Magister Artium - MA / Foetal Alcohol Spectrum Disorder (FASD) is a global problem that affects various communities. FASD denotes a pattern of abnormalities intermittently seen in children born to women who consume huge quantities of alcohol during pregnancy (Church & Kaltenbach, 1997). Church and Kaltenbach (1997) suggest that FAS may be one of the primary causes of hearing, speech and other language problems in children. The two main approaches used to determine the effects of FASD on language are standardised language test (using a statistical approach to test some or all four domains of language, namely, phonology, syntax, morphology and semantics) applied to close-ended questionnaire answers and, to some extent, narrative analysis (in the course of which researchers use wordless picture books to analyse narratives in order to determine the social-communicative characteristics of individuals with FASD). Although the use of standardized measures of language might be helpful to determine problematic areas in relation to the different language domains (Wyper & Rasmussen, 2011), they do not show the difficulty with social-communicative functions which these children might be facing (Coggins, Friet, & Morgan, 1998). On the other hand, while narrative analysis addresses an important level of language (discourse level), it does not foreground the inherently interactive nature of language use and the problems that may be associated with communicative interactions. These shortcomings, in turn, suggest possible limitations in the interventions intended to address the language needs of children with FASD. There is, therefore, a need for complementary approaches that offer a more rounded picture of language impairment in children with FASD. In this study, three approaches are used in identifying features of the speech of children with FASD against the backdrop of comparisons with features in the speech of normally developing children. Firstly, conversational analysis (applied to spontaneous, open-ended speech) is introduced as a means to determine the more social-interactive aspects of speech impairment in children with FASD. Secondly, measures of linguistic aspects of speech (the mean length of utterance, Index of Productive Syntax and the number of different word roots) designed specifically for spontaneous speech are employed (they are applied to the same spontaneous data as the conversational analysis data). Thirdly, the more traditional standardized language test measures applied to non-spontaneous speech are used (covering the four domains of syntax, phonology, semantics, and pragmatics). The study’s objectives are to (1) compare patterns in the interactive speech of FASD children and normally developing children; (2) explore the relationship between FASD children and normally developing children in relation to both spontaneous speech measures and standardized measures of language; and (3) compare the impact of the primary caregiver's level of education on testing through spontaneous measures versus standardised measures. Using data from 14 children in the Bellville suburb of Cape Town, South Africa, the study finds that, on the conversational analysis measures, children with FASD, in contrast to normally developing children, tend to obey fewer rules of turn-taking, to overlap less, to engage less in self-repair and to struggle with management and maintenance of topics. The study also finds that children whose scores on the standardized language tests (with non-spontaneous data) suggest they have no language difficulty, especially in terms of phonology, obtained scores in measures of spontaneous speech that indicated language difficulty. The study also found that the socio-economic status of caregivers was a credible explanation for certain features in the speech of children with FASD is very similar to features in the speech of normally developing children. This finding highlights the role of family setting in mitigating the effects of FASD. / National Research Foundation (NRF)

Thesis (MPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2010. / ENGLISH ABSTRACT: The study examines the implementation of an intervention aimed at stopping alcohol consumption during pregnancy in order to decrease Foetal Alcohol Spectrum Disorder (FASD) and how this affected changes in alcohol consumption. FASD is a growing concern in South Africa where the prevalence rate is almost 12/100 at some schools in the Western Cape; the highest reported FASD rate in the world. FASD is caused by alcohol consumption during pregnancy and it is an irreversible mental and physical disability in children. FASD is preventable through abstinence from alcohol consumption during pregnancy. The intervention study (referred to as the Ceres Intervention Study), utilised a cluster-randomised trial design, with a control and intervention group, where the control arm of the study received basic screening and information on FASD, while the intervention arm of the study received a more comprehensive intervention, consisting of a variety of screening and counselling techniques. The study took place during 2007/2008 in the Witzenberg sub-district in Ceres in the Western Cape Province of South Africa. The Study used research techniques combined with therapeutic methods and techniques to mediate behaviour change in pregnant women. From the Ceres Intervention Study it was found that 60% of pregnant women changed their drinking behaviour, which led to questions around how this behaviour change took place. The main aim of this study therefore is to examine how pregnant women changed their drinking behaviour during this intervention and also what facilitated the change that was observed. In order to examine the behaviour change, data from the intervention arm and control arm of the study was analysed and a profile of the women was developed. A focus on the intervention arm of the study resulted in distinguishing further between two sub-groups within the intervention arm, namely, the change and no-change groups. Mainly quantitative data was obtained with the use of various tools, however from the comments and experiences of participants, qualitative data could be used as complementary to quantitative data to provide more clarity as to how behaviour change was facilitated in the study. Results from the study suggest that there is a dialectical interplay between client and counsellor which facilitate generative mechanisms that may lead to behaviour change. / AFRIKAANSE OPSOMMING: Hierdie studie lig die implementering van 'n intervensie toe met die doel om die gebruik van alkohol gedurende swangerskap te stop teneinde Fetale Alkohol Spektrum Afwyking (FASD) te verminder en die gepaardgaande gedragsverandering by swanger vroue te ondersoek. FASD is 'n groeiende probleem in Suid-Afrika waar die voorkoms van FASD by 12/100 kinders by sommige skole in die Weskaap gerapporteer is. FASD word veroorsaak deur alkohol-gebruik tydens swangerskap en kan permanente verstandelike en fisiese gestremdheid by kinders veroorsaak. FASD kan voorkom word deur geen alkohol tydens swangerskap te gebruik nie. Die intervensie (of die Ceres Intervensie-studie) maak gebruik van 'n kliniese ontwerp met 'n kontrole en 'n intervensie groep, waar die kontrole arm van die studie basiese assessering asook inligting oor FASD ontvang het, terwyl die intervensie arm 'n meer omvattende intervensie bestaande uit 'n verskeidenheid assesserings sessies en beradingstegnieke ontvang het. Die studie is gedurende 2007/2008 in die Witzenberg sub-distrik in Ceres in die Weskaap, Suid-Afrika, geïmplementeer. Die studie maak gebruik van navorsingstegnieke gekombineer met wetenskaplik gebaseerde intervensie metodes en tegnieke om gedragsverandering by swanger vroue te onderhandel. In die Ceres Intervensie-studie is bevind dat 60% van die swanger vroue hul alkohol-gebruik gedrag verander het. Dit het aanleiding gegee tot vrae rondom hoe hierdie gedragsverandering plaasgevind het. Die hoofdoel van hierdie studie is dus om te kyk na hoe swanger vroue hul alkohol-gebruik verander het gedurende die intervensie asook wat hierdie verandering in gedrag moontlik gemaak het. Om hierdie gedragsverandering te ondersoek is data van die intervensie arm en kontrole arm ontleed en is 'n profiel van die vroue saamgestel. Die fokus op die intervensie arm van die studie het aanleiding gegee tot die verdere onderskeiding tussen twee sub-groepe binne die intervensie arm, naamlik, die groep wat verander het en die groep wat nie verander het nie. Kwantitatiewe data is hoofsaaklik ingesamel, alhoewel kwalitatiewe data wat verkry is uit opmerkings en ondervindings van deelnemers as aanvullende inligting tot die kwantitatiewe data gebruik is teneinde die gedragsverandering wat plaasgevind het toe te lig. Bevindinge uit die studie dui op 'n dialektiese verhouding tussen klient en berader wat skeppende meganismes teweeg bring en sodoende moontlike gedragsverandering bevorder.