South Africa has the highest prevalence of Foetal Alcohol Spectrum Disorders (FASD) worldwide. Despite the high prevalence of FASD in children and the resulting need for services, appropriate identification and management of most genetic and congenital disorders are critically lacking in South Africa. As a result of the established risk for communication delay from birth, young children with FASD need early communication intervention (ECI). There appears to be a dearth in research on the communication difficulties of local young children with FASD. Determining comprehensive communication profiles of young children may serve to emphasize their need for ECI. The main aim of the study was to present the distinctive communication profiles of a group of young children with FASD. The sub-aims entailed the description of their developmental histories, family/care-giving contexts, communication functioning and identifying developmental trends across the participants. A collective case study design following a quantitative approach was selected. The study was cross-sectional and descriptive statistics was used to describe the participants’ communication skills. A purposive sampling procedure was utilized as a limited number of participants could be found with a diagnosis of FASD. Five participants diagnosed with FASD, living in the Gauteng area, between the ages of 4 to 58 months took part in the study. The empirical study comprised of two phases. Phase 1 entailed the development of the Interview Schedule, the Assessment Protocol and the conduction of a pilot study. Phase 2 comprised the data collection, analysis and interpretation of results. The results of the study indicated that all five participants presented with incomplete case histories obtained from the foster parents and general developmental delays. According to the Four-Level Early Communication Assessment Framework the greatest delays included all aspects of communication skills. A developmental trend of the combined communication profiles of the participants indicated an increase in delay with an increase in chronological age. The participants presented with complex multiple neuro-developmental needs to be viewed within a developmental systems and ecological framework. Based on the results of this study the diverse roles of the speech-language therapist working with young children with FASD and their families were identified. A framework for interdisciplinary service delivery to this population was suggested. The study succeeded in the attempt to provide a comprehensive, in-depth description of a group of the five participants’ unique communication skills. In addition the study also highlighted the shortage of services, e.g. limited early identification and services dedicated to families affected by alcohol related problems. The study is of value to the speech-language therapist in the clinical and research domain. Future research is recommended to expand and support the findings. AFRIKAANS : Suid-Afrika vertoon die hoogste prevalensie van Fetale Alkohol Spektrumafwykings (FAS) wêreldwyd. Ten spyte van die hoë prevalensie van FAS in kinders en die voortspruitende behoefte aan dienste, is toepaslike identifikasie en hantering van die meeste genetiese en kongenitale afwykings in Suid-Afrika krities ontoereikend. As ‘n resultaat van die bevestigde risiko vir kommunikasie agterstand vanaf geboorte, benodig jong kinders met FAS vroëe kommunikasie intervensie (VKI). Daar blyk ‘n gaping in die navorsing aangaande die kommunikasie probleme van plaaslike jong kinders met FAS te wees. Omvattende kommunikasie profiele van jong kinders met FAS kan die behoefte aan VKI dienste beklemtoon. Die hoofdoel van die studie was om die kommunikasie profiele van ‘n groep jong kinders met FAS voor te lê. Die sub-doelwitte het die beskrywing van hulle ontwikkelings geskiedenis, gesin/sorggewer konteks, kommunikasie funksionering en die identifisering van ontwikkelings neigings in al die deelnemers behels. ‘n Saamgestelde gevallestudie is geselekteer volgens ‘n kwantitatiewe navorsings benadering. Die studie is ‘n kruisdeursnee ontwerp en beskrywende statistieke is gebruik om die deelnemers se kommunikasie vaardighede te beskryf. ‘n Doelgerigte steekproef prosedure is gebruik omdat ‘n beperkte aantal deelnemers met ‘n diagnose van FAS gevind kon word. Die vyf deelnemers wat geselekteer was vir die steekproef was gediagnoseer met FAS, woonagtig in die Gauteng area en het binne die 0 – 5 jaar ouderdomsgroep geval. Die empiriese studie het uit twee fases bestaan. Fase 1 het die ontwikkeling van die onderhoud skedule, die assesserings protokol en die uitvoering van ‘n loodsstudie ingesluit. Fase 2 het die data insameling, analise en interpretasie van resultate behels. Die resultate van die studie het aangedui dat al die deelnemers gepresenteer het met onvolledige gevalsgeskiedenisse wat van hul pleegouers verkry is en ‘n algemene ontwikkelings agterstand. Volgens die Vier-Vlak Vroëe Kommunikasie Assesserings Raamwerk het die grootste agterstande alle aspekte van kommunikasie vaardighede behels. ‘n Ontwikkelings neiging vanuit die gekombineerde kommunikasie profiele van die deelnemers het ‘n toename in agterstand met ‘n toename in kronologiese ouderdom aangedui. Die deelnemers presenteer met veelvuldige neuro-ontwikkelings behoeftes wat binne die ontwikkelings sisteem en ekologiese raamwerk beskou moet word. Gebasseer op die resultate is die diverse rolle van die spraak-taalterapeut wat met jong kinders met FAS en hulle families werk, geïdentifiseer. ‘n Raamwerk vir interdissiplinêre dienslewering aan hierdie populasie word voorgestel. Die studie het geslaag in die poging om ‘n omvattende, in-diepte beskrywing van die deelnemers se unieke kommunikasie vaardighede te verskaf. Addisioneel het die studie ook die tekort aan dienste, naamlik beperkte vroëe identifikasie en dienste toegewy aan families geaffekteer deur alkohol verwante probleme, uitgelig. Die studie is van waarde vir die spraak-taalterapeut in die kliniese en navorsings domein. Toekomstige navorsing vir die uitbreiding en ondersteuning van die studie se bevindinge word aanbeveel. / Dissertation (MCommunication Pathology)--University of Pretoria, 2011. / Speech-Language Pathology and Audiology / Unrestricted

