This research describes the development of communicative intention of young children with cochlear implants in order to study the relationship between the early communicative intention of these children and their later verbal communication. Five children under the age of three years with cochlear implants were selected from the records of the University of Stellenbosch, Tygerberg Academic Hospital’s Cochlear Implant Unit, Cape Town as subjects. Video recordings of each of the five subjects in unstructured free play interaction with their caregivers, before cochlear implantation and each six months after cochlear implantation over a period of two years were used to identify the development of their communicative intention. The Communicative Intention Inventory (Coggins&Carpenter, 1981) was used to classify the communicative behaviour of the subjects according to the types of communication functions that were used, as well as the way in which they expressed the functions of communication. Results of the study show that the development course of the functions of communication that the subjects used over a two-year period, were consistent with the development patterns found in younger children with normal hearing. There was however marked individual differences between the subjects during the transition from nonverbal to dominantly verbal ways of communication as far as the rate of development of verbal communication was concerned. A strong relationship was found among the five subjects regarding the use of the nonverbal communication functions, request for object or action and protest before cochlear implantation and their total verbal communication two years after cochlear implantation, which could account for these individual differences in the rate of verbal communication development after cochlear implantation. Indications for clinical application and future research were identified on the basis of these conclusions. The data collected during the research is seen as meaningful in clinical decision-making regarding the suitability of young children under the age of three years with a profound hearing loss for cochlear implantation and their therapeutic management. / Dissertation (M (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / Unrestricted

Die hoofdoelstelling van die navorsing was om die ontwikkelende sosialisering van adolessente met ernstige gehoorverlies met hul normaalhorende portuur te begryp en te beskryf. Die navorsingsvraag was, Hoe ontwikkel die adolessent met ernstige gehoorverlies sosiale verhoudings met sy/haar normaal horende portuurgroep? ‘n Ondersoek na vier adolessente met ernstige gehoorverlies is gedoen, om hul interaksiesituasie met hul horende portuurgroep beter te begryp. Die studie het ‘n meervoudige gevallestudie-ontwerp gevolg vanuit die postmoderne interpretiwistiese perspektief. Bronfenbrenner se bio-ekologiese sisteemteorie is benut as die teoretiese basis vir die studie, ten einde die totale konteks van die adolessent met gehoorverlies te begryp. Die deelnemers is volgens die maksimum variasiebeginsel gekies en die data is met behulp van kwalitatiewe metodes, naamlik observasies en onderhoude, ingesamel. Die analiseproses het uit gerigte tematiese analise en analitiese vergelyking bestaan. Die resultate het getoon dat interaksie tussen adolessente met gehoorverlies en hul normaal horende portuur suksesvol kan geskied, maar dat dit met bepaalde hindernisse (soos oningeligtheid en onsekerheid omtrent die gehoorverlies) gepaard gaan en van beide partye word aanpassings geverg. Individuele bates van die adolessent met gehoorverlies moet ook benut word en uitgebou word om die minder sterk punte te ondersteun. Die adolessent met gehoorverlies se spraak (artikulasie) en spraakleesvermoë is van kernbelang ten einde deur die horende gemeenskap verstaan te word, asook om hulle te verstaan. Gereelde deurlopende blootstelling aan die horende gemeenskap wat deur die ouers gefasiliteer word, blyk die sleutel te wees tot suksesvolle interaksie en integrasie in die breë gemeenskap. ENGLISH ABSTRACT: The main purpose of the study was to understand and describe the developing socialization of adolescents with severe hearing loss with their normally hearing peers. The central research question was, How does the adolescent with severe hearing loss develop social relationships with his/her normally hearing peers? The research was conducted with four adolescents with severe hearing loss, better to understand their interactive situation with their normally hearing peers. The research took the form of a multiple case study design, conducted from the postmodern interpretive perspective. Bronfenbrenner’s bio-ecological systems theory formed the theoretical basis of the study, to understand the full context of the adolescent with hearing loss. Participants were selected in accordance with the maximum variation sampling principle. Data were collected by qualitative methods, namely observations and interviews. The data analysis consisted of focussed thematic analysis and analytical comparison. The results showed that interaction between adolescents with hearing loss and their normally hearing peers can be successful, but it is accompanied by certain challenges such as a lack of information and uncertainty about the hearing loss and adaptations are required from both parties. The individual assets of die adolescent with hearing loss should be utilised and developed to support the weaker characteristics. The speech- and speech reading skills of the adolescent with hearing loss are of the utmost importance to be understood by the hearing community as well as to understand them. Continual exposure to the hearing community, facilitated by the parents, appears to be key to the successful interaction and integration into the broader community. / Dissertation (MEd)--University of Pretoria, 2008. / Educational Psychology / unrestricted

