Thesis (MOccTher)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: The rights of people with disabilities to equal opportunities for employment is acknowledged on a national and international level. A key area whereby this can be addressed is through effective vocational rehabilitation programmes in occupational therapy. The delivery of high quality health care services is an important issue for the consumer and government within the health arena. This implies that standards have to be developed for the various services. The standards will serve the purpose of activating quality assurance and quality improvement processes in all health care services. Vocational rehabilitation of people with disabilities and the emphasis that is placed on good quality care, resulted in the question: "How can occupational therapists ensure that they will deliver a good quality service in a vocational assessment area?". The question is posed specifically in terms of the assessment of a person's work abilities, as this step is viewed as most important in the vocational rehabilitation process. The step(s) that follow will be determined by the results obtained from the assessment. The purpose of the study is to identify a standard statement and generic measurement criteria that will be used to set the standards for Structure, Process and Outcome for vocational assessment areas. The establishment of measurement criteria is viewed as a starting point in the quality assurance cycle. The results of the study will initiate quality assurance and quality improvement in vocational assessment areas. Although the role of the occupational therapist is clearly delineated regarding vocational rehabilitation and the importance of the occupational therapy contribution recognised in this regard, could no information pertaining to standards and measurement criteria for work assessment areas be identified through a literature study. It was therefore decided to develop a standard statement and measurement criteria according to the Donabedian Model of Structure, Process and Outcome for vocational assessment areas in South Africa. Occupational therapists with at least one year experience of vocational rehabilitation of patients were requested to rate the proposed standard statements and measurement criteria. A survey method (adapted Delphi method) was used whereby the participants had to rate the proposed standard statements and measurement criteria on a four-point scale. The results obtained were used to draw up a standard statement and measurement criteria to ensure that quality assurance and quality improvement will become a reality in vocational assessment areas in South Africa. / AFRIKAANSE OPSOMMING: Die regte van persone met gestremdhede tot gelyke indiensneming word op nasionale en internasionale vlak erken. Die aanbieding van effektiewe werkrehabilitasieprogramme deur arbeidsterapeute is een van die belangrikste wyses waarop die situasie aangespreek kan word. Die lewering van hoë gehalte gesondheidsdienste word toenemend deur die verbruikers en die staat vereis. Dit impliseer dat standaarde vir die dienste vasgestel moet word om gehalteverbetering en gehalteversekering in gesondheidsdienste te vestig. Werkrehabilitasie van persone met gestremdhede en die kwessie van hoë gehalte dienste het die volgende vraag laat ontstaan: "Hoe kan die arbeidsterapeut verseker dat 'n hoë gehalte diens in 'n werkbepalingsarea gelewer word?". Die vraag handel spesifiek oor die bepaling van 'n persoon se werkvermoëns aangesien dié stap as baie belangrik binne die werkrehabilitasieprogram beskou word. Die stap(pe) wat hierna sal volg, salop besluit word na aanleiding van die resultate van die bepaling. Die doel van die studie is om 'n standaardstelling en generiese metingskriteria volgens Donabedian se model te identifiseer om die standaarde vir die Struktuur, Proses en Uitkoms van werkbepalingsareas in Suid-Afrika daar te stel. Die bogenoemde metingskriteria sal dit moontlik maak om die gehalteversekeringsiklus te inisieër. Gehalteversekering en gehalteverbeteringsaksies sal as gevolg hiervan in werkbepalingsareas kan plaasvind. Ten spyte van die feit dat die rol van die arbeidsterapeut in werkrehabilitasie duidelik uiteengesit is en die belang daarvan erken word, kon geen inligting oor 'n standaardstelling en metingskriteria vir werkbepalingsareas in die literatuur gevind word nie. Arbeidsterapeute met minstens een jaar ondervinding van werkrehabilitasie van pasiënte het hulle menings ten opsigte van 'n standaardstelling en metingskriteria uitgespreek. 'n Opname metode (gewysigde Delphi metode) is gebruik en deelnemers het op 'n vierpuntskaal hul voorkeure ten opsigte van 'n standaardstelling en metingskriteria aangedui. Die resultate wat op dié wyse bekom is, is gebruik om 'n finale standaardstelling en voorkeur metingskriteria voor te stel. Die gebruik hiervan in werkbepalingsareas sal daartoe lei dat gehalteversekering en gehalteverbetering in dié areas in Suid-Afrika tot uitvoer gebring sal word.

