Caregivers of children with Complex Communication Needs from low socio-economic  backgrounds are deprived of facilities for communication training. As a result, they struggle to communicate with their children even for activities of daily living. This study focuses on how professionals help such parents to communicate with their non-verbal children. Also, it looks into the condition of parents and the facilitators and the barriers professionals face while working in such situations. To conduct the study qualitative study design with an interview method was chosen. Data were collected from seven participants who are special educators. The results revolves around various themes related to the aim. The main results deal with the burden of caregivers, their motivation level, issues related to lack of training, building rapport with parents, the role of parents, and teaching basics. Studying the barriers and facilitators of professionals identified changes in children, parents' positive attitude, regular follow-up, mother as a caregiver, and other support services as facilitators. Barriers were focused on lack of changes, negative attitudes, grandparents as caregivers, hygiene, transportation, and workload. The results indicate that issues were rooted in low socio-economic backgrounds and the need to provide extra support for caregivers to communicate effectively with their children.

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Early reading literacy is foundational to all other academic learning. It is imperative that elementary students with and without disabilities be provided with evidence-based reading instruction. Elementary students with developmental disabilities (DD) and complex communication needs (CCN) benefit from evidence-based reading instruction that incorporates individualized, explicit instruction and appropriate assistive technology. Research to identify evidence-based practices for students with DD and CCN is necessary to assist teachers to close the gap in overall achievement for this group of learners. The purpose of this study was to determine the efficacy of the early reading program Go Talk Phonics (Ahlgrim-Delzell, Browder, &Wood, 2014) that incorporated evidence-based systematic instruction delivered through assistive technology to teach reading to elementary students ( n = 2 ) with DD and CCN. The two participants in this single-case designed study did not make adequate progress toward the objectives of Lesson One of the intervention in order to continue on to Lessons Two and Three. Although the participants in this study were less successful in the objectives of the lesson than participants in the Ahlgrim-Delzell et al., (2014) study, there were differences in the participants, assistive technology, and design of the experiment. Important considerations were revealed when selecting academic interventions for students with CCN and DD. Assessment of broader aspects of the students' skills and literacy experience, as well as differential reinforcement procedures specific to instructional demands may be necessary to see gains from instruction.

Phonological awareness is the ability to recognize, reflect on and manipulate sound structures of a language. This ability has been shown to be crucial when acquiring literacy. The PhonicStick is a speech-generation communication device, which was initially developed for individuals with complex communication needs (CCN) though more recent research has focused on the effects of the device on factors important for literacy acquisition. In the present study the effects on phonological awareness were evaluated after seven group training sessions with the PhonicStick. The participants of the study were 20 typically developing South African 5-6 year old children. All participants where pre and post tested with The Phonological Awareness Test part c) isolation and a PhonicStick test which tested the ability to produce isolated phonemes and combinations of three phonemes with the device. The results of the study showed that training with the PhonicStick did not appear to improve results on The Phonological Awareness Test part c) isolation. However, it was found that the participants of the training group had improved their ability to manoeuvre the PhonicStick and to produce isolated phonemes and combinations of three phonemes. / Fonologisk medvetenhet är förmågan att känna igen, reflektera över och manipulera ett språks ljudstrukturer. Denna förmåga har visat sig vara betydelsefull vid tillägnandet av läs- och skrivförmåga. The PhonicStick är ett talgenererande kommunikationshjälpmedel som ursprungligen utformades för individer med komplexa kommunikationsbehov. Senare forskning har även fokuserat på hjälpmedlets effekter på faktorer som är viktiga vid tillägnandet av läs- och skrivförmåga. I föreliggande studie utvärderades effekterna på fonologisk medvetenhet hos 20 normalutvecklade sydafrikanska barn i åldrarna 5-6 år efter sju gruppträningstillfällen med the PhonicStick. Alla deltagare i studien pre- och posttestades med två test. Deltest c) från The Phonological Awareness Test rörande förmågan att isolera ljud, samt ett PhonicStick test. Detta testade förmågan att producera isolerade fonem och kombinationer bestående av tre fonem med the PhonicStick. Studiens resultat visade att träning med the PhonicStick inte resulterade i förbättrat resultat på The Phonological Awareness Test del c) isolerade fonem. Däremot tydde resultatet på att deltagarna i testgruppen förbättrade sin förmåga att styra the PhonicStick samt producera isolerade fonem och fonemkombinationer bestående av tre fonem.

Thesis submitted in fulfilment of the requirements for the degree Master of Technology in Information Technology in the Faculty of Informatics & Design at the Cape Peninsula University of Technology / Research on health informatics has seen a steady increase during this decade as the role of information technology in the health sector becomes pertinent. Findings of previous research in this domain have uncovered vast information needs of health workers, particularly in developing countries. However, there is a need to continue with multidisciplinary research in priority areas such as midwifery practice and in the environment of marginalised settings. This study explores the significance of the information needs and information-seeking behaviour or practice of midwives during the antenatal and intrapartum care within the environment of a midwifery unit. Additionally, the researcher obtained permission from Faculty of Informatics and Design – CPUT and Health department authority – Western Cape Government in South Africa, to conduct research in the Elsies River Midwifery Obstetric Unit (ERMOU). The research was carried out as case study in a Midwifery Obstetric Unit in the Western Cape, South Africa. The investigator conducted semi-structured interviews and observations to collect qualitative data of the antenatal and intrapartum care environment. The data was transcribed and analysed using thematic analysis and essomenic modelling. The findings comprehensively point to the importance of this research context. The study found that midwives acquired patients’ information from a handwritten Maternity Case Record (MCR) book and midwives’ colleagues, and often during handovers. In addition, midwives also communicate with each other during care activities in the ERMOU. It was apparent that the use of such communication practices is inadequate, and midwives did not always have sufficient information to make appropriate decisions in the ERMOU. All patient information, referral notes, and reporting is paper-based. In addition, essomenic models were used to depict the midwives’ work activities in the antenatal and intrapartum care environment in the Unit. Furthermore, essomenic models defined all the systematic processes that occur in the ERMOU which is described by midwives’ activities and work environment. To improve communication, future research is recommended to consider the importance of the continuity of the education of midwives. Further research will be on the implementation of nursing informatics and the electronic health record system in the Elsies River Midwifery Obstetric Unit.

