The purpose of this thesis was to evaluate the efficacy of an intervention to increase the production of emotion words in five children with language impairment. Participants were between the ages of 5;11 (years; months) and 11;3 (at the onset of enrollment in treatment) and had been identified with language impairment. Each participant completed between three and six baseline sessions, 20 twenty-minute intervention sessions, and three follow-up sessions. Tasks included story reading, story enactment, and journaling. Each session was recorded and then coded for emotion category (sadness, anger, fear, and surprise), errors made, type of production, and valence agreement. Total emotion word production per category is reported along with percentage of non-overlapping data calculations to determine the effectiveness of treatment for each participant for each emotion word category. Based on percentage of non-overlapping data calculations, treatment was moderately effective for four of the five participants in at least one or more emotion word category. Treatment was mildly effective for all five participants in at least one emotion category. Each participant was observed to make between one and five valence errors throughout the intervention. The errors made by participants often involved the substitution of a simple emotion word category for a more complex emotion word category. Participants were more successful with intervention tasks when provided increased support from the clinician, as seen by most productions being made in response to a question or in response to a cue. While results from this intervention were variable, participants generally made improvements from their participation in this intervention. Utilization of a similar intervention framework with a few alterations based on the limitations observed would be beneficial in future research.

Neonatal communication intervention is important in South Africa, which has an increased prevalence of infants born with risks for disabilities and where the majority of infants live in poverty. Local literature showed a dearth of information on the current service delivery and roles of speech-language therapists (SLTs) and audiologists in neonatal nurseries in the South African context. SLTs have the opportunity to provide the earliest intervention, provided that intervention is well-timed in the neonatal nursery context. The aim of the research was to compile a locally relevant neonatal communication intervention instrument/tool for use by SLTs in neonatal nurseries of public hospitals. The study entailed descriptive, exploratory research. During phase 1, a survey was received from 39 SLTs and 2 audiologists in six provinces. The data revealed that participants performed different roles in neonatal nurseries, which depended on the environment, tools, materials and instrumentation available to them. Many participants were inexperienced, but resourceful in their attempts to adapt tools/materials. Participants expressed needs for culturally appropriate and user-friendly instruments for parent guidance and staff/team training on the topic of developmental care. During phase 2, a tool for parent guidance titled Neonatal communication intervention programme for parents was compiled in English and isiZulu. The programme was piloted by three participants. Suggestions for enhancements of the programme were made, such as providing a glossary of terms, adapting the programme's language and terminology, and providing more illustrations. SLTs and audiologists must contribute to neonatal care of high-risk infants to facilitate development and to support families.

Children with Developmental Language Disorder (DLD) often face problems in areas of social communication including negotiating with peers, entering ongoing interactions, and engaging in conflict resolution. A potential cause of these social communication difficulties is the decreased ability to make emotional inferences. This thesis investigates the effects of a social communication intervention on the ability of school-aged children with DLD to make inferences about emotions. Five children with DLD between the ages of 6;10 and 12;4 participated in a social communication intervention that highlighted principles of emotion understanding (recognizing emotions in facial expressions, inferring emotions with contextual information, and discussing reasoning behind emotions) using story books to illustrate concepts. Data were gathered before and after intervention using a psychometrically balanced measure of emotional inferencing ability. Results revealed notable improvements in three of the participants and consistent performance in two of the participants baseline to follow-up. While performance on the emotional inferencing task varied due to multiple factors, the participants that showed improvement produced real growth which encourages future research to be conducted.