Thesis (MOccTher)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Background Temperament and sensory thresholds play an important part in how a person processes sensory information. Because people are differently construed, the way we perceive sensory information and act on the information will differ. Any person who suffers from an ailment or condition that interferes with this process of receiving, interpreting and acting on stimuli from our environments may find this process even harder. Behavioural observations that deviate from the "norm" are often found in children with attention-deficit/hyperactivity disorder (ADHD) and sensory processing disorder (SPD). More recent research focused on the relationship between ADHD and SPD. Dunn developed the Sensory Profile Caregiver1 and Sensory Profile School Companion2 (SPSC) measures to identify children’s sensory processing difficulties. Although many studies have been conducted using the Sensory Profile, no studies have been conducted outside the United States of America (USA) to establish whether Dunn’s SPSC will differentiate between children who are considered to be "normal" and those diagnosed with ADHD. Aim The aim of this study was to investigate how learners with ADHD in the Western Cape would perform on Dunn’s Sensory Profile School Companion (SPSC) and the ADHD Rating Scale-IV³ in order to assess the sensory processing problems of learners with ADHD in South Africa (see note end of abstract). Methodology A descriptive study was conducted using a convenience sample (n=108) from learners in the Western Cape between the ages of five and ten years and diagnosed with ADHD. Data collection consisted of a demographical form completed by the parents/legal guardians of the learners, as well as the completion of two questionnaires by the educator of the learners. The first questionnaire, the ADHD Rating Scale-IV, was used to classify the learners into subtypes of ADHD. The second questionnaire was Dunn’s SPSC, which is a teacher-report measure of learners’ responses to sensory input in the school environment. The following statistical analyses were performed: • descriptive statistics to provide means, medians and measurements of dispersion of the learners in the Western Cape on the SPSC; • The Kruskal-Wallis one-way ANOVA probability value to consider if significant differences existed between the medians of the 13 group scores of the SPSC; and • The Welsh T-test to compare learners with ADHD in the Western Cape with SPSC norms and Dunn’s sample of learners with ADHD. Results The results showed that there were significant differences (p=0.000) on all 13 group scores of the SPSC in learners with ADHD in the Western Cape showing significantly more behaviours characterising poorer sensory processing, when compared to Dunn’s normal sample. The comparison to Dunn’s sample of learners with ADHD did not yield significant differences in 11 of the 13 group scores, indicating that learners with ADHD in the Western Cape did not differ from Dunn’s ADHD learners. Avoiding and School Factor 4 showed significant differences, with the Western Cape group showing more extreme behaviours related to sensory input than Dunn’s group. The results using the ADHD Rating Scale-IV were less significant and it was found that the rating scale could not differentiate between the two types of ADHD, although some inferences could be made regarding the use (or not) of medication. There was a significant difference (p < 0.01) on the inattentive, hyperactive-impulsivity and total scores of the ADHD Rating Scale-IV with learners not on medication showing a higher frequency of ADHD behaviours. Conclusion Dunn’s SPSC was found to be a good measure to assess learners with ADHD’s sensory processing problems. The ADHD Rating Scale-IV, on the other hand, could not classify the learners into the subtypes and therefore cannot be used when learners are already using medication. Further investigation is recommended to try to establish a link between the different subtypes of ADHD and the placement of learners on the different quadrants of Dunn’s SPSC as well as the School Factors and Sensory Section Scores. / AFRIKAANSE OPSOMMING: Agtergrond Temperament en sensoriese drempels speel 'n belangrike rol in die wyse waarop 'n persoon sensoriese inligting verwerk. Omdat mense verskillend is, sal die manier waarop ons sensoriese inligting waarneem en dan daarop reageer, verskil. Enige persoon wat aan 'n kwaal of toestand ly wat inmeng met hierdie proses van hoe sensoriese insette uit die omgewing opgeneem, geïnterpreteer en dan op gereageer word, sal dit moeilik vind. Gedrag wat afwyk van die "norm" word dikwels in kinders met aandagafleibaarheid/hiperaktiwiteitsteuring (AAHS) en sensoriese prosesseringsdisfunksie (SPD) waargeneem. Meer onlangse navorsing fokus op die verhouding tussen AAHS en SPD. Dunn het die Sensory Profile Caregiver4 en die Sensory Profile School Companion5 (SPSC)-skale ontwikkel om kinders se sensoriese prosesseringsprobleme te identifiseer. Alhoewel baie studies gedoen is wat die Sensory Profile gebruik het, is daar geen studies buite die VSA gedoen om te bepaal of Dunn se SPSC tussen kinders wat as normaal beskou word en dié wat met AAHS gediagnoseer is, kan differensiëer nie. Doelstelling Die doel van hierdie studie was om ondersoek in te stel na hoe leerders met AAHS in die Wes- Kaap op Dunn se Sensory Profile School Companion (SPSC) en die ADHD Rating Scale-IV6 sou presteer om die sensoriese prosesserings probleme van leerders met AAHS te assesseer. Metodiek 'n Beskrywende studie is gedoen met 'n gerieflikheidsteekproef (n=108) van leerders tussen die ouderdomme vyf en tien jaar oud in die Wes-Kaap wat met AAHS gediagnoseer is. Datainsameling het bestaan uit 'n demografiese vorm wat deur die ouers/wettige voogde van die leerders ingevul is, sowel as die voltooiing van twee vraelyste deur die opvoeder van die leerders. Die eerste vraelys, die ADHD Rating Scale-IV, is gebruik om die subtipes van AAHS te klassifiseer. Die tweede vraelys was die Sensory Profile School Companion (SPSC) wat 'n meting met behulp van die onderwyser se verslag is wat die leerders se reaksie ten opsigte van sensoriese insette in die skoolomgewing meet. Die tweede vraelys (Dunn se SPSC) is deur onderwysers ingevul ten einde leerders se response op sensoriese insette in die skoolomgewing te bepaal. Die data is aan die volgende ontledings onderwerp: beskrywende statistiek wat die gemiddelde, mediane en metings van die verspreiding van leerders in die Wes-Kaap op die SPSC verskaf; • die Kruskal-Wallis-eenrigting-ANOVA waarskynlikheidswaarde om vas te stel of daar beduidende verskille tussen die mediane van die 13 groeptellings van die SPSC is; en • die Welsh T-Toets om leerders met AAHS in die Wes-Kaap te vergelyk met die SPSCnorme en Dunn se steekproef van leerders met AAHS. Resultate Die resultate het beduidende verskille getoon (p=0.000) op al 13 groeptellings van die SPSC by leerders met AAHS in die Wes-Kaap, wat dui daarop dat hierdie groep aansienlik meer probleme kenmerkend aan sensoriese verwerking toon as wat in Dunn se normale steekproef waargeneem is. Die vergelyking met Dunn se steekproef met AAHS het in 11 van die 13 groeptellings nie beduidende verskille getoon nie wat aandui dat leerders met AAHS in die Wes-Kaap nie veel verskil het van Dunn se AAHS-leerders nie. Avoiding en School Factor 4 het beduidende verskille getoon met leerders in die Wes-Kaapse groep wat meer uiterstes in gedrag getoon het ten opsigte van sensoriese insette as dié van Dunn se groep. Die resultate waar die ADHD Rating Scale gebruik is, was minder beduidend en daar is bevind dat die skaal nie kon differensiëer tussen die twee tipes AAHS nie, alhoewel daar afleidings gemaak kon word ten opsigte van die gebruik (of nie) van medikasie. Daar was 'n beduidende verskil (p < 0.01) in die onoplettende, hiperaktief-impulsiwiteit en totale tellings van die ADHD Rating Scale-IV met leerders nie op medikasie nie, wat 'n hoër frekwensie van AAHS-gedrag getoon het. Slot Daar is bevind dat Dunn se SPSC 'n goeie maatstaf is om die sensoriese verwerkingsprobleme van leerders met AAHS te assesseer. Die ADHD Rating Scale-IV aan die ander kant kon nie die leerders in die verskillende subtipes klassifiseer nie en kan dus nie gebruik word wanneer die leerders reeds medikasie gebruik nie. Verdere ondersoek word aanbeveel in ’n poging om 'n skakel te kry tussen die verskillende subtipes AAHS en die plasing van leerders op die verskillende kwadrante van Dunn se SPSC sowel as die School Factors- en Sensory Section-tellings.

