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Clinical Questions: What top-down and bottom-up interventions across the psychology, audiology, educational, and speech language pathology domains are most effective for children and adolescents with Central Auditory Processing Disorder (CAPD)? What considerations for planning research and intervention might be offered to a classroom teacher to further support students diagnosed with CAPD, especially in relation to the Multi-Tiered System of Supports (MTSS), formerly known as Response to Intervention (RTI)? Method: Inter-Disciplinary Literature Review Study Sources: PsycInfo, Linguistics and Language Behavior Abstracts, ProQuest, International Journal of Audiology, American-Speech-Language Hearing Association, Journal of Neurotherapy, Medline-Esbcohost, ERIC Ebscohost, Professional Development Collection Education, and What Works Clearinghouse Number of Included Studies: 16 Age Range: 2-13 years Primary Results: 1) Phonological awareness training was the primary reading educational construct found among the included interventions in this literature review. 2) Most CAPD studies employed a combination of both bottom-up and top-down treatments in intervention. This finding may possibly indicate that in order for a CAPD intervention to be even more beneficial to the student, both bottom-up and top-down treatments should be considered and incorporated in relation to the student's individualized needs. Conclusions: Results confirmed very little research and few intervention implications on CAPD students within the educational research discipline, including special education. Search results primarily included methods to improve listening in the classroom environment, but did not specifically mention intervention in relation to CAPD and its implications. Results also confirmed that a multi-disciplinary effort is needed to provide clinical decision and effective intervention for the CAPD population.

The low physical activity (PA) levels of children have become a national public health concern in South Africa. Moreover, the quality of Physical Education (PE) in South African schools has been compromised by challenges resulting from the subject’s reintroduction after a long absence from the school curriculum. Up to date no study has investigated the effects of a quality PE programme, within the prescriptions of the South African Curriculum and Assessment Policy Statement (CAPS), on the PA and fitness levels of twelve to thirteen years old South African children. Furthermore, no PA measuring instrument exists that has been validated specifically for South African children of this age group, with which to conduct such a study. The objectives of this study were therefore, firstly, to validate a standardised PA questionnaire for Grade 7 learners in a South African context; secondly, to evaluate the effects of an enhanced quality PE programme presented by well-trained teachers, on the PA levels, and thirdly on the physical and motor fitness of Grade 7 learners in Potchefstroom, South Africa. For the first objective, 108 schoolchildren aged twelve to thirteen years (boys, n=45; girls, n=63) from two primary schools in Potchefstroom participated in this study to validate the Children’s Leisure Activities Study Survey (CLASS) for children in a South African context. Test-retest reliability of the questionnaire was examined with an interval of 3 weeks, while validity was assessed by comparing measurements of the reported minutes in PAs from questionnaire responses with ten physical fitness parameters using the Eurofit test battery. Data analysis included Cronbach’s alpha coefficients, paired t-test and intra-class correlation coefficients (ICC), and Spearman correlation coefficients (r). The results showed substantial internal consistency and significant intra-class correlations estimates for all intensities of PA and sedentary time (ST). Non-significant differences were found in the means of test and retest measurements. Aerobic fitness was significantly correlated with all intensities of PA and ST, and the results of several of the other fitness tests had significant associations with vigorous PA. For the fulfillment of the second and the third objectives, 110 Grade 7 learners (experimental school, n = 40; control schools, n = 70) were studied. The twelve-week PE intervention programme was presented according to the prescriptions of the CAPS which allocates one hour per week to PE, but included 5 quality-enhancing components namely well-trained teachers, homework activities, a reward system, improvised apparatus and the monitoring of activity intensity. Data was collected by means of the validated CLASS questionnaire, anthropometric measurements as well as physical and motor fitness tests, by means of the Eurofit test battery. Data analysis included Kruskal-Wallis and Wilcoxon signed-rank tests, a series of analyses of covariance (ANCOVA), Tukey’s post hoc analysis, and interpreting effect sizes for practical significance. The results showed practically and statistically significant increases in moderate PA, vigorous PA, and total PA as well as decreases in sedentary behaviours. Furthermore, the learners’ data on physical and motor fitness levels showed statistically significant improvements among most of the experimental groups with regard to six of the ten fitness parameters. Based on these results, it can be concluded that the enhanced quality PE programme is effective in improving the PA, physical and motor fitness levels of South African primary school children. Therefore it is recommended that PE programmes in South Africa include the quality-enhancing components used in this intervention programme. Moreover, the modified CLASS questionnaire is a valid and reliable measure of PA among South African Grade 7 schoolchildren. / PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2015

