Family-based activity settings of typically developing three-to-five-year old children in a low-income African context

The transition towards family-centered practice in early childhood intervention has shifted the focus from looking at the child in isolation towards understanding the child in context. The primary context for the child’s development is the family setting which is inextricably linked to the family’s culture, beliefs and values. The cultural context is transmitted through activity settings which make up the everyday experiences and events that involve the child’s interactions with various people and the environment. Activity settings are a part of daily life and include activities like eating dinner, bath time, listening to stories and getting ready for school. Furthermore, activity settings represent how families can and do structure their time, based on tradition, the orientations provided by culture and the socio-economic system within which they live. Intervention goals that fit easily into these settings are more likely to be adopted and practised, as they are less likely to disrupt the daily functioning and coherence of the family. While there is a clear emphasis in the literature on developing intervention approaches that are applicable to families from diverse cultural contexts, little is known about the beliefs and practices of low-income urban families in South Africa. Children in Africa have frequently been judged against Euro-American norms and standards, where the aim has been to change instead of understand the context in which children live. This study therefore aims to identify everyday activities that provide children with varied opportunities for learning and development within the natural environment of the family context. A descriptive design using structured interviews was utilised to obtain information about the activity settings that children aged 3-5 years engaged in. Face-to-face interviews with 90 caregivers were conducted, utilising a self-constructed interview schedule consisting of a written list of closed and open-ended questions. This approach was chosen as it holds no bias against respondents who have varied literacy levels. The interview schedule was developed through a process of consultation with parents/caregivers from the Soweto community, using focus group discussions. The results provide information on the types of activities that children participate in, the frequency of participation, the partners involved, as well as the purpose of the activities. Caregiver perceptions on the importance of activities were also obtained through closed and open-ended questions.Thesis (PhD)--University of Pretoria, 2009.Speech-Language Pathology and AudiologyUnrestricte

Family-based activity settings of children in a low-income African context

BACKGROUND : There has been an overwhelming call to improve the understanding of how children develop within an African context as Euro-American definitions of competence have been uncritically adopted as the norm for children in Africa. The activities that children engage in within the family setting are seen as important to understand how children develop within context. The use of activity settings is closely aligned with a strengths-based perspective of family-centred practice and contributes to improved sustainability of intervention. OBJECTIVES : This study that was conducted in Soweto, South Africa, aims to describe activity settings that typically developing young children in low-income African contexts participate in. METHOD : A descriptive design using structured interviews was utilised to obtain information about activity settings that children aged 3–5 years and 11 months engaged in. Structured interviews with 90 caregivers were conducted. RESULTS : Findings show that children participate in a variety of activities with varied participation levels. The types of activities are dependent on the context and perceptions of caregivers. CONCLUSION : These findings draw attention to understanding activities that children engage in within the family context.This article is based on the first author’s unpublished thesis titled ‘Family-based activity settings of typically developing three-to-five-year old children in a low-income African context’ currently uploaded onto an academic repository available at https://repository.up.ac.za/handle/ 2263/28788.The National Research Foundationhttp://www.ajod.orgam2019Centre for Augmentative and Alternative Communication (CAAC

Bridging the Access Gap: The Telepractice Experience of Speech Therapists and Audiologists at a Public Health Care Facility in South Africa

South Africa is a low to middle income country (LMIC) with a population of 60 million people. The public health sector serves more than 80% of the population. Chris Hani Baragwanath Academic Hospital is a central level public health care facility situated in Gauteng. The Speech Therapy and Audiology Department provides insight into their telepractice services through a qualitative approach. The onset of the COVID-19 pandemic resulted in therapists exploring telepractice as a sustainable model of service delivery. Therapists and patients encountered many challenges to the implementation of telepractice, however, the commitment of therapists ensured that creative solutions were developed. A comprehensive needs analysis at public health institutions is required to ensure the sustainability of telepractice. A hybrid model (telepractice and in-person consults) holds the potential to reduce the financial burden on patients and increase access to quality patient- centered care

Voices of children with intellectual disabilities on participation in daily activities

BACKGROUND : Participation in daily activities is expressed as a human right. Full participation of children with disabilities in daily activities creates optimal opportunities for learning and development. Previous studies have focused primarily on proxy ratings of participation of children with intellectual disabilities in daily activities. However, little is known about how the children rate barriers and facilitators to their participation in everyday activities. OBJECTIVES : To identify barriers to and facilitators for everyday activities as experienced by children with intellectual disabilities from low- and middle-income countries and high-income countries. The research questions were as follows: ‘what barriers to participation do children with disabilities experience in everyday activities?’ and ‘what facilitators to participation do children with disabilities experience in everyday activities?’ METHOD : A qualitative content analyses was used in this study, and individual interviews were conducted with 49 children with intellectual disabilities. The interviews were performed using pictures. The children also selected the most important activities and described in their own words the facilitators and barriers relevant to being able to perform the activities. RESULTS : The most important activities were organised leisure activities, formal learning at school, taking care of other family members and family mealtimes. Self-reported barriers identified were personal functioning, social exclusion and lack of resources. The identified facilitators included satisfaction, personal capability, being included and having access to resources. CONCLUSION : These findings provide important knowledge about the factors to consider in the development of interventions, aimed at improving the participation of children with intellectual disabilities.The National Research Foundation (NRF) and Swedish Foundation for International Cooperation in Research and Higher Education (STINT).http://www.ajod.orgpm2021Centre for Augmentative and Alternative Communication (CAAC

