Thesis (MPhil(Rehabilitation))--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Having a child with neurodevelopmental disabilities has a significant impact on the well-being of parents, including experiencing distress and enduring emotional, financial and physical pressure, due to caring for their. They require formal and informal support systems. Formal support includes counselling services. The purpose of the study was to determine what role psychosocial counselling at Tygerberg Academic Hospital (TAH) plays in the lives of parents of children with neurodevelopmental disabilities. A descriptive, qualitative approach was followed using semi-structured interviews that focused on the participants’ experiences and perceptions regarding their psychosocial needs and counselling. Eleven parents participated in the study. They were sampled purposively. Emerging themes were identified through content analysis of interviews. The themes identified were: - Emotions; - Parents’ life and relationships; - Lack of support systems to deal with the pressure of care giving; - Social workers; - Challenges with regard to compliance with healthcare provision; and - Gaps identified. The interviews found that parents received no psychosocial counselling at TAH. This was a disappointment to participants. They indicated feeling very isolated and emotional, and experiencing psychological burnout, while such social work services provided focussed on applications for social grants and patient healthcare treatment. Parents identified a great need for counselling services at the hospital as they believed counselling would assist them to work through emotions, address psychosocial needs, find coping strategies and identify available resources within their communities, which would be beneficial to the psychosocial functioning of the whole family. The parents also identified a need for parent support group services at the hospital. The initiation of this service and support groups for parents is recommended. / AFRIKAANSE OPSOMMING: Om 'n kind met neuro-ontwikkelingsgestremdhede te hê, het 'n beduidende impak op die welstand van ouers, insluitend spanning en verduur van emosionele, finansiele en fisieke druk, as gevolg van die versorging van die kind. Hulle benodig formele en informele ondersteuningsnetwerke. Formele ondersteuning sluit beradingsdienste in. Die doel van hierdie studie was om te bepaal wat die rol is van psigososiale berading by die Tygerberg Akademiese Hospitaal in die lewens van ouers van kinders met neuro-ontwikkelingsgestremdhede. 'n Beskrywende, kwalitatiewe benadering is gevolg deur gebruik te maak van semi-gestruktureerde onderhoude wat fokus op die deelnemers se ervarings en persepsies ten opsigte van psigososiale behoeftes en berading. Elf ouers het aan die studie deelgeneem. Die deelnemers was doelgerig geselekteer. Temas is geïndentifiseer deur die inhoud van die onderhoude te analiseer. Die temas was as volg: Emosies; - Ouers se lewens en verhoudings; - Tekort aan ondersteuningstrukture om die druk van versorging te hanteer; - Maatskaplike werkers; - Uitdagings met betrekking tot nakoming met gesondheidsorgvoorsiening en - Identifisering van gapings. Die onderhoude het bevestig dat ouers geen psigososiale berading by Tygerberg Akademiese Hospitaal ontvang nie. Dit was teleurstellend aan die deelnemers. Hulle is geneig om geïsoleerd en emosioneel te voel en beleef ook psigiese uitbranding, terwyl maatskaplikewerk dienste hoofsaaklik fokus op toelaagaansoeke en die pasiëntgesondheidsorgbehandeling. Ouers het 'n groot behoefte aan beradingsdienste by die Tygerberg Akademiese Hospitaal geïdentifiseer, omdat hulle glo dat berading hulle sal help om deur emosies en psigososiale behoeftes te aan te spreek, baasraakstrategieë te vind en beskikbare hulpbronne binne hul gemeenskappe wat voordelig sal wees vir die psigososiale funksionering van die gesin te identifiseer. Die ouers het ook 'n behoefte vir ouerondersteuningsgroepdienste by die hospitaal geïdentifiseer. Die inisiasie van beradingsdienste en ouerondersteuningsgroepdienste word aanbeveel.

