Thesis (Ph. D.)--University of Hong Kong, 2007. / Title proper from title frame. Also available in printed format.

Thesis (B.Sc)--University of Hong Kong, 1999. / "A dissertation submitted in partial fulfilment of the requirements for the Bachelor of Science (Speech and Hearing Sciences), The University of Hong Kong, 14th May, 1999." Also available in print.

Auditory impairment in patients with craniofacial clefts has been well studied for decades. However, most previous research has only focused on middle ear disorders and related auditory consequences in this group. Studies of higher level auditory status and central auditory processing abilities of this group—particularly in children—have been unsystematic and have significant limitations, while the potentially negative impact of central auditory impairment on children should not be ignored. One important area which needs further research is the status of the central auditory nervous system (CANS) in children with non-syndromic cleft lip and/or palate (NSCLP). In order to objectively investigate possible central auditory impairment in children with NSCLP, the present research programme was initiated. Firstly, two major studies aimed to provide anatomical structural analysis and functional evaluation of the auditory structures of CANS in a group of infants with NSCLP, and compare the results to those of normal controls (Studies 1 and 2). Secondly, a pilot study (Study 3) was conducted to provide preliminary data and suggest methodology to support a major, future research programme to comprehensively investigate central auditory processing abilities in children with NSCLP. A multi-disciplinary approach that included brain magnetic resonance image (MRI) scanning, auditory evoked potentials (AEP) recording, and a central behavioural auditory test battery assessment protocol, was applied in the present research programme. Based on the results of the studies and data analysis, it was concluded that: (1) Structural abnormalities of CANS in infants with NSCLP may be primarily located in the left cerebral hemisphere and cortical abnormalities were more marked compared with those in other subcortical locations. The development and maturation of the auditory cortex in infants with NSCLP may be abnormal, compared with that in normal children; (2) Infants with NSCLP might have normal auditory sensory function at brain stem and subcortical levels, yet this group may have significant impaired auditory discriminatory function at cortical level; (3) Children with NSCLP may show normal auditory processing abilities in a quiet listening environment. However, they may be more vulnerable to background noise and have impaired auditory processing abilities in areas such as monaural low redundancy and temporal resolution ability. In summary, combining the results of MRI, AEP and behavioural measurements in the present research programme, it is suggested that children with NSCLP are at potential risk of both structural abnormalities and functional disorders of the CANS, particularly at auditory cortical level. In addition, this group might also be at risk of auditory processing impairments to some degree, particularly in noisy environments. The present research programme has made a contribution to our understanding of the central auditory status of children with NSCLP, which was not systematically investigated in previous studies, and provided information on which to base further research. The research findings should draw the attention of researchers and clinicians to improving auditory assessment and intervention for patients with craniofacial cleft disorders. Further efforts in this field in the long-term may help to develop a more sophisticated audiological evaluation and intervention approach for this population. / published_or_final_version / Speech and Hearing Sciences / Doctoral / Doctor of Philosophy

Thesis (Ph. D.)--Texas State University-San Marcos, 2007. / Vita. Includes bibliographical references (leaves 111-129).

