Introduction: Adults with intellectual disability (ID) have a right to be included in post-school education (PSE) opportunities such as learnership programmes. They face many barriers, however, including the fact that learning facilitators do not know how to include and teach these learners with ID in a PSE context. Problem: No literature or documented evidence has been captured about inclusive educational approaches describing how learning facilitators taught adults with ID in three learnership programmes that can be used to develop training programmes that will equip learning facilitators with the necessary skills for teaching this group of learners. Rationale: Learning facilitators need to be adequately trained, equipped and supported to meet specific learning needs of adults with ID in learnerships. This study will provide a resource of practice-based educational strategies that could serve as the basis for this training. Aim: To describe how learning facilitators in learnership programmes at Organisation X provided teaching to adults with ID. Method: An indepth, moderately structured, open-ended interview method was used to collect data from six participants. Three Universal Design for Learning (UDL) principles and related guidelines were used to inform how the interview questions were structured. Findings: The main theme was “a learnership takes time, patience and many adjustments but it has to be done” that comprised three categories: namely “dealing with intellectual disability”, “streamlining learnership strategies” and “perceiving the 'just right’ learnership”. The sub-categories identified were populated into the UDL Framework. Discussion: Learnership programmes with adults with ID are time consuming and personally demanding for learning facilitators, but adults with ID have a right to access these programmes. Training programmes for learning facilitators need to include aspects of how to deal with learners with ID, what curriculum differentiation strategies need to be streamlined, and how to create the 'just right’ learnership. Conclusions: Learning facilitators believe that learners with ID have the right to access PSE and participate in learnerships. The success of post-school learnerships lies in providing the “just right” curriculum that offers support for both educator and learner.

Title: Determinants of positive functional outcomes at 16 weeks after flexor tendon repair at a tertiary hospital in the Eastern Cape of South Africa: A descriptive, analytical study. Introduction: Flexor tendon injuries account for a substantial number of hand injuries presenting to health care facilities, yet rehabilitation following flexor tendon repair remains a challenge. There is limited research pertaining to flexor tendon rehabilitation in middle economic income countries like South Africa. Objectives: The aim was to identify determinants of positive functional outcomes sixteen weeks after flexor tendon repair at a tertiary hospital in South Africa. The objectives were: 1) to describe the functional outcomes at four, eight, twelve and sixteen weeks post flexor tendon repair using total active motion (TAM), muscle strength and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, 2) to ascertain the demographic profile for patients presenting to the hospital with a flexor tendon injury, 3) to describe the rate of recovery between the four assessment intervals, and 4) to cross-culturally translate the DASH questionnaire into isiXhosa. Method: Ethical approval was obtained through the University of Cape Town’s Human Research Ethics Committee. A quantitative, descriptive, analytical design was used. The DASH was translated as per the guidelines for cross-cultural translation by the Institute for Work and Health. All patients presenting to the target institution with a flexor tendon injury between February and August 2017 formed the sample. Twenty-two participants were recruited. Participants were assessed at four, eight, twelve and sixteen weeks post operatively using TAM, muscle strength and the DASH questionnaire. Demographic and treatment factors for each participant were compared to 16-week DASH scores using Mann-Whitney U and Kruskal-Wallis ANOVA tests. The rate of recovery was analysed using Spearman’s Rank Correlation Coefficient, Friedman’s ANOVA and Wilcoxon Matched Pairs for TAM, DASH score and muscle strength respectively. Results: Time to repair was the only factor to have statistical significance at 16-weeks post operatively (H(df=9)=15.3; p=0.05). Rate of recovery when compared to DASH (F(df=3)=12.98; p=0.005) and muscle strength (Z=3.076; p=0.002) scores showed statistical significance, though TAM did not (rs(df=2)=0.06; p=0.78). The epidemiological profile was similar to those documented elsewhere in South Africa and globally. Conclusion: The outcomes achieved in the present study were poorer than those described in the vast body of literature in the field, but similar to those described in a similar cohort elsewhere in the country. The demographic profile was similar to those previously documented in South Africa and across the globe, but with different environmental and institutional barriers. Rate of recovery appears greatest between four and eight weeks, as well as between weeks twelve and sixteen. Time to repair showed that it is not harmful to delay primary flexor tendon repair up to six days post injury. Recommendations for future policy, education, practice and research were made.