Thesis (MEd)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Education supporting factors is of great importance for children who are growing up in very challenging circumstances. The challenge of poverty affects people differently and people also react differently towards it. If educators can understand why certain children can withstand certain risk factors such as severe contextual backlogs, whilst others cannot, they will have a better understanding where to intervene, and also how to put preventative measures in place. (Garmenzy, 1991). This resilience who is intrinsic amongst children, acts as protective factors against certain developmental factors to which children might be exposed to. The different supportive structures who is critical for the learners, acts as extrinsic protective factors. The stronger the protective factors are, the better the parents can resist the pressure from poverty (Ross,1995). This study therefore aimed to understand what education supporting factors exist for learners who are growing up in challenging circumstances. The researcher worked from an interpretive paradigm. The study’s orientation is a basic qualitative research and included the following: purposive sample selection to identify research participants, open questionnaires to gather their biographic information, individual interviews and field notes to generate data, and content analysis to analyse data. Research findings indicate that the encouragement and extensive support that the learners enjoy plays a huge role in their lives. The study also highlighted that if the learners’ intrinsic resilience can be further developed and when the extensive support is sustainable, the learners can be successful and handle life’s challenges. / AFRIKAANSE OPSOMMING: Onderwys ondersteunende faktore is van groot belang by kinders wat in uitdagende omstandighede groot word. Die uitdaging van armoede raak mense op verskillende maniere en mense reageer verskillend daarop. As opvoeders kan verstaan waarom sommige kinders risiko faktore soos erge kontekstuele agterstande kan weerstaan, terwyl ander nie kan nie, sal hulle ’n beter kans staan deur te weet hoe om in te gryp, en hoe om voorkomende maatreëls te tref (Garmenzy, 1991). Hierdie veerigtigheid wat inherent onder leerders is, tree as beskermende faktore op teen ontwikkelingsfaktore waaraan die kind blootgestel kan word. Die verskillende ondersteuningsnetwerke wat kritiek is vir die leerders, tree op as eksterne beskermende faktore, want hoe sterker die ondersteuning is, hoe beter kan ouers die druk wat deur armoede veroorsaak word weerstaan (Ross,1995). Die studie het dit ten doel om te verstaan en insig te bekom met watter faktore onderwys ondersteun, vir leerders wat in uitdagende omstandighede grootword. Die navorser het binne ’n interpretivistiese paradigma gewerk. Die studie se orientasie is ’n basiese kwalitatiewe navorsing en het die volgende ingesluit: doelbewuste seleksie om te bepaal wie die deelnemers was, oop vraelyste om hul biografiese inligting te bekom, individuele onderhoude en veldnotas om data te genereer, asook inhoudsanalise om die data te analiseer. Navorsingsbevindinge dui daarop dat die aanmoediging en uitgebreide ondersteuning wat die leerders geniet ’n groot rol in hul lewens speel. Uit die studie was dit duidelik dat as die leerders se inherente veerkragtigheid verder ontwikkel word en die uitgebreide ondersteuning is volhoubaar, kan die leerders suksesvol wees en die alledaagse uitdagings met gemak hanteer.