Thesis (MOccTher (Interdisciplinary Health Sciences. Occupational Therapy))--University of Stellenbosch, 2007. / Objectives: The study aimed to identify the functions that occupational therapy leaders perform in clinical settings in the Metropole District of the Provincial Administration of the Western Cape (PAWC) and determine the influence of these functions on clinical practice. Methodology: The researcher used a descriptive design and a non-standardised questionnaire which was compiled to collect the data for the study. The questionnaire was piloted with a group of occupational therapy leaders from the Boland Overberg Region. Feedback was used to refine the final study questionnaire. Thirty-five study questionnaires were mailed or handed to the participants in the study and the researcher received 25 completed questionnaires; therefore, the response rate was 71.4%. The data were analysed using the Statistical Package for the Social Sciences (SPSS 10.0) for all the questions. Descriptive statistics were used to report the data. Inter-observer reliability was checked by using the split-half method. The results revealed that the study questionnaire was reliable as Cronbach's Alfa was calculated at 0.90, correlation coefficient Pearson’s r was calculated at 0.51, and Spearman-Brown was calculated at 0.67. Results: The results were presented in relation to the respondents’ number (N = 25). The participants identified 57 leadership functions, grouped as managerial, ethics-related, education, research, and consultation functions. The participants reported to have high performance in both direct and indirect occupational therapy services. Performance in the direct occupational therapy services functions was higher than the performance in the indirect occupational therapy services. Minimal performance in occupational therapy leadership functions was reported for consultation, ethics related, and research functions which need to be addressed by in-service training. The indirect occupational therapy services enabled the participants in the study to perform on a more optimum level regarding the direct occupational therapy services. The occupational therapy leaders had many empowering factors in their work place such as subordinates, supervisors, and top management. Conclusion: The 57 leadership functions identified in the study culminated in an occupational therapy leadership functions framework (OTLFF) which represents the managerial activities of the occupational therapy leaders in the PAWC. These study findings are useful guidelines for occupational therapy professionals and students as guidelines for leadership training, participant facilities to compile job descriptions, and educational facilities to set educational curricula. Recommendations: The study had many shortcomings; therefore, generalisation of results can't be done. The researcher recommends replication of the study using a larger and more representative sample.

Thesis (MScPhysio)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: Muscle weakness is a problem for many young people with spastic cerebral palsy (CP). Many studies have reported that selective strength-training programs can improve muscle strength. However, most of these studies are of single group design and do not adequately control for confounding variables. Objective: To determine the impact of a comprehensive strength training program targeting multiple muscle groups on adolescents with CP, using basic inexpensive free weights and resistance devices. Method: A randomised clinical trial evaluated the effects of an eight-week strength-training program on 31 independently ambulant adolescents with spastic CP, with or without walking aids, from Eros School (19 males, 12 females; mean age 16 years 1 month; range 13 - 18 years). The Kin-Com dynamometer, 3-D gait analysis, the Economy of Movement test and a questionnaire was used to evaluate selected muscle strength, the degree of crouch gait, free walking velocity and stride length, energy consumption during walking and perceptions of body image and functional competence. Twenty one subjects took part in the strength-training program and were compared with 10 control subjects. Results were analysed using repeated measures ANOVA and bootstrap analysis. Results: Compared with the control, significant improvement in the degree of crouch as measured by the sum of the ankle, knee and hip angles at midstance (p=0.05) and perceptions of body image (p=0.01) were noted for the experimental group. Significant trends were also noted for isometric knee extension muscle strength at 30° as well as for hip abduction at 10° and 20°. Walking efficiency, -velocity and stride length remained unchanged as well as perceptions of functional ability. Conclusion: A strength-training program targeting multiple muscle groups including upper and lower limbs as well as the trunk, can lead to changes in muscle strength and improve the degree of crouch gait with improved perception of body image. Successful participation in such a program at school may motivate children with CP to continue with home-based basic strength training. Strength training alone did not decrease oxygen consumption during walking and inclusion of aerobic exercise is recommended. / AFRIKAANSE OPSOMMING: Spierswakheid is 'n probleem vir baie jong mense met serebrale verlamming (SV). Navorsing het getoon dat selektiewe versterkende oefenprogramme selektiewe spiere kan versterk, maar die meeste studies bestaan uit 'n enkel groep met onvoldoende beheer oor verstrengelde veranderlikes. Doel: Om die impak van 'n omvattende versterkende oefenprogram met basiese, goedkoop gewigte en weerstandsaparaat wat vele spiergroepe teiken, op adolesente met spastiese SV te evalueer. Metodologie: Die effekte van 'n agt weke lang versterkende oefenprogram is op 31 onafhanklik mobiel adolesente met spastiese SV, met of sonder loophulpmiddel, van Eros Skool deur middel van 'n ewekansige kliniese proef geevalueer (19 manlike, 12 vroulike deelnemers; gemiddelde ouderdom 16 jaar 1 maand; omvang 13 - 18 jaar). Die Kin-Com dinamometer, "3-D gait analysis", die "Economy of Movement" toets en 'n vraelys is gebruik om geselekteerde spiersterkte, die hoeveelheid knie fleksie gesien in die onderste ledemaat tydens loop, loopspoed en treelengte, energieverbruik tydens loop asook persepsies van liggaamsbeeld en funksionelevermoë te evalueer. Een en twintig het in die versterkende oefenprogram deelgeneem en is met 10 kontrole deelnemers vergelyk. Resultate is met behulp van herhaalde metings "ANOVA" en "bootstrap