Juan Bornman

The World Health Organisation's terminology and classification: application to severe disability

Purpose: The purpose of this article is to describe the international classification system proposed by the World Health Organisation for describing individuals with disability. Initially the ‘International classification of impairment, disability and handicap’ (ICIDH) was used. This has been replaced by the ‘International classification of functioning, disability and health’ (ICF). Both of these systems will be described and followed by a discussion of the advantages and disadvantages of using the WHOs classification framework. An application to the field of severe disability will be made throughout. Method: Providing a theoretical framework for classification of disability in accordance with the system proposed by the WHO. Results: The ICF is a useful tool that contributes to uniformity of international terminology and standardization in the disability field. It is not a minority model, and focuses on strengths and skills. Conclusions: An international classification system such as the ICF offers a conceptual framework for information that is relevant to the long-term consequences of disability. Although any type of classification system has certain limitations, the advantages present within the ICF outweigh the limitations.

The World Health Organization's international classification of functioning, disability and health: implications for clinical and research practice in the field of augmentative and alternative communication

In 2001, the World Health Organization (WHO) ratified and published a new classification system, the International Classification of Functioning, Disability and Health (ICF). There has been a varying amount of discussion and debate across the health and disability fields about what the ICF means and what it has to offer. However, there has been little discussion of its use and value in the field of augmentative and alternative communication (AAC). This article describes the earlier International Classification of Impairments, Disabilities, and Handicaps (ICIDH), upon which the current ICF was based; and outlines the ICF and the preliminary, derived Child and Youth version of the ICF (ICF-CY). The article also proposes what the ICF has to offer the AAC field, from both a clinical and research perspective; and concludes with a discussion of the advantages and challenges of using the ICF.

Using the ICF in goal setting: Clinical application using Talking Mats®

Purpose. The purpose of this article is to suggest how Talking Mats® can be used in accordance with the International Classification of Functioning, Disability and Health (ICF) proposed by the World Health Organisation (WHO) when setting intervention goals. Method. A theoretical framework for using Talking Mats® when setting intervention goals in accordance with the ICF is provided. Conclusions. An international system such as the ICF offers a conceptual framework that can be used to set appropriate goals for intervention. Talking Mats® on the other hand can be seen as the strategy through which individuals can be empowered to participate in this goal-setting activity.

The challenges of realising inclusive education in South Africa

In South Africa, up to 70% of children of school-going age with disabilities are out of school. Of those who do attend, most are still in separate, “special” schools for learners with disabilities. This situation prevails despite the push for the educational inclusion of learners with disabilities over twelve years ago by the South African policy document, the Education White Paper 6. In this article, we take a primarily top-down theoretical approach to policy implementation and focus on two main factors that hinder the implementation of inclusive education. Firstly, we focus on what we regard as the most significant constraint, namely, the apparent lack of clarity in the policy, i.e. ambiguity about the goals for inclusion and the means through which they can be achieved and, secondly, various issues around the poor implementation of the policy. We argue further that the primary means by which the divide between inclusive policy and practice will ultimately be closed is through the implementation and enforcement of education policy by the South African Department of Education.

The use of a digital voice output device to facilitate language development in a child with developmental apraxia of speech: a case study

Purpose : The study aimed at describing the language and communication abilities of a child diagnosed with Developmental Apraxia of Speech (DAS), who used a Macaw Digital voice output device. Method : This case study describes the training of a mother in the use of a Macaw digital voice output device to give her child with DAS access to higher levels of language functioning. It also provides longitudinal information pertaining to the childs school progress in the three years following the implementation of the device. Results : Results indicate that the use of a digital device is useful in facilitating communication and language development in a young child with DAS. Specific evidence of an increase in the cognitive complexity of questions directed at the child is provided, as well as an increase in the number of questions directed to the child. Regarding the childs responses, it was noted that appropriate answers increased, as did the number of communication modalities and communication attempts. Longitudinal data indicates that the child was able to maintain these positive impacts. Conclusions : Digital voice output devices can be used as a method to facilitate higher cognitive functioning and has various positive impacts on the functioning of a child with DAS. These devices need to be considered as a tool to facilitate the development of communication and speech development for this population.PURPOSE The study aimed at describing the language and communication abilities of a child diagnosed with Developmental Apraxia of Speech (DAS), who used a Macaw Digital voice output device. METHOD This case study describes the training of a mother in the use of a Macaw digital voice output device to give her child with DAS access to higher levels of language functioning. It also provides longitudinal information pertaining to the childs school progress in the three years following the implementation of the device. RESULTS Results indicate that the use of a digital device is useful in facilitating communication and language development in a young child with DAS. Specific evidence of an increase in the cognitive complexity of questions directed at the child is provided, as well as an increase in the number of questions directed to the child. Regarding the childs responses, it was noted that appropriate answers increased, as did the number of communication modalities and communication attempts. Longitudinal data indicates that the child was able to maintain these positive impacts. CONCLUSIONS Digital voice output devices can be used as a method to facilitate higher cognitive functioning and has various positive impacts on the functioning of a child with DAS. These devices need to be considered as a tool to facilitate the development of communication and speech development for this population.