Traditional remedial intervention programmes address academic and perceptual deficits but not emotional needs. Existing literature suggests that most children with learning disabilities have concomitant emotional, behavioural and social difficulties; however an apparent lack of consensus regarding the types of emotional and behavioural difficulties faced by these children exists especially amongst teachers, parents and professionals in the field of learning disabilities. The aim of this study was to discover which emotions might emerge during Gestalt play therapy sessions with children receiving remedial intervention. Three respondents from three different remedial programmes participated in the study. Data was gathered from the therapeutic sessions as well as from unstructured interviews with parents, teachers and professionals in the field of learning disabilities. Recommendations are made as to how Gestalt play therapy could be implemented as an additional support for children receiving remedial intervention. / Tradisionele remediërings-programme spreek slegs akademiese en perseptuele tekortkominge aan en nie emosionele behoeftes nie. Bestaande literatuur dui daarop dat die meeste kinders met leerprobleme gepaardgaande emosionele, gedrags- en sosiale probleme ervaar. Daar is egter 'n gebrek aan konsensus tussen onderwysers, ouers en professionele persone op die gebied van leerprobleme, oor die tipe emosionele en gedragsprobleme waarmee hierdie leerders te kampe het. Die doel van hierdie studie was om vas te stel watter emosies tevoorskyn mag kom, tydens Gestalt-speel-terapie-sessies met leerders wat remediëringsonderrig ontvang. Drie respondente van drie verskillende remediërende programme het aan die studie deelgeneem. Data is ingesamel van terapeutiese sessies, sowel as van ongestruktureerde onderhoude met ouers, onderwysers en professionele persone in die veld van leerprobleme. Die bevindings van die studie blyk in ooreenstemming te wees met bestaande literatuur, naamlik dat kinders met leerprobleme bykomende emosionele en sosiale probleme ondervind. Aanbevelings is gemaak oor hoe Gestalt spelterapie geïmplementeer kan word as 'n addisionele ondersteuning vir kinders wat remediërende intervensie ontvang. / Social Work / M. Diac. (Play Therapy)

As people meet their basic biological needs, they become increasingly concerned with higher level needs, such as personal development and positive well-being. The term "subjective well-being" (SWB) refers to people's evaluations of their lives and although relatively stable, people's levels of SWB are influenced by life events. The high position of esteem needs in Maslow's hierarchy of needs reflects the importance of self-esteem in people's judgement of their quality of life. A one group post test only, analytical research design was utilised with 570 residents of an informal settlement in Soweto. A structured questionnaire was designed to obtain information on demographic variables, levels of SWB and levels of self-esteem. The levels of SWB and self-esteem within the community were relatively high. Multiple regression analyses models confirmed that demographic factors are weakly correlated with SWB and self-esteem. Self-esteem was highly correlated with life satisfaction. / Psychology / M.A. (Psychology)

Summaries in Afrikaans and English / Text in Afrikaans / Die waarde van visueel-perseptuele skoling of terapie vir visueel-perseptueel gestremde leerlinge as 'n subgroep van leergestremdheid, is reeds vir dekades 'n omstrede aangeleentheid. Hierdie omstredenheid is ondersoek aan die hand van sewe internasionaal erkende psigometriese toetse. Die interne konsekwentheidskoeffisiente van hierdie toetse het vir die huidige studie van 0,62 tot 0,95 gestrek. 'n Faktorontleding van die toetsinterkorrelasies het 'n gemeenskaplike faktor blootgele. Ses toetse was primer visueel-perseptueel, en Goodenough <1926> se skaal is vir die bepaling van intelligensie gebruik. Bykomend hiertoe, is leerlinge se prestasies in hul eerste taal, wiskunde en skrif gebruik om die effek van terapie te bepaal. Proefpersone is as visueel-perseptueel gestremd gediagnoseer deur 'n opvoedkundige sielkundige en 'n visuele skolingsentrum in Pretoria, waar eksper imentele leerlinge terapie ontvang het. Hierdie diagnoses is deur die Test for Visual Analysis Skills wat beduidend tussen normale en visueelperseptueel gestremdes onderskei, bevestig. Die toets se geldigheid vir Suid-Afrikaanse omstandighede is in 'n voorstudie bepaal. Honderd en ses, ses- tot negejarige proefpersone (82 seuns en 