analysis" geanaliseer. Resultate: In vergelyking met die kontrole groep, het die experimentele groep betekenisvolle verbetering getoon in die hoeveelheid fleksie gesien in die ondersteledemaat (p=0.05) soos bereken deur die som van die enkel-, knie- en heuphoek in midstaan fase tydens loop, asook in liggaamspersepsie (p=0.01). Beduidenisvolle tendense is ook gesien by die experimentele groep vir isometriese knie ekstensie spiersterkte by 30° asook vir heup abduksie by 10° en 20°. Energieverbruik tydens loop asook loopspoed en treelengte was onveranderd asook persepsie van funksionele vermoë. Gevolgtrekking: 'n Versterkende oefenprogram wat verskeie spiergroepe teiken, insluitende die onderste en boonste ledemate asook die romp, kan lei tot In verbetering in spiersterkte, minder fleksie in die onderste ledemate tydens loop asook 'n verbetering in ligaamspersepsie. Suksesvolle deelname aan so 'n program op skool, mag kinders dalk motiveer om In basiese versterkende oefenprogram tuis voort te sit. Versterkende oefening alleen het geen vermindering in suurstofverbruik tydens loop veroorsaak en die insluit van aerobiese oefening word aanbeveel.

Thesis (MOccTher)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: Despite the existence of many guidelines for rehabilitation services both internationally and in South Africa, there is a need for a uniform format for the measurement and reporting of outcomes reached by clients utilising these services. Traditionally, statistics on client numbers fail to report actual outcomes attained by clients. Aim: This aim of the study was to describe the outcomes achieved by clients after participating in rehabilitation at the Bishop Lavis Rehabilitation Centre (BLRC) over a three month period. It was done by describing clients’ function according to the World Health Organisation’s International Classification of Function (ICF) model, and included both the environmental and personal factors impacting on an individual’s function. Method: The study employed a descriptive design and used six measuring instruments which exceeded acceptable test-retest requirements to gather data from within the framework of the ICF Model. A field worker was trained to administer the majority of instruments which were pilot-tested for pre and post-test purposes. A sample of 78 clients who met the inclusion criteria was selected from the five main diagnostic categories seen at the BLRC. All clients were evaluated on referral, and again after receiving rehabilitation services for three months. An open-ended questionnaire was also administered as part of the post-test to obtain clients’ personal perspective on outcomes reached, as well as their subjective opinion of the rehabilitation experience. Data on the impact of various demographic and environmental factors on function was also gathered and statistically analysed in conjunction with the qualitative data obtained from the interviews in order to identify the rehabilitation outcomes achieved by the clients included in this study. Results: Clients reported a statistically significant decrease in the impact of disability on their function, with ‘mobility’ emerging as the aspect of function which improved the most after rehabilitation. The effect of most demographic and environmental factors investigated were perceived as facilitating rather than debilitating to rehabilitative outcomes, with ‘faith’ reported to be most facilitating and ‘monthly income’ the most debilitating of all factors. Subjectively, clients perceived their participation in rehabilitation to be a contributing factor to the improvement in their function, and generally expressed a positive attitude toward the rehabilitation experience. Recommendations based on the results of this study are presented to inform governing bodies involved in rehabilitation in South Africa. / AFRIKAANSE OPSOMMING: Ten spyte van die bestaan van veelvuldige riglyne vir rehabilitasie dienste, beide internasionaal en in Suid-Afrika, is daar steeds ‘n behoefte vir uniforme riglyne vir die meting en rapportering van die uitkomste wat kliënte bereik met deelname aan hierdie dienste. Tradisionele statistiek rakende kliëntegetalle rapporteer nie die werklike uitkomste wat kliënte bereik het nie. Doel: Die doel van die studie was om die uitkomste te beskryf wat kliënte bereik na hul deelname aan rehabilitasie by Bishop Lavis Rehabilitasiesentrum (BLRS) oor ‘n drie maande periode. Dit is gedoen deur kliënte se funksionering te beskryf volgens die Wêreld Gesondheidsorganisasie se Internasionale Klassifikasie van Funksie (IKF) model, insluitend beide die omgewings- en persoonlike faktore wat ‘n impak op ‘n individu se funksionering kon hê. Metode: Die studie het gebruik gemaak van ‘n beskrywende studiestruktuur. Dit het ses meetinstrumente gebruik wat beter as aanvaarbare vereistes vir toets-hertoets-betroubaarheid getoon het om data binne die raamwerk van die IKF-model in te samel. ‘n Veldwerker is opgelei vir die administrasie van die meerderheid van die meetinstrumente wat vir voor- en na-toets doeleindes in ‘n loodstudie getoets is. ‘n Steekproef van 78 kliënte wat aan die insluitingskriteria voldoen het, is geselekteer uit die vyf hoof diagnostiese groepe gesien by BLRS. Alle kliënte is geevalueer met verwysing en weer na hulle drie maande se rehabilitasie dienste ontvang het. Administrasie van ‘n oop-einde vraelys is ook as deel van na-toetsing gedoen om kliënte se persoonlike perspektief van die uitkomste wat hulle bereik het in te samel, sowel as hulle subjektiewe opinie van die rehabilitasieproses. Data oor die impak wat verskeie demografiese en omgewingsfaktore op funksionering kon hê is ingesamel, statisties ontleed en gebruik saam met die kwalitatiewe data wat met onderhoudsvoering ingesamel is om sodoende die rehabilitasieuitkomste te identifiseer wat behaal is deur kliënte wat ingesluit was in die studie. Resultate: Kliënte rapporteer ‘n statisties beduidende vermindering in die impak van gestremdheid op hulle funksionering, met ‘mobiliteit’ wat uitstaan as die area van funksionering wat die meeste verbeter het na rehabilitasie. Die effek van die meeste demografiese en omgewingsfaktore wat ondersoek was, is as fassiliterend eerder as inhiberend tot rehabilitasieuitkomste ervaar, met ‘geloof’ gerapporteer as die mees fassiliterende en ‘maandelikse inkomste’ as die die mees inhiberende faktor. Op 'n subjektiewe vlak het kliënte hul deelname aan rehabilitasie as ‘n bydraende faktor tot hul verbetering in funksionering ervaar, en het hulle oor die algemeen ‘n positiewe houding teenoor rehabilitasie gerapporteer.

