Abstract A multiple opposition approach to phonological intervention is described as an alternative contrastive approach for the treatment of severe speech disorders in children. The development and theoretical constructs of this approach are presented within the context of a clinical case study. The multiple opposition approach is based on the premise that the systemic level of phonological organization is essential in the description and intervention of disordered sound systems. Phonological descriptions identify phoneme collapses, which are viewed as phonologic strategies developed by the child to accommodate a limited sound system relative to the full adult system of the ambient language. Intervention is then directed systemically across the child’s entire rule, or collapse, by using larger treatment sets of multiple oppositions rather than by one contrast at a time.

CLP is a complex condition and can have a far-reaching impact on an individual. Collaboration between the school-based SLP and the CLP team will ensure holistic treatment for the child. A paucity of literature exists regarding school-based SLP’s referrals to cleft palate teams. This research describes and explores the referral practices of school-based SLP’s to CLP teams.Learner Outcome(s): Participants will be able to identify and describe the best practices of school-based SLPs making referrals to cleft palate teams Participants will be able to list the potential barriers in providing services and referrals for children with CLP and VPD in school systems Participants will be able to describe the advantages of collaboration between school-based SLPs and CLP teams in the appropriate care of children with CLP and VPD

This study surveyed speech-language pathologists (SLPs) working in medical settings in the state of Florida in order to: (a) assess the availability of AAC devices, related materials, and services in acute, sub-acute, long-term care, and outpatient medical facilities, (b) examine barriers and supports in providing AAC services to patients with complex communication needs (CCN) in the aforementioned settings, and (c) determine perceived levels of AAC knowledge of health care practitioners. One of the study's major findings was that 97.59% of SLPs served at least one patient they identified as having CCNs, and 94.1% of respondents indicated that their patients could benefit from increased access to AAC devices and service delivery. A notable finding relating to the need for increased AAC-related communication partner instruction (CPI) is as follows: 97% and 100% of respondents indicated that increased CPI for medical practitioners/staff and family members, respectively, were important elements in order to ensure functional communication for individuals with AAC needs in the medical setting. Major barriers to providing AAC services related to device access (i.e., lack of AAC supports / devices, lack of funding for equipment, length of time of device funding). Other barriers were related to the nature of medical settings (i.e., frequently changing caseloads, limited time with patients) and demands of the job (i.e., lack of time to prepare AAC materials / devices). Supports to providing AAC services included low-tech AAC options and mobile technologies. In terms of practitioner knowledge, 57.6% of respondents rated themselves not at all or somewhat knowledgeable regarding AAC. Physicians, nurses, and other rehabilitation professionals were rated as less than knowledgeable by 95%, 97%, and 84.3% of participants, respectively. Overall, the findings of this study suggests there is a high prevalence of patients in medical settings with AAC needs, and some face unmet communication needs resulting from barriers related to the setting itself, lack of access to AAC devices and materials, and limited time spent on AAC service delivery.

No description available.