The low physical activity (PA) levels of children have become a national public health concern in South Africa. Moreover, the quality of Physical Education (PE) in South African schools has been compromised by challenges resulting from the subject’s reintroduction after a long absence from the school curriculum. Up to date no study has investigated the effects of a quality PE programme, within the prescriptions of the South African Curriculum and Assessment Policy Statement (CAPS), on the PA and fitness levels of twelve to thirteen years old South African children. Furthermore, no PA measuring instrument exists that has been validated specifically for South African children of this age group, with which to conduct such a study. The objectives of this study were therefore, firstly, to validate a standardised PA questionnaire for Grade 7 learners in a South African context; secondly, to evaluate the effects of an enhanced quality PE programme presented by well-trained teachers, on the PA levels, and thirdly on the physical and motor fitness of Grade 7 learners in Potchefstroom, South Africa. For the first objective, 108 schoolchildren aged twelve to thirteen years (boys, n=45; girls, n=63) from two primary schools in Potchefstroom participated in this study to validate the Children’s Leisure Activities Study Survey (CLASS) for children in a South African context. Test-retest reliability of the questionnaire was examined with an interval of 3 weeks, while validity was assessed by comparing measurements of the reported minutes in PAs from questionnaire responses with ten physical fitness parameters using the Eurofit test battery. Data analysis included Cronbach’s alpha coefficients, paired t-test and intra-class correlation coefficients (ICC), and Spearman correlation coefficients (r). The results showed substantial internal consistency and significant intra-class correlations estimates for all intensities of PA and sedentary time (ST). Non-significant differences were found in the means of test and retest measurements. Aerobic fitness was significantly correlated with all intensities of PA and ST, and the results of several of the other fitness tests had significant associations with vigorous PA. For the fulfillment of the second and the third objectives, 110 Grade 7 learners (experimental school, n = 40; control schools, n = 70) were studied. The twelve-week PE intervention programme was presented according to the prescriptions of the CAPS which allocates one hour per week to PE, but included 5 quality-enhancing components namely well-trained teachers, homework activities, a reward system, improvised apparatus and the monitoring of activity intensity. Data was collected by means of the validated CLASS questionnaire, anthropometric measurements as well as physical and motor fitness tests, by means of the Eurofit test battery. Data analysis included Kruskal-Wallis and Wilcoxon signed-rank tests, a series of analyses of covariance (ANCOVA), Tukey’s post hoc analysis, and interpreting effect sizes for practical significance. The results showed practically and statistically significant increases in moderate PA, vigorous PA, and total PA as well as decreases in sedentary behaviours. Furthermore, the learners’ data on physical and motor fitness levels showed statistically significant improvements among most of the experimental groups with regard to six of the ten fitness parameters. Based on these results, it can be concluded that the enhanced quality PE programme is effective in improving the PA, physical and motor fitness levels of South African primary school children. Therefore it is recommended that PE programmes in South Africa include the quality-enhancing components used in this intervention programme. Moreover, the modified CLASS questionnaire is a valid and reliable measure of PA among South African Grade 7 schoolchildren. / PhD (Human Movement Science), North-West University, Potchefstroom Campus, 2015