Current research in the field of geriatric audiology focuses on the audiological assessment and management. However there is a lack of published work describing the perspectives of the geriatric individuals with a hearing loss regarding the audiological service delivery received. This study aimed to determine the perspectives of the geriatric individuals with a hearing loss in this regard. Convenience sampling was utilised to recruit 50 geriatric individuals who wore hearing aids, in Gauteng. A two phase methodology was employed in this study. Phase one included a questionnaire aimed to determine the geriatric individuals’ perspectives of the audiological assessment and management processes conducted by the audiologist. Phase two, a focus group discussion regarding audiological service delivery, included 7 geriatric individuals who were randomly selected from the 50 geriatric individuals in phase one of the study. Results revealed that geriatric individuals with a hearing loss; perceived the audiological services received as adequate. However the results obtained from the questionnaire indicate that the majority of these geriatric individuals were not provided with a full test battery of assessment and management procedures as required. Therefore South African audiologists need to evaluate the assessment and management procedures used when working with the geriatric population. AFRIKAANS : Resente navorsing in die veld van geriatriese oudiologie fokus hoofsaaklik op oudiologiese evaluering en behandeling. Daar bestaan egter beperkte literatuur wat geriatriese individue met ‘n gehoorverlies se persepsies beskryf oor die proses van evaluering en dienslewering. Gevolglik was die doel van hierdie studie om geriatriese individue met ‘n gehoorverlies se persepsies aangaande oudiologiese dienste te bepaal. ‘n Twee-fase metodiek is in hierdie studie aangewend. ‘n Vraelys is in fase een gebruik om 50 geriatriese individue met ‘n gehoorverlies en wat gepas is met gehoorapparate, se persepsies aangaande oudiologiese dienslewering te bepaal. Sewe geriatriese individue het deelgeneem aan die tweede fase, naamlik ‘n fokusgroepbespreking aangaande oudiologiese dienslewering. Resultate dui daarop dat geriatriese individue met ‘n gehoorverlies die oudiologiese dienste wat hulle ontvang het as voldoende ervaar, Die meerderheid van die geriatriese individue het egter aangedui dat ’n.volledige oudiologiese toetsbattery nie tydens die evaluasieproses uitgevoer is nie en toepaslike gehoorapparaatevaluering- en passingsprosedures nie gevolg is nie. Die implikasies hiervan is dat oudioloë werksaam in Suid-Afrika die evaluering- en behandelingsprosedures wat toegepas word vir die geriatriese populasie, voortdurend moet evalueer en aanpas. Copyright / Dissertation (M. Communication Pathology)--University of Pretoria, 2009. / Speech-Language Pathology and Audiology / unrestricted

Any factor that interferes with a child’s ability to interact with the environment in a normal manner is a potential source of, or contributing factor to, the presence of a developmental delay (Rossetti, 2001). According to Bam (2001) the Human Immunodeficiency Virus (HIV) is considered as an established risk factor under the category of serious infections and does not only have a negative effect on the normal development of a child, but also leads to serious audiological complications (Bankaitis&Schountz, 1998). Heterogeneity of auditory manifestations in individuals with HIV/AIDS is a feature of this virus (Friedman&Noffsinger, 1998). When considering the wide spectrum of audiological problems associated with pediatric HIV/AIDS, the role of the audiologist in the treatment of these children are highlighted (Bankaitis, 1998). Effective treatment of this heterogeneous population can however only take place within a team of medical professionals as their complex needs require a wide spectrum of skills (McNeilly, 2000). In South Africa nursing personnel play an important role in the early identification of a hearing loss and other audiological abnormalities (Thathiah, 2001). Part of a nurse’s job involve the provision of services in hearing health care, therefore they can serve as assistants for the audiological profession (Thathiah, 2001). Although rehabilitation services in rural areas are limited, developmental disabilities can be prevented or minimized if it is identified early. Early identification of hearing losses and other audiological abnormalities associated with HIV/AIDS can however only take place if nursing personnel have the necessary knowledge and skills to address these problems efficiently. To thus provide optimal audiological services to children with HIV/AIDS nursing personnel must be able to function as a link between the audiologist and the community. In the light of the current government involvement with the provision of optimal health care service to