The Iconicity of Picture Communication Symbols for Children with English Additional Language and Mild Intellectual Disability

Abstract The purpose of this study was to examine the iconicity of 16 Picture Communication Symbols (PCS) presented on a themed bed-making communication overlay for South African children with English as an additional language and mild intellectual disability. The survey involved 30 participants. The results indicated that, overall, the 16 symbols were relatively iconic to the participants. The authors suggest that the iconicity of picture symbols could be manipulated, enhanced, and influenced by contextual effects (other PCS used simultaneously on the communication overlay). In addition, selection of non-target PCS for target PCS were discussed in terms of postulated differences in terms of distinctiveness. Potential clinical implications and limitations of the study, as well as recommendations for future research, are discussed.

Reducing the Risk of Being a Victim of Crime in South Africa: You can tell and be Heard!

People who use Augmentative and Alternative Communication (AAC) know that silence is not always golden. Persons with disabilities and in particular those with complex communication needs, have a heightened risk of becoming victims of crime, abuse, and neglect. This study looked at the vocabulary needed to disclose or report crime or abuse in South Africa, and also focussed on the development of communication boards for this purpose, in four of the 11 official South African languages (Afrikaans, English, Sepedi, and isiZulu). Thirty-six participants in four language-based focus groups (English, Afrikaans, Sepedi, and isiZulu) were asked to generate a list of possible words they deemed important when wanting to disclose a crime, abuse or neglect. Participants then prioritized the top 55 words. A total of 56 words appeared on two or more of the lists from the four language groups. The board was developed using Picture Communication Symbols (PCS), the most frequently used symbol set in South Africa, according to an electronic mail survey. A discrepancy analysis revealed that these 56 words could be represented by 219 symbols. Symbols were developed for two words (swear, threaten) for which no PCS symbols existed. The process of developing the communication boards described in this paper may be useful to AAC communities in other countries, and the boards can serve as templates for other languages.

South African teachers' attitudes toward learners with barriers to learning : attention-deficit and hyperactivity disorder and little or no functional speech

This study examined teachers’ attitudes toward learners with two types of barriers to learning: a learner with attention-deficit and hyperactivity disorder (ADHD), and a learner with little or no functional speech (LNFS). The results indicated that although teachers reported that the learner with ADHD would be more disruptive in class and have a more negative effect on the classroom climate, they overwhelmingly favoured including this learner over the learner with LNFS. The data indicated that teachers were concerned about the ability of the learner with LNFS to participate academically and socially in the classroom. They also were significantly more concerned about their own ability to cope with the learner with LNFS. The article concludes with the need for ongoing inclusive education training for all teachers in South Africa if successful inclusive education is to become a reality.

Translucency and Learnability of Blissymbols in Setswana-speaking Children: An Exploration

Although the importance of iconicity in the learning of symbols has been widely acknowledged, there have been few systematic investigations into the influence of culture on the ratings of symbol iconicity. The purposes of this study were two-fold: to determine (a) the translucency ratings of specific Blissymbols as rated by 6- to 7-year-old Setswana-speaking children (one of South Africas 11 official languages); and (b) whether the ratings changed after second and third exposures in order to determine the learnability of these symbols. This study is partially based on the study by Quist et al. (), which utilized Dutch and American participants. Thirty-four Setswana children were exposed to 93 selected Blissymbols. A 3-point semantic differential scale consisting of three faces accompanied each Blissymbol, without the written gloss. This procedure was repeated over a period of 3 days. The results indicated that the majority of Blissymbols were rated as having high translucency ratings. The research further demonstrated significant differences in translucency between first and second exposures, suggesting that learning of the symbols had occurred. The comparison between the results of the current study and the results reported in the Quist et al. study reveal that the translucency ratings of the majority of the selected Blissymbols ranged from moderate to high for all three studies, but that the distribution of symbols across the ratings appears to be different.

Issues in AAC research: how much do we really understand?

Purpose. The purpose of this introductory paper is to provide some overview of and background to the issues that were raised at the Augmentative and Alternative Research Seminar in conjunction with the First Regional AAC conference on 23 February 2004. A group of 45 AAC researchers and professionals convened for one day to discuss some basic research issues in AAC. This paper highlights themes and perspectives that emerged from the research seminar discussions. Method. Literature reviews and discussion are used to provide a historical perspective on some of the issues raised. Two focus areas were identified for the purpose of this introductory paper; firstly, terminological issues that arose and secondly common themes that emerged during the paper presentations, discussions and/or written papers. Terminological issues include a brief description of the field of AAC for the benefit of those readers who might not be familiar with the field, whereafter the discussion focuses on the use of the term “complex communication needs” as referring to individuals who use AAC, the differentiation between symbols, signs, symbols sets and systems as well as the terms verbal and nonverbal, pre-linguistic and non-symbolic. The common themes throughout the papers include a discussion on the importance of context in communication, the chicken and egg question (i.e., comprehension and production), issues on multimodality, descriptive strategies for understanding interaction, and the use of typical interaction as a framework for understanding AAC interaction. Conclusions. In reviewing some of the issues in the field it is apparent that the issues we face now and those faced in AAC during earlier years are similar, however the need for a stronger database is apparent as the approach towards evidence-based practice becomes more prominent. The move to understand the nature of complex relationships in interaction is highlighted, for example, the multiple associations between environment, comprehension as well as the use of multi-modal communication. Whilst it became evident that most of these issues need further research in relation to typical interactions, applications to the field of AAC are most challenging.