Introduction and rationale: Clinical experience with infants presenting with feeding difficulties and increasing referrals of infants with colic led to this study. There is uncertainty whether the speechlanguage therapist should play a role in the management of this condition. Despite extensive clinical research into the multiple factors related to the condition, the etiology of infantile colic has not yet been established. Suck- swallow-breathing coordination (SSBC), which is key to successful feeding, has not yet been investigated as a factor in this condition. Goals: The goal of the study was to give a comprehensive description of the symptoms and the SSBC of a group of young infants with colic. Sub-goal 1 was to compile a list of symptoms based on a description by parents of infants with infantile colic, which could be used to compare symptoms of a group of infants with the condition to a group without the condition. Sub-goal 2 was to describe SSBC, in a group of infants with the condition, by conducting a clinical assessment. Sub-goal 3 was to compare SSBC in a group of infants with colic to a group without the condition of the same age. Method: A descriptive survey design and interview guide was used in Phase 1. The parents of 60 infants with colic participated in this study. A correlation research design (Phase 2) and the List of symptoms for Infantile Colic (compiled in Phase 1) as well as the Assessment Protocol for SSBC (compiled in Phase 2) were used. A new research group of 50 participants with infantile colic and a control group of 28 participants with the condition, whose ages correlated with those of the research group, was selected. An interview was conducted with the parents of all participants. SSBC was clinically assessed in all the participants. Results: Parental description of infantile colic resulted in a comprehensive list of 27 symptoms. Audible swallowing of air and a feeding duration of more than 20 minutes were described more by parents than found in the literature. Statistically significant differences were found when the postural control and SSBC of the research group were compared with the control group. The difficulties with SSBC differed across the age categories of the participants. Conclusion: The study indicated that infantile colic is related to a disturbance in postural control and components of SSBC, and infants with the condition have subtle feeding difficulties. The speech-language therapist therefore has a role to play in the clinical assessment of infantile colic and the development of treatment strategies. / Dissertation (MA)--University of Pretoria, 2014. / lk2014 / Speech-Language Pathology and Audiology / MA / Unrestricted

Infants, toddlers and young children with cleft lip and palate (CLP) often present with multiple risk profiles due to the complex interaction between genotypical, phenotypical and environmental risk factors influencing their communication development at different ages. Current research recommends the need for a comprehensive early communication intervention (ECI) approach to the treatment of young children with CLP. The areas of strength and weakness in communication development and the factors influencing children with CLP at specific age-group intervals are under-emphasized. The aim of this study was to identify and describe the age-specific risk factors and assets which could influence the communication development of young children with CLP visiting a university-based ECI clinic, the Clinic for High-Risk Babies (CHRIB). Furthermore, the developmental areas of strength and weakness in the child with CLP at three specific age-group intervals, ranging from 1 month to 48 months were described. A retrospective, descriptive, between-subject developmental design with a correlation approach was employed. Purposive sampling was implemented as a non-randomized sampling method and 227 participants were included in the study. The data was extracted from the CHRIB database and analyzed by means of basic descriptive and advanced inferential statistical methods. Extensive data processing of all the potential factors that could have an influence on the early communication developmental areas of children with CLP was performed. A final analysis of the most important associations was performed in the SPSS. The findings revealed that expressive and receptive language and listening skills presented as the most vulnerable communication areas across all three age-groups. The cumulative effect of the risk factors was the greatest in the *[12;24) months age-group since this age group presented with the highest frequency of delayed communication development. The majority of participants in all three age-groups presented with areas of strength, which include age-appropriate cognitive skills, pragmatic development, gestural development and gross motor development. Low birth weight presented as a persistent phenotypical risk factor which influenced the development of functions related to language use in the [1;12) and [12;24) months age groups, and gross motor development and receptive language in the *[12;24) months age group. The environtypical factors such as education and occupation of the mother, as well as the type of day care, indicated significant associations with listening skill development in the [1;12) months group and with the development of functions relating to language use in the [12;24) months age group. Parent-child interaction showed recurrent significant associations with receptive and expressive language across the three age groups. The findings indicated that young children with CLP have unique communication profiles at different age intervals and that these age-specific risk factors and assets should be recognized to ensure a comprehensive approach to ECI services to these young children and their families. / Dissertation (MCommunication Pathology)--University of Pretoria, 2011. / Speech-Language Pathology and Audiology / Unrestricted