people with HIV and Acquired Immune Deficiency Syndrome (AIDS), it is necessary to recognize and address the audiological needs of these individuals. The aim of this study was to determine the perception of nursing personnel, working in state hospitals in North West, regarding the audiological manifestations of HIV/AIDS in the pediatric population. A quantitive research design was employed in the form of a descriptive survey. The knowledge of 156 nursing personnel, working in fifteen different state hospitals in North West, was assessed through the use of a self-constructed questionnaire. This research concluded that the majority of the nursing personnel do not have sufficient knowledge regarding hearing health care and HIV/AIDS within the pediatric population. The assumption can thus be made that these children don’t get sufficient and effective intervention services and this will effect their development as well as quality of life negatively. Furthermore, respondents appeared not to have fully realized the importance of their role as health workers within the audiological context. The nursing personnel identified a need for information regarding the audiological manifestations of HIV/AIDS in the pediatric population and there appears to be a specific role for the audiologist in training the nurses regarding this above mentioned issue. This study emphasizes the importance of early identification and intervention of hearing disorders in children, especially children with HIV, within South Africa and indicates the need for further research with regards to this population. / Dissertation (MCommunication Pathology)--University of Pretoria, 2008. / Speech-Language Pathology and Audiology / unrestricted

This study focused on designing a training programme for audiometricians, using the principles of instructional design. Instructional design is the continuing, systematic development of instructional specifications, utilizing researched strategies and principles to create detailed outcomes for the development, implementation, evaluation and maintenance of training programmes. An audiometrician is defined by SANS (10083:2004), as a person registered with the Health Professions Council of South Africa as an audiometrician, hearing aid acoustician or someone trained in audiometry. Audiometricians are adult learners. Therefore, in addition to instructional design principles, the principles of adult learning were also incorporated in the training programme. The successful training of audiometricians may ensure that noise induced hearing loss is significantly reduced when audiometric monitoring is appropriately implemented as part of a hearing conservation programme. Training for audiometricians is critical in this process as incorrect audiometric monitoring may negatively influence the outcomes of a hearing conservation programme. This study followed a descriptive research design where the results were described in a quantitative manner. Data was collected by means of electronically mailed questionnaires. All participants were practicing audiometricians at the time of the study and were registered with the South African Society for Occupational Health Nursing. All participants had an audiometric certificate as qualification. For the analysis of data, 181 completed questionnaires were used. The results were analyzed and described in terms of the respondents’ own experience regarding audiometry; their opinions regarding the topics they have been taught in audiometry; the duration of their own training programmes and their opinions regarding a future training programme for audiometricians. Based on the results of the above analysis, the instructional design programme for audiometricians was developed. The obtained results were used to determine what the topics, content, duration, learning outcomes and learner evaluation methods should be in the development of a training programme for audiometricians. This research study developed a training programme for audiometricians in order to ensure that all future audiometricians have the necessary knowledge to perform comprehensive hearing evaluations, interpret audiometric findings and thereby assist in reducing noise induced hearing loss in the industrial sector through hearing conservation programmes. AFRIKAANS : Hierdie studie is toegespits op die ontwerp van ‘n onderrigprogram vir oudiometriste waarin die beginsels van onderrigontwerp toegepas is. Onderrigontwerp behels die deurlopende en stelselmatige ontwikkeling van onderrigspesifikasies deur gebruik te maak van nagevorsde strategieë en beginsels om gedetailleerde uitkomste vir die ontwikkeing, evaluering en onderhoud van opleidingsprogramme daar te stel. ‘n Oudiometris word gedefinieer deur wetgewing (SANS 10083:2004) as ‘n person wat geregistreer is by die Health Professions Council of South Africa as ‘n oudiometris, gehoorapparaat akoestikus of iemand wat opgelei is in oudiometrie. Oudiometriste is volwasse leerders. Om hierdie rede is nie net die beginsels van onderrigontwerp nie, maar ook die beginsels van volwasse leer in die onderrigprogram geïnkorporeer. Suksesvolle onderrig van oudiometriste kan verseker dat die voorkoms van geraas-geïnduseerde gehoorverlies verminder, mits oudiometriese monitering toepaslik as deel van ‘n program vir gehoorkonservering geïntegreer word. Opleiding vir oudiometriste is krities belangrik in hierdie proses want