Orientadores: Ivone Panhoca, Maria de Lurdes Zanolli / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-07T03:32:00Z (GMT). No. of bitstreams: 1 Zia_Juliana_M.pdf: 453743 bytes, checksum: a3f9df2fe00b38841f34460513f326d4 (MD5) Previous issue date: 2006 / Resumo: Linguagem, aqui, é a esfera simbólica que "sustenta" e torna possível o exercício da vida em sociedade, possibilitando a estruturação das relações sociais, desta forma, a linguagem é o que faz dos indivíduos ¿seres sociais¿. E o gesto, nesta concepção teórica, é compreendido como uma esfera simbólica, como unidade sígnica, que participa das relações sócio-interativas humanas, fazendo parte do processo maior de construção do conhecimento. O objetivo geral deste trabalho foi analisar a gestualidade de uma criança com atraso de linguagem nas relações interativo-lingüísticas no contexto da terapia fonoaudiológica em grupo. Trata-se de um estudo de caso de observação participante, realizado por meio do método qualitativo, utilizando-se como diretriz teórico-metodológica os pressupostos da abordagem histórico-cultural. O estudo enfocou uma das cinco crianças que formavam um grupo terapêutico fonoaudiológico, todos do sexo masculino, com hipótese diagnóstica de atraso de linguagem, na faixa etária de 5 a 8 anos de idade. As cinco crianças foram trabalhadas em grupo durante oito meses, em sessões semanais de uma hora e meia de duração, totalizando 23 sessões terapêuticas. O material coletado foi composto de aproximadamente 34 horas de vídeo-tapes e 500 páginas de transcrições, além dos relatórios semanais das sessões. A análise de dados foi realizada por meio da análise microgenética. Este tipo de interpretação de dados é realizado por meio da análise detalhada dos recortes que refletem ações, fatos e processos dos episódios interativos ocorridos em um determinado contexto, representados aqui, na terapia fonoaudiológica em grupo. O objeto de estudo eleito foi o desenvolvimento da língua(gem), entendido como um processo dinâmico na relação do sujeito com ela, ou seja, a ¿língua em atividade¿. Esta forma de tratar os dados permite uma análise mais completa e detalhada dos processos de desenvolvimento. Adotou-se, portanto, uma posição desenvolvimental. Através da análise qualitativa dos dados, observou-se o que a interpretação e atribuição de sentidos aos gestos produzidos pela criança, por parte dos outros membros do grupo, viabilizaram sua inserção no grupo terapêutico, possibilitando que ela fosse interpretada e conseguisse interpretar, constituindo-se, assim, como sujeito daquele grupo. Concluiu-se que o fato de o gesto ser acolhido / significado naquele determinado contexto lingüístico-interativo favoreceu a (re) construção da linguagem da criança e, acima de tudo, a (re) construção da sua identidade / Abstract: Language, in this case, is the symbolic sphere that ¿sustains¿ and makes possible the exercise of life in society, providing structure in social relationships. Therefore, language is what makes individuals ¿social beings¿. And gesture, in this theoretical conception, is comprehended as a symbolic sphere, as a signal unit, that participates in human social-interactive relationships, as well as in the major process of knowledge building. The general objective of this work was to analyze gestures of a child with language delay in interactive-linguistic relationships under the context of group phonoaudiologicall therapy. This is a case study of participant observation, performed by means of the qualitative method, utilizing presuppositions as the theoretical-methodological guideline of the historical-cultural approach. The study focused on one of the five children who completed a phonoaudiological therapeutic group, all of them being males, with diagnostic hypothesis of language delay, in the age group between 5 and 8 years old. The five children were studied in group during eight months, in week sessions of one and a half hours of duration, totalizing 23 therapeutic sessions. The collected material was compounded of nearly 34 hours of videotapes and 500 pages of transcriptions, in addition to week reports of the sessions. The data analysis was performed by means of the microgenetic analysis. This kind of data interpretation is accomplished through the detailed analysis of cuttings that reflects actions, facts and processes of interactive episodes occurred in a certain context, represented in this case by the group phonoaudiological therapy. The selected object of study was the development of the language, understood as a dynamic process in its relationship with the subject, i.e. the ¿language in activity¿. This form of treating the data allows a more whole and detailed analysis of development processes. Therefore, a developmental position was adopted. Through the data qualitative analysis, it was observed that the interpretation and attribution of feelings to gestures produced by the child, through other members of the group, viabilized their insertion in the therapeutic group, allowing that they were interpreted and able to interpret, constituting this way as the subject of that group. The conclusion is that the fact of the gesture being received / signified in that determined linguistic-interactive context favored the (re) building of the child¿s language and, above all, the (re) building of their identity / Mestrado / Saude da Criança e do Adolescente / Mestre em Saude da Criança e do Adolescente

