Kerstin Monika Tonsing

Eye gaze technology: a South African perspective

Abstract Purpose: Based on the bioecological model by Bronfenbrenner, this paper will provide a broad perspective on factors that need to be taken into account in order to facilitate communication and participation in preliterate children making use of electronic Augmentative and Alternative Communication (AAC) systems accessed through eye gaze. Method: Two case studies of children who have been provided with the technology described are presented. The case studies were analysed using the four nested systems of the ecology as a framework to describe not only the environment, but also the processes and interactions between the persons and their context. Results: Risk and opportunity factors are evident at all levels of the ecology. Conclusions: While a good fit between the person and the technology is an essential starting point, additional factors pertaining to the partner, the immediate environment as well as meso-, exo- and macrosystemic issues (such as societal attitudes and funding sources) have a significant influence on benefits derived. In resource-limited environments, the lack of support at more distal levels of the ecology (meso-, exo- and marosystemic levels) seems to be a factor that differentiates these environments from more resourced ones. Implications for Rehabilitation Within resource-limited environments lack of support from wider ecological systems pose a risk to the implementation of eye gaze technology. Attempts to improve collaboration between all role players could provide the opportunity for the establishment of an integrated plan for intervention and set the stage for information sharing and multiskilling between role players. Intervention should not only be aimed at addressing the needs of the individual client and their family, but also focus on building community capacity that could provide support to others.AbstractPurpose: Based on the bioecological model by Bronfenbrenner, this paper will provide a broad perspective on factors that need to be taken into account in order to facilitate communication and participation in preliterate children making use of electronic Augmentative and Alternative Communication (AAC) systems accessed through eye gaze. Method: Two case studies of children who have been provided with the technology described are presented. The case studies were analysed using the four nested systems of the ecology as a framework to describe not only the environment, but also the processes and interactions between the persons and their context. Results: Risk and opportunity factors are evident at all levels of the ecology. Conclusions: While a good fit between the person and the technology is an essential starting point, additional factors pertaining to the partner, the immediate environment as well as meso-, exo- and macrosystemic issues (such as societal attitudes and funding sources) have a sign...

Supporting the production of graphic symbol combinations by children with limited speech : a comparison of two AAC systems

The aim of this study was to compare the efficacy with which the use of a speech generating device (Apple iPadTM with GoTalk NowTM application) versus a communication board promoted the production of two-symbols combinations (agent-action and attribute-entity combinations) by children limited speech within a shared story reading context. Four children between the ages of 6;8 (years; months) and 11;4 with severe motor speech disorders and a variety of developmental disabilities participated in the study. An adapted alternating treatment design was used. All four participants showed increased production of two-symbol combinations in both intervention conditions. The Wilcoxon ranked pairs test did not show differences between the conditions for any participant. The results suggest that symbol combination skills can effectively be taught using either AAC system. A preference assessment indicated that all participants preferred to use the speech generating device during shared story reading.

Topics of Social Conversation in the Work Place: A South African Perspective

The aim of the study was to analyze topics that occur in social conversations between employees in a University employment context. Samples of social conversation of 6 participants without disabilities were recorded on 9 days. The samples were analyzed for topics referenced under the three referential frames of time, person, and content. Results indicate that the topics of present, self and food were most frequently referenced under each of the three frames. Analysis of the content frame indicated the presence of three topics that were referenced frequently in all samples. Other topics were referenced frequently in only some samples. Comparisons were made between these findings and two previous investigations into topic use by adults from a Western culture. Overlap—particularly in more frequently referenced topics—suggested the presence of topics, which seemed to occur commonly in adult conversations, and, more specifically, conversations in the workplace. The topics identified in this study are discussed in terms of implications for guiding AAC intervention.

Teaching Graphic Symbol Combinations to Children with Limited Speech During Shared Story Reading

Abstract The aim of this study was to determine the effect of an intervention strategy on the production of graphic symbol combinations in children with limited speech. Four children between the ages of 6;5 and 10;8 (years;months) with limited speech participated in the study. A single-subject, multiple probe design across three different types of semantic relations was used. Generalization to untrained exemplars was also monitored. Results were mixed across the four participants: two participants learned to combine symbols across different types of relations, maintained these skills post intervention, and generalized their skills to untrained combinations; and two participants showed less consistent evidence of learning. The effects, as measured during structured probes, were strong for one participant, moderate for another, and inconclusive for the two others. Responses during shared story reading suggested that the measurement probes might have underestimated participants’ ability to combine symbols.

Teachers’ perceptions of implementation of aided AAC to support expressive communication in South African special schools: a pilot investigation

Abstract Although the provision of assistive technology for students with disabilities has been mandated in South African education policy documents, limited data are available on the implementation of aided augmentative and alternative communication (AAC) in classrooms. This pilot investigation used a concurrent mixed-methods survey design to determine the extent to which aided AAC was implemented to foster students’ expressive communication in preschool to Grade 3 classrooms in special schools from six urban school districts in the Gauteng (the smallest, most affluent and most densely populated of the nine South African provinces), and also obtained teachers’ perceptions of this process. A total of 26 teachers who taught students who used aided AAC for expression participated. Although there is evidence of provision and also implementation of aided AAC in classrooms, various limitations still exist. Teachers identified an array of factors that influenced the implementation of aided AAC, including those related to themselves, the classroom context, the characteristics of aided AAC, students using AAC, and other stakeholders. These factors are discussed in the light of international literature as well as the local context, and are used as a basis to suggest a research agenda for AAC in the South African education system.