Thesis (MPhil (Rehabilitation))-- University of Stellenbosch, 2011. / ENGLISH ABSTRACT: The needs and rights of people with disabilities are often not adequately featured in national development strategies. Furthermore, their aspirations to participate in community activities are denied by socio-economic and cultural barriers in societies. Against this background, the aim of this study was to explore the involvement of people with disabilities in poverty-reduction strategies in Malawi. In particular, the study investigated the factors that promoted or hindered their participation in development strategies and showed how the contributions of people with disabilities were reflected in the Malawi Growth and Development Strategy (MGDS). This study could be a useful resource in bringing about an understanding of disability inclusion in the context of the MGDS in Malawi. The study was conducted in three main cities of Malawi, namely; Blantyre, Lilongwe and Mzuzu. Qualitative research methods were used employing an exploratory study design. Data was collected using two data collection methods, namely; key informant interviews and focus group discussions. A purposive sample of 15 people was selected to participate in key informant interviews. Using these key informants, a snowballing technique was used to identify 30 respondents that participated in three focus group discussions, each comprising 10 participants. Interviews were conducted until saturation point was reached and no new information was elicited. Interviews were tape-recorded and transcribed verbatim. A thematic content analysis was conducted following a systematic process of coding data and grouping codes into categories from which themes were generated. This study has shown that there was minimal participation of people with disabilities in consultation meetings of the MGDS formation process. Overall, the study found that people with disabilities have limited education and knowledge to effectively participate at policy-making level. The study also found that the process of including disability in all spheres of life is very slow because of societal stereotypes and negative attitudes towards disability. Although there are several disability legal frameworks, there is no Disability Act that is enforceable by law. Therefore, people with disabilities are not protected by law. This trend should be reversed to improve self-representation of people with disabilities throughout policy formation processes. / AFRIKAANSE OPSOMMING: Die behoeftes en regte van gestremde mense word dikwels nie voldoende ingesluit by nasionale ontwikkelingstrategieë nie. Meer nog, hierdie mense se strewe om deel te wees van aktiwiteite in die gemeenskap word deur sosio-ekonomiese en kulturele grense in gemeenskappe verhinder. In die lig hiervan is die doelwit van hierdie studie om die betrokkenheid van gestremde mense by armoedeverligtingstrategieë in Malawi te ondersoek. Dié studie fokus in die besonder op dié faktore wat gestremde mense se deelname aan ontwikkelingstrategieë bevorder of verhinder, en toon aan hoe die bydraes van gestremde mense in die Malawi Groei- en Ontwikkelingstrategie (MGOS) weerspieël word. Hierdie studie kan 'n nuttige instrument wees om begrip te vestig vir gestremde mense in die konteks van die MGOS. Die studie is uitgevoer in drie hoofstede van Malawi, naamlik Blantyre, Lilongwe en Mzuzu. Kwalitatiewe navorsingsmetodes is met behulp van 'n proefstudieontwerp gebruik. Inligting is verkry deur twee data-insamelingsmetodes te gebruik, naamlik onderhoude met segspersone en fokusgroepbesprekings. 'n Doelgerigte steekproef van 15 mense is gekies om aan die onderhoude met die belangrikste segspersone deel te neem. Tydens hierdie onderhoude is 'n sneeubaltegniek gebruik om 30 respondente te identifiseer, wat toe deelgeneem het aan 3 fokusgroepbesprekings wat elk uit 10 deelnemers bestaan het. Onderhoude is gevoer totdat 'n versadigingspunt bereik is en geen nuwe inligting ingewin kon word nie. Onderhoude is opgeneem en verbatim getranskribeer. 'n Tematiese inhoudsontleding is gedoen deur 'n sistematiese proses om inligting te kodeer en kodes in kategorieë te groepeer, waaruit temas dan geïdentifiseer is. Hierdie studie toon aan dat gestremde mense minimaal betrokke was by konsultasievergaderings oor die MGOS se vormingsproses. Oor die algemeen het die studie bevind dat gestremde mense te min opleiding en kennis het om op beleidsvormende vlak doeltreffend te kan deelneem. Die studie het ook bevind dat die proses om gestremde mense by alle sfere van die lewe in te sluit, baie stadig verloop weens die samelewing se stereotipes en negatiewe ingesteldheid teenoor gestremde mense. Al is daar verskeie regsplanne vir gestremde mense in plek, is daar geen Wet op Ongeskiktheid wat afgedwing kan word nie. Daarom word gestremde mense nie deur die wet beskerm nie. Hierdie neiging behoort omgekeer te word om selfverteenwoordiging van gestremde mense in al die beleidsvormingsprosesse te bevorder.