Thesis (MOccTher)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Prior to the commencement of this study, an abundance of information on the topic of autism spectrum disorders and its symptoms, its prevalence and the effect on the family’s psychosocial- and emotional wellbeing were available. However, studies to describe the impact of a child with autism spectrum disorder on the occupations of families were limited, especially within the South-African context, and the researcher could find no information describing the impact of such a child specifically relating to the daily occupations of their mothers. This qualitative study used a phenomenological approach to explore how mothers with children on the spectrum of autism experience the impact of the child on their own daily occupations, and the meaning they derive from these experiences. Purposive sampling was used in selecting eleven mothers whose children attended therapeutic and medical follow up at one of the tertiary public hospitals in the Western Cape. In-depth semi-structured interviews following an interview guideline were conducted with each of the participants. The interviews were audio taped, and thereafter transcribed verbatim. A process of open coding was used to analyze the transcribed interviews. The findings emerging from the data-analysis process, uncovered three themes, namely ‘mothering as an identity’, mothering as an occupation’, and ‘making sense and moving forward’. These themes emphasized the immense changes the mothers had to face with regards to their occupational engagement, as well as on a personal level due their children’s diagnosis of autism spectrum disorder. It also brought to light the factors influencing the experiences and actions of mothers, shaping their mothering identities, as well as their needs and barriers in terms of successful participation in their everyday occupations. The study reported on the occupational risk factors these mothers face, as well as the enabling elements with regards to successful and meaningful occupational engagement. Occupational therapists working with children should be especially conscious of the inseparable relationship between the occupations of the child they are treating, and the occupations of the primary caregiver when implementing therapy programs. Only through ensuring the successful and meaningful participation in occupations of both the mother and the child, the occupational therapist will be able to improve the health and well-being in the one or the other. Careful selection and collaborative goal setting when planning therapy programs are therefore essential. / AFRIKAANSE OPSOMMING: Verskeie studies het in die verlede rapporteer oor die diagnose, simptome en prevalensie van outisme spektrum steurnisse. Studies wat die impak van hierdie toestand op die emosionele en psigo-sosiale welstand van families ondersoek het, was ook volop. Beperkte inligting, veral binne die Suid-Afrikaanse konteks, was egter beskikbaar om die impak van ‘n kind op die spektrum van outisme op families se deelname in alledaagse aktiwiteite te ondersoek. Met die aanvang van hierdie studie, kon die navorser geen inligting vind wat spesifiek na die impak van ‘n kind met outisme op hulle moeder se deelname in alledaagse aktiwiteite ondersoek ingestel het nie. Hierdie kwalitatiewe studie het gebruik gemaak van ‘n phenomelogiese benadering om die ervarings van moeders, met ‘n kind op die spektrum van outisme, te ondersoek rakende die impak van hierdie kind op die deelname van hulle eie alledaagse aktiwiteite, asook die betekenis wat die moeders aan hierdie ervarings kon heg. Doelgerigte steekproeftrekking is gebruik in die seleksie van elf moeders wie se kinders terapeuties en medies opgevolg word by ‘n tersiêre publieke hospital in die Wes-Kaap. In-diepte, semi-gestruktureerde onderhoude is gevoer met elk van die deelnemers aan die hand van ‘n onderhoud riglyn. Die onderhoude is op band opgeneem, waarna dit verbatim getranskribeer is. ‘n Proses van oop kodering is gebruik om die getranskribeerde onderhoude te analiseer. Die resultate wat verkry is gedurende die data-analise proses, het die volgende temas uitgelig, naamlik ‘moederskap as indentiteit’, ‘moederskap as beroep’, en ‘om sin maak en aan te beweeg’. Hierdie temas het die geweldige veranderinge vir die moeders in terme van deelname aan hulle alledaagse aktiwiteite, sowel as op persoonlike vlak, beklemtoon. Die faktore wat die deelnemers se ervarings en aksies, en dus hulle identiteit as moeders beïnvloed het, was ook geïdentifiseer. Die resultate het ook die struikelblokke en behoeftes van hierdie moeders in terme van suksesvolle deelname aan hulle alledaagse aktiwiteite, aangedui. Die studie het die risiko faktore, sowel as die elemente wat benodig word vir suksesvolle deelname aan alledaagse aktiwiteite, uitgelig. Arbeidsterapeute werksaam in die veld van pediatrie, behoort bewus te wees van die onafskeidbare verhouding tussen die deelname aan alledaagse aktiwiteite van die kind wat hulle behandel, en dié van die primêre versorger. Slegs wanneer suksesvolle deelname aan aktiwiteite deur beide die kind én die moeder verseker word, kan die welstand en gesondheid in die een of die ander bevorder word. Die seleksie van terapie doelwitte in samewerking met die familie en primêre versorger, is dus kardinaal.

