Risk is a crucial concept in healthcare communication. This is attested to by a large body of research on risk communication in psychology, sociology, and, more recently, discourse analysis. This previous research has primarily focused on how healthcare providers manage risk talk, whereas patients’ risk talk has received little attention. Where it has been researched, it has been presented in an oversimplified way, namely that the patients have been reported to perceive their risk in a simplified, ‘all-or-nothing manner’. Using theme-oriented discourse analysis (Roberts and Sarangi, 2005), this study challenges this simplified perception by examining patients’ risk talk in prenatal screening for Down syndrome. The data for this study comprises 14 video-recorded consultations collected in one prenatal hospital in Hong Kong. The particular focus of the study is on patients who have received a ‘positive’ result from the initial screening for Down syndrome that has put them in a high-risk group by increasing their probability of having a baby with Down syndrome. In these consultations patients are informed about further testing to confirm the diagnosis. To examine the patients’ risk talk, the transcripts of the interactions have been coded along the lines of structural, thematic and interactional maps (Roberts and Sarangi, 2005) to note down risk talk by patients, what is it concerned with and the interactional dynamics of how it is managed. The analysis suggests that patients’ risk talk concerns three types of risks, namely the “risk of occurrence” (that is the probability of having a child with Down Syndrome) the “risk of knowing” (that is dealing with the knowledge about having a child with Down Syndrome) and what has been referred to in this study as the “risk of not knowing” (that is not finding out about the condition due to the uncertainty surrounding the tests). In contrast to the findings in the previous studies, the patients in the data actively initiate risk talk by raising clarification questions and talking about their concerns. The analysis has revealed the differences in how different types of risk talk are constructed by the patients. These differences are discussed in regards to the phases of the consultation in which risk talk occurs and whether risk talk is aimed at eliciting further information or making a decision about pursuing further testing. The analysis has also noted that risk communication is a joint activity involving the patients and the healthcare providers. In addressing patients’ risk talk the healthcare providers in the data take on an indirect approach, thereby avoiding influencing the patients’ decision-making and managing the uncertainty surrounding prenatal screening. The analysis has also pointed out that the patients’ socioeconomic and cultural backgrounds have a crucial impact on how risk talk is constructed by the patients. / published_or_final_version / Linguistics / Master / Master of Philosophy

While obstructive sleep apnea among children with Down syndrome is very common, the pre-existing risk factors and its impact to neurodevelopment are not well known. The aims and objectives of this systematic review are to determine the prevalence of OSA among DS children and to identify the associated risk factors. 6 articles that met the inclusion criteria were retrieved after using PubMed and Google Scholar in literature searching. The prevalence of OSA has great variation among different countries but are relatively high, ranging from 57% to 79%. OSA was significant associated with obesity, age and tonsil size. It is also known to associate with behavioral problem in DS children and delay their neurodevelopment. Therefore, early treatment followed by appropriate modification in lifestyle and diet is crucial in managing OSA. / published_or_final_version / Public Health / Master / Master of Public Health

published_or_final_version / abstract / Physiology / Doctoral / Doctor of Philosophy

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In the present study, performance on a range of mathematical reasoning and number processing tasks was assessed across two syndrome groups for which numerical ability is under-researched: Fragile X syndrome and Down syndrome. Given the paucity of current research, it was unknown whether all aspects of arithmetic and number processing would be globally affected across groups or whether there would be syndrome specific proficiencies and deficiencies. Statistical analysis revealed that males with fragile X syndrome performed significantly worse on all tasks even when performance was compared to typically developing children of a similar developmental level. However, when performance was compared to children with Down syndrome differing profiles emerged, with greater weaknesses by the fragile X syndrome males on specific tasks requiring mental arithmetic and basic numeracy skills. The importance of using syndrome specific information in the assessment of math disabilities and the design of early educational interventions are discussed.