Thesis (MAud)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Speech audiometry for diagnostic purposes is widely used by audiologists around the world, but its application is starting to shift more towards rehabilitative purposes for people with hearing impairment. This has created the need for the development of appropriate test materials, including speech-in-noise tests, in the first language of the person undergoing rehabilitation. This document describes a study entailing the first phase in the development of an Afrikaans sentence perception test in noise based on the City University of New York (CUNY) topic-related sentences (Boothroyd, Hanin & Hnath, 1985). The test is called Sinslyste in Afrikaans vir Volwassenes in Lawaai [Sentence lists in Afrikaans for Adults in Noise] (SAV-L). Twenty-seven sentence lists containing 12 sentences each were compiled and evaluated by eight speakers of Afrikaans for their naturalness before they were recorded together with three-talker babble as masking noise. The recorded material was then presented to six groups of ten participants each (with the exception of nine participants in one of the rounds) and adjusted in intensity to improve inter-list reliability. Two scorers were used at intervals to determine inter-rater reliability. Test conditions were also replicated after an interval of six months or more to establish test-retest reliability. In a last round of testing, the test was administered at the intended presentation level to assess the appropriateness of the chosen level. Through adjustment of list intensities, inter-list reliability was improved to a 13.87% variance between list scores. Test-retest reliability showed a bias with an intra-class correlation agreement of 0.859. This was thought to be due to participants’ improved familiarity with the clinical environment over time, however longer term measures of test-retest reliability remains to be done. Inter-rater reliability was very high with an intra-class agreement of 0.999. The intended test level of 50dBHL with a signal-to-noise (SNR) ratio of +5dB, was found to be an acceptable fixed SNR. The test can be used in its current form for assessment of amplification candidacy as well as monitoring of progress during rehabilitation. Further research is indicated for the establishment of the sensitivity of the test. It is concluded that just as a clinician is expected to select the most suitable diagnostic test based on the patient’s history, signs and symptoms, so should the audiologist be expected to select the most appropriate rehabilitative measure based on the patient’s communication needs and established treatment goals. The SAV-L is a valuable contribution to the pool of speech perception tests available as rehabilitative measures, and is specifically suitable for adults with well-developed spoken language. / AFRIKAANSE OPSOMMING: Spraakoudiometrie vir diagnostiese doeleindes word algemeen gebruik deur oudioloë regoor die wêreld, maar die toepassing daarvan is besig om te skuif na rehabilitasie van mense met gehoorgestremdheid. Die behoefte vir die ontwikkeling van geskikte toetsmateriaal, insluitend spraak-in-geraastoetse, in die eerste taal van die persoon wat rehabilitasie ondergaan, het dus begin ontwikkel. Hierdie dokument beskryf ‘n studie wat die eerste fase van die ontwikkeling van a Afrikaanse spraakpersepsietoets in geraas behels. Dit is gebaseer op die City University of New York (CUNY) onderwerp-verwante sinne (Boothroyd, Hanin & Hnath, 1985). Die ontwikkelde toets is benoem Sinslyste in Afrikaans vir Volwassenes in Lawaai (SAV-L). Sewe-en-twintig sinslyste met twaalf sinne per lys is saamgestel en geëvalueer deur ag Afrikaans-sprekende persone om hulle natuurlikheid te bepaal voordat dit opgeneem is tesame met drie-spreker babbel as maskeringsgeraas. Die opgeneemde materiaal is aan ses groepe van tien deelnemers elk aangebied (met die uitsondering van slegs nege deelnemers in een van die rondtes) en aangepas in intensiteit om inter-lys betroubaarheid to verbeter. Twee tellers is van tyd tot tyd gebruik om inter-beoordelaar betroubaarheid te bepaal. Toetskondisies was ook ná ‘n periode van ses maande gereplikeer om toets-hertoets betroubaarheid to bepaal. In ‘n laaste rondte van toetsing was die toets geadministreer teen die beoogde toetsvlak om die geskiktheid van hierdie toetsvlak te bepaal. Inter-lys betroubaarheid is verbeter na ‘n 13.87% variase tussen sinslystellings deur die aanpassing van die intensiteite van die lyste. Toets-hertoets betroubaarheid het ‘n voorkeur met ‘n intra-klas korrelasie ooreenstemming van 0.859 getoon. Hierdie voorkeur was vermoedelik weens die deelnemers se toenemende bekendheid met die kliniese omgewing, alhoewel langer termyn metings nog gedoen moet word om hierdie tendens verder te ondersoek. Inter-beoordelaar betroubaarheid was goed met ‘n intra-klas korrelasie van 0.999. Die beoogde toetsvlak van 50dBGP met ‘n sein-tot-ruis ratio van +5dB is as ‘n geskikte ratio bevind. Die huidige vorm van die toets kan gebruik word vir die evaluasie van kandidaatskap van klankversterking sowel as monitering van vordering tydens rehabilitasie. Verdere navorsing is aangedui vir die bepaling van die toets se sensitiwiteit. Daar is afgelei dat net soos daar van ‘n klinikus verwag word om die mees geskikte diagnostiese toets te kies gebaseer op die pasiënt se geskiedenis, tekens en simptome, net so moet daar van die die oudioloog verwag word om die mees geskikte rehabilitasiemeting te selekteer, gebaseer op die pasiënt se kommunikasiebehoeftes en vasgestelde behandelingsdoelwitte. Die SAV-L is ‘n waardevolle hulpmiddel in die versameling spraakpersepsietoetse wat beskikbaar is vir rehabilitasiemetings en is spesifiek geskik vir volwassenes met goed-ontwikkelde gesproke taal.

