative abilities and early learning indicators showed similar trends as only 51% of narratives were age-appropriate and only 49% of participants were on track with their early learning indicators. The MAIN’s ability to predict participants’ achievement in early learning standards proved to be limited. Conclusion: This study provided information about the narrative abilities of preschool Afrikaans and Xhosa-speaking children. There were moderate correlations between early learning indicators and narrative abilities, but the MAIN may not be sensitive and specific enough to identify children at risk for early learning problems. The highest and lowest levels of narrative structural complexity can be used for a differential diagnosis of children at risk of early learning problems.
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    Telepraktyk en die behandeling van volwassenes met vokale hiperfunksie : 'n Omvangsbepaling
    (Stellenbosch : Stellenbosch University, 2022-12) Theron, Margarita; Klop, Daleen; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Speech-Language and Hearing Therapy.
    AFRIKAANSE OPSOMMING: Die navorsingsvraag vir hierdie studie was: Wat is bekend in gepubliseerde navorsing oor die gebruik van telepraktyk in die behandeling van volwassenes met vokale hiperfunksie? Die hoofdoel van hierdie studie was om kennis in te win aangaande die behandeling van stempatologiee deur die gebruik van telepraktyk. Daar was twee spesifieke doelwitte vir die studie. Doelwit een was om die bestaande literatuur sistematies te ondersoek en te bepaal wat bekend is oor die gebruik van telepraktyk in die behandeling van stemprobleme. Doelwit twee was om kundiges te raadpleeg om temas en gapings in die kennis te identifiseer, met spesifieke verwysing na die haalbaarheid van telepraktyk in die Suid-Afrikaanse konteks. Arksey en O'Malley (2005) stel voor dat ’n raamwerk, bestaande uit ses stappe, gebruik word om die omvangsbepaling uit te voer. Stappe een tot vyf dek die volgende: die identifisering van die navorsingsvraag, die identifisering van relevante studies, die keuse van die studies, die dataversameling, opsomming en rapportering van die resultate. Die sesde stap behels ’n doelgerigte konsultasiefase. In hierdie studie is onderhoude gevoer met kundiges op die gebied van stemterapie en telepraktyk. Die sesde stap van konsultasie lei dus tot die verbetering van navorsing deur kundiges te betrek. Dit dra by tot die geldigheid en veralgemeenbaarheid van die studietemas. Pollock et al (2020) en Peters et al (2020) noem dat die konsultasiefase as ’n vereiste fase van ’n omvangsbepaling beskou behoort te word. In hierdie omvangsbepaling is konsultasie dwarsdeur die studie aangewend, byvoorbeeld konsultasie met die bibliotekaris as ’n deskundige op die gebied van inligtingskunde. Daar is besluit om ook kundiges aan die einde van die studie in te sluit. Die konsultasie met verkose kundiges is dus deel van die omvangsbepaling, soos omskryf deur die Joanna Briggs Institute (JBI)-riglyne, en moet nie as ’n afsonderlike komponent van die studie beskou word nie. Die konsultasiefase het die vorm van ’n kwalitatiewe beskrywingsontwerp aangeneem. Die doel van hierdie fase was om die bruikbaarheid van die resultate te verhef deur die opinies van kenners te verkry. Ses kenners wat tans in privaat praktyke in die Wes-Kaap en Gauteng werksaam is, is gekies om die kundige menings in die steekproefneming te lewer. Daar is besluit om spraak- en taalterapeute wat in privaat praktyk werk, te werf. Die rede hiervoor was dat spraak- en taalterapeute in privaat praktyk meer geneig is om telepraktyk met stempasiënte te gebruik. Tematiese ontledings is gebruik om die temas gevind in die data verkry uit die omvangsbepaling en konsultasie met kundiges te identifiseer, ontleed, beskryf en rapporteer. Die doel van die konsultasiefase in die omvangbepaling was nie ’n in-diepte kwalitatiewe verkenning nie, maar eerder om te help met die verfyning van die navorsingsvraag, die verduideliking van definisies en die verskaffing van ’n dieper begrip van die navorsing, en om navorsingsgapings te identifiseer (Pollock, 2020). ’n Voorlopige literatuursoektog het geen gepubliseerde studies oor telepraktyk in stemterapie vir die Suid-Afrikaanse konteks getoon nie. Telepraktyk bied baie voordele, maar beperkte navorsing binne die Suid-Afrikaanse gesondheidsorgstelsel is al gedoen om die uitvoerbaarheid en doeltreffendheid van stemterapie vir die lewering van spraak-taalterapie te ondersoek. Daar is ook min data oor hoe spraak-taalterapeute hierdie metodes gebruik en implementeer in hul praktyke.