Thesis (MEdPsych (Educational Psychology))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Fetal Alcohol Spectrum Disorder, which is the most common cause of mental and learning disabilities in the world, is totally preventable. Fetal Alcohol Spectrum Disorder is not a genetic or inherited condition; however, it is permanent and reduces human potential. There is no cure or treatment. Fetal Alcohol Spectrum Disorder does not distinguish between race, class or culture and can affect children from all socio-economic groups. It is however more prevalent amongst poor, uneducated, uninformed and marginalised (minority groups) or aboriginal communities due to a variety of historical, sociopolitical and economic reasons. Fetal Alcohol Spectrum Disorder has become a public health problem in South Africa in provinces like the Western and Northern Cape (winegrowing areas), where substantial research has been conducted and where alcohol abuse can be traced back to the ‘dop’ system. The highest documented prevalence of Fetal Alcohol Spectrum Disorder in the world has been identified in these provinces amongst a marginalised group of people classified in South Africa as ‘coloured’. A substantial amount of research has been conducted on the characteristics, manifestation and prevalence of Fetal Alcohol Spectrum Disorder in South Africa, but no research has yet been done to ascertain educators’ knowledge of and attitude to learners with Fetal Alcohol Spectrum Disorder. In view of the high prevalence of Fetal Alcohol Spectrum Disorder in South Africa, and the possibility that many of the learners with learning and behavioural problems in our schools could be victims of Fetal Alcohol Spectrum Disorder (also known as a ‘hidden disability’) I concentrated my research on schools situated in low socio-economic areas on the Cape Flats where poverty and unemployment are high and shebeens are plentiful. Through this research I firstly wished to establish how much knowledge educators have of Fetal Alcohol Spectrum Disorder and what their attitudes are toward learners manifesting the disorder. Secondly, my aim was to ascertain to what extent educators are able to support and identify these learners. Qualitative research methods and an interpretive constructivist paradigm were used to conduct the study. Data was primarily collected through the use of interviews, focus group discussions, observations and a research journal. Nine participants, from three different low socio-economic schools (one from each educational phase) on the Cape Flats, were involved. Themes that emerged from the data were analysed and recorded through the constant comparative method. They are discussed together with the research findings. This study revealed important issues pertaining to educators’ knowledge of Fetal Alcohol Spectrum Disorder and whether they are able to assist learners presenting with this disorder in mainstream education in South Africa. A number of recommendations are made for further research in this field. / AFRIKAANSE OPSOMMING: Fetale Alkohol Spektrumsindroom, wat as die algemeenste oorsaak van verstandelike en leergestremdhede in die wêreld beskou word, is ʼn sindroom wat voorkom kan word. Die sindroom is nie geneties of oorerflik nie, maar die skade is permanent omdat daar geen behandeling en teenmiddel is nie. Dit het gevolglik ʼn negatiewe impak op menslike vermoëns. Fetale Alkohol Spektrumsindroom kan kinders van alle sosioekonomiese groepe affekteer en alhoewel dit nie kultuur-, ras- of klasgebonde is nie, is dit oorwegend ʼn algemene verskynsel onder groepe met ʼn lae opvoedingspeil, diegene wat oningelig en gemarginaliseer is (minderheidsgroepe) of dié wat as inboorlinggemeenskappe bekend staan, wat toegeskryf kan word aan verskeie historiese, sosio-politieke en ekonomiese redes. Fetale Alkohol Spektrumsindroom is tans ʼn openbare gesondheidsprobleem in Suid-Afrika, veral in die wynstreke van die Wes- en Noord-Kaap. Omvattende navorsing is al in genoemde provinsies gedoen waar alkoholmisbruik ʼn lang aanloop het en verbind word met die dopstelsel. Die Wes-Kaap en Noord-Kaap is alombekend as provinsies met die hoogste voorkomsyfer van Fetale Alkohol Spektrumsindroom FASD in die wêreld, veral onder ʼn gemarginaliseerde groep mense wat as die kleurlinge’ bekend staan. Alhoewel omvattende navorsing oor die karaktereienskappe, manifestasies en voorkoms van Fetale Alkohol Spektrumsindroom in Suid-Afrika reeds gedoen is, kon geen navorsing gevind word wat die kennis van opvoeders en hul en houdings jeens leerders met Fetale Alkohol Spektrumsindroom probeer vasstel nie. As die hoë voorkoms van Fetale Alkohol Spektrumsindroom in ag geneem word, asook die moontlikheid dat baie leerders in ons skole leer- en gedragsprobleme manifesteer, kan daar waarskynlik slagoffers van Fetale Alkohol Spektrumsindroom wees en wie se gestremdhede dus ‘onsigbaar’ is. My navorsing fokus daarom hoofsaaklik op skole in die lae sosio-ekonomiese areas van die Kaapse Vlakte, waar armoede en werkloosheid hoogty vier en waar daar ʼn hoë voorkoms van onwettige drankwinkels (‘sjebiens’) is. My primêre doel met hierdie navorsing was om die kennis van onderwysers oor Fetale Alkohol Spektrumsindroom te bepaal en om die houding van opvoeders jeens leerders wat met kenmerke van hierdie sindroom vas te stel. Ek wou ook vasstel tot welke mate opvoeders bevoeg om is leerders met Fetale Alkohol Spektrumsindroom te identifiseer en te ondersteun. Kwalitatiewe navorsingsmetodes en ʼn interpretatiewe konstruktivistiese paradigma is in die studie gebruik. Data is primêr ingesamel met behulp van onderhoude, fokusgroep-besprekings, observasies en ʼn navorsingsjoernaal. Nege deelnemers verbonde aan drie verskillende skole met lae sosio-ekonomiese vlakke (een opvoeder van elke opvoedingsfase), op die Kaapse Vlakte was by die studie betrokke. Temas wat blootgelê is deur die data is ontleed en by wyse van die konstante vergelykende metode opgeneem. Hulle word saam met die navorsingsbevindings bespreek. Die navorsing toon belangrike aspekte van opvoeders se kennis van Fetale Alkohol Spektrumsindroom. Dit bevraagteken ook of hoofstroom-opvoeders in staat is om leerders met Fetale Alkohol Spektrumsindroom te ondersteun. Voortspruitend uit die bevindings word aanbevelings gemaak vir verdere ondersoeke op hierdie gebied.