An exploration of pain-related vocabulary: implications for AAC use with children

Abstract Children with significant communication difficulties who experience pain need appropriate means to communicate their pain in order to receive appropriate treatment. Augmentative and alternative communication (AAC) strategies could be used to enable children to self-report pain. The aim of this research study was to identify the common vocabulary children with typical development use to describe physical pain experiences and develop and socially validate an appropriate pain-related vocabulary list for children who use or could benefit from using AAC. A sequential, exploratory, mixed-method design was employed. This paper focuses on the quantitative phase. A set of scenarios was developed to gather pain-related vocabulary appropriate for children aged 6;0–7;11 (years;months) and children aged 8;0–9;11, from 74 children, 61 parents, and 56 teachers. Some 629 pain-related words or phrases were suggested and then classified into seven categories. A composite list of the 84 most frequently occurring pain-related vocabulary items was compiled and socially validated by three adults who used AAC. They emphasized the need to individualize vocabulary and provided suggestions for vocabulary organization for display on any type of AAC system. Despite similarities in the categories of words offered by the various respondent groups, the differences underscore the importance of more than one perspective (particularly that of children and adults) in generating a comprehensive vocabulary list.

Teachers' Interactions during Storybook Reading: A Rural African Perspective.

Research Findings: Teaching thinking skills is an important goal of formal primary and secondary education. Storybook reading is a well-established routine in the first few school years. Thinking skills can easily be fostered during these potentially language-rich interactions, making storybook reading a powerful tool for preparing young children for formal schooling. The aim of this research pilot project was to describe how 5 rural South African Grade R teachers interacted with their class during storybook reading. Teachers were videotaped during 3 consecutive story-reading sessions. Their utterances were transcribed and coded according to type and according to the cognitive level at which they fell. Results indicated that teachers used mainly utterances falling at a cognitively lower level and that they favored the use of requesting in their interactions. Although teachers used an interactive reading style and engaged children, their use of storybook reading as a strategy to foster higher level thinking was limited. Practice or Policy: These results are interpreted against a background of African cultural norms for adult–child interactions, taking into account that culture is ever changing. Implications for teacher training and further research are given.

The perspectives of adults with aphasia and their team members regarding the importance of nine life areas for rehabilitation: a pilot investigation

Objectives: Client-centred rehabilitation implies that persons with aphasia and their significant others are actively involved in all decisions regarding rehabilitation, including the setting of rehabilitation priorities and goals. This study aimed to describe and compare the perspectives of adults with aphasia, their significant others and their speech-language pathologists (SLPs) regarding the importance of nine life areas for the rehabilitation of adults with aphasia. Method: A total of 15 adults with expressive aphasia rated the importance of nine life areas using the Talking Mats™ framework. A questionnaire was used to obtain the ratings of 15 of their significant others and the 15 SLPs treating them. Results: Most life areas were rated as important to work on in rehabilitation by most participants. The adults with aphasia rated the areas as important more frequently than their significant others and SLPs. All participants rated Communication as important. Statistically significant differences were noted for three of the nine life areas. Discussion: The life areas which the participants were questioned about seem to provide a good starting point for rehabilitation teams to find common ground for collaborative goal setting. The Talking Mats™ approach allowed adults with aphasia to participate in the process. It can be a useful tool to promote client-centred rehabilitation for adults with expressive communication difficulties.

Factors Perceived by Rehabilitation Professionals to Influence the Provision of Assistive Technology to Children: A Systematic Review

ABSTRACT Background: The use of Assistive Technology (AT) by children with disabilities has been associated with significant development and improvement in outcomes within all spheres of life. However, AT is often underutilized. Appropriate selection of AT by rehabilitation professionals could improve the satisfaction of the user and their family with their AT. Data sources: A systematic search identified six studies that investigate the factors that occupational therapists, physiotherapists, as well as speech and language pathologists perceive to influence their provision of AT to children. Study appraisal: Two qualitative and four quantitative articles were identified. Both article types were appraised using the Mixed Methods Appraisal tool (Pluye et al., 2011). Synthesis method: A process of deductive thematic analysis by using themes from the Assistive Technology Device Selection Framework (Scherer et al., 2007), was followed by inductive thematic analysis to uncover subthemes. Data from all six articles are synthesized to provide a view of factors that are perceived to influence AT selection. Implications of findings: Within a family-centered perspective, both family and child expectations and preferences should be considered. Professionals should consider the influence of their own preferences and knowledge on the AT they recommend.

Language Assessment for Children With a Range of Neurodevelopmental Disorders Across Four Languages in South Africa

Purpose The purpose of this study is (a) to examine the applicability of a culturally and linguistically adapted measure to assess the receptive and expressive language skills of children with neurodevelopmental disorders (NDDs) in South Africa and then (b) to explore the contributions of 2 additional language measures. Method In Part 1, 100 children with NDD who spoke Afrikaans, isiZulu, Setswana, or South African English were assessed on the culturally and linguistically adapted Mullen Scales of Early Learning (MSEL). Clinicians independently rated the childrens language skills on a 3-point scale. In Part 2, the final 20 children to be recruited participated in a caregiver-led interaction, after which the caregiver completed a rating scale about their perceptions of their childrens language. Results Performance on the MSEL was consistent with clinician-rated child language skills. The 2 additional measures confirmed and enriched the description of the childs performance on the MSEL. Conclusions The translated MSEL and the supplemental measures successfully characterize the language profiles and related skills in children with NDD in multilingual South Africa. Together, these assessment tools can serve a valuable function in guiding the choice of intervention and also may serve as a way to monitor progress.