Previous research has indicated success using Social Stories with preschoolers with mild levels of autism. The purpose of this study was to determine if Social Stories implemented in the home setting would be effective with preschool children diagnosed with moderate to severe autism. Social Stories were implemented with 3 male preschool-aged participants. Two were classified as in the moderate range and one was in the severe range of autism. A variety of socially inappropriate behaviors were addressed including inappropriate dinnertime behaviors, transitioning to bedtime, and inappropriate touching. Data revealed no significant change in target behaviors (dinnertime behaviors and transitioning to bedtime) exhibited by moderately functioning preschool children. However, data did reveal a decrease in the frequency of inappropriate touching from the child who fell in the severe range of functioning. It is not clear from the current research whether it was the severity level of autism or the types of target behaviors that may have resulted in a lack of success using the Social Story intervention.

published_or_final_version / Paediatrics and Adolescent Medicine / Master / Master of Philosophy

published_or_final_version / abstract / toc / Speech and Hearing Sciences / Master / Master of Science in Audiology

Thesis (Ph. D.)--Drexel University, 2005. / Includes abstract and vita. Includes bibliographical references (leaves 121-125).

Thesis (MSc)--Stellenbosch University, 2001. / ENGLISH ABSTRACT: Although the neurodevelopmental therapy (NDT) treatment approach is used extensively in the management of children with cerebral palsy, there is currently very little documented research to support its efficacy. The purpose of this study was to evaluate the efficacy of NDT in terms of its effect on motor function in a group of 10 cerebral palsy children. A multiple simple single-subject design was used in which the children each acted as their own controls. A 5 week baseline period, during which no intervention was received by the children, was followed by a 5 week intervention phase during which the children received twice weekly NDT treatment. The children were assessed at the beginning and end of each phase using the Gross Motor Function Measure (GMFM), and an assessment tool, which allowed the establishment of individualised outcome measures, called TELER. The group of children demonstrated no statistically significant gains in motor function on either of the outcome measures during the baseline phase of the study. However during the intervention phase the overall improvements demonstrated by the group on both the GMFM and TELER were statistically significant. Nine out of the ten children achieved greater improvements in their goal total GMFM scores during the intervention phase than during the baseline phase. Similarly all of the children achieved a greater number of clinically significant improvements on the TELER outcome measures. NDT was beneficial and useful in promoting motor function in this group of cerebral palsy children. / AFRIKAANSE OPSOMMING: Alhoewel die Neuro-ontwikkelingsterapie (NOT) behandelingsbenadering wydeverspreid gebraik word in die behandeling van kinders met serebrale verlamming, is daar huidiglik baie min gedokumenteerde navorsing om die effektiwiteit daarvan te staaf. Die doel van hierdie studie was om die effektitiwiteit van NOT te evalueer met betrekking tot die impak daarvan op die motoriese funksie van ‘n groep van 10 kinders met serebrale verlamming. ‘n Veelvuldige eenvoudige enkeling -subjek raamwerk is gebruik waarvolgens die kinders elk as hul eie kontrolegoep ageer het. ‘n 5-weke basislyn fase, waartydens die kinders aan geen intervensies onderwerp is nie, is gevolg deur ‘n 5-weke intervensie fase waartydens die kinders twee keer per week NOT behandeling ontvang het. Die kinders is geevalueer aan die begin en einde van elke fase met die Oorhoofse Motoriese Funksie Maatstaf (OMFM)/Gross Motor Function Measure (GMFM), asook ‘n evalueringsmaatstaf genaamd TELER, wat die bepaling van geindivualiseerde resultate moontlik gemaak het. Die groep kinders het geen statistics bewese vordering in motoriese fiinksies getoon volgens beide die evalueringsmaatstawwe tydens die basislyn fase van die studie nie. Daarteenoor het die groep tydens die intervensie fase oorhoofs gesproke statistics bewese vordering getoon met betrekking tot beide die OMFM en die TELER. Nege uit die 10 kinders het groter vordering getoon met hul totale OMFM resultate tydens die intervensie fase as gedurende die basislyn fase. A1 die kinders het tegelykertyd ‘n groter hoeveelheid substantiewe kliniese verbeterings getoon met betrekking tot hul TELER uitkomste. NOT was voordelig en nuttig in terme van die verbetering van motoriese funksie in die groep van serebraal verlamde kinders.