Thesis (MSocialWork)--Stellenbosch University, 2002. / ENGLISH ABSTRACT: In this study an explorative and a descriptive design has been implemented with the aim of obtaining knowledge, insight, and understanding of the psycho-social implications of a cleft lip and/or cleft palate for the individual child as well as the family. The motivation for this study was a result of the lack of knowledge on the psycho-social adjustments of an individual/child with a cleft lip and/or cleft palate and his/her family. The researcher became conscious of this lack during a full preliminary inquiry and this lack has been confirmed by the Department of Social Work as well as the Department of Maxillo-Facial-and Oral Surgery at Tygerberg Hospital. The aim of this study is therefore to create guidelines concerning social welfare interference in families after the birth of a baby with a cleft lip and/or cleft palate, in order to improve psycho-social functioning. The literature study included occurrence and incidence, embryological development, etiology of cleft lip and/or cleft palate as well as the psycho-social implications for the individual/child and the family. The medical aspects, namely the etiological and embryological development of cleft lip and/or cleft palate only serves as a background for the medical social worker that forms part of the interdisciplinary team of a cleft palate/lip clinic. This research focuses primarily on the psycho-social implications of a cleft lip and/or cleft palate on the individual/child as well on the family. The literature study also included the theoretical perspectives which determine the social worker's task and the system and strength perspective has been focused on. These perspectives have been implemented according to the development-aimed approach. The researcher decided to involve ten pre-school children with congenital deformity, between the ages of one month to six years as well as their mothers, who are from the service area of the Tygerberg Hospital in the research. The study was determined by a combination of qualitative as well as quantitative research methods, namely structured interviews as well as structured questionnaires. The results of this research confirmed the results of the literature study to a great extent, namely that individuals/children with a congenital deformity, as well as their families, are a highrisk group for psycho-social problems. These psycho-social problems indicate relationship problems in the family, cognitive problems for the individual/child as well as social adjustment problems for the individual/child and the family. Therefore the results gave an indication of what the content of intervention programmes for this target group should be. The recommendations focused on three areas, namely general recommendations concerning prenatal clinics where the cleft lip and/or cleft palate should be identified, general recommendations concerning guidelines for the social worker before intervention in the target group starts and recommendations with the aim of creating guidelines for social welfare intervention, in order to limit the psycho-social implications on the individual/child. The recommendations include further research in order to address society's ignorance concerning cleft lip and/or cleft palate. This research should focus on the development of social welfare programmes which, by primary prevention, aim at improved informing the society of this deformity. / AFRIKAANSE OPSOMMING: 'n Verkennende sowel as 'n beskrywende ontwerp is in hierdie studie geïmplementeer ten einde kennis, insig en begrip oor die psigo-sosiale implikasies van 'n gesplete lip en/of verhemelte vir individu/kind sowel as die gesin te verkry. Die motivering vir hierdie studie het na vore gekom weens die leemte rakende kennis oor die psigo-sosiale aanpassings van 'n individu/kind met 'n gesplete lip en/of verhemelte en sy/haar gesin. Die navorser het van hierdie leemte bewus geword tydens 'n volledige voorondersoek en hierdie leemte is deur die Departement Maatskaplike Werk sowel as die Departement Kaak- en Mondchirurgie te Tygerberg Hospitaal bevestig. Die doel van hierdie studie is dus om riglyne daar te stel ten opsigte van maatskaplike intervensie met gesinne ná die geboorte van 'n baba met 'n gesplete lip en/of verhemelte, ten einde psigo-sosiale funksionering te verbeter. Die literatuurstudie het die voorkoms en insidensie, embriologiese ontwikkeling, etiologie van gesplete lip en/of verhemelte sowel as die psigo-sosiale implikasies vir die individu/kind en die gesin ingesluit. Die mediese aspekte, naamlik die etiologiese en embriologiese ontwikkeling van gesplete lip en/of verhemelte dien slegs as agtergrond vir die geneeskundige maatskaplike werker wat deel vorm van die interdissiplinêre span van 'n gesplete verhemelte/lip kliniek. Hierdie navorsing fokus primêr op die psigo-sosiale implikasies van gesplete lip en/of verhemelte op die individu/kind sowel as op die gesin. Die literatuurstudie het ook die teoretiese perspektiewe wat die maatskaplike werker se taak rig, ingesluit en daar is op die sisteem- en sterkteperspektief gefokus. Hierdie perspektiewe is aan die hand van die ontwikkelingsgerigte benadering geïmplementeer. Daar is besluit om tien voorskoolse kinders met kongenitale deformiteit, dus tussen die ouderdomme van een maand tot ses jaar sowel as hul moeders, wat vanuit die Tygerberg Hospitaal se diensarea afkomstig is, by die ondersoek te betrek. Die ondersoek is deur 'n kombinasie van kwalitatiewe sowel as kwantitatiewe navorsingsmetodes, naamlik gestruktureerde onderhoude sowel as gestruktureerde vraelyste, gerig. Die resultate van hierdie ondersoek het tot 'n groot mate die bevindinge van die literatuurstudie bevestig naamlik dat individue/kinders met 'n kongenitale deformiteit, sowel as hul gesinne, 'n hoë risikogroep vir psigo-sosiale probleme is. Hierdie psigo-sosiale probleme dui byvoorbeeld op verhoudings-probleme in die gesin, kognitiewe probleme vir die individu/kind sowel as sosiale aanpassingsprobleme vir die individu/kind en die gesin aan. Die resultate het dus 'n aanduiding gegee van wat die inhoud van intervensieprogramme vir hierdie teikengroep behoort te wees. Die aanbevelings het op drie areas gefokus naamlik algemene aanbevelings ten opsigte van voorgeboorteklinieke waar gesplete lip en/of verhemelte geïdentifiseer moet word, algemene aanbevelings ten opsigte van riglyne vir die maatskaplike werker voordat intervensie met die teikengroep begin en algemene aanbevelings ten einde riglyne daar te stel vir maatskaplike intervensie, sodat die psigo-sosiale implikasies op die individu/kind beperk word. Die aanbevelings sluit in verdere navorsing ten einde die onkunde van die samelewing ten opsigte van gesplete lip en/of verhemelte aan te spreek. Hierdie navorsing moet fokus op die ontwikkeling van maatskaplikewerk-programme wat deur primêre voorkoming die samelewing beter aangaande die deformiteit inlig.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

