Erratum: Why do people who stutter attend stuttering support groups?

No abstract available.

Swallowing and feeding of young children on high-flow oxygen therapy.

BACKGROUND:  Oral feeding practices of young patients on high-flow oxygen (HFO2) have been controversial. Limited literature exists on this topic, but new studies suggest introducing oral feeds. OBJECTIVE:  This study aims to describe the changes in swallowing and feeding of a group of young children on HFO2. METHOD:  Twelve participants (mean age 34.17 months [s.d. = 3.97]) on HFO2 were assessed clinically at the bedside using the Schedule of Oral Motor Assessment. Assessments were conducted twice to determine the change in characteristics: upon approval from the managing doctor when respiratory stability on HFO2 was achieved and for a second time on the last day of receiving HFO2 (mean 2.6 days apart). Patients received standard in-patient care and speech therapy intervention. RESULTS:  Most participants displayed typical oral motor function at initial and final assessments for liquid, puree and semi-solid consistencies. Purees and soft solid consistencies were introduced to most participants (n = 11, 91.7%). Solids and chewables were challenging for all participants during both assessments. Half of the participants displayed gagging and a wet vocal quality with thin liquids at the initial assessment only. CONCLUSION:  This small-scale study found that HFO2 should not preclude oral diets, but in this sample, small amounts of oral feeding could be introduced with caution, in an individualised manner, and with a collaborative multidisciplinary approach. Further research is essential.Contribution: Partial oral feeding of specific consistencies was possible during the assessment of young paediatric in-patients on HFO2. Monitoring of individual patient characteristics and risk factors by a specialist feeding team is essential.

Why do people who stutter attend stuttering support groups?

BACKGROUND:  Stuttering support groups (SSGs) have been a long-standing invaluable resource for people who stutter (PWS) but research into SSGs is only emerging. Speech-language therapists (SLTs) need further insight to successfully facilitate SSGs. OBJECTIVES:  To determine PWS' perspectives regarding why they attend SSGs in South Africa. METHOD:  Thirteen PWS who attend SSGs, between 20 and 58 years old, were a part of this qualitative study. Purposive sampling was utilised. Semi-structured telephonic interviews were used and data was analysed thematically. RESULTS:  Four themes, namely, 'altered perceptions', 'increased sense of community', 'support group reciprocity', and 'support group environment, participants and topics', were identified. The results yielded clinical implications which included SLTs encouraging: (1) improved perceptions of being a PWS through education and self-empowerment, (2) PWS' connections between meetings to increase the sense of community, (3) reciprocity in meetings, (4) sharing personal stories to promote learning and general self-management and (5) support, praise and education to empower and encourage PWS. This study's findings show that SSGs helped PWS accept their stutter and gain confidence. This study showcased how SSGs can help PWS manage their fluency and gain confidence. Additionally, this study supports current research which suggests that dysfluency and social-emotional well-being should be equally addressed. CONCLUSION:  Recommendations were generated from PWS' perspectives and included focusing discussions on fluency, emotions and sharing personal stories. Insights from PWS helped better inform SLTs of their role within SSGs including guiding and facilitating conversations.Contribution: People who stutters' perspectives can be used in clinical practice to help SLTs meet the needs of PWS and guide best practice when facilitating SSGs.

Developmental characteristics of young children in a low-income South African community.

Adequate early childhood development is critical for later-life success. Developmental profiles of specific populations are required to support implementation of early intervention services. Three hundred fifty-three caregivers of children with mean age 17.9 months (SD = 10.5) were selected from a primary healthcare clinic. Overall positive identification of signs of a developmental delay, with the Bayley Scales of Infant and Toddler Development III, was 51.8% (n = 183). Logistic regression analysis determined the effect of age and gender on results. Prevalence of developmental delay increased with age from 33.1% for children under 12 months to 61.7% and 66.3% for children between 13-24 months and 25-36 months, respectively. Females were 1.82 times (95% CI [1.16, 2.85]) more likely to have had no signs of developmental delay; 2.30 times (95% CI [1.14, 4.65]) in motor and 2.06 times (95% CI [1.23, 3.45]) in adaptive behaviour domains. One-third of children presented with low levels of adaptive behaviour functioning. One hundred and one (28.6%) participants across age groups displayed superior social-emotional ability, possibly due to familial structures and relationships. One-third of children presented with poor adaptive behaviour function, attributed to cultural differences. This study contributes to information on developmental characteristics of children in South Africa.