Lived experiences of South African rehabilitation practitioners during coronavirus disease 2019

Background: In South Africa, the sharp rise in people with severe illness because of coronavirus disease 2019 (COVID-19) in early 2020, meant that health systems needed to adapt services and operations, including rehabilitation services. Important insights into the lived experiences of rehabilitation personnel enacting these adaptations in an African context are limited. Objectives: The aim of this study was to explore the lived experiences of rehabilitation practitioners working in the public sector in South Africa during the COVID-19 pandemic. Method: A phenomenological approach and a duo-ethnographic design were used. A recruitment letter was circulated requesting volunteers. Maximum variation sampling was used to select the 12 participants of this study. Data were collected through interviews via Zoom, and critical conversations were facilitated by a non-rehabilitation partner who is known for challenging health inequities. The interviews were audio-recorded and transcribed verbatim. Data were analysed through elements of qualitative content and thematic analysis. Data were coded, categorised, clustered into concepts and formulated into themes. Results: Three themes were identified: (1) ‘Management became the enemy’, (2) ‘Tired of being resilient’ and (3) ‘Think out of the box…think on our feet’. Conclusion: The results of this study highlighted new ways of practice, innovative adaptations, and usage of resources and platforms. Contribution: This study highlights the re-imagining of accessible rehabilitation services that could lead to deeper onto-epistemological shifts amongst the rehabilitation practitioners

Intervention practice for preschool children in need of special support : a comparative analysis between South Africa and Sweden

This article describes and compares intervention for children in need of special support in South Africa and Sweden. This is achieved by developing a theoretical understanding of current intervention approaches and describing the challenges within the South African and Swedish contexts. Ecological development theory, natural environments and activity settings are discussed to justify the conceptualising of intervention practices. Recommendations are made for a more integrated approach that is culturally relevant and meaningful to children and their families

Test-retest reliability of Picture My Participation in children with intellectual disability in South Africa

BACKGROUND : Picture My Participation (PmP) is a promising instrument for measuring the participation in everyday situations of children with intellectual disability (ID), particularly in low- and middle-income countries. AIM : To explore test-retest reliability of PmP by comparing two repeated measurements of children with ID in an urban context in South Africa. METHODS : A picture-supported interview with 31 children with ID, aged 7–17 years, was conducted twice, two weeks apart. The children rated their participation, operationalised as attendance and involvement, in 20 everyday activities. Analyses were completed for total scores, for the four subcomponents and at item level. RESULTS : Test-retest agreement at an item level for both attendance and involvement showed slight/fair agreement for most activities (Kappa = 0.01–0.40), and moderate agreement for some activities (Kappa = 0.41–0.60). Moderate agreement was shown for the total scale and at component level (ICC = 0.5–0.75), except for (firstly) attendance of and involvement in ‘Family Activities’ (ICC = 0.26 for attendance, 0.33 for involvement), and (secondly) involvement in ‘Personal Activities’ (ICC = 0.33). CONCLUSION : The result indicates that PmP can reliably be used at component level and as a screening tool for intervention planning to identify participation and participation restrictions in children with ID.https://www.tandfonline.com/toc/iocc20hj2021Centre for Augmentative and Alternative Communication (CAAC

Test-retest reliability of Picture My Participation in children with intellectual disability in South Africa

Background Picture My Participation (PmP) is a promising instrument for measuring the participation in everyday situations of children with intellectual disability (ID), particularly in low- and middle-income countries. Aim To explore test-retest reliability of PmP by comparing two repeated measurements of children with ID in an urban context in South Africa. Methods A picture-supported interview with 31 children with ID, aged 7-17 years, was conducted twice, two weeks apart. The children rated their participation, operationalised as attendance and involvement, in 20 everyday activities. Analyses were completed for total scores, for the four subcomponents and at item level. Results Test-retest agreement at an item level for both attendance and involvement showed slight/fair agreement for most activities (Kappa = 0.01-0.40), and moderate agreement for some activities (Kappa = 0.41-0.60). Moderate agreement was shown for the total scale and at component level (ICC = 0.5-0.75), except for (firstly) attendance of and involvement in 'Family Activities' (ICC = 0.26 for attendance, 0.33 for involvement), and (secondly) involvement in 'Personal Activities' (ICC = 0.33). Conclusion The result indicates that PmP can reliably be used at component level and as a screening tool for intervention planning to identify participation and participation restrictions in children with ID