Jeannie Van der Linde

The Effect of Hydration on the Voice Quality of Future Professional Vocal Performers

OBJECTIVES The application of systemic hydration as an instrument for optimal voice quality has been a common practice by several professional voice users over the years. Although the physiological action has been determined, the benefits on acoustic and perceptual characteristics are relatively unknown. The present study aimed to determine whether systemic hydration has beneficial outcomes on the voice quality of future professional voice users. STUDY DESIGN A within-subject, pretest posttest design is applied to determine quantitative research results of female singing students between 18 and 32 years of age without a history of voice pathology. METHODS Acoustic and perceptual data were collected before and after a 2-hour singing rehearsal. The difference between the hypohydrated condition (controlled) and the hydrated condition (experimental) and the relationship between adequate hydration and acoustic and perceptual parameters of voice was then investigated. RESULTS A statistical significant (P = 0.041) increase in jitter values were obtained for the hypohydrated condition. Increased maximum phonation time (MPT/z/) and higher maximum frequency for hydration indicated further statistical significant changes in voice quality (P = 0.028 and P = 0.015, respectively). CONCLUSION Systemic hydration has positive outcomes on perceptual and acoustic parameters of voice quality for future professional singers. The singers ability to sustain notes for longer and reach higher frequencies may reflect well in performances. Any positive change in voice quality may benefit the singers occupational success and subsequently their social, emotional, and vocational well-being. More research evidence is needed to determine the parameters for implementing adequate hydration in vocal hygiene programs.

Perceptions of rural primary healthcare personnel about expansion of early communication intervention

Background Early communication intervention services rendered by speech-language therapists and audiologists to families of infants and young children with feeding difficulties, hearing loss or emerging communication disorders should be implemented throughout South Africa. Early intervention can ameliorate risks, enhance development and may prevent further delays. Based on research initiated during a community-service year experience in a rural subdistrict, an incremental process of establishing accessible early communication intervention services was deemed feasible. Such a process cannot be successful if the collaboration of primary healthcare personnel and managers is not ensured. Objectives The aim of the article was to describe the perceptions of primary healthcare personnel with regard to expansion of early communication intervention services to infants at risk of developmental delay. Method A qualitative descriptive survey design was followed. Semi-structured interviews were conducted with 20 primary healthcare nurses and sisters and eight primary healthcare programme managers in Ditsobotla subdistrict in the North West province of South Africa. Results The participants indicated that by improving team work, developing training programmes and evaluating identification methods and resources, the step-by-step rollout of early communication intervention functions on four organisational levels may be a realistic goal for sustainable services in the resource-limited district. Conclusion The positive perceptions and contributions by participants promise a rich human-resource basis for transdisciplinary collaboration between speech-language therapists, audiologists and primary healthcare personnel in order to reduce the burden of early communication disorders in a rural district.

Vocal effectiveness of speech-language pathology students: Before and after voice use during service delivery

Background As a professional voice user, it is imperative that a speech-language pathologists (SLP) vocal effectiveness remain consistent throughout the day. Many factors may contribute to reduced vocal effectiveness, including prolonged voice use, vocally abusive behaviours, poor vocal hygiene and environmental factors. Objectives To determine the effect of service delivery on the perceptual and acoustic features of voice. Method A quasi-experimental., pre-test–post-test research design was used. Participants included third- and final-year speech-language pathology students at the University of Pretoria (South Africa). Voice parameters were evaluated in a pre-test measurement, after which the participants provided two consecutive hours of therapy. A post-test measurement was then completed. Data analysis consisted of an instrumental analysis in which the multidimensional voice programme (MDVP) and the voice range profile (VRP) were used to measure vocal parameters and then calculate the dysphonia severity index (DSI). The GRBASI scale was used to conduct a perceptual analysis of voice quality. Data were processed using descriptive statistics to determine change in each measured parameter after service delivery. Results A change of clinical significance was observed in the acoustic and perceptual parameters of voice. Conclusion Guidelines for SLPs in order to maintain optimal vocal effectiveness were suggested.