Thesis (MOccTher)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: As a South African occupational therapist (OT) trained to provide occupational therapy using a sensory integration approach (OT/SI), to children and their families, I have personal experience of different parent perceptions and experiences regarding OT/SI as a treatment approach to improving their children’s occupational performance. This made me question the various factors that may influence a parent’s perceptions and experiences, and how these factors may ultimately influence the outcome of OT/SI intervention for the child and family. Additionally, I wanted to know what OT/SI intervention was like for parents of a child with difficulties processing and integrating sensory information and what changes should be made to ensure we are meeting both child and parents’ needs. To date, no research exists regarding parents’ perceptions and experiences of OT/SI intervention in South Africa. Despite this, OT/SI intervention is widely used among South African paediatric occupational therapists. This study focused on the lived experience of OT/SI intervention for parents in the Western Cape, South Africa. The purpose of this study was to explore and describe South African parents’ perceptions and experiences of OT/SI intervention received. This study not only sought to explore whether parents thought OT/SI intervention was valuable or not, but also to understand the meaning, the broader context and the process by which parent’s opinions had come into being, and how these may have influenced the meaning ascribed to the intervention. The study sample consisted of nine parents, including mothers and a father, of children with difficulties processing and integrating sensory information, who lived in various regions of the Western Cape, South Africa. Purposive sampling was used to select participants in this study. Using a qualitative, phenomenological approach, data was collected during face=to=face interviews, participant observation and researcher’s field notes. Four themes that pertain to the aims of the study were revealed during the analysis. They included: “It was tough because we didn’t understand”, “Just suddenly everything made so much sense”, “Mobilized my child into the world”, and “OT/SI intervention facilitators proposed by participants”. These themes describe the progression of the participant’s perceptions and experiences before OT/SI intervention, during intervention, and after having received the intervention, as well as the recommendations they proposed to facilitate OT/SI intervention in South Africa. I found that factors such as poor awareness and understanding of OT/SI intervention amongst the participants negatively influenced their understanding of their child’s occupational performance, their role as parents and their social performance as a family in various social contexts. Key points of transformation were identified during the ‘input phase’ of OT/SI intervention, which either facilitated or created a barrier in the participants’ shift to the ‘after phase’ of OT/SI intervention. Despite the barriers, all participants perceived and experienced a shift to the ‘after phase’ of OT/SI intervention. For some participants, this shift included changes they perceived in their child, which influenced social performance of the child and family. However, for the majority of participants, this shift meant a number of factors: a better understanding and expectations of their child; changes in their child’s abilities, activities and self=worth; changes in themselves as parents and how this influenced their parent=child relationship; as well as changes in their child’s and family’s social performance in various contexts. Insight gained from the participants’ recommendations and my interpretation of findings, allowed recommendations to be made in an attempt to overcome the barriers and promote the facilitators that will make a difference to OT/SI intervention in South Africa. Recommendations were made within two contexts: the broader social context of South Africa and the context of OT/SI intervention received by children and their parents. / AFRIKAANSE OPSOMMING: As ‘n Suid=Afrikaanse arbeidsterapeut (AT), opgelei om arbeidsterapie met ‘n sensoriese integrasie benadering (AT=SI) te verskaf aan kinders en hul families, het ek persoonlike ondervinding van verskeie ouers se persepsies en ervarings omtrent AT=SI as ‘n behandelingsbenadering om die kind se arbeidsprestasie te bevorder. Dit het my laat wonder watter faktore die ouer se persepsies en ervarings sou beïnvloed, asook hoe hierdie faktore die uitkoms van die AT=SI behandeling vir die kind en die familie sou beïnvloed. Ek wou ook uitvind hoe die ouer van ‘n kind met SIA (SID), AT=SI intervensie beleef het en watter veranderinge behoort aangebring te word om te verseker dat beide die kind en die ouers se behoeftes nagekom word. Tot dusver bestaan daar geen navorsing aangaande die ouer se persepsies en ervarings van AT=SI intervensie in Suid=Afrika nie. Ten spyte hiervan word AT=SI alom gebruik deur pediatriese arbeidsterapeute in Suid=Afrika. Hierdie studie fokus dus op ouers se persoonlike ervaring van AT= SI intervensie in die Wes=Kaap, Suid=Afrika. Die doel van hierdie studie was om die persepsies en ervarings van Suid=Afrikaanse ouers wat AT= SI intervensie ontvang het, te ondersoek. Hierdie studie het nie net gepoog om vas te stel of die ouers gedink het dat AT=SI waardevol was aldan nie, maar ook om die betekenis, die breër konteks, en die proses waardeur hul opinies gevorm is en hoe dit hulle beïnvloed het, te verstaan. Die steekproef het bestaan uit nege ouers, insluitend moeders en ‘n vader, van kinders met SIA (SID), woonagtig in verskillende streke in die Wes=Kaap, Suid=Afrika. ‘n Doelgerigte steekproef is gebruik om die deelnemers vir die studie te kies. ‘n Kwalitatiewe=fenomenologiese benadering is gebruik om data in te samel deur aangesig=tot=aangesig onderhoude, waarneming van deelnemers, asook die navorser se veldnotas. Vier temas wat direk verwant was aan die doelwitte van die studie, is tydens die analise van die data geïdentifiseer. Dit het die volgende ingesluit: “Dit was moeilik want ons het nie verstaan nie”, “Ewe skielik het alles so baie sin gemaak”, “My kind in die wêreld gemobiliseer ”, “AT=SI intervensie fasiliteerders voorgestel deur die deelnemers”. Hierdie temas beskryf die vordering van die deelnemers se persepsies en ervarings voor die aanvang van AT=SI intervensie, gedurende die intervensie en ook nadat intervensie voltooi is, asook die aanbevelings wat hulle gemaak het om AT=SI intervensie in Suid=Afrika te fasiliteer. Ek het bevind dat faktore soos deelnemers se swak bewustheid en begrip van AT=SI intervensie, hul begrip van hul kind se arbeidsprestasie, hul rol as ouers en hul sosiale optrede as ‘n familie in verskeie sosiale kontekste, negatief beïnvloed het. Kernpunte van verandering is geïdentifiseer gedurende die ‘inset=fase’ van die AT=SI intervensie, wat die deelnemers se vordering na die ‘na= fase’ van AT=SI intervensie òf gefasiliteer het, òf bemoeilik het. Ten spyte van die struikelblokke het alle deelnemers ‘n skuif na die ‘na=fase’ van AT=SI intervensie waargeneem en ervaar. Vir sommige deelnemers was hierdie skuif die veranderde optrede wat hulle in hul kind waargeneem het, wat die kind en familie se sosiale gedrag verander het. Vir die meerderheid deelnemers het hierdie skuif egter ‘n aantal faktore ingesluit: ‘n beter begrip en verwagting van hulle kind; veranderinge in hulle kind se vermoëns, aktiwiteite en eiewaarde; veranderinge in hulself as ouers en hoe dit hul ouer=kind verhouding beïnvloed het; asook veranderinge in die kind en familie se sosiale gedrag in verskeie kontekste. Die deelnemers se voorstelle en my interpretasie van die bevindinge het my in staat gestel om voorstelle te maak om die struikelblokke te probeer oorkom en die fasiliteerders aan te moedig wat die verskil gaan maak in AT=SI intervensie in Suid=Afrika. Aanbevelings is gemaak vir twee areas: die wyer sosiale konteks van Suid=Afrika, asook die konteks van die AT=SI intervensie wat ontvang word deur kinders en hulle ouers.

