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This research problem concerns a follow-up study of seventy-nine boys who have undergone extensive therapy and supervised training in group-living over an extended period of time at Camp Woodland Springs, Dallas, Texas. The problem under consideration is one of determining the operating efficiency of this institution in its main purpose of rehabilitating boys who have generally lacked the social and personal skills necessary to satisfactory adjustment in their respective environments.

Thesis (MA)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Movement plays an important role in a child’s life. Typically developing children develop motor skills as they explore their environment. Motor skills are important, as they contribute to a child’s overall wellbeing, assisting in play, academics, social development and physical activity. These motor milestones developed during childhood, and can be used as indicators of atypical development. Children with a complex neurodevelopmental disorder such as Autism Spectrum Disorder (ASD) show signs of atypical development, as they are recognised as being clumsy and uncoordinated in their gross and fine motor skills. Besides motor delays, parents and caregivers report that children with ASD also exhibit delays in social communication, interaction and repetitive behaviours and interests, during the early stages of development. Research has suggested a possible relationship between motor and social development. For example, motor skills are important as they provide children with the necessary tools to successfully engage in physical activity, socially communicate and interact with peers. Children with ASD, however, participate in physical activity less often than typically developing children which hinders the mastery of motor skills, in turn causing social isolation and further social dysfunction. Interventions are, therefore, necessary to provide children with ASD opportunities to learn the essential gross motor skills, which could help them improve their self-esteem, leading to increased participation in physical activity and further social skill development. The purpose of the current study was to implement a 12-week specialised group intervention programme to improve the gross motor and social skills of selected children diagnosed with ASD between the ages of 8 and 13 years. In the Cape Town area, a governmental school for autistic learners was recruited to take part in this study, as the school divided learners into classes based on their level of autistic function. Therefore, the sample in the current study was a sample of convenience. Two classes (N=7) at the school participated; 1 formed the experimental group (n=4) and the other the control group (n=3). The children completed the Movement Assessment Battery for Children-2 (MABC-2), and parents or legal guardians and teachers of participants filled out the Social Responsiveness Scale-2 (SRS-2) questionnaire. This was done to provide an overview of the children’s fine and gross motor and social skill proficiency. A 12-week group intervention programme was designed and then implemented by the researcher, with the focus on improving overall gross motor proficiency and social skills of participants in the experimental group. The effect of the 12-week group intervention programme was determined by analysing and comparing the pre- to post-test results. The group-time interaction effect was examined to determine if the experimental group presented a different effect from the control group over time. The main findings of the current study showed that the 12-week group intervention programme made significant improvements in the total motor proficiency as well as in the balance subtest of the MABC-2 in children with ASD. Significance was also found within the experimental group in the aiming and catching subtest of the MABC-2. Unfortunately, the current study found no significant improvements after the 12-week group intervention programme in total social skill competency, as well as in all subtests of the SRS-2 in children with ASD. The current study shows the effectiveness of a 12-week group intervention programme on the gross motor skills of children with ASD. The findings also suggest that social skills should be taught alongside motor skills, in order to achieve positive outcomes in both