Thesis (MPhil (Rehabilitation))--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Despite the ever increasing number of persons with disabilities (PWDs) in Ethiopia and the resulting conditions of abject poverty, efforts made to curb the existing situation, thereby improving the lives and citizenry contributions of PWDs, has been minimal. Consequently, poverty and insufficient participation of PWDs continue to be the distinctive features characterizing the disability sector and movement in Ethiopia. This research was aimed at investigating the role, involvement and impact of PWDs and the Disability Rights Movement (DRM) in Ethiopia in realizing the effective inclusion of disability in the country‟s development agenda, with a specific focus on Poverty Reduction Strategy Papers (PRSPs). A qualitative research paradigm, using a case study design, was employed as a research method in this study. Data were collected using two data collection methods; namely, key informant interviews (KIIs) and focus group discussions (FGDs). Purposive sampling and snowballing techniques were used to select 44 people who participated in ten key informant interviews and three focus group discussions (each FGD attended by 8 to 10 participants). The researcher was flexible enough to conduct additional KIIs and FGDs until the data saturation point was reached. Semi-Structured Interview Guides were employed as data collection tools. A thematic content analysis was conducted following a systematic process of coding data and grouping codes into categories and emerging themes. The study was conducted in Addis Ababa, the capital of Ethiopia, in collaboration with the Federation of Ethiopian National Associations for People with Disabilities (FENAPD) – the umbrella Disabled People Organization (DPO) in Ethiopia. The results of the study revealed that the disability movement in Ethiopia has not been active enough in ensuring the involvement of PWDs in the country‟s development endeavours. It was also reiterated that, even if the Ethiopian government was one of the first signatories of the UN Convention on the Rights of Persons with Disabilities (CRPD), the practical recognition that it has so far conferred to disability and PWDs in its development plans has been less than satisfactory. The study also underlined the fact that some recent progresses, such as the mentioning of disability in the currently under-review third PRSP document of Ethiopia, should be strengthened in order to pave the way for a more comprehensive inclusion of disability. Imminent challenges and opportunities facing the Ethiopian disability movement have also been explored in the study. It is hoped that the results of this study will provide the pertinent disability stakeholders in Ethiopia, including the government, with useful, timely and concrete research evidence, especially as Ethiopia is now engaged in a process of launching its latest PRSP documents. / AFRIKAANSE OPSOMMING: Ten spyte van die immer toenemende getal mense met gestremdhede (MMG's) in Etiopië en die gevolglike volslae armoede, is daar uiters min pogings aangewend om die bestaande situasie te bedwing en só die lewensgehalte en burgerskapbydraes van MMG's te verhoog. Gevolglik bly armoede en die ontoereikende deelname van MMG's eienskappe wat die gestremdheidsektor en -beweging in Etiopië kenmerk. Hierdie navorsing was daarop gemik om ‟n ondersoek te doen na die rol, betrokkenheid en invloed van MMG's en die Beweging vir die Regte van Gestremde Mense (BRGM) in Etiopië om gestremde mense doeltreffend by die land se ontwikkelingsagenda in te sluit, met spesifieke klem op Armoedeverligtingstrategieë (AVS'e). 'n Kwalitatiewe navorsingsparadigma, waartydens 'n gevallestudie gebruik is, was die navorsingsmetode van hierdie studie. Inligting is verkry deur twee data-insamelingsmetodes, naamlik onderhoude met belangrike segspersone (OBS'e) en fokusgroepbesprekings (FGB's). Doelgerigte seleksie en sneeubaltegnieke is gebruik om 44 mense te kies, wat toe aan 10 onderhoude met belangrike segspersone en 3 fokusgroepbesprekings deelgeneem het. (Elke FGB het uit 8 tot 10 deelnemers bestaan.) Die navorser was buigsaam genoeg om meer onderhoude en groepbesprekings te hou totdat die inligting 'n versadigingspunt bereik het. Semigestruktureerde onderhoudsriglyne is gebruik as instrument om die inligting in te samel. 