The traditional role of speech-language therapists as feeding specialists appears to have focused primarily on the mechanics of feeding disorders, without fully considering the impact of nutritional needs on a child's development and communication. The aim of the study was to investigate the experiences and perceptions of a group of speech-language therapists regarding nutritional issues in children requiring feeding therapy or early communication intervention. A qualitative research design was employed in the form of a descriptive survey and a questionnaire was compiled as the data collection instrument. Forty-nine questionnaires were delivered to speech-language therapists within the Johannesburg and Pretoria geographical areas, of which 32 were suitable for analysis. Closed ended questions were analyzed quantitatively using descriptive statistics while responses to open-ended questions were categorized thematically. Results indicated that all respondents came into contact with clients who had, or who were at risk for, feeding disorders and nutritional deficiencies. However, findings revealed that during assessment and treatment of these clients, respondents tended to neglect issues related to nutrition, as well as psychosocial issues pertinent to feeding disorders. Furthermore, respondents appeared not to have fully realized the importance of their role as communication specialists within the feeding context. It was found that the majority of respondents were involved within a multidisciplinary team approach; however, the application of the more effective transdisciplinary approach was limited. This was confirmed by results revealing that collaboration with other professionals, such as dieticians, did not consistently occur. In terms of training, it was evident that respondents received the majority of their training in feeding therapy from continued education, which included aspects of nutrition. However, undergraduate training was perceived as having limitations within the theoretical content as well as practical application, and did not incorporate nutritional aspects. In light of the apparent need for a more holistic view of paediatric clients with feeding disorders, suggestions were made regarding the inclusion of vital nutritional issues and psychosocial factors within training and transdisciplinary service delivery in South Africa. Furthermore, relevant research topics within the field of paediatric feeding were presented. Broadening perspectives by means of holistic research and training may enhance service delivery to children with paediatric feeding disorders. / Dissertation (MCommPath)--University of Pretoria, 2002. / tm2015 / Speech-Language Pathology and Audiology / MCommPath / Unrestricted