aspects of development. Further investigation is needed with regards to the relationship between motor and social skills, as well as additional examinations as to whether improved motor skills, results in improved social development. / AFRIKAANSE OPSOMMING: Beweging speel ʼn belangrike rol in ʼn kind se ontwikkeling tot ʼn volwaardige volwassene. Kinders sal tipiese motoriese vaardighede aanleer soos hulle hul omgewing verken. Motoriese vaardighede is belangrik omdat dit tot akademiese, sosiale, fisieke, speel aktiwiteite en ʼn kind se algehele welstand bydra. Die mylpale wat gedurende die kinderjare bereik word, is ʼn belangrike aanwyser van atipiese ontwikkeling. Kinders met ʼn komplekse neuro-ontwikkelingsversteuring soos Outisme Spektrum Versteuring (OSV), toon tipies tekens van atipiese ontwikkeling omdat hulle onbeholpe en ongekoördineerd in hul groot en fynmotoriese vaardighede voorkom. Afgesien van motoriese agterstande rapporteer ouers en versorgers dat kinders met OSV gedurende die vroeë kinderjare ook agterstande in sosiale kommunikasie, interaksie en herhalende gedrag en belangstellings toon. Navorsing toon ʼn moontlike verhouding tussen motoriese en sosiale ontwikkeling. Motoriese vaardighede is belangrik omdat dit kinders met die nodige vaardighede toerus om fisieke aktiwiteite suksesvol uit te voer, om te kan speel, om te sosialiseer en om met hulle eweknieë te kan verkeer. Kinders met OSV sal tipies aan minder fisieke aktiwiteite as kinders wat normaal op dié gebiede ontwikkel, deelneem en sodoende sal dit tot verdere sosiale isolasie en sosiale disfunksie aanleiding gee. Intervensies is daarom, belangrik om kinders met OSV geleenthede te bied om die noodsaaklike grootmotoriese vaardighede, wat hul selfagting kan verhoog, hul deelname aan fisieke aktiwiteite kan verhoog en verbetering in sosiale ontwikkeling kan aanmoedig, aan te leer. Die doel van die huidige studie was om met ʼn gespesialiseerde groep intervensieprogram die grootmotoriese en sosiale vaardighede van ʼn geselekteerde groep kinders, tussen die ouderdom van 8 en 13 jaar, wat met OSV, gediagnoseer is te implementeer. Een regeringskool vir Outistiese leerders in die Kaapstad omgewing is geselekteer om aan hierdie studie deel te neem. Omdat die skool die leerders in klasse op grond van hul graad vlak van Outisme verdeel, is daar van ʼn gerieflikheidsteekproef gebruik gemaak. Leerder in twee klasse (N=7) van die skool het deelgeneem; 1 groep was die eksperimentele groep (n=4) en die ander groep (n=3) die kontrolegroep. Die kinders het die Movement Assesment Battery for Children-2 (MABC-2), voltooi en die ouers of die wettige voogde en onderwysers het die Social Responsiveness Scale-2 (SRS=2), vraelys voltooi. Die is gedoen om ʼn oorsig van die kinders se fyn- en grootmotoriese- sowel as sosiale vaardighede te bekom. Die 12-week groep intervensieprogram wat op die algehele verbetering van groot motoriese- en sosiale vaardighede van al die deelnemers in die eksperimentele groep gefokus het, is deur die navorser ontwikkel en geïmplementeer. Die effek van die 12-week groep intervensieprogram is deur die ontleding en vergelyking van die voor- en na-toets data bepaal. Die groep-tyd interaksie-effek is ondersoek om te bepaal of die eksperimentele groep 'n ander effek as die kontrole groep met verloop van tyd toon het. Die belangrikste bevindinge van die huidige studie het getoon dat die 12-week groep intervensieprogram aansienlike verbeteringe in die totale motoriese vaardigheid, sowel as in die balans sub-toets van die MABC-2, by kinders met OSV te weeg gebring het. Betekenis is ook binne die eksperimentele groep by die mik- en vang sub-toets van die MABC-2 gevind. Ongelukkig is geen betekenisvolle verbeteringe in sosiale vaardighede, sowel as in al die sub-toetse van die SRS-2 by die kinders met OSV gevind nie. Die huidige studie het die doeltreffendheid van 'n 12-week groep intervensieprogram op die grootmotoriese vaardighede van kinders met OSV getoon. Die bevindinge dui ook daarop dat sosiale vaardighede saam met motoriese vaardighede aangeleer moet word, om sodoende positiewe uitkomste in beide aspekte van ontwikkeling te kan bereik. Verdere navorsing met betrekking tot die verhouding tussen motoriese en sosiale vaardighede is nodig, sowel as verdere navorsing om te bepaal of verbeterde motoriese vaardighede ʼn verbetering in sosiale ontwikkeling sal toon.