The communicative interchanges of a congenitally deaf child who received a cochlear implant at 24 months of age were videotaped in fifteen hourly sessions over a nine month period while she participated in auditory-verbal therapy prior to and following implantation. The present study examined selected early communicative behaviors. Using Tait's (1993) protocol for charting communicative adult-child interaction, gestures, eye-gaze, and sound uttered either by the child or an adult during communicative interchanges were transcribed from the videotapes. Results corresponded with Tait's, revealing growth in the child's communicative interaction across sessions. In less than three months following implantation phonemic measures rose dramatically. Almost all phonemic measure correlations were significant, high, and positive.

A DISSERTATION SUBMITTED TO THE DEPARTMENT OF SPEECH PATHOLOGY AND AUDIOLOGY, FACULTY OF ARTS, UNIVERSITY OF THE WITWATERSRAND, JOHANNESBURG IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS IN SPEECH PATHOLOGY / Aspects of communicative competence encompassing syntactic, pragmatic and social skill dimensions were examined in preschool children. Subjects comprised five language-impaired children who had been declared remediated after a period of language therapy (Age 5.0-6.5) and five children of the same age considered to be linguistically normal. unstructured mother/child interactions yielded language samples which were analysed according to the Language Assessment Remediation and Screening procedure. Structured child/unfamiliar interlocutor dyadic interactions were analysed in terms of the Behavioural Inventory of Speech Act Performances and according to a devised pragmatic addendum. Social skill profiles were obtained by means of the Devereaux Elementary school Behaviour Rating Scale. No statistical differences occurred between groups on linguistic, pragmatic and social skill dimensions. Individual profiles of certain presumably remediated subjects revealed ineffective communicative modes in a structured dyadic context as well as communicative deficits and behavioural problems in the classroom situation. Significant correlations emerged among various linguistic pragmatic and social skill parameters. Theoretical and clinical implications of these correlations and of deficits uncovered by particular measures in different contexts, are discussed. / Andrew Chakane 2018

Continuous inter-limb coordination is the movement relationship between body limb segments (e.g. an arm and a leg) (Magill & Anderson, 2014) and is organized within the framework of the characteristics of the environmental conditions, the task demands, and the limb dynamics (e.g. the action capabilities of the individual) (Holt et al., 2000). When maximal coordination is achieved, stability, which is the defined as the system’s ability to offset a perturbation (Li et al., 2005), is optimized (Meyns et al., 2012). Individual coordinative relationships provide insights into neuromuscular deficiencies and their corresponding coordination difficulties (Kurz & Stergiou, 2004), such as those affecting children with cerebral palsy (CP) (Meyns et al., 2012). CP describes a group of neurodevelopmental disorders attributed to a non-progressive disturbance in the developing brain (Bax et al., 2005). Children with unilateral spastic CP (USCP), the most common subtype (Odding et al., 2006), are affected on one side of their body, experience problems with bimanual coordination, and indicate lower levels of inter-limb coordination and stability compared to their typically developing peers. This can affect both their functional independence and quality of life (Steenbergen et al., 2008; Meyns et al., 2012). To date, no study has evaluated whether inter-limb coordination of this population during a gross motor task can be improved with treatment. The goals of this study were to evaluate continuous inter-limb coordination and stability in children with USCP compared to typically developing children (TDC) and to determine if coordination and stability of children with USCP could be improved with intensive upper extremity (UE) intervention. Constraint Induced Movement Therapy (CIMT) and Hand Arm Bimanual Intensive Therapy (HABIT) were employed to both improve UE function and determine whether inter-limb coordination and stability are also improved. A total of 33 age-matched children participated, divided evenly into three groups of Treatment (n=6, CIMT; n=5, HABIT), No-Treatment, and Typically Developing. Vicon 3-D motion capture was used to collect movement data. Continuous measures of coordination using relative phase analysis, including Mean Absolute Relative Phase (MARP) and Deviation Phase (DP) were used to quantify coordination (MARP) and stability (DP) during novel, gross motor tasks of standing and in-place marching with symmetric and asymmetric arm swing. Results indicated that children with USCP have a lower level of coordination compared to TDC (p<0.05), but there is no difference in the stability of their patterns (p>0.05). This indicates that all children have difficulty producing consistent cyclical movements with their arms, regardless of pathology. All children also demonstrated greater difficulty coordinating their UE during the in-place marching tasks compared to the standing tasks (p<0.05), which may be due to the inherent increase in degrees of freedom associated with the addition of the lower extremities to the task. Treatment of either CIMT or HABIT improved coordination between the arms (p<0.05), but also decreased stability between the more affected arm and leg during the in-place marching tasks (p<0.05) with symmetric and asymmetric arm swing, respectively. This decrease in stability may represent the children’s inability to consistently execute the same cyclical movements for an extended period of time due to their newly learned patterns resulting from improvements in UE function after treatment. This is the first study to identify similarities in stability between TDC and children with USCP and to demonstrate improvements in continuous, inter-limb coordination after intensive UE intervention in this pathologic population. The finding that TDC do not indicate greater stability in their motor patterns may imply that their patterns are not yet mature. Therefore, it may be efficacious to intervene at a young age to ensure correct coordinative patterns are learned and become stable as the child matures. Evidence that both function and continuous coordination between the arms are improved after intervention also suggests that with increased gross motor practice during the intervention, continuous inter-limb coordination may improve in a greater variety of tasks. Due to the prominence and accessibility of UE interventions, implementation of more gross motor tasks may be an economical way to advance coordination, which can positively impact activities of daily living and increase participation in community activities in children with USCP.