The Effect of Superficial Hydration, With or Without Systemic Hydration, on Voice Quality in Future Female Professional Singers.

OBJECTIVE: The aim of this study was to describe the effect of superficial hydration, with or without systemic hydration, on voice quality in future female professional singers by assessing acoustic and perceptual parameters of voice production as well as symptoms of vocal fatigue. STUDY DESIGN: This is an experimental design study. METHODS: A study was performed on a sample of 24 female voice majors to ascertain the effect of superficial hydration, with or without systemic hydration, on acoustic parameters and perception of vocal fatigue. The study replicated a prior study by van Wyk et al (2016) with some modifications; we looked at the effect of both systemic and superficial hydration independently and together on voice quality and vocal fatigue. Acoustic measurements including GRBASI, jitter, shimmer, F0 MPT, frequency min and max, intensity min and max, and dysphonia severity index were measured along with perceived vocal fatigue using the Vocal Fatigue Index. RESULTS: A statistically significant increase in MPT values were obtained when comparing pre- and post-test results of the hypo hydrated (P = 0.015) and superficial hydration condition (P = 0.004). A significant increase in frequency min (Hz) within the hypo hydrated condition was also observed (P = 0.019). A significant increase was observed in the intensity min (dB) (P = 0.010) and F0 min (Hz) (P = 0.002) within the combined hydration condition. Also, when superficial hydration was applied, mean shimmer % (P = 0.016), MPT (sec) (P = 0.003) and dysphonia severity index (P = 0.020) scores increased significantly in a between-group, post-test comparison. A significant reduction in mean intensity max (dB) (P = 0.049) and intensity min (dB) (P = 0.018) was also observed. CONCLUSIONS: This study demonstrates that the use of superficial hydration results in positive outcomes of perceptual parameters of voice quality and symptoms of vocal fatigue in future female professional singers. However, mixed results were observed regarding the acoustic parameters of voice. The superficial hydration data is compelling enough to warrant implementing in a vocal hygiene protocol for singers.

Responsive communication coaching for early childhood practitioners in underserved South African contexts: Clinical perspectives.

Children spend longer hours with early childhood development (ECD) practitioners who are well-placed to facilitate critical early language development. ECD classrooms include a growing number of children at risk for communication delays. Greater collaboration between speech-language therapists (SLTs) and ECD practitioners is needed. Research highlights that responsivity coaching improves communication development. Therefore, responsive communication coaching was identified as a possible approach to early communication development within the classroom. This clinical perspective serves as a reflection on the programme by examining ECD practitioners' perceptions thereof. Responsive communication coaching was identified as a means to improve practitioner-student collaboration within classrooms. This reflection aimed to describe ECD practitioners' perceptions of responsive communication coaching implemented by student SLTs. Early childhood development practitioners were recruited from three sites in low to middle socio-economic settings, where most children were English additional language learners. Coaching was presented to 15 practitioners via 16 sessions conducted by student SLTs under supervision. Practitioners completed a custom-designed survey regarding their skill development and experiences of the coaching. All practitioners expressed benefit from coaching. Half of the practitioners (50%) rated coaching as very helpful, while 37% perceived it as helpful. The remaining practitioners (13%), based at the special needs preschool, perceived coaching as quite helpful. Thematic analysis identified the following benefits: enhanced interaction, improvements in children's communication and the use of responsive communication strategies. Speech-language therapists need to collaborate with and support ECD practitioners in novel ways. The exploratory findings suggest that ECD practitioners benefit from SLT student-led responsive communication coaching sessions.

