This study examined the effectiveness of the Otago screening protocol in identifying school-aged children with severe speech and language impairments. In order to do so, the results of the Otago screening protocol were compared with those of comprehensive language assessment as determined by best practice protocol (Gillon & Schwarz, 1998, Kennedy, 2002). Following the completion of the screening and the comprehensive assessments, an evaluation of the true positives and false positives was calculated, and an analysis of the false negative outcomes made. Findings indicated that fourteen of the twenty participants were true positives, three were true negatives, three were false positives, and none were false negatives. The Positive Predictive Value and Negative Predictive Value of the screening protocol was 100%. Test Sensitivity and Specificity were very high at 82% and 100%. Inter-rater reliability was very high, generally ranging from 92-100%. Adding a standardised measure of phonological awareness would improve efficiency of the screening protocol. Consideration of alternative screening tools, such as the GAPS test (Gardner et al, 2006) and the CELF-4 screening test (Semel, Secord & Wiig, 2004), should be made. Additional factors which could influence a screening protocol are discussed. The Otago screening protocol is a valid procedure to detect severe speech and language impairments in school-aged students referred to Special Education.

Speech-language pathologists have no clear guidelines on how to assess, diagnose or treat bilingual children with speech disorders. This thesis addresses this issue. The phonological development of 91 Cantonese-English and Punjabi-English bilingual children is described. Two Cantonese-English bilingual children's phonological development over the year they were first exposed to English is also presented. The bilingual children's phonological systems were clearly differentiated. The bilingual children's speech also included many phonological processes that would be considered atypical for a monolingual child. The use of these processes is argued to be characteristic of normal bilingual development. The longitudinal data showed that the atypical error patterns were transient and directly related to the introduction of the second language. Some `atypical' error patterns could be plausibly explained by referring to the nature of the two phonological systems. Other atypical processes could be explained by language-specific differences in normal developmental or adult variation patterns. This thesis argues that the differences evident in the bilingual children's phonological patterns are due to `hypothesis testing' resulting in underspecified realisation rules. There was no indication that bilingual children process phonological input and output differently to monolingual children. However, they differentiate the cognitive-linguistic information they abstract from the two languages, and they use separate phonological realisation rules for each language. This thesis argues that bilingual children use the same phonological processing mechanism for both languages, however they are able to filter each language through the appropriate language-specific phonological information. Case studies of 21 children with disordered speech and treatment case studies of 2 children are also presented. The disordered speech data supports current psycholinguistic models of speech processing the hypothesised levels of breakdown fit with the error profiles evident. The bilingual children with speech disorder validate Dodd's (1995) classification system: four different types of disorder were evident. The results of the two treatment case studies presented suggest that unless intervention targets the underlying deficit the effect of intervention will be language-specific. The investigation into bilingual children with disordered speech indicates that speechlanguage pathologists need to assess both languages of a bilingual child to determine the language-specific patterns and the type of disorder and that it is important to compare bilingual children to their bilingual normally developing peers, not to monolingual developmental data.

This study examined the effectiveness of the Otago screening protocol in identifying school-aged children with severe speech and language impairments. In order to do so, the results of the Otago screening protocol were compared with those of comprehensive language assessment as determined by best practice protocol (Gillon & Schwarz, 1998, Kennedy, 2002). Following the completion of the screening and the comprehensive assessments, an evaluation of the true positives and false positives was calculated, and an analysis of the false negative outcomes made. Findings indicated that fourteen of the twenty participants were true positives, three were true negatives, three were false positives, and none were false negatives. The Positive Predictive Value and Negative Predictive Value of the screening protocol was 100%. Test Sensitivity and Specificity were very high at 82% and 100%. Inter-rater reliability was very high, generally ranging from 92-100%. Adding a standardised measure of phonological awareness would improve efficiency of the screening protocol. Consideration of alternative screening tools, such as the GAPS test (Gardner et al, 2006) and the CELF-4 screening test (Semel, Secord & Wiig, 2004), should be made. Additional factors which could influence a screening protocol are discussed. The Otago screening protocol is a valid procedure to detect severe speech and language impairments in school-aged students referred to Special Education.