24 dogters>, van normale intelligensie, gesigskerpte en gehoor, is betrek. Drie en vyftig het die eksperimentele groep gevorm wat onderverdeel is in 32 wat terapie voltooi het, en 21 wat nie het nie. Hierdie leerlinge is individueel afgepaar met kontroleleerlinge van dieselfde geslag, ouderdom, huistaal, sosio-ekonomiese status en skoolstanderd. Eksperimentele leerlinge het visuele terapie in n breer groepsverband vir een uur per week ontvang. Terapieperiodes het van 4 tot 15 maande gewissel. Die eksperimentele ontwerp was 'n voortoets-natoets-tweegroepontwerp. t-Toetse vir afhanklike (afgepaarde) groepe is uitgevoer op die verskille tussen voor- en natoetstellings, asook tussen die eksperimentele en kontrolegroepe. Geeneen van die primer visueel-oerseptuele meettegnieke het beduidende resultate opgelewer nie. Dit is aanduidend van die ondoeltreffendheid van visueel-perseptuele terapie om die tekorte waarop dit gemik is, reg te stel. Die waarde van visueel-perseptueie terapie is inteendeel beperk tot 'n oorhoofse verbetering in konseptualisering en intellektuele ryping by die groep wat terapie voltooi het. Skrif was die enigste vak wat by dieselfde groep beduidend verbeter het. Hierdie resultaat is egter twyfelagtig vanwee beoordelingstekorte. / The value of visual perceptual training or therapy, to visually perceptually impaired pupils as a subgroup of the learning disabled, has been a controversy far decades. This controversy was investigated by means of seven internationally recognised psychometric tests. The internal consistency coefficients of these tests for the present study ranged from 0,62 to 0,95. A factor analysis of test intercorrelations revealed a common factor. Six tests were primarily visual perceptual, whilst the Goodenough (1926) scale determined intelligence. Additionally, pupils' performance in their first language, mathematics and writing, was used to assess the therapeutic effect. Subjects were diagnosed as visually perceptually impaired by an educational psychologist and a visual training centre in Pretoria where experimental pupils received therapy. These diagnoses were confirmed by the Test for Visual Analysis Skills, which significantly differentiates between the normal and visually perceptually impaired. This test's validity for South African circumstances was determined in a prestudy. One hundred and six, six to nine year old subjects <82 boys and 24 girls>, of normal intelligence, visual acuity and hearing, were involved. Fifty three formed the experimental group which was subdivided in 32 who completed therapy, and 21 who did not. These pupils were individualiy matched with controls of similar sex, age, home language, socio economic status and school standard. Experimental pupils received visual therapy within a broader group context for one hour per week. Therapy periods fluctuated between 4 and 15 months. The experimental design was a pretest-posttest two group design. t-Tests for dependant <matched) groups were conducted on the differences between pre and oosttest scores, as well as between the experimental and control groups. None of the primarily visual perceptual tests revealed significant results. This signifies the inefficiency of visual perceptual therapy to rectify the deficits at which it is directed. The value of visual perceptual therapy is, on the contrary, restricted to an overall improvement in conceptualization and intellectual maturation within the group which completed therapy. Writing was the only subject which improved significantly within the same group. However, this result is dubious, due to evaluation deficits. / Psychology / D.Litt. et Phil. (Psychology)

As people meet their basic biological needs, they become increasingly concerned with higher level needs, such as personal development and positive well-being. The term "subjective well-being" (SWB) refers to people's evaluations of their lives and although relatively stable, people's levels of SWB are influenced by life events. The high position of esteem needs in Maslow's hierarchy of needs reflects the importance of self-esteem in people's judgement of their quality of life. A one group post test only, analytical research design was utilised with 570 residents of an informal settlement in Soweto. A structured questionnaire was designed to obtain information on demographic variables, levels of SWB and levels of self-esteem. The levels of SWB and self-esteem within the community were relatively high. Multiple regression analyses models confirmed that demographic factors are weakly correlated with SWB and self-esteem. Self-esteem was highly correlated with life satisfaction. / Psychology / M.A. (Psychology)