'n Tematiese inhoudsontleding is gedoen ná 'n sistematiese proses om inligting te kodeer en kodes in kategorieë en duidelike temas te groepeer. Die studie is uitgevoer in Addis Abeba, die hoofstad van Etiopië, in samewerking met die Federasie van Etiopiese Nasionale Verenigings vir Mense met Gestremdhede (FENVMG) – die oorkoepelende organisasie vir gestremde mense in Etiopië. Die bevinding van hierdie studie is dat die gestremdheidsbeweging in Etiopië nie aktief genoeg is om die betrokkenheid van MMG's in die land se ontwikkelingsondernemings te verseker nie. Daar is ook bevestig dat, selfs al was die regering van Etiopië een van die eerste ondertekenaars van die Verenigde Nasies (VN) se Kongres oor die Regte van Mense met Gestremdhede (KRMG), die praktiese erkenning wat tot dusver aan gestremde mense in dié land se ontwikkelingsplanne gegee is, geensins bevredigend is nie. Die studie lê ook klem daarop dat onlangse vordering, soos dat gestremde mense genoem word in die derde AVS-dokument van Etiopië, wat tans hersien word, versterk behoort te word. Só kan die weg gebaan word vir 'n meer omvattende insluiting van gestremde mense. Naderende uitdagings en geleenthede wat die gestremdheidsbeweging in Etiopië sal moet aanpak, word ook in hierdie studie ondersoek.

Thesis (MPhil (Rehabilitation)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Research evidence suggesting the link between disability and poverty has been increasing at an alarming rate in recent years. Despite this, there has been very little attention to ensuring representation and inclusion of people with disabilities in poverty reduction processes. However, disability movements and their partners have been increasing pressure to ensure that people with disabilities effectively participate in the development of national development plans targeting poverty reduction. The aim of this qualitative study was to analyze the extent to which the human rights-based approach can be used as an advocacy tool for mainstreaming disability in the national development processes targeting poverty reduction in Uganda. The study was conducted in Kampala and Kiboga districts, and data were gathered between August and October 2009. Key informant interviews and focus group discussions were used for data collection. Eleven participants were purposively selected to participate in key informant interviews. Using these key informants, the snowballing technique was used to identify twenty people that participated in the two focus group discussions, with each having ten participants. A thematic content analysis was used to analyze data, and this involved coding and cataloguing data into emerging themes and subthemes. The study established that despite several legal frameworks in Uganda, disability mainstreaming is still far from being achieved. Translation of policies into practice was identified as a major challenge, making it difficult for people with disabilities to be meaningfully involved in poverty reduction processes. Negative attitudes and misconception of disability by both policy makers and civil society, were also seen to be contributing to the exclusion of people with disabilities in poverty reduction processes and programmes. Lack of capacity and meaningful political representation of disabled people seem to negatively impact on effective participation, monitoring and evaluation of the poverty-reduction processes in Uganda. The study recommends the need to strengthen capacity and advocacy work among people with disabilities and their promoters to ensure their effective participation and inclusion of disability in the national development agenda. It further recommends the need to adopt the human rights-based approach in any development initiative, ensuring disability mainstreaming in policies and the national development plan, in order to effectively address poverty reduction in Uganda. The researcher also challenges disability and development researchers to engage in more wider-scale studies in order to establish more evidence on the need to adopt the human rights-based approach to national development. / AFRIKAANSE OPSOMMING: Navorsingsbewyse wat dui op ‟n verband tussen gestremdheid en armoede het in die afgelope jare onrusbarend toegeneem. Ten spyte hiervan is daar baie min aandag gegee om seker te maak dat gestremde mense by die armoedeverligtingsprosesse verteenwoordig en ingesluit word. Bewegings vir gestremde mense, asook dié bewegings se vennote, het egter al hoe meer druk begin uitoefen om seker te maak gestremde mense neem doeltreffend deel aan nasionale ontwikkelingsplanne wat op armoedeverligting gemik is. Die doel van hierdie kwalitatiewe studie was om te ontleed in watter mate die menseregtebenadering gebruik kan word as ‟n instrument om voorspraak te maak vir die hoofklem wat gestremdheid moet ontvang in die nasionale ontwikkelingsprosesse wat op armoedeverligting in Uganda gemik is.