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    Communication, cognitive functioning, and feeding and swallowing information needs of caregivers of individuals diagnosed with alzheimer’s disease within a support group setting
    (Stellenbosch : Stellenbosch University, 2022-04) Le Roux, Carla; De Beer, Alida; Bardien, Faeza; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health and Rehabilitation Sciences. Speech-Language and Hearing Therapy.
    ENGLISH SUMMARY: Background: The number of individuals with Alzheimer’s disease will rise significantly in the coming years. This is a concern as Alzheimer’s disease affects numerous functions within the scope of the speech-language therapist. However, due to the limited number of speech-language therapists in South Africa, individual speech and language therapy is not a viable option. Support groups may be a more optimal way of providing speech and language therapy service-related information. Objectives: The study aimed to determine the speech therapy-related information needs of caregivers of individuals with Alzheimer’s disease, as well as their preferred support group structure. The study further aimed to describe common speech and language therapy-related points of discussion at support groups and the current structure of support groups in the Western Cape. Method: A convergent parallel mixed method research design was used, and qualitative and quantitative data were collected simultaneously. Semi-structured interviews were conducted with caregivers of individuals with Alzheimer’s disease, whilst an online survey was used to collect data from support group facilitators. Results: The results indicated that caregivers had both directly stated, as well as indirectly stated information and support needs. Caregivers had more directly stated information and support needs about cognitive functioning than communication or feeding and swallowing. Their information and support needs were influenced by the current level of functioning of the individual with AD, caregivers’ perceptions about the features of AD and their management, as well as acceptance of these difficulties. Caregivers did, however, have more indirectly stated information needs about communication as well as feeding and swallowing. There were also discrepancies identified between caregivers’ support group structure preferences and the current support group structure in the Western Cape. Conclusion: The factors driving caregivers’ information and support needs guide the information provided at support groups. As much information and support needs are indirectly stated, these needs may likely not be expressed in support groups. Subsequently, caregivers’ knowledge about these areas of difficulty may remain limited. This may negatively affect caregiver understanding-and management of these difficulties. Furthermore, accessibility of support groups may be negatively impacted by the discrepancies between caregiver preferences and current support group structure.
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    Speech-language therapy treatment practices for multilingual speakers with aphasia : a scoping review
    (Stellenbosch : Stellenbosch University, 2021-03) Heunis, Ingrid; Bardien, Faeza; Dawood, Gouwa; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Speech Language and Hearing Therapy.