Thesis (MOccTher)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Play is widely acknowledged as a cornerstone of childhood development. Its significance stretches beyond developing cognitive abilities and school readiness to the development of social skills, emotional expression and well-being. The milieu, or environment, is recognized as highly influential with regards to occupational performance; the play environment is therefore also of great importance to child development. However, there is a lack of knowledge regarding the assessment of this play environment, especially in a developing country context. This study therefore focuses on the play environment at South African crèches, specifically with regards to assessing the environmental factors impacting children’s play, namely play space, play objects, play time and play mates (including caregivers). The National Guidelines of ECD Services in South Africa had already set standards relating to play space, play time and caregiver ratio’s at crèches. Criteria for play objects were established as part of this study through an extensive literature review. These criteria were then applied in a quantitative, cross-sectional descriptive survey at registered crèches in Macassar, a community in the Cape Flats outside Cape Town. The survey results indicated that crèches complied to play space and play time regulations, but that not all crèches complied with the regulations regarding caregiver-child ratio’s and play object adequacy. The crèches especially lacked in gross motor play objects. These findings emphasize the importance of establishing practical criteria and guidelines for all aspects of the play environment and enforcing those standards at day care crèches. The study also provides a useful framework for measuring the adequacy of the play environment at South African crèches. / AFRIKAANSE OPSOMMING: Spel is ‘n belangrike hoeksteen in kinderontwikkeling en het ‘n noemenswaardige impak op kognitiewe ontwikkeling, skoolgereedheid, die ontwikkeling van sosiale vaardighede, uitdrukking van emosies en algemene welstand. Die milieu, of omgewing, word wyd aangeslaan vir die invloed wat dit op arbeidsverrigting uitoefen en die spelomgewing is daarom belangrik. Daar is egter ‘n tekort in kennis aangaande die spel omgewing, veral in die konteks van ‘n ontwikkelende land soos Suid-Afrika. Hierdie studie bestudeer dus die spel omgewing in Suid-Afrikaanse dagsorgsentrums. Speel-spasie, speeltyd, speelgoed en speel-maats vorm saam die omgewingsfaktore wat op die spel omgewing impakteer en die studie fokus dus op hierdie vier faktore. Die Nasionale Riglyne vir Voorskoolse Kinder Ontwikkeling in Suid Afrika het reeds standaarde gestel ten opsigte van die vewagte fisiese spasie, speeltyd en die getal kinders tot versorgers (versorger-kind verhouding) by Suid Afrikaanse dagsorg sentrums. Kriteria wat meet of daar voldoende speelgoed beskikbaar is vir kinders se optimale ontwikkeling is na aanleiding van ‘n literatuurstudie ontwikkel. Hierdie kriteria, tesame met die kriteria wat deur die Nasionale Riglyne gestel is, is gebruik om die spelomgewing by dagsorg-sentrums in die Macassar gemeenskap op die Kaapse Vlaktes net buite Kaapstad te meet d.m.v ‘n beskrywende opname. Volgens die sensus resultate voldoen die dagsorgsentrums wel aan kriteria ten opsigte van fisiese spasie en beplande speeltyd, maar ontbreek hulle ten opsigte van die versorger-kind verhouding. Die resultate dui ook aan dat al die dagsorg-sentrums nie voldoende speelgoed gehad het om die volle spektrum van kinderontwikkeling te dek nie. Hulle het veral ontbreek in speelgoed vir grof-motoriese spel. Die studie beklemtoon die belang van praktiese en spesifieke riglyne en standaarde sowel as die implementering van hierdie standaarde. Die studie verskaf ook ‘n raamwerk wat gebruik kan word in die assesering van die spel omgewing in ‘n ontwikkelende konteks, sowel as om toekomstige intervensies te lei.