Orientador: Adriana Lia Friszman de Laplane / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-21T04:12:08Z (GMT). No. of bitstreams: 1 Jordao_LindaBoghossian_M.pdf: 20684428 bytes, checksum: 613e5801cd4fe29e55225489f0394f85 (MD5) Previous issue date: 2012 / Resumo: Tomando como ponto de partida as dificuldades de leitura e escrita observadas em uma sala de aula de 4ª. Série do ensino fundamental, a pesquisa teve como objetivos desenvolver uma proposta de intervenção em sala de aula, com base na perspectiva do Letramento e com enfoque nas práticas de leitura e escrita, e discutir as possibilidades de contribuição da Fonoaudiologia na escola. Foi utilizada uma abordagem qualitativa com caráter de pesquisa-ação, com a finalidade de produzir mudanças no meio pesquisado. A pesquisa foi realizada em uma escola estadual de ensino fundamental da cidade de Campinas, por uma equipe interdisciplinar de pesquisadoras e professoras. A proposta de intervenção foi desenvolvida em parceria com a professora de sala, por meio de um projeto temático, em que os alunos produziram um filme. O projeto temático permitiu integrar conhecimentos de diferentes tipos e agregou o trabalho de professores, alunos e pesquisadores. Os resultados mostraram que os alunos participantes se engajaram de forma ativa nas atividades propostas durante o projeto de intervenção e que o seu desempenho em leitura e escrita melhorou, assim como o comportamento da turma estudada. A pesquisa propiciou a reflexão sobre o papel da Fonoaudiologia como interlocutora da equipe escolar. Concluiu-se que o fonoaudiólogo pode somar esforços com os professores e contribuir com os conhecimentos que a sua disciplina integra para propiciar a compreensão do processo de letramento e melhorar o desempenho dos alunos na aprendizagem escolar / Abstract: As a starting point the reading and writing difficulties observed in a 4th Grade classroom, the research aimed to develop a proposal on classroom intervention, based on the literacy perspective and focused on reading and writing practices, and discuss the possibilities of the contribution of Speech and Language Pathology at schooL It was used a qualitative approach focusing collaborative action-research in order to produce changes in the environment studied. The survey was conducted in a public Junior High School in the city of Campinas, by an interdisciplinary team of researchers and teachers. The intervention proposal was developed in partnership with the classroom teacher through a thematic project, in which the students produced a film. The thematic project allowed integrating different kinds of knowledge and added value to the work of the teachers, students and researchers. The results showed that the students participated in an active way in the activities proposed during the intervention and their performance in reading and writing have improved, as well as the behavior of the group studied. The research led to a reflection regarding the role of the Speech Therapy as the spokesperson of the school staff. It was concluded that the Speech and Language Pathologist can join and add forces with the teachers and contribute to the knowledge that their discipline provides to offer an understanding of the process of Literacy and to improve student performance in school learning / Mestrado / Interdisciplinaridade e Reabilitação / Mestra em Saúde, Interdisciplinaridade e Reabilitação

Language recovery was examined in 108 individuals with aphasia in the chronic phase of recovery who participated in various forms of aphasia treatment over extended periods of time. The Western Aphasia Battery (WAB) was administered at multiple time points and Aphasia Quotient (AQ) scores were used as a measure of language performance over time. As a group, the cohort showed an improvement of +6.52 AQ points, yielding an average rate of change of +4.07 AQ points per year. The rate of change was greatest at earlier times post onset (between three months and two years), and improvement was greatest for individuals with aphasia in the moderate severity range. Age, sex, and fluency did not have a significant effect on recovery. Education level had marginal predictive value in the direction of those with less education showing greater rate of improvement. These results suggest that language recovery continues during the chronic stage for individuals who are involved in some form of rehabilitation activity, especially in individuals with aphasia of moderate severity.