INTRODUÇÃO: O envelhecimento populacional é uma problemática para o setor saúde, que pelas suas características são mais freqüentes os processos de hospitalização, que conseqüentemente favorecem a presença de incapacidades funcionais temporais ou permanentes nos idosos, fato que não é priorizado em pacientes hospitalizados e que requer estratégias de solução visando a melhora da qualidade de vida. OBJETIVO: estudar o impacto de uma intervenção comunicativa fundamentada na concepção de Paulo Freire na capacidade funcional dos idosos, por meio de atividades básicas da vida diária (ABVD). METODOLOGIA: estudo quase-experimental em 184 pacientes, divididos em grupo controle (n=92), experimental (n=92), no hospital HGDIMP, San Luis de Potosí, México. Prévia aprovação do comitê de ética, foi aplicado o índice de Barthel por meio de entrevista para as ABVD: duas semanas antes da hospitalização, na admissão, após 48 horas da hospitalização, na alta e duas semanas depois da alta hospitalar. O instrumento \"índice de Bartel \" foi submetido a uma adaptação cultural e a uma prova piloto em 96 idosos. Foi aplicado o questionário de Pfiffer (SPMSG), validado ao espanhol, para identificar o estado cognitivo e um questionário para dados gerais e antecedentes de saúde. A intervenção comunicativa iniciou 48 horas após hospitalização e terminou duas semanas depois da alta hospitalar. Aplicaram-se estatísticas descritivas, análise multivariada de perfis, testes t de student e exato de Fisher; para tanto, foi utilizado o programa SPSS versão 13.0. RESULTADOS: A idade média dos participantes foi 70 ± 7,7 anos, 60% casados, 41,9% com ensino fundamental completo e 40,2% analfabetos.As principais causas de hospitalização foram por doenças cardiovasculares (40,2%) As co-morbidades mais freqüentes foram hipertensão arterial (49,5%) e Diabetes Mellitus (33,2%) . Antes da hospitalização 37,0% consumiam um medicamento, 25,5% consumiam dois, sendo os mais utilizados os antihipertensivos (39,1%) e hipoglicemiantes (30,4%). O nível de saúde percebido foi 50,5% para \"regular\" e 38,6% para \"bom\". Antes da hospitalização as ABVD mais afetadas foram subir e descer escadas (18,5%), tomar banho (17,4%) e todas as ABVD, de ambos os grupos apresentaram p>0,050, não apresentando diferenças significantes. Na admissão ao hospital observou-se aumento da dependência em todas as ABVD, principalmente tomar banho, vestir-se e caminhar; porém analisando as ABVD, entre os grupos controle e experimental, encontrou-se p=0,015 para caminhar e para transferência da cama para a cadeira p=0.030. Encontrou-se diferença significante entre os grupos. Após 48 de hospitalização houve recuperação das ABVD no grupo controle (media 50,1) e no grupo experimental 40,2 p=0,003; portanto, houve significância estatística. Após finalizar a intervenção, a média do grupo experimental aumentou para 90,0 e o grupo controle apresentou 67,0, p=0,001, observando-se diferenças significantes. Ao comparar os perfis médios encontrou-se p<0.001, razão pela qual conclui-se que não houve paralelismo. A média das ABVD foi maior no grupo experimental em relação ao controle. CONCLUSÕES: o presente estudo mostrou a efetividade de uma intervenção comunicativa, na melhoria da capacidade funcional em pacientes idosos hospitalizados, além de identificar fatores de risco que podem ser controlados. Considera-se que a proposta contribui na recuperação e obtenção da melhora do grau de independência dos idosos por médio de sua participação ativa. / INTRODUCTION: Population aging is a problem for the health sector. Due to its characteristics, hospitalization processes are more frequent, consequently favoring the presence of temporary or permanent disabilities in the elderly, a fact that is not prioritized in hospitalized patients and that demands solution strategies with a view to a better quality of life. OBJECTIVE: To study the impact a communication intervention based on Paulo Freire\'s conception exerts on elderly people\'s functional capacity through basic activities of daily living (ADL). METHODOLOGY: Quasi-experimental study of 184 patients, divided in a control (n=92) and experimental group (n=92), at the HGDIMP hospital in San Luis de Potosí, Mexico. After approval from the ethics committee was obtained, the Barthel index was applied to the BADL through an interview: two weeks before the hospitalization, at the time of hospitalization, after 48 hours of hospitalization, upon discharge and two weeks after discharge from hospital. The \"Barthel index\" was submitted to cultural adaptation and to a pilot test involving 96 elderly. Pfiffer\'s questionnaire was applied (SPMSG), in its version validated for Spanish, in order to identify the cognitive state, while a questionnaire was used to collect general data and health antecedents. The communication intervention started 48 hours after hospitalization and finished two weeks after discharge from hospital. Descriptive statistics and multivariate profile analyses were applied, as well as student\'s t and Fisher\'s exact test, using SPSS software version 13.0. RESULTS: The participants\' mean age was 70 ± 7.7 years, 60.0% were married, 41.9% had finished basic education and 40.2% were illiterate. The main causes of hospitalization were cardiovascular diseases (40.2%). The most frequent comorbidities were arterial hypertension (49.5%) and Diabetes Mellitus (33.2%). Before hospitalization, 37.0% used to take one and 25.5% two medications. The most frequently used drugs were antihypertensive (39.1%) and hypoglicemic agents (30.4%). The perceived health level was 50.5% for \"regular\" and 38.6% for \"good\". Before two weeks of hospitalization, the most affected BADL were climbing and moving down stairs (18.5%), bathing (17.4%) and all BADL in both groups displayed p>0.050, without significant differences. Upon hospital admission, increased dependence was observed on all BADL, mainly bathing, dressing and walking; however, when analyzing the BADL between the control and experimental groups, p=0.015 was found for walking, and p=0.030 for moving from the bed to the chair. A significant difference was found between the groups. After 48 of hospitalization, recovery of BADL was found in the control group (mean 50.1) and in the experimental group 40.2 p= 0.003; thus, statistical significance was found. After finishing the intervention, the mean of the experimental group increased to 90.0 and that of the control group to 67.0 p=0.001, observing significant differences. When comparing the mean profiles, p<0.001 was found. Therefore, it was concluded that no parallelism occurred. The mean score of BADL was higher in the experimental than in the control group. CONCLUSIONS: this study showed the efficacy of a communication intervention for the improvement of functional capacity in hospitalized elderly patients, and also identified risk factors that can be controlled. The proposal contributes to the elderly people\'s recovery and achievement of a better independence level through their active participation.