Augmentative and alternative communication (AAC) is an evidence-based practice targeting the communication deficits of children with complex communication needs (CCN). While young children with communication disorders are attending preschool and using AAC, and specifically speech-generating devices (SGDs), with increasing frequency, best practices for implementation with this population are largely unexplored. In an effort to contribute to the knowledge base for teachers, the essential communication partners for children in the classroom setting, this research explored the interactions of four teacher-child dyads and analyzed the prompts and cues used to elicit communicative acts from the children. Results of statistical and descriptive analyses revealed that, while teachers overwhelmingly favor and use verbal prompts over other stimuli, these prompts were no more effective in eliciting communicative acts. These results indicate that teachers would benefit from instruction in a variety of techniques for enhancing communication via AAC; future research directions towards this purpose are detailed.

This study examined teacher characteristics and practices identified as effective through current research for teaching students with complex communication needs. For this population, communication issues are more complex than those typically encountered in other settings. Specifically, the researcher asked: what are the desired characteristics and practices for this population, and are the desired characteristics and practices present in current settings? Working with six teachers in a large urban school district, this study utilized a multiple case study design. Criteria for participation included the teacher as the primary reading/language arts instructor for a student who used an augmentative and alternative communication system (AAC). This study builds on prior research and fills a gap in current research through a focus on the teacher. This study was conducted through three phases: a survey of teacher characteristics, observations of teacher practices, and a semi-structured interview. Four instruments were utilized to ensure validity. Results suggest that teachers for this population require knowledge on language and literacy specific to the non-verbal child. AAC training is critical in regard to programming and navigation. The use of other technology supports which offer auditory, visual, and access options are essential. Strong collaborative teams (school and district) are also important. However, one of the most significant findings documents that success may lie with the teacher's 'choice' to embrace challenges with this population. This issue of 'choice' questions the teacher's willingness (personally or professionally) to accept this commitment. This finding also questions the degree to which teachers are willing to pursue opportunities. Recommendations include the need for: training (teachers and paraprofessionals), pursuit of opportunities for supports, addressing parent issues, a district-based liaison between home and school, and to examine issues which prevent the recommended instructional time (90 minutes of reading instruction plus 45 minutes of supplemental instruction). Conclusions indicated that participants ranged from effective to ineffective. The identification of 'highly qualified' teachers through level of education and amount of experience did not correlate with participants' level of effectiveness. Given the limited research available, this study addresses a need in the field and lays the foundation for future research with this population.

This study surveyed speech-language pathologists (SLPs) working in medical settings in the state of Florida in order to: (a) assess the availability of AAC devices, related materials, and services in acute, sub-acute, long-term care, and outpatient medical facilities, (b) examine barriers and supports in providing AAC services to patients with complex communication needs (CCN) in the aforementioned settings, and (c) determine perceived levels of AAC knowledge of health care practitioners. One of the study's major findings was that 97.59% of SLPs served at least one patient they identified as having CCNs, and 94.1% of respondents indicated that their patients could benefit from increased access to AAC devices and service delivery. A notable finding relating to the need for increased AAC-related communication partner instruction (CPI) is as follows: 97% and 100% of respondents indicated that increased CPI for medical practitioners/staff and family members, respectively, were important elements in order to ensure functional communication for individuals with AAC needs in the medical setting. Major barriers to providing AAC services related to device access (i.e., lack of AAC supports / devices, lack of funding for equipment, length of time of device funding). Other barriers were related to the nature of medical settings (i.e., frequently changing caseloads, limited time with patients) and demands of the job (i.e., lack of time to prepare AAC materials / devices). Supports to providing AAC services included low-tech AAC options and mobile technologies. In terms of practitioner knowledge, 57.6% of respondents rated themselves not at all or somewhat knowledgeable regarding AAC. Physicians, nurses, and other rehabilitation professionals were rated as less than knowledgeable by 95%, 97%, and 84.3% of participants, respectively. Overall, the findings of this study suggests there is a high prevalence of patients in medical settings with AAC needs, and some face unmet communication needs resulting from barriers related to the setting itself, lack of access to AAC devices and materials, and limited time spent on AAC service delivery.

The purpose of this study was to examine special needs teachers´ knowledge about visual scaffolding and their opportunities for supporting teachers in creating an accessible learning environment. Special needs teachers were given questions formulated and connected to how they experience their own professional qualifications when they support other teachers in using visual scaffolding, in what way they think visual scaffolding can be used in order to create an accessible learning enviroment and what sort of visual scaffolding they find recommendable in different learning environments and school subjects. Semi-structured interviews were conducted with ten special needs teachers in Swedish compulsory school. The recorded interviews were transcribed and analysed in relation to the research questions. The results showed that special needs teachers recommend that visual scaffolding ought to be used in order to make learning environments accessible by visualizing what pupils are asked to do, how they are supposed to perfom different tasks as well as making words and expressions clear. Using pictures was pointed out as the best support, followed by using symbols, drawings and tangible concrete materials. Further education in visual scaffolding, time for collegial learning, discussions and competent guidance also emerged as critical factors for special needs teachers in their support and guidance to class tecahers.

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