Thesis (MSc (Interdisciplinary Health Sciences. Speech-Language and Hearing Therapy))--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Spinal cord injury is a devastating sudden cause of disability which renders a person paralyzed and dependent on care immediately after the incident. A person who has suffered a spinal cord injury requires an intensive rehabilitation program to achieve physical independence as well as reintegration into the community. The aim of this study was to evaluate the rehabilitation program for patients with complete paraplegia at the Netcare Rehabilitation Hospital, a 120 bed private rehabilitation facility in Johannesburg, where rehabilitation for patients with physical disabilities is offered by an interdisciplinary team. The rehabilitation program was evaluated in terms of effectiveness including the degree of physical independence the patients achieved and how well the program prepared patients for successful integration into the community. The Functional Independence Measure (FIM), a standardized outcome measure that measures certain physical and cognitive functions and the Needs Assessment Checklist (NAC), an instrument designed to assess if the rehabilitation program is geared towards the patients’ individual needs were used as outcome measure. FIM scores were determined on admission and discharge and NAC scores were determined at discharge. A convenient, consecutive sample of sixteen patients with complete paraplegia (ASIA A), with a neurological level between T1 and T12, formed the study population. Consistently high FIM and NAC scores in the area of physical functioning suggested that the rehabilitation program at Netcare Rehabilitation Hospital was effective in terms of providing patients with physical independence. However, NAC results showed that the patients were not completely ready to reintegrate back to their communities. Areas that were identified as particularly problematic were knowledge on follow up health care services in the community, readiness for work and accessibility of the home and work environments. Therefore it is recommended that the rehabilitation team re-evaluate the program and incorporate strategies with the aim to improve it’s effectiveness in terms of preparing patients for community reintegration. It is also recommended that further research is conducted to assess the current success rate with regards to community reintegration and determine challenges to re-integration in order to assist with program panning. / AFRIKAANSE OPSOMMING: ‘n Spinaalkoordbesering is ‘n skielike oorsaak van gestremdheid wat die persoon verlam en afhanklik van sorg laat direk na die voorval. ‘n Persoon wat ‘n spinalkoordbesering opdoen benodig ‘n intensiewe rehabilitasie program om weer fisies onafhanklik te wees en ook om hom/haar voor te berei om weer by die gemeenskap in te skakel. Die doel van hierdie studie was om die rehabilitasie program by die Netcare Rehabilitasie Hospitaal, ‘n 120 bed private rehabilitasie fasiliteit in Johannesburg, waar rehabilitasie vir fisies gestremde persone deur ‘n interdissiplinere span aangebied word, te evalueer. Die program is geevalueer in terme van twee uitkomste naamlik, die graad van fisiese onafhanklikheid wat die pasiënte behaal en tot watter mate die program pasiente voorberei vir herintegrasie in die gemeenskap Die “Functional Independence Measure” (FIM), ‘n gestandaardiseerde uitkoms skaal wat sekere fisiese en kognitiewe funksies meet en die “Needs Assessment Checklist” (NAC), `n instrument wat ontwikkel is om te evalueer of rehabilitasie programme pasiente se spesifieke behoeftes aanspreek. Is gebruik om the rehabilitasie program te evalueer. Die FIM is met toelating en ontslag voltooi en die NAC is met ontslag voltooi. ‘n Steekproef van sestien pasiente met volledige spinaalkoordletsels (ASIA A) tussen T1 en T12 het die studie populasie gevorm. Deurgans hoë FIM en NAC tellings vir fisiese funksionering het daarop gedui dat die rehabilitasie program by die Netcare Rehabilitation Hospital effektief is in terme van fisiese onafhanklikheid van pasiente. Aan die ander kant het die NAC tellings daarop gedui dat die program minder suksesvol is wat betref die voorbereiding van pasiente vir gemeeskapsintegrasie. Spesifieke probleem areas sluit in kennis van waar om opvolg gesondheidssorg in die gemeenskap te bekom, gereedheid vir werk en toeganklikheid van die huis en werksomgewing. Daar word aanbeveel dat die rehabilitasie span by Netcare Rehabilitasie Hospitaal die program herevalueer om die effektiwiteit van die program in terme van die voorbereiding vir gemeenskaps herintegrasie te verbeter. Dit word ook aanbeveel dat ‘n opvolg studie gedoen word om die huidige sukses ten opsigte van gemeenskaps herintegrasie te evalueer en sruikelblokke te identifiseer ten einde die span the help met program beplanning.