No description available.

PURPOSE: The purpose of this study was to investigate the relationship between auditory-perceptual measures of monopitch and acoustic correlates, and to compare these measures between a group of participants with Parkinson’s disease (PwPD) and a control group of age- and sex-matched participants without Parkinson’s disease. METHOD: Twenty listeners rated 60 recordings of speakers (30 PwPD, 30 controls) on degree of monopitch using a VAS. An acoustic correlate was derived by tracking the difference between fundamental frequency variations at final and non-final unit boundaries (foVUBdiff) in the 60 speech recordings. RESULTS: PwPD were rated as having a higher degree of monopitch and were found to have a lower foVUBdiff when compared to the control group. A statistically significant relationship between auditory-perceptual measures of monopitch and acoustic correlate was found. CONCLUSION: This study revealed the following: (1) PwPD were found to have higher auditory-perceptual ratings of monopitch when compared to the control group; (2) PwPD were found to have less foVUB at non-final unit boundaries and less foVUBdiff between unit boundaries when compared to the control group; (3) There is a correlation between the auditory-perceptual measures of monopitch and acoustic correlate. Together, these findings suggest that the acoustic correlate, foVUBdiff taken across unit boundaries in The Rainbow Passage shows promise as an objective measure of perceived monopitch.

Conversation treatment for persons with aphasia (PwA) can lead to significant changes on measures of language impairment and quality of life. The COVID-19 pandemic resulted in greater use of telepractice treatment delivery; however little evidence exists regarding efficacy of a telepractice conversation group. The present study investigated the effects of telepractice group conversation treatment on standardized measures of language function and social oriented/patient-reported outcomes, as compared to in-person, and no-treatment control data. Eight PwA were recruited for inclusion in a telepractice conversation group treatment using a delayed, within-subjects design. Participants were compared to data taken from a larger RCT conducted previously (seven in-person participants and eight no-treatment control group participants). Results of evaluations conducted at baseline, pre-treatment, and post-treatment intervals revealed significant improvement from pre to post treatment on repetition and picture description tasks for the telepractice group. Compared to in-person group and no-treatment group data, results suggest superior benefits for in-person delivery of conversation group treatment compared to telepractice delivery. However, both in-person and telepractice treatment are superior to a no-treatment paradigm. Overall, results prompt further research regarding telepractice group conversation treatment for PwA.

No description available.

The lack of contextually relevant conceptual tools to promote play makes implementing playbased, occupation-centred practice challenging for occupational therapists working with children with HIV/Aids in low resourced settings. This doctoral thesis focussed on reviewing and generating evidence, and further proposed a play-based intervention framework for children with HIV/Aids living in a low resourced setting. Theoretical frameworks used to guide the intervention development process and content of the play-based intervention were the United Kingdom Medical Research Council (UK MRC) framework for development and evaluation of complex interventions and Cooper's Model of children's play. The development of the play-based intervention involved four phases: 1) conducting a systematic review, 2) profiling of the play of children with HIV/Aids, 3) drawing perspectives of caregivers through in-depth interviews, and 4) gaining consensus from experts on components to include in the play-based intervention framework. In phase 1, a systematic review following the PRISMA guidelines was conducted to identify evidence that support the development of play-based interventions. Eighteen studies that focused on play as an outcome and compared the play of children with Special Health Care Needs (SHCN) to that of typically developing children met the eligibility criteria. The Kmet checklist was used to evaluate the methodological quality of the studies included. The systematic review revealed paucity of research on the play of children with SHCN such as those with HIV/Aids. Phase 2 was undertaken to generate more evidence by comparing the play profiles of 44 children with HIV/Aids aged 4-7 years to that of 52, age and gender matched typically developing children. The children were video-recorded while playing with a playmate at school or clinic and home settings. The Test of playfulness was used to score the videos by two independent raters and the scores were subjected to rasch analysis. A comparison of play profiles revealed that children with HIV/Aids were significantly less playful outdoors as compared to typically developing children (t(94) = 3.57, p = 0.001). Children with HIV/Aids also had more challenges with social play skills. In phase 3, contextual understanding of the play of children with HIV/Aids was sought through in-depth interviews with fifteen purposively selected caregivers whose children with HIV/Aids had participated in phase 2 of the study. The interviews were audio-recorded, transcribed verbatim and analysed thematically. The following four themes emerged: ‘Ubuntu is no more'; ‘survival is primary (chikuru kurarama)'; ‘play affirms that my child is still like other children'; and ‘more is required for a child with HIV'. Caregivers also reported on how contextual factors such as HIV/Aids stigma, poverty and cultural beliefs shaped the play of their children. In phase 4, findings from phases 1, 2 and 3 were synthesised and presented to experts in the field of play, HIV/Aids and intervention development during a two-round Delphi study. Experts were asked about their opinions and to rate what should be included in the play-based intervention framework. Consensus agreement was reached when at least 70% of Delphi experts rated each item at 3 or higher on a 5-point Likert Scale. Experts agreed on the application of Cooper's Model of children's play as a theoretical framework, as well as principles and techniques for the play-based intervention. This study is the second in occupational therapy to report on the play of children with HIV/Aids. It is the first one to review and generate evidence to support play-based interventions targeted at children with HIV/Aids. Evidence generated in this study showcased the need for occupation-centred, play-based services for children with HIV/Aids, particularly those living in low resourced settings. The play-based intervention proposed is child-led, allowing for physical and active involvement of the child. To increase social interaction and continuity into the home environment, playmates and caregivers must be included. Unique to this play-based intervention is advocacy for more play opportunities, access to nutrition and inclusion of culturally sensitive practices. Future studies should include feasibility on various aspects of the play-based intervention before implementing randomised controlled trials to test the effectiveness of the intervention are conducted.