Thesis (MMed)--Stellenbosch University, 2005. / ENGLISH ABSTRACT:The decentralisation of health care services in the primary health care system poses a challenge to the delivery of care to the communities in Zambia. Little is being done in the Ministry of Health to incorporate community-based rehabilitation (CBR) in the mainstream of primary health care service delivery despite rehabilitation being regarded as the fourth component of primary health care. According to statistics, there are 256 690 (2.7%) persons with disabilities in Zambia, of which 38.8% are persons with physical disabilities. There are various community-based rehabilitation programmes in the country trying to meet the needs of persons with disabilities but these programmes have not been evaluated to determine the impact which CBR has on the lives of persons with disabilities. This study aimed to determine the impact of a community-based rehabilitation intervention strategy on persons with physical disabilities in an urban and rural setting in Zambia. It is hoped that the results of this study can be utilised as a means to lobby the Zambian government to become involved in the rehabilitation process. An experimental study was done using a community-based rehabilitation intervention strategy on 66 persons with physical disabilities, of which 62% were male and 38% female, from Lusaka urban and Chipata rural community-based rehabilitation programmes. The researcher completed a self-compiled questionnaire during a personal interview with the participants/proxy. The questionnaire comprised demographic data and an assessment of the disability status of persons with physical disabilities regarding movement, functional activities and their integration into the community. Perceptions of persons with physical disabilities or their proxy as regards their disability status and experiences were also assessed by means of two open-ended questions in the questionnaire. The community-based rehabilitation intervention strategy was conducted for six (6) months by the community rehabilitation workers who visited participants once a week. Data was analysed both quantitatively and qualitatively to determine the impact of a community-based rehabilitation intervention strategy and to test the null hypothesis. The results of this study showed that in Lusaka on one hand, persons with physical disabilities had improvements in movement, functional activities and integration level. On the other hand, Chipata showed that persons with physical disabilities had improvements only regarding integration into the community. However, combined scores showed that community-based rehabilitation had an impact on persons with physical disabilities regarding movement, functional activities and integration into the community. The study also showed that there was a correlation between integration and movement, and integration and functional activities. There was no correlation between integration and caregiver provision and dependency, whereas there was a negative correlation between perceptions and integration. Based on these findings, it is recommended that the Ministry of Health takes up the responsibility of spearheading and coordinating community-based rehabilitation programmes and incorporating the activities in the existing structures of primary health care. / AFRIKAANSE OPSOMMING:Die desentralisasie van gesondheidsorgdienste in die primere gesondheidstelsel hou 'n uitdaging vir dienslewering aan gemeenskappe in Zambie in. Die Ministerie van Gesondheid doen nie veel om gemeenskapsgebaseerde rehabilitasie (GBR) by die hoofstroom van primere gesondheidsorg dienslewering in te Iyf nie, ten spyte daarvan dat rehabilitasie as die vierde komponent van primere gesondheidsorg beskou word. Daar word beraam dat daar 256 690 (2.7%) mense met gestremdhede in Zambie is, waarvan 38.8% mense met liggaamlike gestremdhede is. Daar is verskeie gemeenskapsgebaseerde rehabilitasieprogramme in die land wat poog om in die behoeftes van mense met gestremdhede te voorsien, maar hierdie programme is nie geevalueer om die impak van GBR op die lewens van mense met gestremdhede te bepaal nie. Hierdie studie het ten doel gehad om die impak van 'n gemeenskapsgebaseerde rehabilitasieintervensiestrategie vir mense met liggaamlike gestremdhede in 'n stedelike en landelike omgewing in Zambie te bepaal. Daar word gehoop dat die resultate van hierdie studie gebruik kan word om druk op die Zambiese regering uit te oefen om by die rehabilitasieproses betrokke te raak. 