No description available.

This institutional ethnography relies on observations, interviews, and textual analyses to explore the experiences of mothers and children who attend a women-centered agency in Vancouver, Canada where a hot lunch, child care in the emergency daycare, and participation in group activities are vital forms of support. Mothers who come to the centre have many concerns related to their need for safe housing, a sustainable income, adequate food, child care, and support. And like mothers anywhere, they have concerns about their children. While many of the children, the majority of them First Nations, have never had a diagnostic assessment for fetal alcohol syndrome (FAS) or for the relatively new umbrella category, ‘fetal alcohol spectrum disorder’ (FASD), a number of the mothers were concerned or even knew that their children had FAS. This thesis asks – how does it happen that mothers have come to know their children in this way? The study critically examines how FASD knowledge and practices actually work in the setting and what they accomplish. My analysis traces how ruling practices for constructing and managing ‘problem’ mothers and children coordinate work activities for identifying children deemed to be ‘at risk’ for FASD. In their efforts to help their children and improve their opportunities for a better life, mothers become willing participants in group activities where they learn how to attach the relevancies of the FASD discourse to their children’s bodies or behaviours. They also gain instruction which helps them to confess their responsibility for children’s problems. While maternal alcohol use as the cause of FASD is contested in literature and in some work sites it is, in this setting, taken as a fact. This study discovers how institutional work processes involving government, medicine, and education actually shape and re-write women’s and children’s experiences into forms of knowledge that make mothers and children institutionally actionable. It is only by exposing the relations of power organizing mothers’ work that it may be possible to re-direct attention to mothers’ and children’s embodied concerns and relieve mothers of the overwhelming responsibility for which they are held and hold themselves to be accountable. / Graduate

No description available.

Population-based administrative data (2009-2012) from several sources were used to compare the health status and access to health services between a cohort of children in care with developmental disabilities (DD) (n=1,212) and a matched comparison group of children in care without DD (n=2,424). The two study groups were compared on a number of measures, including total respiratory morbidity, prevalence of diabetes, mood and anxiety disorders, continuity of care, injury-related hospitalizations, hospital-based dental care, and total number of ambulatory physician visits. Children in care with DD were significantly more likely to have a history of mood and anxiety disorders, respiratory illnesses, diabetes, hospital-based dental care, and injury-related hospitalizations compared to the matched comparison group. Children in care with DD also had significantly higher number of physician visits than children in the matched comparison group. No significant difference between the two study groups was found for continuity of care. / October 2015