Includes abstract. / Includes bibliographical references. / Swahili is widely spoken in East African countries, but to date there are no culturally and linguistically appropriate materials available for speech language therapists working in the region. The challenges of assessing and managing Swahili speaking children with speech difficulties are further exacerbated by the limited research available on the typical acquisition of Swahili phonology. This exploratory study aimed to describe the phonological development of 24 typically-developing first language Swahili speaking children between the ages of 3;0 and 5;11 years in Dar es Salaam, Tanzania. A cross-sectional design was used with six groups of four children in six month age bands.

Includes abstract. Includes bibliographical references (leaves 210-234).

Bibliography : leaves 177-190. / Transformation of the existing health care system to one relevant to the needs of all its people, is the vision to which South African health providers aspire. This move towards more culturally and linguistically appropriate services is in line with the worldwide trend away from the biomedical to a more biopsychosocial and patient-centered approach to health care. Within the field of Speech-Language and Hearing Therapy (SLHT), the provision of more culturally appropriate services has been emphasized and research has focused on the new field of Cultural Speech-Language Pathology, interpreter-mediated consultations, and the use of more appropriate assessment and rehabilitation procedures. Penn (2000) proposed the use of the cultural narrative as a more appropriate means of gathering information from patients in initial consultations. Research into the use of narratives has been conducted in a number of health related disciplines, however, to date, this area has been under-researched within the field of SLHT and in the South African context. In this study, the researcher explored and documented the cultural narrative within multilingual, multicultural consultations in the field of SLHT in South Africa. The cultural narrative was compared to traditional methods of obtaining case history information in initial consultations across interpreter-mediated consultations with a white, English-speaking clinician and a black Xhosa-speaking clinician with Xhosa-speaking patients. In addition, post-consultation interviews using semi-structured questionnaires were carried out. Both the initial consultations and the post-consultation interviews were recorded and transcribed verbatim. The analysis of the initial consultation transcripts included an in-depth analysis of the interpreting practices. The post-consultation interview transcripts were thematically analyzed. The analysis included an analysis of interpreting and thematic analysis of the post-consultation interviews in which the participants also took part. The major finding of this study was that the cultural narrative method is more culturally appropriate, patient-centered and in line with a biopsychosocial approach to health care than the traditional case history method in both monolingual and multilingual, multicultural, interpreted consultations. This study has numerous theoretical, clinical and future research implications. It is hoped that these findings will be used to inform the training of clinicians and in practical application in clinical encounters. Although this study was conducted within the field of SLHT, the findings are believed to be applicable across all disciplines in health care.

Includes bibliographical references. / This descriptive single subject intervention study aimed to describe the outcomes of an application (app)-based intervention for five children with reading difficulties. All participants were required to have a grade one reading level. Each participant’s language and literacy profiles are detailed in accordance with developmental and information processing models, and intervention was designed based on each child’s specific level of difficulty. Following a baseline control period, each child received approximately six weeks of intervention using the Reading TherAppy and/or Comprehension TherAppy app (Tactus Therapy Solutions) on an iPad ® mini, which was mediated by the researcher on a 1:1 basis. Treated and untreated probe items were administered at three points in the study (baseline, pre, post) in order to determine the effects of intervention on treated and untreated, matched items. Each child’s reading on standardized literacy measures was re-evaluated post intervention. This was followed by an interview with each participant to obtain information about his or her experience of the intervention. Results show that all participants improved their reading of items treated in the intervention. In addition, some of the participants’ standardized reading and spelling scores improved in relation to typically developing peers from pre to post intervention testing. Changes are detailed for each participant using the theoretical models. Child interviews indicated that all children enjoyed a positive experience of intervention. This study aimed to explore and contribute to the limited knowledge base on efficacy, optimal dosage and outcomes of app-based intervention for children with reading difficulties. The implications of the study are discussed in relation to Speech Language Therapists working in educational settings, the functional application of models of reading, and the reading intervention literature.

It became evident in the light of proposed changes in the healthcare system in South Africa that there was little descriptive client data with regard to Speech Therapy and Audiology Services in South Africa to support proactive service planning. This study therefore aimed to describe trends in the demographic, diagnostic, and attendance variables of first-time clients who had attended the Speech Therapy and Audiology out-patient department (OPD) at a tertiary hospital in the Western Cape over a five-year period (1999-2003). A longitudinal, retrolective, descriptive survey was conducted. Records were reviewed for a sample of the population of all new clients who had attended the Speech Therapy and Audiology OPD in the five-year time frame. Data was collected using a form designed for this purpose. The data was coded and then analysed descriptively. It was found that the highest percentages of subjects attended for a hearing loss or voice disorder. The ENT department at the study hospital made the highest percentage of referrals to the Speech Therapy and Audiology Department. This was followed by referrals from the education sector. The age profile showed the highest percentage of subjects to be in the age category of 7-12 years. Similar percentages of male and female subjects were found. English was the language that a client was most likely to speak. Geographically the highest percentage of subjects attending were from the Klipfontein region, followed by the Central area. Attendance data showed that just over 70 % of subjects attended within a three-month period or attended no more than two appointments. Percentage of appointments attended decreased with increasing numbers of booked appointments. Implications of this research include issues around record keeping and service delivery. The results of this study cannot be generalized to all Speech Therapy and Audiology services in South Africa. However, the data may serve as a guide for planning services. Further research addressing service delivery issues is needed with the field of Speech Therapy and Audiology.