Distinctly African health-promoting human occupations are under-researched in occupational therapy. Many occupational therapy interventions used in South Africa have been developed elsewhere and may be inaccessible to many. African dance that produces neurogenic tremors (ADNT) is an occupation that may already be accessible to many, and a potential resource for health and could be used in occupational therapy. Research Question: What is the nature and enactment of ADNT? Aim: The study aimed to explore, describe and explain the nature and enactment of ADNT among professional dancers in Cape Town, South Africa. Research objectives: To explore the perceived temporal, spatial and sociocultural conditions conducive for ADNT. To describe and explain the enactment of ADNT in terms of format, pace, and the sequence of steps involved in performing African dance repertoires that are known to produce neurogenic tremors. To describe the experience of those who participate in ADNT by exploring the subjective effect it has had on stress levels or during stressful periods. Methodology: Case study methodology was used. Semi-structured interviews, focus groups, and participant observation were the data collection methods used. Thematic analysis was employed to analyse the data. Findings: Four themes emerged from the study (1) Triggers: Improvisation, Energy and pushing beyond limits. (2) Essence of self: Embodying Africa through dance. (3) Leaving and returning to the body and (4) Creatures of the soil: Connected to the ground and beyond…for health. Discussion: ADNT is healing, relational, transcendent, and contextually situated. It facilitates self-acceptance (ubuwena) through embodying Africa (KwaNtu) and holds potential to promote social cohesion (ubuntu). It is mainly enacted through improvisation (on and off-stage), through which socio-historical-cultural intergenerational resources (isintu) embedded within, are tapped into. ADNT offers opportunities for connectedness with the self, other people, as well as with transcendent beings. Conclusion: This study has illuminated the nature of ADNT as an extraordinary human occupation that offers participants instances of personal and collective meaning-making, healing, and transcendence. Transcendence is proposed as a source of personal and shared meaning.

Includes bibliographical references (leaves 93-101). / This study focused on a small business enterprise in the Western Cape that primarily employs people with disabilities (PWDs) in the open labour market arena. However, the company has been experiencing annual turnover rates of 26.6% in terms of labour, resulting in a substantial financial loss. The purpose of the study was, therefore, to identify reasons for this attrition by PWDs, which effectively defeats the objective of the economic empowerment of PWDs that the company has set for itself.

Includes bibliographical references (leaves 110-123) / There is a growing demand for primary health care services in South Africa following its adoption by the National Departmet of Health in 1995. To address this demand, the government has implemented compulsory community service (CCS) for all health professional graduates, many of whom are placed in unde-resourced areas of the country with limited infrastructure or professional supervision. Occupational therapy graduates therefore require appropriate knowledge, skills and attitudes for primary health care practice.