Vocal Characteristics of School-Aged Children With and Without Attention Deficit Hyperactivity Disorder.

OBJECTIVES: The aim of this study was to describe the laryngeal anatomy, perceptual, acoustic, and aerodynamic vocal characteristics of school-aged children with and without Attention Deficit Hyperactivity Disorder (ADHD). The predisposition that children with ADHD have for laryngeal injuries are recurrent in nature and are more often than not overlooked as laryngitis. Previous studies have reported varied results on the prevalence rates of pediatric vocal fold nodules within the school-aged ADHD population. STUDY DESIGN: A static, two-group comparison was used in the study to investigate the clinical, perceptual, acoustic, and aerodynamic vocal characteristics of children between 7 and 9 years old with and without ADHD. METHODS: The study replicated the protocol as executed by Barona-Lleo and Fernandez (2016) with additions. The Multidimensional Voice Program and the Voice Range Profile as additions to the assessment of vocal parameters were used with which comparable dysphonia severity index scores were calculated. Once-off clinical, perceptual, acoustic, and aerodynamic voice assessments were conducted on 20 age-gender matched participants (Control group mean age [months] = 98.80, standard deviation = 10.379; ADHD group mean age [months] = 108.00, standard deviation = 10.873). It was hypothesized that children with ADHD would have more hyperfunctional vocal characteristics; leading to laryngeal injuries, than their control group peers. RESULTS: Forty-five percent (n = 9) of the total sample population (both groups combined) had laryngeal pathology. Similar parent reported etiological voice symptoms and vocal habits were seen across both groups. Both groups performed similarly across both perceptual and aerodynamic voice assessments. Acoustically, the control group achieved significantly higher producible pitches than the ADHD group (P = 0.028) and were found to have more dysphonic dysphonia severity index scores than their ADHD group peers (P = 0.034). CONCLUSION: Prepubertal, school-aged children with or without ADHD may have similar vocal characteristics than previously thought. This is in support of the null hypothesis. The authors of the current study recommend that vocal screening in all school-aged children be carried out as an effective measure to monitor voice disorders in the pediatric population. Future research into larger sample sizes with this population with a special focus on the effect that central nervous system stimulants may have on the voice is recommended.

Dysphonia in adults with developmental stuttering: A descriptive study.

BACKGROUND: Persons with stuttering (PWS) often present with other co-occurring conditions. The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) proposes that it is important to understand the full burden of a health condition. A few studies have explored voice problems among PWS, and the characteristics of voices of PWS are relatively unknown. The importance of conducting future research has been emphasised. OBJECTIVES: This study aimed to describe the vocal characteristics of PWS. METHOD: Acoustic and perceptual data were collected during a comprehensive voice assessment. The severity of stuttering was also determined. Correlations between the stuttering severity instrument (SSI) and the acoustic measurements were evaluated to determine the significance. Twenty participants were tested for this study. RESULT: Only two participants (10%) obtained a positive Dysphonia Severity Index (DSI) score of 1.6 or higher, indicating that no dysphonia was present, while 90% of participants (n = 18) scored lower than 1.6, indicating that those participants presented with dysphonia. Some participants presented with weakness (asthenia) of voice (35%), while 65% presented with a slightly strained voice quality. Moderately positive correlations between breathiness and SSI (r = 0.40, p = 0.08) have been reported. In addition, participants with high SSI scores also scored a poor DSI of below 1.6, as observed by a moderate positive correlation between SSI and DSI (r = 0.41). CONCLUSION: The majority of PWS presented with dysphonia, evident in the perceptual or acoustic parameters of their voices. These results can be used for further investigation to create awareness and to establish intervention strategies for voice disorders among PWS.

The Reported Incidence and Nature of Voice Disorders in the Private Healthcare Context of Gauteng.