Background: South Africa is a multicultural, multi-ethnic developing country currently experiencing a unique quadruple burden of disease, of which malnutrition (both over- and under nutrition) is one of them. The increase in childhood obesity within the current South-African health setting is of serious concern, approximately 14% boys and 18% girls currently are overweight and it is estimated that this number will increase to 25% within the next decade. Healthy eating habits and increased physical activity are important components of a healthy lifestyle, and decrease the risk of overweight and obesity. It is also often the corner stone of many lifestyle modification intervention programmes aimed at preventing or decreasing overweight/obesity. Aim: This sub-study was part of a larger intervention study where a nutrition education intervention programme (NEIP) for children in the form of a musical play (based on the South African Food Based Dietary Guidelines [SAFBDG]) was developed to increase nutrition knowledge and thereby also contribute towards healthy lifestyle behaviour. The aim of this sub-study was therefore to explore and describe the attitude of a specific group of primary school children (aged 6-12 years) towards healthy eating, unhealthy eating, and physical activity before and after a NEIP as well as the standard school curriculum. Secondly, it was aimed to identify possible barriers to and motivators for healthy eating, unhealthy eating and physical activity. Methods: Children were randomly selected from the experimental group (n=143) of the main study. Children were selected into one of four focus groups per school (6 children per focus group) from which qualitative data were gathered on children’s attitude and perception towards healthy eating, unhealthy eating, and physical activity. Focus groups were defined by age and gender (boys and girls seperately, grades I-III and grades IVVI seperately), totalling a number of 96 children. A total of 75 children completed this sub-study, 21 children dropped out due to school-related problems or after school activities that clashed with the time slots during which the NEIP was implimented. Quantitative data was gathered with a socio-demographic and physical activity questionnaire, as well as a 3-point hedonic facial expression scale which was used to quantify attitude towards healthy eating, unhealhty eating and physical activity. All data (quantitative and qualitative) were collected at both baseline and end measurements. Results: The main findings of this sub-study were that the attitude of most primary school children towards healthy eating, unhealthy eating or physical activity remained unchanged after a unique NEIP. Five major themes were identified out of focus group discussions namely health awareness, healthy eating, unhealthy eating, physical activity, and consequences of unhealthy eating and sedentary behaviour. Mothers were identified as the main motivator for eating healthy and avoiding unhealthy eating. The taste and smell of food were both either identified as motivators or barriers for healthy eating and unhealthy eating. Older girls associate unhealthy eating with becoming fat while many children associate the combination of unhealthy eating and being sedentary with becoming fat. Most children have a positive attitude towards physical activity and enjoy doing it although the biggest motivator for partaking in physical activity is their parents and not themselves. Conclusion: Even though some children’s attitude did change in the desired direction after the implementation of a unique and fun NEIP, most children’s attitude towards healthy eating, unhealthy eating and physical activity remained unchanged. This might have been due to the measurement tool that was not sensitive enough to detect subtle changes. Various factors that can influence children’s attitude and perceptions towards healthy eating, unhealthy eating and physical activity both positively or negatively were identified. This study is one of only a few that explored and described the ‘true’ motivators of and barriers for children’s attitude towards healthy eating, unhealthy eating and physical activity. Results generated from this sub-study can thus make a valuable contribution to the existing literature available in this specific study field. / Thesis (MSc (Dietetics))--North-West University, Potchefstroom Campus, 2012

The diploma thesis addresses the issue of special education interventions in individuals suffering from specific behavioral disorders. Its theoretical part describes behavioral disorders in general, it explains what specific behavioral disorders are, and deals with their diagnostics and classification. Furthermore, it describes possibilities of interventions with individuals with specific behavioral disorders. It is focused on art therapy as on one of the techniques used in special education interventions. In its empirical part, the thesis treats the problem of the application of art therapy in the Educational care center environment with a client suffering from a specific behavioral disorder. The practical part of the thesis was implemented by means of qualitative research methods, specifically using a case study.

Background: South Africa is a multicultural, multi-ethnic developing country currently experiencing a unique quadruple burden of disease, of which malnutrition (both over- and under nutrition) is one of them. The increase in childhood obesity within the current South-African health setting is of serious concern, approximately 14% boys and 18% girls currently are overweight and it is estimated that this number will increase to 25% within the next decade. Healthy eating habits and increased physical activity are important components of a healthy lifestyle, and decrease the risk of overweight and obesity. It is also often the corner stone of many lifestyle modification intervention programmes aimed at preventing or decreasing overweight/obesity. Aim: This sub-study was part of a larger intervention study where a nutrition education intervention programme (NEIP) for children in the form of a musical play (based on the South African Food Based Dietary Guidelines [SAFBDG]) was developed to increase nutrition knowledge and thereby also contribute towards healthy lifestyle behaviour. The aim of this sub-study was therefore to explore and describe the attitude of a specific group of primary school children (aged 6-12 years) towards healthy eating, unhealthy eating, and physical activity before and after a NEIP as well as the standard school curriculum. Secondly, it was aimed to identify possible barriers to and motivators for healthy eating, unhealthy eating and physical activity. Methods: Children were randomly selected from the experimental group (n=143) of the main study. Children were selected into one of four focus groups per school (6 children per focus group) from which qualitative data were gathered on children’s attitude and perception towards healthy eating, unhealthy eating, and physical activity. Focus groups were defined by age and gender (boys and girls seperately, grades I-III and grades IVVI seperately), totalling a number of 96 children. A total of 75 children completed this sub-study, 21 children dropped out due to school-related problems or after school activities that clashed with the time slots during which the NEIP was implimented. Quantitative data was gathered with a socio-demographic and physical activity questionnaire, as well as a 3-point hedonic facial expression scale which was used to quantify attitude towards healthy eating, unhealhty eating and physical activity. All data (quantitative and qualitative) were collected at both baseline and end measurements. Results: The main findings of this sub-study were that the attitude of most primary school children towards healthy eating, unhealthy eating or physical activity remained unchanged after a unique NEIP. Five major themes were identified out of focus group discussions namely health awareness, healthy eating, unhealthy eating, physical activity, and consequences of unhealthy eating and sedentary behaviour. Mothers were identified as the main motivator for eating healthy and avoiding unhealthy eating. The taste and smell of food were both either identified as motivators or barriers for healthy eating and unhealthy eating. Older girls associate unhealthy eating with becoming fat while many children associate the combination of unhealthy eating and being sedentary with becoming fat. Most children have a positive attitude towards physical activity and enjoy doing it although the biggest motivator for partaking in physical activity is their parents and not themselves. Conclusion: Even though some children’s attitude did change in the desired direction after the implementation of a unique and fun NEIP, most children’s attitude towards healthy eating, unhealthy eating and physical activity remained unchanged. This might have been due to the measurement tool that was not sensitive enough to detect subtle changes. Various factors that can influence children’s attitude and perceptions towards healthy eating, unhealthy eating and physical activity both positively or negatively were identified. This study is one of only a few that explored and described the ‘true’ motivators of and barriers for children’s attitude towards healthy eating, unhealthy eating and physical activity. Results generated from this sub-study can thus make a valuable contribution to the existing literature available in this specific study field. / Thesis (MSc (Dietetics))--North-West University, Potchefstroom Campus, 2012