'n Eksperimentele studie is gedoen deur 'n gemeenskapsgebaseerde rehabilitasie-intervensiestrategie op 66 mense met liggaamlike gestremdhede van die Lusaka stedelike en Chipata landelike gemeenskapsgebaseerde rehabilitasieprogramme toe te pas. Twee en sestig persent (62%) van die respondente was manlik en 38% vroulik. Die navorser het tydens 'n persoonlike onderhoud met deelnemers of hulle gevolmagtigdes 'n selfopgestelde vraelys voltooi. Die vraelys het uit demografiese data en 'n bepaling van die mense se gestremdheidstatus ten opsigte van beweging, funksionele aktiwiteite en hulle integrasie in die gemeenskap bestaan. Persepsies van mense met liggaamlike gestremdhede of hulle gevolmagtigdes rakende hulle gestremdheidstatus en ervarings is ook deur middel van twee oop vrae in die vraelys bepaal.Die gemeenskapsgebaseerde rehabilitasie-intervensiestrategie is vir ses (6) maande toegepas deur gemeenskapsrehabilitasiewerkers wat die deelnemers een maal 'n week besoek het. Data is sowel kwantitatief as kwalitatief ontleed om die impak van 'n gemeenskapsgebaseerde rehabilitasie-intervensiestrategie te bepaal en die nulhipotese te toets. Die resultate van die studie het aangedui dat mense met liggaamlike gestremdhede in Lusaka verbetering ten opsigte van beweging, funksionele aktiwiteite en vlak van integrasie getoon het. Mense met liggaamlike gestremdhede in Chipata, daarteenoor, het slegs ten opsigte van integrasie in die gemeenskap verbetering getoon. Gekombineerde tellings het egter getoon dat gemeenskapsgebaseerde rehabilitasie ten opsigte van beweging, funksionele aktiwiteite en integrasie in die samelewing 'n impak op mense met liggaamlike gestremdhede gehad het. Die studie het ook getoon dat daar 'n korrelasie tussen integrasie en beweging, en integrasie en funksionele aktiwiteite bestaan. Daar was geen korrelasie tussen integrasie en versorgervoorsiening en -afhanklikheid nie, en daar was 'n negatiewe korrelasie tussen persepsies en integrasie. Op grand van hierdie bevindinge word aanbeveel dat die Ministerie van Gesondheid verantwoordelikheid vir die leiding en koordinasie van gemeenskapsgebaseerde rehabilitasieprogramme aanvaar en hierdie aktiwiteite by die aktiwiteite van bestaande primere gesondheidsorgstrukture inlyf.

Thesis (M Speech Path)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: This study was done in collaboration with the Foundation for Alcohol Related Research (FARR), a non-governmental organization whose primary objective is to develop and maintain Fetal Alcohol Spectrum Disorder (FASD) prevention programmes across South Africa. Research has shown the occurrence of FASD in South Africa to be much higher than in other parts of the world. As part of their prevention programmes, FARR uses a three part diagnostic process, including a maternal interview, a dysmorphological examination, as well as a general developmental assessment. The maternal interview questionnaire that FARR currently uses takes an average of two hours per interviewee to complete. Even though a recent study indicates that FASD prevention programmes administered by FARR can potentially reduce FASD prevalence, shorter maternal interviews could improve the use of FARR resources and the ability of FASD research studies to gather meaningful information and inform future prevention efforts. The main purpose of this study was to adjust the maternal interview questionnaire used by FARR in order to make interviews with mothers shorter while delivering the information needed for successful FASD prevention programmes. Data related to the adequacy of the adjusted maternal interview questionnaire was collected and analysed according to an action research approach in four consecutive phases. The research procedures consisted of two separate focus group interviews with five key role players from FARR. During the first focus group interview the main problems with the questionnaire was identified as being (i) the length of the questionnaire, (ii) the unsuitability of the questionnaire to interview someone other than the biological mother, and (iii) inconsistency between interviewers when using the questionnaire. During the second phase of the study the questionnaire was adjusted and revised as part of a second focus group interview. The interviewers, data capturer and data analyst who used the adjusted questionnaire as part of a larger FASD prevention programme made several suggestions on how the questionnaire could be further adjusted to suit the needs of FARR. These suggestions were addressed during the final phase of the study, after which