    ENGLISH SUMMARY : The management of multilingual aphasia, a multi-layered phenomenon, is a growing and complex field in speech-language therapy. Researchers and clinicians are often faced with many challenges and questions when making clinical decisions. The decision-making process includes the following considerations: which language(s) to treat; the transfer of therapeutic benefits between the treated and untreated language(s), or not, and whether there is little or no effect in the untreated language. Despite demographic and epidemiological trends such as increased migration patterns and the linguistic diversity in South Africa (11 official languages), a comprehensive inquiry regarding clinical practices employed by speech-language therapists (SLTs) with multilingual speakers with aphasia has not been conducted yet. Given the limited clinical guidelines available for managing this clinical population, this scoping review was conducted to explore, describe, and summarise reported speech-language therapy treatment practices used with multilingual speakers with aphasia. The scoping review included two phases. Phase one was a literature review investigating international trends in the treatment of multilingual speakers with aphasia (step one to step five). This was followed by the consultation phase (step six) in the form of semi-structured interviews with five South African SLTs working with adult multilingual speakers with aphasia. Content analysis was the primary means of analysis with a quantitative approach in phase one and a qualitative approach in phase two. The scoping review revealed a range of information regarding treatment practices for multilingual speakers with aphasia. There was variability in the practices employed and broad definitions of the terminology used. The primary concern in the stakeholder consultation process was the mismatch between the linguistic diversity amongst SLTs and most of the multilingual population in South Africa. The need for including interpreters in clinical work was also noted. These findings highlight the need to develop local research that includes evidenced-based guidelines regarding treatment practices for multilingual speakers with aphasia, despite the complexity and challenge of the heterogeneous composition of South Africa.
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    Mothers’ experience of feeding their preterm infant during the first months of life within a vulnerable population in South Africa
    (Stellenbosch : Stellenbosch University, 2021-03) Van Schalkwyk, Elanie Antoinette; Gerber, Berna; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Health & Rehabilitation Sciences. Speech Language and Hearing Therapy.
    ENGLISH SUMMARY : Background: Preterm birth is a rising and significant threat to maternal and child health globally. Being the mother of a preterm infant is universally described as a challenging and stressful experience. Mothers of preterm infants with low socio-economic status and from linguistic minority groups, such as poor Afrikaans speaking mothers, face additional challenges that may influence their experience of caring for their preterm infant, namely poverty and limited linguistic and cultural representation within the health constitution. The universal challenges of being a mother of a preterm infant, combined with the more specific challenges of living in poverty and experiencing poor linguistic and cultural representation, bring about risks for both mother and infant. This includes poor maternal mental health; poor mother-infant bonding and attachment; and potential suboptimal developmental outcomes for the child. Research aims: The main aim was to describe and explain how Afrikaans-speaking mothers, living in low socio-economic circumstances in the Western Cape, experienced caring for their preterm infant in the first months of life. The outcomes may facilitate better understanding of the early communication and feeding intervention needs of mothers of at-risk neonates from culturally and linguistically diverse contexts living in poverty. Method: The study entailed a cross-sectional, qualitative design which was exploratory and descriptive in nature. Eleven participants, selected through a purposive sampling method, participated in individual in-depth interviews where a semi-structured discussion schedule was implemented. Nine interviews were then thematically analysed. Participants were Afrikaans-speaking mothers with low socio-economic status who brought their preterm infant (chronological age range of three to six months) for a follow-up appointment at a High-risk Clinic at a public tertiary hospital in Cape Town. The participants were a vulnerable group about whom little information was available in the research literature. Findings: The task of feeding their preterm infant during the hospitalisation period was a significant experience for the participants. Feeding was perceived as a progressive task that is goal-driven and continuously demands a new method of feeding, higher volumes of milk, and increased weight gain in the infant to reach the eventual goal of discharge from hospital. This task was perceived as stressful due to various factors of which insufficient breastmilk supply was a significant contributor. Furthermore, the hospital setting was perceived as something that added to their anxiety surrounding feeding, but simultaneously had the potential to decrease their anxiety. The mothers felt that over time and with experience both they and their infants gradually became more comfortable and skilled in the task of feeding. When the mother-infant dyad was able to breastfeed successfully it was described as an ‘amazing experience’ and one that made the participants feel like mothers at last. Conclusion: The participants experienced feeding as one of the most significant stressors related to caring for their infant, especially in the first months of life while the infant was hospitalised. Various factors were identified that had positive and/or negative influences on this experience. The study findings have implications with regard to future research, as well as education and clinical practice for all healthcare professionals working with preterm mother-infant dyads from culturally and linguistically diverse contexts living in poverty.