Summaries in Afrikaans and English / Text in Afrikaans / Die waarde van visueel-perseptuele skoling of terapie vir visueel-perseptueel gestremde leerlinge as 'n subgroep van leergestremdheid, is reeds vir dekades 'n omstrede aangeleentheid. Hierdie omstredenheid is ondersoek aan die hand van sewe internasionaal erkende psigometriese toetse. Die interne konsekwentheidskoeffisiente van hierdie toetse het vir die huidige studie van 0,62 tot 0,95 gestrek. 'n Faktorontleding van die toetsinterkorrelasies het 'n gemeenskaplike faktor blootgele. Ses toetse was primer visueel-perseptueel, en Goodenough <1926> se skaal is vir die bepaling van intelligensie gebruik. Bykomend hiertoe, is leerlinge se prestasies in hul eerste taal, wiskunde en skrif gebruik om die effek van terapie te bepaal. Proefpersone is as visueel-perseptueel gestremd gediagnoseer deur 'n opvoedkundige sielkundige en 'n visuele skolingsentrum in Pretoria, waar eksper imentele leerlinge terapie ontvang het. Hierdie diagnoses is deur die Test for Visual Analysis Skills wat beduidend tussen normale en visueelperseptueel gestremdes onderskei, bevestig. Die toets se geldigheid vir Suid-Afrikaanse omstandighede is in 'n voorstudie bepaal. Honderd en ses, ses- tot negejarige proefpersone (82 seuns en 24 dogters>, van normale intelligensie, gesigskerpte en gehoor, is betrek. Drie en vyftig het die eksperimentele groep gevorm wat onderverdeel is in 32 wat terapie voltooi het, en 21 wat nie het nie. Hierdie leerlinge is individueel afgepaar met kontroleleerlinge van dieselfde geslag, ouderdom, huistaal, sosio-ekonomiese status en skoolstanderd. Eksperimentele leerlinge het visuele terapie in n breer groepsverband vir een uur per week ontvang. Terapieperiodes het van 4 tot 15 maande gewissel. Die eksperimentele ontwerp was 'n voortoets-natoets-tweegroepontwerp. t-Toetse vir afhanklike (afgepaarde) groepe is uitgevoer op die verskille tussen voor- en natoetstellings, asook tussen die eksperimentele en kontrolegroepe. Geeneen van die primer visueel-oerseptuele meettegnieke het beduidende resultate opgelewer nie. Dit is aanduidend van die ondoeltreffendheid van visueel-perseptuele terapie om die tekorte waarop dit gemik is, reg te stel. Die waarde van visueel-perseptueie terapie is inteendeel beperk tot 'n oorhoofse verbetering in konseptualisering en intellektuele ryping by die groep wat terapie voltooi het. Skrif was die enigste vak wat by dieselfde groep beduidend verbeter het. Hierdie resultaat is egter twyfelagtig vanwee beoordelingstekorte. / The value of visual perceptual training or therapy, to visually perceptually impaired pupils as a subgroup of the learning disabled, has been a controversy far decades. This controversy was investigated by means of seven internationally recognised psychometric tests. The internal consistency coefficients of these tests for the present study ranged from 0,62 to 0,95. A factor analysis of test intercorrelations revealed a common factor. Six tests were primarily visual perceptual, whilst the Goodenough (1926) scale determined intelligence. Additionally, pupils' performance in their first language, mathematics and writing, was used to assess the therapeutic effect. Subjects were diagnosed as visually perceptually impaired by an educational psychologist and a visual training centre in Pretoria where experimental pupils received therapy. These diagnoses were confirmed by the Test for Visual Analysis Skills, which significantly differentiates between the normal and visually perceptually impaired. This test's validity for South African circumstances was determined in a prestudy. One hundred and six, six to nine year old subjects <82 boys and 24 girls>, of normal intelligence, visual acuity and hearing, were involved. Fifty three formed the experimental group which was subdivided in 32 who completed therapy, and 21 who did not. These pupils were individualiy matched with controls of similar sex, age, home language, socio economic status and school standard. Experimental pupils received visual therapy within a broader group context for one hour per week. Therapy periods fluctuated between 4 and 15 months. The experimental design was a pretest-posttest two group design. t-Tests for dependant <matched) groups were conducted on the differences between pre and oosttest scores, as well as between the experimental and control groups. None of the primarily visual perceptual tests revealed significant results. This signifies the inefficiency of visual perceptual therapy to rectify the deficits at which it is directed. The value of visual perceptual therapy is, on the contrary, restricted to an overall improvement in conceptualization and intellectual maturation within the group which completed therapy. Writing was the only subject which improved significantly within the same group. However, this result is dubious, due to evaluation deficits. / Psychology / D.Litt. et Phil. (Psychology)