Bibliography: leaves 139-146.

IsiXhosa is a language that is widely spoken in South Africa. Bilingualism is common in South Africa, with many children learning isiXhosa as a home language and English from a young age. This study investigated three case studies of bilingual children with speech sound disorders. It aimed to describe changes in their speech following intervention according to a tailor made intervention plan. The project aimed to add to the limited research available on intervention for bilingual children with speech sound disorders. The speech of Gcobisa* (4;2), Lulama* (4;0) and Ntando* (3;0) were assessed and their speech sound disorders categorized according to Dodd's diagnostic subcategories. From this, intervention was planned and the language of intervention was selected. Following intervention, the speech of the children was reassessed. Gcobisa's speech was categorized as a consistent phonological delay, and she was provided with intervention using a minimal pairs approach with isiXhosa targets, and showed evidence of generalizing the target phoneme to English words. Lulama's speech was categorized as a consistent phonological disorder, and she received intervention based on an adapted cycles approach in English, with little evidence of change in her phonological systems in English and isiXhosa, but increased intelligibility. Ntando's speech, although more difficult to categorize, was categorized as presenting with a consistent phonological disorder, and he received intervention based on core vocabulary in English. He showed an increase in his consistency and intelligibility in both English and isiXhosa. The data has theoretical implications regarding bilingual development of isiXhosa-English, as it highlights the ways bilingual development may differ from the monolingual development of this language pair, as well as adding to the small set of intervention studies investigating the changes in the speech of bilingual children following intervention. In addition, clinical implications can be drawn, as it provides a possible framework to guide intervention for isiXhosa-English bilingual children with speech sound disorders. *Pseudonyms were used to ensure anonymity.

Children who stutter are bullied and teased by their peers, especially in the primary schooling years. The Classroom Communication resource (CCR) was developed as a teacher-administered classroom-based education programme aiming to improve peers' attitudes towards CWS. The focus of this feasibility study was to determine the initial treatment effect of the CCR to improve peers' attitudes towards CWS and the feasibility for a larger scale cluster randomised trial (CRT) in future. Peer attitudes were determined via a Likert scale questionnaire, the Stuttering Resource Outcomes Measure (SROM), completed by primary school learners. Aim one was to establish if the SROM was a valid and reliable outcomes measure. Aim two utilized a quantitative, CRT design with a control group to describe the direction and magnitude of changes in 196 Grade 7 peers' attitudes towards CWS following the administration of the CCR. It also determined whether the changes were linked to gender or having exposure to a person who stutters. The evidence confirmed that the SROM was a valid and reliable outcomes measure. Attitude changes after the administration of the CCR were analysed through inferential statistics. A significant positive change in SROM scores was found in the experimental group (p=0.005) when compared to the control group (p=0.41). Females had a greater magnitude of change in SROM scores after the administration of the CCR compared to males. Participants with prior exposure to a person who stutters held more positive attitudes towards CWS at pre-test. The magnitude of positive change in SROM was greater in participants who did not have prior exposure to a person who stutters (p=0.007). The study indicated initial positive treatment effect of the CCR and implications for the feasibility of a larger CRT is discussed.

The study aimed to determine the effectiveness of a multi-sensory phonological awareness and letter knowledge programme for disadvantaged first graders. One control group and one experimental group, each consisting of 20 children, were matched for age, gender, school readiness, socio-economic status and phonological awareness. Twenty-nine sessions of phonological awareness and letter knowledge training were administered to the experimental group while the control group received vocabulary stimulation activities for the same length of time. Results indicated that the programme was highly effective in improving phonological awareness, letter knowledge, reading and spelling skills. The experimental group scored significantly higher than the control group on simple phonological awareness tasks such as segmenting the sounds in a word, letter knowledge and in their ability to read and spell real and pseudowords. The results are discussed in terms of the importance of both phonological awareness and letter knowledge in the process of literacy acquisition.

Includes bibliographical references (leaves 82-89). / The aim of my teaching intervention, dialogue journal writing, was to counter these deficit perceptions by affirming the marginal home language at school. More importantly, I aimed to give children who do not often get the opportunity to do so, the space to voice themselves in writing. My research, therefore, aimed at investigating the dialogue journal writing process as a means of raising the status of Xhosa at school, as well as to affirm the voices of children in asymmetrical multilingual settings.