Employment is viewed as one of the pinnacle factors in enhancing quality of life. Despite being a right in South Africa, the employment opportunities available to individuals with Down syndrome are limited. This study aimed to explore the employment experiences of individuals with Down syndrome, their employers and their families in KwaZulu-Natal. This research provided valuable information for Speech-Language Therapists on enhancing communication in the workplace as effective communication in the workplace is crucial for employment. A qualitative approach and phenomenological design were used within the context of International Classification Framework, biopsychosocial model and critical paradigm. Individual semi-structured interviews were conducted and thematic analysis was used to analyse the data. Results revealed that individuals with Down syndrome valued their employment for the emotional and financial support it provided and the skill development opportunities available. Gaps were evident in legislation specific to the employment of individuals with Down syndrome as well as the implementation of these limited policies. Communication is necessary in the workplace; however, it is one of the areas that is severely impacted in individuals with Down syndrome. Employers and family members’ experiences indicated variability in speech intelligibility, language and literacy skills among the participants with Down syndrome linked to cognitive ability, intervention, education received, mood swings and memory loss. Intriguing trends relating to the positive use of technological devices for social and recreational purposes were evident. Employment success can be linked to successful job selection, visual and emotional support. Speech-Language Therapists, employers, family members and the Down syndrome association were found to have crucial roles in providing this support. The role of the Speech-Language Therapist continues to evolve and is required across the lifespan for different purposes. / M.Sc. University of KwaZulu-Natal, Durban 2013

A descriptive survey with 19 Speech-Language Therapists from public health and four from private health was used to obtain an overview of Speech-Language Therapy services for children with cleft lip and/or palate from birth to three years in the KwaZulu-Natal Health Sector. Results are presented for public health, as none of the four private based respondents worked with cleft lip and/or palate from birth to three years. The number of Speech-Language Therapists (9) working with cleft lip and/or palate (0-3 years) in KwaZulu-Natal appears not to have changed significantly over the past two to three years, similar to the incidence of cleft lip and/or palate births. Reasons for Speech-Language Therapists not working with this population included poor referrals and caseloads comprising of clients older than three years. A team approach to cleft care appears challenging but showing development. There are currently four institutions where professionals function as multidisciplinary teams, consisting mainly of Speech-Language Therapists, doctors and nurses. Speech-Language Therapists’ assessments include case history taking, oral peripheral examination, observational feeding assessment and speech-language assessment. Most therapists are consulted within a few days of the birth, which is consistent with international guidelines. Audiological assessment and assessment of resonance were mentioned by a minority of participants. Feeding devices for cleft lip and/or palate are not always available immediately, and hence appears contradictory to the National Rehabilitation Policy. Recommendations include undertaking similar research in other provinces, so as to build a nationwide overview of services for South African children with cleft lip and/or palate. / Thesis (M.Sc.)-University of KwaZulu-Natal, Westville, 2011.