The purpose of this study was to teach 3 children vocal imitation and to compare dev words and random words. A multiple baseline design was implemented across three participants two with an expressive and receptive language delay and one with Autism where the participants were taught to vocally imitate several sounds using the PEAK Relational Training curriculum. The sounds were divided into 2 groups: first set composed of age appropriate sound in sequential order of suggested acquisition and the second set were random but age appropriate sounds. Trial blocks began with the child being asked to imitate a sound from their specific sound set. If the child correctly imitated the sound, child was given their chosen reinforcement (bubbles, surprise eggs or a book). After a trial block of 5 imitation requests, the child is given 5 minutes of free play where the child is able to pick an activity around their home. The results of the study show that children with a language disorders and Autism Spectrum Disorder increased the correct number of sound imitations during the PEAK Relational Training System – Direct Training module. Given both sets of sounds, the age appropriate sound sequence emerged first. Two participants showed an increasing trend at a high level during intervention. The third participant showed an increasing trend but at a low level.

Includes abstract. Includes bibliographical references (leaves 100-112).

Bibliography: leaves 99-104. / This study determines the presence of developmental limb apraxia in deaf signing children and in an oral hearing-impaired child who presents with oral apraxia. The VICON 370 Motion Analysis System was adapted to objecitvely assess the presence of this disorder and to illustrate differences in patterns of movement between the experimental and control subjects.The execution of motor performance of praxic functioning was analysed on a continuum of complexity across signs, gestures and meaningless movement sequence. Qualitative measures of kinematic abnormalities, spatial parapraxias, temporal qualities, quantitative elbow joint angles, resultant tractories of elbow position and wrist joint centre were obtained.

Includes bibliographical references (leaves 97-111).

Includes bibliographical references (leaves185-195).

Includes bibliographical references (leaves 188-203).

Background: The paediatric population with HIV is at higher risk for feeding and swallowing difficulties (FSD) than the general paediatric population, which may contribute to increased morbidity and mortality. Consequences of dysphagia may include insufficient nutritional intake leading to growth faltering, decreased quality of life, and risk of aspiration which may cause respiratory complications and permanent lung damage. Currently, no validated screening measures exist for the identification of FSD in infants and children with HIV/AIDS. Early identification and appropriate management of dysphagia is essential to prevent further complications and negative health outcomes. Research Aims: To determine the validity and reliability of a caregiver questionnaire as a FSD screening tool in infants and children with HIV/AIDS. As a sub-aim, the nature of FSD and the relationship between FSD and other factors, such as age, lower respiratory tract infection, undernutrition and HIV-related factors were also described. Method: A prospective, descriptive clinimetric research design was utilised. Three experts in the field of paediatric FSD were consulted to determine face and content validity of the tool. Key informant interviews were conducted with 15 caregivers of children with HIV, to determine the linguistic appropriates of the tool. Sixty-six participants with HIV/AIDS under the age of 13 years were recruited from the Infectious Diseases Clinic at Red Cross War Memorial Children's Hospital. The screening tool and a comprehensive feeding and swallowing evaluation were conducted with all participants. Additional medical information, such as HIV data, anthropometry information and history of respiratory illness were recorded. Results: The screening tool - the Feeding and Swallowing Questionnaire - was found to have face and content validity. Criterion validity was established with sensitivity of 92% and specificity of 59%. The tool has high internal consistency (Cronbach's alpha = 0.78) and excellent inter-rater reliability (100% agreement). Twenty-five (38%; N=66) participants presented with FSD. Difficulties were noted in all phases of swallowing, as well as behavioural feeding difficulties and delays in reaching age-appropriate feeding and swallowing milestones. FSD were significantly inversely associated with age (p =.008) and length of time on antiretroviral therapy (p =.014) i.e. younger children and children on ART for a short period of time were most likely to have FSD. Conclusions: The results confirm that the Feeding and Swallowing Questionnaire is a reliable and valid tool for the identification of FSD in infants and children with HIV. This tool identifies children likely to have FSD, thereby indicating referral for comprehensive assessment of feeding and swallowing, as well as the necessary management of any FSD. The results highlight the multifaceted nature of FSD in this population. Early identification of FSD may not only benefit the child, but may decrease the associated social and economic burden of frequent hospitalisation related to FSD.