There has been a significant increase in the number of Down Syndrome (DS) births over the past 3 decades in South Africa. This means there are increasingly more mothers, children with DS and family members experiencing the stressors associated with the condition. However, the increase in DS births has led to the advancement of related medical and educational interventions, resulting in more families with a child with DS overcoming these stressors and discovering the positive aspects of having a child with DS. This study aimed to uncover these positive aspects by exploring the positive experiences of a sample of mothers of a child with DS, with the hope that the findings will help society to move away from its focus on the stressors of having a child with DS to instead concentrating on the many ways in which families can cope with these stressors. As part of the research process, face-to-face interviews were conducted as a qualitative approach to gain an in-depth understanding of this research topic. The interviews were all recorded by means of a tape recorder. There is only one hospital in the Western Cape Metropole area that specialises in this condition, and that hospital was consequently selected as the location for this research, since all mothers of children with DS are referred to this hospital. A purposive sampling method and the criterion sampling strategy were used for the selection of these five mothers with whom interviews were conducted in the hospital’s developmental clinic The main findings of the research include both the difficult and positive experiences of being a mother of a child with DS. Two of the major themes that arose in terms of the difficult experiences were: (1) having to make many adjustments to one’s life to accommodate unpredictable health implications, developmental delays, negative perceptions, and unprofessional conduct; and (2) the difficulty of dealing with emotions, emotions of: fear, aloneness, and grieving. The mothers’ positive experiences generally developed out of their attempts to find coping mechanisms for the above challenges, and these positives centre on support, resources, faith in God, accepting the condition, a positive attitude and bonding with their child with DS. The predominant finding in terms of participants’ own recommendations for new mothers of a child with DS was for them to learn to accept the condition. Other findings addressing ways of coping with the condition were as follows: persevering, being hopeful, taking it one day at a time, having awareness and understanding of the diagnosis, being around positive people, attending regular appointments, seeking out guidance and support for your child’s development, loving your child, enjoying your child, and being present in every moment. / Thesis (MSW (Forensic Practice))--North-West University, Potchefstroom Campus, 2013

There has been a significant increase in the number of Down Syndrome (DS) births over the past 3 decades in South Africa. This means there are increasingly more mothers, children with DS and family members experiencing the stressors associated with the condition. However, the increase in DS births has led to the advancement of related medical and educational interventions, resulting in more families with a child with DS overcoming these stressors and discovering the positive aspects of having a child with DS. This study aimed to uncover these positive aspects by exploring the positive experiences of a sample of mothers of a child with DS, with the hope that the findings will help society to move away from its focus on the stressors of having a child with DS to instead concentrating on the many ways in which families can cope with these stressors. As part of the research process, face-to-face interviews were conducted as a qualitative approach to gain an in-depth understanding of this research topic. The interviews were all recorded by means of a tape recorder. There is only one hospital in the Western Cape Metropole area that specialises in this condition, and that hospital was consequently selected as the location for this research, since all mothers of children with DS are referred to this hospital. A purposive sampling method and the criterion sampling strategy were used for the selection of these five mothers with whom interviews were conducted in the hospital’s developmental clinic The main findings of the research include both the difficult and positive experiences of being a mother of a child with DS. Two of the major themes that arose in terms of the difficult experiences were: (1) having to make many adjustments to one’s life to accommodate unpredictable health implications, developmental delays, negative perceptions, and unprofessional conduct; and (2) the difficulty of dealing with emotions, emotions of: fear, aloneness, and grieving. The mothers’ positive experiences generally developed out of their attempts to find coping mechanisms for the above challenges, and these positives centre on support, resources, faith in God, accepting the condition, a positive attitude and bonding with their child with DS. The predominant finding in terms of participants’ own recommendations for new mothers of a child with DS was for them to learn to accept the condition. Other findings addressing ways of coping with the condition were as follows: persevering, being hopeful, taking it one day at a time, having awareness and understanding of the diagnosis, being around positive people, attending regular appointments, seeking out guidance and support for your child’s development, loving your child, enjoying your child, and being present in every moment. / Thesis (MSW (Forensic Practice))--North-West University, Potchefstroom Campus, 2013

This study examines the effects of maternal teaching style on the developing problem-solving abilities of children with Down Syndrome. Mothers were divided into two groups of three each, mothers with positive expectations versus mothers with negative expectations. Mothers and children were videotaped while the mother taught the child to construct a small pyramid from 21 interlocking blocks and again when the child attempted the task independently. The tapes were coded and analyzed to examine maternal instructional style and subsequent independent child performance. Mothers who were considered to have positive expectations towards their children used appropriate scaffolding behaviors significantly more often than the mothers who were considered to have negative expectations towards their children. The children of mothers who were effective scaffolders were significantly more adept and independent problem-solvers than the children whose mothers were not effective scaffolders. The more contingent the mother's instructions were, the more independent and successful the child appeared. Scaffolding is discussed in terms of its benefits for instructing children with Down Syndrome.

Participants with Down syndrome (DS) as well as typically developing peers matched for mental and chronological age completed a 3-step movement sequence in response to visual (lights), verbal (spoken word), meaningful auditory (music), and non-meaningful auditory (tones) instructions. Results indicate that participants with DS demonstrated slower reaction time in the visual condition but were more consistent in their movement time and made fewer errors suggesting they adopted a strategy in which they traded speed for accuracy. Further, they were slowest, most variable, and made the most errors in the non-meaningful auditory condition indicating that the amount of meaning associated with the method of instruction is an important determinant of motor performance. These results support the assertion that motor performance for persons with DS is determined in part by the unique pattern of cerebral lateralization for this population while at the same time demonstrating the importance of task and stimulus familiarity.