Performance of EAL learners on a non-South African Articulation Test (GFTA-2)

Abstract: Research on the various aspects of child language development in South Africa has generally been an area neglected by specialists in the study of language. In South Africas multilingual urban settings, English is the language of mutual understanding in most classrooms. The assessment of language (including speech sound production) in English additional language (EAL) pre-schoolers is hampered by the fact that insufficient standardised resources are available for use with young multilingual South African children. Research indicates that the Goldman-Fristoe Test of Articulation – Second Edition (GFTA-2) is a popular formal assessment instrument used for assessing childrens articulation abilities by many speech-language therapists in South Africa. The study described the performance of English second language learners, aged between four and nine years, on the GFTA-2 in an urban region in the Gauteng province of South Africa. A descriptive, dominant-less-dominant model research design was used. No significant difference in performance between the second language learners and the normative indicators was noted. The results illustrate the need to adapt the GFTA-2 for the South African context.

Compilation of a preliminary checklist for the differential diagnosis of neurogenic stuttering

BACKGROUND Neurogenic stuttering (NS) is the most frequently occurring acquired form of stuttering in children and adults. This form of stuttering is primarily caused by neurological incidents. Owing to controversies with regard to similarities between developmental stuttering (DS) and NS symptomatology, differential diagnosis is problematic. Differential diagnosis will guide the appropriate management of persons who stutter (PWS). OBJECTIVES The aim of this study was to describe and highlight the characteristics of NS in order to compile a preliminary checklist for accurate diagnosis and intervention. METHOD An explorative, applied mixed method, multiple case study research design was followed. Purposive sampling was used to select four participants. A comprehensive assessment battery was compiled for data collection. RESULTS The results revealed a distinct pattern of core stuttering behaviours in NS, although discrepancies existed regarding stuttering severity and frequency. It was also found that DS and NS can co-occur. The case history and the core stuttering pattern are important considerations during differential diagnosis, as these are the only consistent characteristics in people with NS. CONCLUSION It is unlikely that all the symptoms of NS are present in an individual. The researchers scrutinised the findings of this study and the findings of previous literature to compile a potentially workable checklist.

Evaluation of a Zulu translation of the Parents’ Evaluation of Developmental Status

Background One of the greatest challenges in early communication intervention in South Africa is developing and implementing successful identification strategies in primary health care (PHC). A shortage of trained PHC personnel is one of the barriers to providing adequate health services in South Africa. This dearth of services creates the need to substitute clinician-administered developmental screening tools with parent-administered tools. Aim To determine the accuracy of the Zulu Parents’ Evaluation of Developmental Status (PEDS) in comparison with the outcome of the English PEDS. Setting The data were collected in a clinical, non-contrived environment at Stanza Bopape Community Health Clinic in Mamelodi, City of Tshwane. Methods The PEDS is a standardised, parent-completed questionnaire regarding the child’s general development. The English PEDS was translated into Zulu by a Zulu linguist. There were 99 potential participants in the study of whom 83 met the necessary prerequisites. Results Of the participants whose home language is Zulu, 54% preferred the PEDS in English over the PEDS in Zulu. This indicates a skewed preference towards English, with only slight associations between language preference and age, education and home language. Conclusion The Zulu PEDS displayed high positive and negative correspondences, representative of an accurate translation of the English PEDS. It is recommended that this study should be repeated in a community where the majority are Zulu home language speakers.

Developmental screening : predictors of follow-up adherence in primary health care

BACKGROUND The importance of early identification for infants and young children with developmental delays is well established. Poor follow-up on referrals, however, undermines the effectiveness of early intervention programmes. OBJECTIVES To identify factors, including text message reminders, that influence follow-up adherence for early intervention after developmental screening in primary health care. A secondary objective surveyed reasons for follow-up default. METHODS The PEDS tools were used to screen 247 high-risk children. A risk assessment questionnaire was completed with caregivers whose children were referred for speech-language and/or occupational therapy (n=106, 43%). A quasi-experimental correlational study was employed to identify risk factors for defaulting on appointments. A thematic analysis of telephonic interviews was also employed to determine reasons for follow-up defaults. RESULTS Follow-up adherence was 17%. Participants who were never married, divorced or widowed were 2.88 times more likely to attend a follow-up appointment than those who were married or living together (95%, CI 0.97-8.63). Text message reminders did not improve follow-up. More than half (58%) of participants who defaulted on appontments could be reached for telephonic interviews. Interviews showed that 87% of participants were unconcerned about their childs development. Other reasons for defaulting were employment, logistical issues, other responsibilities and forgetfulness. CONCLUSION Follow-up adherence for early intervention services following a positive primary health care screen was poor. Increased awareness and education regarding the importance of development for educational success is needed.