indien oudiometriese monitering verkeerd gedoen word, kan dit die gehoorkonserveringsprogram in totaliteit negatief beïnvloed. ‘n Beskrywende navorsingsontwerp is in hierdie studie gebruik en die resultate is kwantitatief beskryf. Data is deur middel van vraelyste wat elektronies versend is, versamel. Al die deelnemers was ten tye van die studie praktiserende oudiometriste wat by die South African Society for Occupational Health Nursing geregistreer was. Elkeen was in besit van ‘n oudiometriese sertifikaat as kwalfikasie. Vir data-ontleding is 181 voltooide vraelyste gebruik. Die data was geanaliseer en beskryf in terme van die respondente se eie ervaring ten opsigte van oudiometrie; hul mening omtrent die temas wat by hul opleiding ingesluit was; die duur van hul opleidingsprogramme en hul idees omtrent ‘n toekomstige opleidingsprogram vir oudiometriste. Die onderrigontwerp-program is op grond van die resultate van bognoemde analise ontwikkel. Die resultate wat verkry is, is gebruik om die temas, inhoud, duur, leeruitkomste en evalueringsmetodes in die ontwikkeling van ‘n opleidingsprogram vir oudiometriste te bepaal. Hierdie studie is gerig op die ontwikkeling van ‘n opleidingsprogram vir oudiometriste met die doel om te verseker dat hulle oor die nodige kennis beskik om omvattende gehoorevaluerings uit te voer, om oudiometriese bevindinge te interpreteer en daardeur, in gesondheidssorgprogramme, by te dra tot die vermindering van geraas-geïnduseerde gehoorverlies in die industriële sektor Copyright / Dissertation (MCommunication Pathology)--University of Pretoria, 2012. / Speech-Language Pathology and Audiology / unrestricted

Afrikaans text / Alhoewel daar al vorige navorsing oor die dowe of hardhorende kind gedoen is, handel dit meestal oor die vroee identifisering van die kind se gehoorverlies,sy/haar plasingsmoontlikhede, en kommunikasie,asook die hantering van die kind met gehoorverlies binne die skoolopset. Die meeste beskikbare literatuur wat handel oor riglyne by die hantering van die dowe of hardhorende kind binne die gesinsopset, is verouderd. Hierdie studie is 'n fenomenologiese navorsingstudie. Uit die semi-gestruktureerde onderhoude is verskeie temas geidentifiseer wat betrekking het op die hantering van die dowe of hardhorende kind in die gesin. Praktiese riglyne is vir ouers daargestel ten op sigte van die dowe of hardhorende kind se kommunikasie, gesinslewe,die skool, asook sy/haar emosionele en sosiale funksionering. / Although previous research has been done abouth the hard-hearing child, most of the available research concentrates on early identification of hearing lost, placement and communication as well as to cope with hearing loss within the school environment. The majority of the literature which is currently available concerning guidelines for the deaf or hard-hearing children within the family group, is outdated. A phenomenological study has been done. By means of semi-structured interviews practical guidelines have been collected. Several themes were identified in the course of these interviews, namely: communication by the child with hearing loss, the effect of the hearing loss on the family members, the impact of hearing loss in the school environment and the implications of hearing loss on the child's emotional and social functioning. Guidelines were suggested for the practical management of deaf and hard-hearing children concerning communication, family life, scool and emotional and social functioning. / Educational Studies / M. Ed. (Voorligting)

Afrikaans text / Alhoewel daar al vorige navorsing oor die dowe of hardhorende kind gedoen is, handel dit meestal oor die vroee identifisering van die kind se gehoorverlies,sy/haar plasingsmoontlikhede, en kommunikasie,asook die hantering van die kind met gehoorverlies binne die skoolopset. Die meeste beskikbare literatuur wat handel oor riglyne by die hantering van die dowe of hardhorende kind binne die gesinsopset, is verouderd. Hierdie studie is 'n fenomenologiese navorsingstudie. Uit die semi-gestruktureerde onderhoude is verskeie temas geidentifiseer wat betrekking het op die hantering van die dowe of hardhorende kind in die gesin. Praktiese riglyne is vir ouers daargestel ten op sigte van die dowe of hardhorende kind se kommunikasie, gesinslewe,die skool, asook sy/haar emosionele en sosiale funksionering. / Although previous research has been done abouth the hard-hearing child, most of the available research concentrates on early identification of hearing lost, placement and communication as well as to cope with hearing loss within the school environment. The majority of the literature which is currently available concerning guidelines for the deaf or hard-hearing children within the family group, is outdated. A phenomenological study has been done. By means of semi-structured interviews practical guidelines have been collected. Several themes were identified in the course of these interviews, namely: communication by the child with hearing loss, the effect of the hearing loss on the family members, the impact of hearing loss in the school environment and the implications of hearing loss on the child's emotional and social functioning. Guidelines were suggested for the practical management of deaf and hard-hearing children concerning communication, family life, scool and emotional and social functioning. / Educational Studies / M. Ed. (Voorligting)