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 (M Speech Path)--University of Stellenbosch, 2011. / ENGLISH ABSTRACT: Various approaches to the communication-development of the young child with a hearing impairment exist, of which the auditory-verbal approach is one. This approach is based on the principle that the child with a hearingimpairment develops speech- and language skills by using his/her residual hearing that is appropriately strengthened with the use of a hearing aid and/or cochlear implant. One of the most important requirements for the successful application of this approach is the appropriate transfer of the techniques and strategies that is used in institution-based intervention to the child’s home environment. Parents, teachers, speech-language therapists and audiologists are responsible for facilitating the transfer of intervention methods and acquired skills to the home environment and it is important that all team members are aware of his/her own, as well as each other’s roles, in the application of this approach. The principal aim of the proposed research project was to describe and explain the perceptions of parents/caregivers, teachers, speech-language therapists and audiologists, that are involved in the intervention of the hearing impaired child, regarding the auditory-verbal approach to education. Semi-structured interviews were conducted with nine parents of hearing impaired children younger than the age of four, and with four teachers that are involved in the education of the said children. Lastly, semi-structured interviews were held with four speech-language therapists and two audiologists that are involved in the provision of the intervention to hearing impaired children younger than four years. All the participants were affiliated with a specific centre for children with hearing impairment in the Western Cape province of South Africa. All the participants noted that parents must take part in the decision-making process with regards to the selection of the most suitable communication approach for their child with a hearing loss. Participants also agreed that most parents choose the auditory-verbal approach to communication development of their child because speech as a communication medium, is familiar to them and it is also associated with normality. Parents also indicated that the auditory-verbal approach is the most suitable approach for all children with a hearing loss. Teachers, speech-language therapists and audiologists did not completely agree with the parents as they mentioned some aspects, e.g. the presence of additional disabilities must be taken into account before a decision can be made regarding whether the child with hearing loss could follow the auditory-verbal approach to communication development. All participants displayed a positive attitude towards the auditory-verbal approach and it appears that parents, teachers, speech-language therapists and audiologists have good insight into the principles and outcomes of this approach. / AFRIKAANSE OPSOMMING: Daar bestaan verskeie benaderings tot kommunikasie-ontwikkeling by die jong kind met gehoorverlies waarvan die ouditief-verbale benadering een opsie is. Hierdie benadering is gebaseer op die beginsel dat die kind met gehoorverlies spraak- en taalvaardighede ontwikkel deur gebruik te maak van hulle residuele gehoor wat deur middel van die gebruik van ‘n gehoorapparaat en/of kogleêre inplanting toepaslik versterk word. Een van die belangrikste vereistes vir die suksesvolle toepassing van die benadering is toepaslike oordrag van die tegnieke en strategieë wat in terapie gebruik word, na die kind se tuisomgewing. Ouers, onderwysers, spraak-taalterapeute en oudioloë speel ‘n baie belangrike rol om hierdie oordrag na alledaagse kontekste te fassiliteer en dit is belangrik dat elke spanlid bewus is van sy/haar rol asook die ander lede se rolle in die toepassing van die benadering. Die hoofdoelwit van die voorgestelde navorsingsprojek was om ouers/versorgers, onderwyseresse, spraaktaalterapeute en oudioloë, betrokke by die intervensie en opvoeding van die kind met gehoorverlies, se persepsies rakende die ouditief-verbale benadering tot opvoeding te beskryf en te verduidelik. Tydens die studie is daar semi-gestruktureerde onderhoude gevoer met onderskeidelik nege ouers van kinders, jonger as vier-jaar oud, met gehoorgestremdheid en met vier onderwyseresse wat betrokke is by die die opvoeding van genoemde ouers se kinders met gehoorverlies. Laastens is daar ook semi-gestruktureerde onderhoude gevoer met vier spraak-taalterapeute en twee oudioloë wat betrokke is by die verskaffing van intervensie aan kinders met gehoorverlies, jonger as vier-jaar oud. Al die deelnemers was verbonde aan ’n spesifieke sentrum vir kinders met gehoorverlies in die Wes-Kaap provinsie van Suid Afrika. Al die deelnemers het aangedui dat ouers betrek word by die besluitnemingsproses rakende die keuse van die mees geskikte kommunikasie-benadering vir die kind met gehoorverlies. Deelnemers het almal saamgestem dat ouers meestal die ouditief-verbale benadering tot kommunikasie-ontwikkeling vir hulle kind kies omdat spraak as kommunikasiemedium bekend is aan die ouers en verband hou met normaliteit. Ouers het aangedui dat die ouditief-verbale benadering die mees toepaslike benadering is vir enige kind met gehoorverlies. Onderwyseresse, spraak-taalterapeute en oudioloë het nie volkome saam met die ouers gestem nie en hulle het genoem dat daar sekere aspekte, byvoorbeeld die teenwoordigheid van bykomende gestremdhede, is wat oorweeg moet word voor daar besluit word of die kind die ouditief-verbale benadering tot kommunikasieontwikkeling moet volg. Deelnemers het oor die algemeen ‘n positiewe houding getoon teenoor die ouditief-verbale benadering en dit wil voorkom asof ouers, onderwyseresse, spraak-taalterapeute en oudioloë goeie begrip toon van die beginsels en uitkomstes van die benadering.

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.