Early detection of communication delays with the PEDS tools in at-risk South African infants

Background Prevalence of communication delays or disorders is increasing, possibly because of various environmental risk factors. Selection and implementation of effective screening tools are important to detect at-risk infants as early as possible. This study aimed to evaluate the accuracy of the Parents’ Evaluation of Developmental Status (PEDS), PEDS-Developmental Milestones and PEDS tools to detect communication delays in infants (6–12 months) in a South African primary healthcare context. Method A comparative study design evaluated the accuracy of the PEDS tools to detect communication delays, using an internationally accepted diagnostic assessment tool, the Rossetti Infant-Toddler Language Scale (RITLS). A convenience sample of 201 infants was selected at primary healthcare clinics. Results Expressive and receptive language sensitivity scores were low across all three screens (ranging between 14% and 44%). The PEDS tools had high sensitivity (71%) and specificity (73%) ratings for the receptive and expressive language and socio-emotional domain in combination. Conclusion In the sample population, the PEDS tools did not accurately detect receptive and expressive language delays; however, communication delays in general were identified. Future research determining accuracy of the PEDS, PEDS-Developmental Milestones and PEDS tools for children aged 2–5 years in detecting communication delays should be prioritised.

Risks associated with communication delays in infants from underserved South African communities

BACKGROUND For optimal development young children need warm, responsive, enriched and communicative environments for learning social, language, and other skills. Infants and toddlers exposed to psychosocial risk lack enriched environments and may present with communication delays. AIM To investigate the relationship between psychosocial risks and communication delays in infants from underserved communities in South Africa. SETTING Primary healthcare facilities in Tshwane district, South Africa. METHODS A parent interview and Rossetti Infant Toddler Language Scales were used to collect data from caregivers of 201 infants aged 6-12 months, selected through convenience sampling. Associations between communication delays and risks were determined (Chi-square and Fishers exact tests). A log-linear model analysis was used to model the simultaneous effect of significant risks on the probability of having communication delays. RESULTS Communication delays were present in 13% of infants. Infants with two or more siblings, born from mothers aged 18-29 years who own their house, had a 39% chance of presenting with communication delays. CONCLUSION Developmental screening and early intervention is important in primary healthcare contexts in South Africa, as a clear relationship has been established between three risk factors and communication delays in infants.BACKGROUND For optimal development young children need warm, responsive, enriched and communicative environments for learning social, language, and other skills. Infants and toddlers exposed to psychosocial risk lack enriched environments and may present with communication delays. AIM To investigate the relationship between psychosocial risks and communication delays in infants from underserved communities in South Africa. SETTING Primary healthcare facilities in Tshwane district, South Africa. METHODS A parent interview and Rossetti Infant Toddler Language Scales were used to collect data from caregivers of 201 infants aged 6-12 months, selected through convenience sampling. Associations between communication delays and risks were determined (Chi-square and Fishers exact tests). A log-linear model analysis was used to model the simultaneous effect of significant risks on the probability of having communication delays. RESULTS Communication delays were present in 13% of infants. Infants with two or more siblings, born from mothers aged 18-29 years who own their house, had a 39% chance of presenting with communication delays. CONCLUSION Developmental screening and early intervention is important in primary healthcare contexts in South Africa, as a clear relationship has been established between three risk factors and communication delays in infants.

Development of a Setswana tonal minimal pair word list as research tool

This study reports on the development of a Setswana tonal minimal pair word list, which could be implemented as research tool in the field of Bantu language linguistics and in speech pathology in South Africa. The development of the list was conducted in four phases. These are described as four separate studies. All involved Setswana L1 participants living in the urban areas of Gauteng. In Study 1, a 45-pair preliminary list was compiled from dictionaries. During Study 2, eleven L1 speakers’ familiarity with each word was determined. Based on these results the list was narrowed down to 20 pairs. Study 3 entailed the validation of pictorial stimuli, which illustrate the target words. Ten different participants took part. Four pairs were not consistently familiar and were removed, resulting in the experimental list of 16 pairs. This list was validated in Study 4 and involved nine typical L1 speakers and five listeners. Word-specific analyses revealed that some words had a negative impact on the results. Six pairs were removed. A final list of 10 pairs rendered results more aligned to the expectation of typical speakers and listeners. Validation should continue to determine applicability in populations from exclusively rural or urban areas.