The current exploratory study, as part of the Massachusetts Farm Fresh (MAFF) research project: 1) examined the effect sensory attributes (i.e. taste profile, color, shape, texture, growth pattern) of the target vegetables have on children’s willingness to explore and consumption and 2) compared these outcomes for: facilitator-guided (FG), vs. children’s self-guided (SG) exploration. We conducted a 6-week multi-sensory nutrition education intervention with Western Massachusetts Head Start preschoolers (3-5 years of age; n=94 children) using eight vegetable pairs; outcome measures were recorded by observers. Data were analyzed using SPSS version 20.0. Results are reported for 50 children with complete data at both baseline and follow-up. Willingness improved from baseline (40-50% of children = SCORE O) to follow-up (20-40% = SCORE 0) for all vegetables. Willingness scores (1) increased for “lower-sugar” vegetables (broccoli, cauliflower, green bean, radish) (p=.013) (2) were lower for white vegetables (cauliflower, parsnip) versus the other color categories (red, green, orange) and (3) were higher for both pod (sugar snap peas, green beans) and long-root (carrot, parsnip) versus root vegetables (beet, radish). Pre-post mean (SE) consumption (g) increased for carrots (p=.013) (2.45+/-.39 vs 3.49+/-.43) and radishes (p=.023) ( .90+/-.22; vs 1.45+/-.29) ). At follow-up consumption of ”higher-sugar” vegetables was greater (p=.000) and carrot-parsnip pair was higher than broccoli-cauliflower (mean difference 1.49+/-.51) (p=.005) and beet-radish1.01+/-.55) (p=.071) pairs. Overall, children’s willingness and consumption varied by sensory attributes of the vegetables. The multi-sensory approach successfully activated children’s senses while providing exposure to a variety of local vegetables in the Head Start setting.

The purpose of this project was to evaluate the effectiveness of an educational lifestyle modification (LM) intervention on blood pressure (BP) among adults with prehypertension. Prehypertension is a precursor to hypertension (HTN) and is a public epidemic in the United States. Approximately 68 million (31%) U.S. adult’s aged ≥18 years have hypertension. Hypertension can cause significant target organ damage, lead to coronary heart disease, heart failure, stroke, and kidney failure. Early identification and the primary treatment of persons with prehypertension with LM have the potential to minimize the progression and delay the onset of comorbidities associated with hypertension. This quality improvement project retrospectively reviewed changes in blood pressure for a small sample (n=5) of patients diagnosed with prehypertension who received education about modifying lifestyle behaviors according to nationally accepted clinical practice guidelines. Blood pressure measurements were extracted from the medical record beginning at the time of the education through a three month period. Descriptive data indicates that all five patients had a decrease in systolic and diastolic blood pressure. The median systolic blood pressure at baseline was 129 mmHg decreasing to 121 mmHg at end of study period. The median diastolic blood pressure was 86 mmHg decreasing to 76 mmHg. Integration of lifestyle modification education and subsequent blood pressure monitoring during a routine primary care visit is feasible and may help motivate patients to implement changes and subsequently reduce blood pressure. Future studies should include identifying strategies for improving patient participation.