Thesis (MOccTher (Interdisciplinary Health Sciences. Occupational Therapy))--University of Stellenbosch, 2005. / According to the Occupational Therapy Practice Framework (2002), the objective of occupational therapy is to help people to participate in activities of daily life which are purposeful and meaningful to them and in which they are expected to participate. According to educators, learners are increasingly experiencing problems with performing academic tasks, and learning barriers, especially with regard to visual perception, are on the increase. Various external factors, such as educational policy pertaining to inclusive education and a younger age for school admission, as well as internal factors, such as learning readiness, may contribute to the occurence of learning barriers that can restrict the academic progress of learners. Learners are increasingly being referred to occupational therapists. Occupational therapists also provide guidance to learner supporters. Occupational therapists refer learners with visual perception problems with possible eye tracking problems for vision therapy, after which occupational therapy is resumed. Meanwhile, learners still have to function in the school environment, which means that incorrect capturing of information processing can take place. According to literature, the promotion of eye movements is regarded as part of occupational therapy services in the USA. In South Africa the proposed model by Fishman-Hellerstein and Fishman (1999: 148) of cooperation between optometrists and occupational therapists is followed. In this approach eye movements are regarded as underlying building blocks of visual perception and the effect of eye movements on the academic performance of learners is clearly described (Green, 2001). There is a shortcoming in the literature where eye movements are promoted as integral to a visual perception programme. Occupational therapy needs to investigate effective methods of intervention that are time and cost effective in order to address the growing problem, especially in South Africa. A clinical experimental field trial with a convenience sample was used to investigate the effect of occulomotor exercises in combination with a visual perception programme on the visual perception of seven-year-old learners with visual perception problems. The study population was seven-year-old learners with visual perception learning barriers from neighbouring schools with foundation phase education. Inclusion and exclusion criteria were applied. Sifting procedures included questionnaires to parents and educators, “Beery-Buktenica Developmental Test of Visual-Motor Integration” 4th edition of Beery (1997) for visio-motor integration, and a screening test by an optometrist. A visual perception programme was presented to the control groups and the experimental groups over ten sessions. An eye exercise of 15 minutes was included with the experimental groups. The Developmental Test of Visual Perception, 2nd edition, by Hammill, Pearson and Voress (1993) was used as measuring instrument in the pre-test and post-test to determine effectiveness, which was statistically indicated by using the repeated measures ANOVA. The results indicated no significant difference between the visual perception programme with eye exercises and the one without. Two tests of the sub-ability of visual perception showed a tendency towards improvement. The educators indicated that the learners benefited functionally from the programme and that it made a difference in academic performance. Behaviour and emotional events may have influenced the results of the study because of external factors. It is recommended that the study be repeated with a larger sample and a longer programme presented over six months to a year. Occupational therapists can include eye exercises integral to activity participation by adapting activities and through the optimal use of space for activities so that the learner would have to adapt to it visually.

Thesis (MOccTher)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The retention and throughput rates of postgraduate students are a national and an international concern. There is a tendency for postgraduate students, irrespective of which Master of Occupational Therapy programme they are registered for, to have difficulty in completing the thesis or research assignment, resulting in delayed throughput or non-completion. This study aimed to understand and describe from the postgraduate student’s perspective, what factors facilitated or hindered the completion of the Master of Occupational Therapy programmes. Qualitative research using a phenomenological design was used in order to obtain a rich description of the students’ lived experiences in the M-programmes so as to gain insight into their experiences. Purposive sampling was used and data was generated by means of in-depth, one-to-one interviews. The findings have shown that numerous factors in various combinations at different points in time during the study period shaped the experience of the mature, female, part-time postgraduate student. Participants were intrinsically motivated to engage in studies as they desired the growth in their professional knowledge and skills. The experience of supervision varied depending on how the student and supervisor were matched and on the student’s expectations and needs of the relationship. The development of critical thinking and writing skills required effort and time, which influenced the postgraduate student’s motivation, retention and throughput rate. Within the work environment very little negotiation for study opportunity was possible. Although this negotiation was far more likely within the home and with family, household and family responsibilities persisted over the long study period of two or more years. This study has shown that the main hindrances to the completion of studies are the lack of time and the demands of the multiple roles that the mature, female part-time postgraduate student has to contend with. / AFRIKAANSE OPSOMMING: Die volharding en deurvloeikoers van nagraadse studente is nasionaal sowel as internasionaal ‘n bekommernis. Daar is ‘n tendens vir nagraadse studente om te sukkel met die voltooing van die tesis of navorsingsopdrag, afgesien van die Meester in Arbeidsterpie program waarvoor hulle gerigestreer is. Die doel van hierdie studie was om vanuit die nagraadse student se perspektief, die faktore wat die voltooing van die Meester van Arbeidsterapie programme fasiliteer of verhinder te verstaan en beskryf,. Kwalitatiewe navorsing met ‘n fenomenologiese navorsingsontwerp is gebruik om ‘n ryk verduideliking van die student se ervaringe van die M-programme te bekom om sodoende insig in hul ervarings te kry. Daar is van ‘n doelgerigte steekproef gebruik gemaak en data is gegenereer deur middel van in-diepte een-tot-een onderhoude. Die bevindinge het getoon dat verskeie faktore in verskillende kombinasies op verkillende tye gedurende die studie-periode die ervaring van die deelnemers as volwasse, vroulike, deeltydse nagraadse studente bepaal het. Nagraadse studente was intrinsiek gemotiveerd om te studeer omdat hulle wou groei ten opsigte van hul professionele kennis en vaardighede. Hul ervaring van studieleiding is bepaal deur hoe gepas die studieleier vir die betrokke student was en ook van die student se verwagtinge en behoeftes van die studieleier-student verhouding. Die ontwikkeling van kritiese denke en skryfvaardighede het inspanning en tyd vereis, wat die nagraadse student se motivering, volharding en deurvloeikoers beïnvloed het. Min onderhandeling vir studie-geleenthede was moontlik binne die werksomgewing. Alhoewel hierdie onderhandeling meer moontlik binne die huis- en familie omgewing was, het huishoudelike en familie verantwoordelikhede steeds voortgegaan oor die lang studie tydperk van twee of meer jare. Hierdie studie het bevind dat die grootste hindernisse vir die voltooiing van studies die tekort aan tyd en die eise van die meervoudige rolle waarmee die volwasse, vroulike deeltydse student worstel is.