The present study explored the effect of the birth of a child with a cleft lip and palate on family functioning within the context of family systems theory. Five families, each with a child who was born with a cleft lip and palate, were included in the study. The five couples were all married and they were the biological parents of their children whose ages ranged from two months to five years. All five sets of parents were initially interviewed together and then had separate individual interviews where the Family Assessment Measure-III was administered. The results reflected each family's distinctive patterns of interaction and how they adapted to the birth of a child with an orofacial cleft. Factors found to affect family functioning included: External support systems, individual coping skills, family rules and boundaries, open communication and cohesion among family members. / Psychology / M. A. (Psychology)

The topic of cleft lip and/or palate is widely researched in literature. However no research to date has focused on mothers' experiences raising twins when one twin is born with a cleft lip and/or palate. This qualitative study aims to explore the unigue experiences of these mothers. The epistemological foundations of this study are postmodern, social constructionist and systemic. In accordance with a gualitative methodology data was collected in the form of the participants' personal written stories. This was done from a post-modern paradigm, from a systemic perspective. Themes that were extracted from the stories according to thematic content analysis, not only reflect the experiences of mothers raising twins when one twin is born with a cleft lip and/or palate, they also provide an in-depth understanding of these mothers' experiences and unique situations. Recommendations for future research are offered. / Psychology / M.A. (Clinical Psychology)

The present study explored the effect of the birth of a child with a cleft lip and palate on family functioning within the context of family systems theory. Five families, each with a child who was born with a cleft lip and palate, were included in the study. The five couples were all married and they were the biological parents of their children whose ages ranged from two months to five years. All five sets of parents were initially interviewed together and then had separate individual interviews where the Family Assessment Measure-III was administered. The results reflected each family's distinctive patterns of interaction and how they adapted to the birth of a child with an orofacial cleft. Factors found to affect family functioning included: External support systems, individual coping skills, family rules and boundaries, open communication and cohesion among family members. / Psychology / M. A. (Psychology)

The topic of cleft lip and/or palate is widely researched in literature. However no research to date has focused on mothers' experiences raising twins when one twin is born with a cleft lip and/or palate. This qualitative study aims to explore the unigue experiences of these mothers. The epistemological foundations of this study are postmodern, social constructionist and systemic. In accordance with a gualitative methodology data was collected in the form of the participants' personal written stories. This was done from a post-modern paradigm, from a systemic perspective. Themes that were extracted from the stories according to thematic content analysis, not only reflect the experiences of mothers raising twins when one twin is born with a cleft lip and/or palate, they also provide an in-depth understanding of these mothers' experiences and unique situations. Recommendations for future research are offered. / Psychology / M.A. (Clinical Psychology)