Objective: The purpose of the study is to explore the gap of service quality between pediatric therapist and family of children with disabilities. Service Quality Model and SERVQAL were used to evaluate and compare expectations and performance of service quality for pediatric therapist and family members. Based on the research results, pediatric therapist and rehabilitation department can adjust the service quality and responsiveness. Method: Pediatric therapists and family of children with disabilities from 7 hospitals or rehabilitation clinics in Kaohsiung area completed an adapted SERVQUAL questionnaire. A total of 60 SERVQUAL questionnaires from pediatric therapists and 228 questionnaires from family members were distributed. Fifty-four questionnaires from pediatric therapists and 209 questionnaires from family were returned (response rate is 90% and 91%, respectively). The collected data was analyzed with descriptive statistics, t-test, and one-way ANOVA by using SPSS Windows version 17.0. Result: (1) The dimension of assurance was ranked the most important in expectations and performance of service quality for pediatric therapists and family of children. (2)The major expectation gap between pediatric therapists and family of children is the dimension of Responsiveness, and then Empathy. (3)The major gap between expectations and performance of service quality for pediatric therapists is the dimension of Tangibles. (4)The factor influences expectation of service quality is sex of pediatric therapists and family of children, autism diagnosis, and the level of the disabilities handbook. The factor influences performance of service quality is sex of pediatric therapists, the level of hospitals where therapists work, autism diagnosis, and the level of the disabilities handbook . Conclusion: For family of children with disabilities, it is very important that pediatric therapists not only get professional knowledge but also with abundant working experience. About service quality, pediatric therapists shall maintain professional and reliable services. The study suggests the tangible quality can be improved such as facilities, assistive device, environment cleaning, and parking problem.

While there is considerable evidence that applied behaviour analysis (ABA) is an efficacious treatment for Autistic Disorder (AD) in a controlled research setting, the effectiveness of current applications of ABA in the South African context have not yet been established. The aim of the present study was to evaluate the effectiveness of an intensive ABA programme for a young child with AD. A single case study was conducted using a within-subject, repeated measures, evaluation design. The ABA treatment, an applied verbal behaviour version ofABA (AVB/ABA), was implemented by behaviour consultants and technicians at TRIAD (Therapy and Research in Autistic Disorders): a private centre in Durban, KwaZulu-Natal, that specialises in the behavioural treatment of children with AD. The subject was a young boy, who was diagnosed with AD at the age of 21 months, initiated treatment at TRIAD at 22 month of age, and underwent 20 hours of treatment per week over a 22 month period. Cumulative outcome data across all learning domains was obtained using the standard outcome measure at the centre: the Assessment of Basic Language and Learning Skills (ABLLS). The ABLLS was administered by a senior behaviour consultant on five occasions, namely at baseline (i.e., at 0 months); at various intervals throughout the intervention (at 2,3, and 14 months); and in the final week of the study period (at 22 months). Results were tabulated and converted into linear graph format by the researcher. In addition, the caregiver was asked to rate the child's progress on a five point Likert scale as a means of establishing the social validity of the behaviour change. Visual inspection of the linear graphs revealed that the subject improved considerably across all ABLLS domains over the 22 month period and the child's caregiver rated that his behaviour had "significantly improved" since the onset of the intervention. In addition, at the end of the 22 month treatment period, the subject was enrolled in a mainstream school with the assistance of an aide and was engaging with same-age peers. The present study thus provides support for the effectiveness of the AVBIABA programme at TRIAD, contributes to the existing ABA outcome literature, and provides further evidence for the efficacy of the AVB approach to ABA. Furthermore, results confirm the role of predictor variables, such as age at onset, hours of treatment, skill acquisition rates, and parental involvement. Finally, given the gains made in the present study, it is suggested that the initial cost of intensive treatment may be economical in the long term. / Thesis (M.A.)-University of KwaZulu-Natal, 2008.