OBJECTIVES: The study aimed to determine the incidence and nature of voice disorders, as reported by ear, nose, and throat specialists (ENTs), in the Gauteng private healthcare context. STUDY DESIGN: This is a cross-sectional survey design. METHODS: The respondents had to be certified ENTs working in the private healthcare context in Gauteng. The survey was sent out electronically to all 94 ENTs, registered with the ENT Society, working in the private healthcare context; thus, no additional requirements had to be met. The survey inquired about the total number of referrals from January 2015 to January 2016, the total number of referrals who were diagnosed with a voice disorder, as well as information regarding the patients such as the nature of the voice disorders. RESULTS: Of the 94 surveys sent out, 24 of them were completed (25.5%). The incidence of voice disorders reported was 5.2%. The most commonly diagnosed voice disorder is acute laryngitis (32%). The majority of ENTs (75%) received referrals from general practitioners and referred to speech-language pathologists if the patient presented with a voice disorder. CONCLUSIONS: The results from this study may enable healthcare professionals to adequately plan service delivery resource allocations to provide appropriate services. Additional studies are required to examine the incidence of voice disorders in the public healthcare context as well as the prevalence of voice disorders in Gauteng.

An Exploratory Study of the Implementation of Early Intervention Workshops for Primary Caregivers in Johannesburg

Background. If primary caregivers are able to stimulate their children's development effectively; then the prevalence of children at risk of cognitive and language developmental delays could decrease and the shortage of available services for the identified children could be addressed; as hopefully fewer children would require extensive early intervention (EI) services later on in life.Objective. To develop and implement an EI workshop with primary caregivers on how to provide language and cognitive stimulation through daily living activities (DLAs). Methods. Two workshops were conducted at two daycare centres; focusing on daily language stimulation; with the primary caregivers of children aged between 0 and 3 years. A pre-workshop; semi-structured group interview was conducted to gain insight into the participants' knowledge and expectations. This was followed with a post-workshop; semi-structured group interview to gain insight into and feedback on how the participants were able to carry over the techniques in order to stimulate their children in DLAs. The data were analysed using thematic data analysis.Results. It was found that although participants demonstrated the basic understanding of the concept of EI; their knowledge improved with the workshop. The participants reported that they were able to implement the techniques gained from the workshop and noticed a change in their children's behaviour and communication within the space of 1 week. The participants also reported on the ease of stimulating their children through DLAs and that no additional time had to be scheduled for stimulation. Conclusion. The workshops have the potential to target populations regardless of their socioeconomic status; cultural beliefs; linguistic differences; and access to medical institutions

Translating tools for better parent-based assessment: An exploratory study.

BACKGROUND: Current speech language assessment and intervention measures are not always culturally valid, as they are not standardised specifically for the various cultural groups within the South African population; and thus need to be adapted. OBJECTIVES: The objective of this study was to examine the appropriateness and utility of translations of the Ages & Stages Questionnaire (ASQ) instrument (60 month age group) from English to the Hindi language and culture, which is represented in South Africa. METHODS: Biographical questionnaires, ASQ and evaluation thereof were translated in Hindi and completed by parents of 15 typically developing South African preschool children of Indian origin, at the 60 month age level (including children between 57 and 66 months). RESULTS: Participants reported that the questions were well phrased, and that illustrations and tips helped them to complete the questionnaires quickly and accurately. They preferred to be questioned in Hindi, which helped them understand the questions and made it easier to provide the necessary information to answer the questions. CONCLUSIONS: In conclusion, it is evident that this translation of the ASQ (60 month age group) from English to Hindi served as an appropriate tool for use with the middle socioeconomic class Hindi (Indian) language and culture. The results of this study would assist to determine the functionality of culturally and linguistically valid assessment tools for different populations, and would contribute to the development of Early Childhood Intervention as a whole in South Africa. It would also contribute to the development of multilingual informal school-readiness screening questionnaires appropriate for the South African context. This is particularly relevant, as school-readiness assessments take place at 60 months to ensure that the child is ready to learn by school age (6-7 years).[PDF to follow].