the adjusted questionnaire was finalized. Findings from the study suggest that identified problems with FARR’s original maternal interview questionnaire were successfully addressed by the adjusted questionnaire, while simultaneously satisfying the objectives of a maternal interview as identified by participants during the first focus group interview. Results confirmed that more maternal interviews could be conducted in the same time period using the adjusted interview questionnaire compared to when the original questionnaire was used, due to the fact that the questionnaire was shorter and took less time to administer. As part of this study an additional questionnaire was developed specifically for caregiver interviews. According to FARR role players, inconsistency between interviewers was for the most past successfully addressed by the development of this additional questionnaire and the development of an interviewer guideline. Recommendations for future research include the further development and evaluation of the caregiver questionnaire and interviewer guideline. / AFRIKAANSE OPSOMMING: Hierdie studie is uitgevoer in samewerking met die “Foundation for Alcohol Related Research” (FARR), ‘n nie-regeringsorganisasie met die primêre objektief om Fetale Alkohol Spektrum Afwyking (FASA) voorkomingsprogramme in Suid-Afrika te ontwikkel en te handhaaf. Volgens navorsing is die voorkoms van FASA in Suid-Afrika beduidend hoër as in ander dele van die wêreld. ‘n Drie-delige diagnostiese proses word as deel van FARR se voorkomingsprogramme gebruik, insluitend ‘n onderhoud gefokus op moeders, ‘n dismorfologiese ondersoek, asook ‘n evaluasie van die kind se algehele ontwikkeling. Die moeder-onderhoudsvraelys wat tans deur FARR gebruik word neem gemiddeld twee ure om te voltooi. Alhoewel ‘n onlangse studie aandui dat die voorkomingsprogramme deur FARR oor die potensiaal beskik om die prevalensie van FASA te verlaag, kan korter moeder-onderhoude potensieël daartoe lei dat bronne beter benut word, asook dat FASA voorkomingstudies betekenisvolle inligting versamel vir die ontwikkeling van toekomstige voorkomingsprogramme. Die hoofdoel van die huidge studie was om die moeder-onderhoudsvraelys wat tans deur FARR gebruik word aan te pas, om sodoende die onderhoude met moeders korter te maak terwyl die nodige inligting vir suksesvolle FASA voorkomingsprogramme steeds verkry word. Gedurende hierdie studie is data rakende die toereikendheid van die aangepaste moederonderhousdvraelys versamel en geanaliseer volgens ‘n aksie-navorsingsbenadering in vier opeenvolgende fases. Die navorsingsprosedures het bestaan uit twee afsonderlike fokusgroeponderhoude met vyf van die sleutelrolspelers van FARR. Gedurende die eerste fokusgroeponderhoud is die hoofprobleme met die vraelys geïdentifiseer as (i) die lengte van die vraelys, (ii) die ongeskiktheid van die vraelys om ‘n onderhoud met iemand anders as die biologiese moeder te voer, en (iii) die inkonsekwentheid tussen onderhoudvoerders met die gebruik van die vraelys. Gedurende die tweede fase van die studie is die vraelys aangepas en hersien as deel van ‘n tweede fokusgroeponderhoud. Die onderhoudvoerders, data verwerker en data analis wat die aangepaste vraelys gebruik het as deel van ‘n groter FASA voorkomingsprogram het verskeie aanbevelings gemaak rakende hoe die vraelys verder aangepas kan word om te voldoen aan FARR se behoeftes. Laasgenoemde aanbevelings is aangespreek gedurende die laaste fase van die studie, waarna die aangepaste vraelys gefinaliseer is. Die bevindinge van die studie dui aan dat die geïdentifiseerde probleme met FARR se oorspronklike moeder-onderhoudsvraelys suksesvol deur die aangepaste vraelys aangespreek is, terwyl die objektiewe van ‘n moeder-onderhoud (soos geïdentifiseer deur die deelnemers aan die eerste fokusgroeponderhoud) steeds vervul is. Resultate het bevestig dat meer moeder-onderhoude in dieselfde tydsperiode met behulp van die aangepaste vraelys gevoer kon word as met die oorspronklike vraelys, as gevolg van die feit dat dit korter was en minder tyd geneem het om te voltooi. As deel van die studie is ‘n bykomstige vraelys spesifiek vir sorggewer-onderhoude ontwikkel. Volgens die FARR rolspelers is inkonsekwentheid tussen die onderhoudvoerders grootliks suksesvol aangespreek deur middel van die ontwikkeling van hierdie bykomstige vraelys asook die ontwikkeling van ‘n riglyn vir onderhoudvoerders. Aanbevelings vir verdere navorsing sluit die verdere ontwikkeling en evaluasie van die sorggewer-vraelys en onderhoudvoerder riglyn in.