Many school-age children with language impairment (LI) have difficulties with aspects of social and emotional learning. This study was structured to evaluate one aspect of the effectiveness of a social communication intervention, the appropriate production of emotion words. Four school-aged children with LI participated in 20 sessions of story-based intervention targeting understanding and usage of emotion-based words. Emotions targeted included the emotion word categories of happiness, sadness, anger, fear, surprise, and disgust. Because the knowledge of the emotion word categories varied from child to child, each child had different target words. The percentage of correct production of targeted emotion word categories was tracked, recorded and presented in figure format. The percentage of correct productions provided an estimation of the participants' usage and understanding of emotion-based words from session to session. Percentage of nonoverlapping data (PND) for each participant (subdivided by emotion) was calculated where appropriate as one measure of the effectiveness of the intervention. Although somewhat variable, the data showed that the children did make progress in their use of some of the emotion word categories that they did not understand at baseline. The results of the study present some promising preliminary findings.

This thesis examines the efficacy of a social communication intervention in increasing the emotion word productions in school-aged children with language impairment (LI). The study had a multiple baseline single subject design in which 5 children between the ages of 6 and 11 received 20 intervention sessions, each lasting 20 minutes. Intervention activities included reading and discussing children's books, enacting the stories using toys, and journal writing to reflect on experiences in each session. Emotion word productions during intervention sessions were coded for total productions within the categories of happiness, anger, sadness, fear, surprise, and disgust. Productions were also coded for type (spontaneous, in response to a question, cued, or imitated) and valence agreement. The percentage of non-overlapping data (PND) was calculated (measuring the overall percentage of sessions in which the participants produced more emotion words than they did in the baseline session with the most emotion word productions) in order to show efficacy of the intervention for each participant. According to PND calculations, the intervention was generally effective for 3 of the 5 children and was effective in at least one emotion category for each participant. Participants demonstrated no difficulties with valence agreement. Data regarding types of production indicated that the majority of emotion word productions during the intervention were elicited in some way rather than spontaneous. These results suggest that children with LI increased the number of emotion word productions during the intervention, but were still dependent upon the scaffolding provided by the intervention.

Children diagnosed with Language Impairment (LI) often have difficulty with aspects of social communication. This thesis evaluates the effects of a social communication intervention focused on facilitating the correct production of emotion words in four elementary school-aged children with LI. Researchers monitored changes from pretreatment baseline data, through the intervention, and ended with posttreatment follow-up data for the emotions happiness, surprise, fear, anger, sadness, and disgust. Based on baseline measures, emotion categories in which the child showed limited proficiency were targeted for the 20 intervention sessions. The emotions targeted were different for each child. Each intervention session contained a combination of storybook therapeutic strategies such as story enactment, story sharing, and modeling by the clinician to help increase the child's emotion understanding. The child participated in emotion recognition and emotion inferencing tasks. The data for each participant was analyzed individually and formatted into figures. Data analyzation was performed using percentage of non-overlapping data (PND) which provided insight into how successful the intervention was for each of the targeted emotions. The results of each child's emotion based words were varied, some participants making good progress and others showing little or no gains. These results suggest that the intervention was effective for some of the children and should continued to be refined.