Indiana University-Purdue University Indianapolis (IUPUI) / Little is known regarding the psychosocial outcomes of adult siblings of adults with autism. Accordingly, the current study sought to: (1) illuminate factors that predict health-related quality of life, caregiver burden, and reported benefits in adult siblings of adults with autism, using a stress and coping framework and (2) compare outcomes of siblings of adults with autism (n = 31) to siblings of adults with Down syndrome (DS) (n = 54). For the within subject hypotheses, analyses were repeated within the DS group and an overall Disability group (n = 97). The Disability group consisted of participants in the Autism and Down syndrome groups plus twelve individuals in a mixed group of adult siblings of adults with DS who presented with co-morbid symptoms of autism. Variables were organized using The Adult Sibling Caregiver Conceptual Model (ASCCM) into three categories: antecedents (e.g., sibling relationship quality, problem behaviors of the disabled sibling), mediators (e.g., coping strategies, cognitive appraisal types), and psychosocial outcome variables (i.e., mental and physical health-related quality of life, caregiver burden, and reported benefits). For the within subject primary hypotheses, I posited a series of relationships between the antecedents and outcomes based on prior literature on demographic and individual difference predictors (e.g., siblings of adults with autism with fewer problem behaviors would have increased health-related quality of life [HRQOL], decreased caregiver burden, and increased reported benefits) and on stress and coping factors related to the burden of providing care for an individual with autism (e.g., greater use of avoidant coping strategies would be related to lower HRQOL, increased caregiver burden, and decreased reports of benefits). Exploratory hypotheses also were examined (e.g., being married would be associated with increased HRQOL, decreased burden, and increased reported benefits). The within-subject results indicated support for eight of the ten primary hypotheses and five of the six exploratory hypotheses when examined within at least one of the study groups: Autism, DS, or Disability. Overall, sibling caregivers, regardless of their sibling’s disability, reported more favorable psychosocial outcomes when demands were lower (e.g., less severe levels of problem behaviors, fewer autism symptoms exhibited by their disabled sibling, decreased additional pile-up stress), when resources were available to cope with stress (e.g., social support, respite care), and when healthy responses to stress were reported (e.g., use of emotion focused vs. avoidant coping strategies, use of challenge vs. threat appraisal types). Of note, reported benefits, which have rarely been examined in the autism literature, were strongly related to the quality of a sibling relationship across all study groups, and with the helpfulness of received services and perceived social support within the Autism group. The between subject hypotheses also were largely supported. As expected, compared to siblings of those with Down syndrome, siblings of those with autism demonstrated greater levels of caregiver burden and lower mental HRQOL. Moreover, there was a rank ordering in levels of caregiver burden across disability groups; siblings of adults with DS reported the lowest burden, siblings of adults with DS with symptoms of autism reported significantly higher levels of burden, and siblings of those with autism reported the most burden. The results imply that autism, either alone or co-morbid with another diagnosis, presents an increased risk of stress and caregiver burden, not only in parent caregivers, but also in sibling caregivers. Interestingly, there was also evidence for higher levels of stress related growth within the Autism group compared to the DS group. Future research will be needed to generalize the results of this study to broader samples of adult siblings while taking a life course perspective to assess changes in non-disabled siblings’ outcomes over time.