Autistic adolescents need direct, systematic training of social skills since major difficulties in communication, lack of empathy, and various changes during adolescence present major roadblocks to the acquisition of normal peer relationships and increasing independence. A case study approach was utilized to examine treatment effects of a social skills training program implemented with four autistic adolescent boys in a naturalistic setting. Findings based on objective measures and subjective reports indicated that each subject made gains in targeted social skills over the course of treatment. Treatment strategies such as modeling, coaching, roleplaying, one to one instruction, and in vivo procedures were found to be effective teaching techniques. Major benefits and limitations of the study were discussed.

A research report in partial fulfilment of the requirements for the degree of Masters of Arts in Audiology by coursework and research report in the Faculty of Humanities, University of the Witwatersrand, 2016 / Auditory-verbal therapy (AVT) is an intervention approach used as part of an aural (re)habilitation programme conducted by an audiologist with deaf or hard-of-hearing (HOH) children. AVT is a refinement of the oral-aural approach and emphasizes listening instead of visual input. Previous research has focused on AVT in developed countries; however, there is limited available research in developing countries such as South Africa. This study explores and describes the relevance of AVT provided by audiologists in Gauteng, South Africa. The specific objectives of the study were to explore the differences between AVT and general paediatric aural rehabilitation therapies conducted by audiologists; the impact of language on the implementation of AVT and the challenges associated with AVT training. A qualitative research design was used. A purposive sampling strategy was used to identify and recruit participants. Ten audiologists currently conducting aural rehabilitation were selected to participate in the study. The sample size was divided into five audiologists who had obtained the LSL certification (equivalent to AVT certification) and five audiologists without the LSL certification. A pilot study was conducted prior to data collection to determine the applicability of the research study. Thereafter semi-structured interviews were conducted, using an interview schedule. Thematic analysis was employed and themes were described qualitatively. Results revealed the emergence of three resounding themes which included challenges, differences in therapy approaches, and implementation and contributing factors to the success of AVT. The results concluded the need for the implementation of newborn hearing screening programmes to assist with early identification and detection of hearing loss. The study identifies a strong need for the increase in the number of certified LSL therapists in South Africa and additional AVT comprehensive programmes to be implemented at various institutions in Gauteng. Awareness regarding the success of AVT implementation needs to be raised. Finally, the HPCSA needs to revisit and explicitly define the role of audiologists interacting with deaf or HOH children with the LSL qualification being a mandatory postgraduate pre-requisite for working in the field of aural rehabilitation. Key words: Auditory-verbal therapy; aural rehabilitation; deaf; hard-of-hearing. / GR2017

The primary goal of human locomotion is to stably translate the center of mass (CoM) over the ground with minimum expenditure of energy. Pelvic movement is crucial for walking because the human CoM is located close to the pelvic center. Because of this anatomical feature, pelvic motion directly contributes to the metabolic expenditure, as well as in the balance to keep the center of mass between the legs. An abnormal pelvic motion during the gait not only causes overexertion, but also adversely affects the motion of the trunk and lower limbs. In order to study different interventions, recently a cable-actuated robotic system called Tethered Pelvic Assist Device (TPAD) was developed at ROAR laboratory at Columbia University. The cable-actuated system has a distinct advantage of applying three dimensional forces on the pelvis at discrete points in the gait cycle in contrast to rigid exoskeletons that restrict natural pelvic motion and add extra inertia from the rigid linkages. However, in order to effectively use TPAD for rehabilitation purposes, we still need to have a better understanding of how human gait is affected by different forces applied by TPAD on the pelvis. In the present dissertation, three different control methodologies for TPAD are discussed by performing human experiments with healthy subjects and patients with gait deficits. Moreover, the corresponding changes in the biomechanics during TPAD training are studied to understand how TPAD mechanistically influences the quality of the human gait. In Chapter 2, an ‘assist-as-needed’ controller is implemented to guide and correct the pelvic motion in three dimensions. Here, TPAD applies the correction force based on the deviation of the current position of the pelvic center from a pre-defined target trajectory. This force acts on the pelvic center to guide it towards the target trajectory. A subject in the device experiences a force field, where the magnitude becomes larger when the subject deviates further away from the target trajectory. This control strategy is tested by performing the experiments on healthy subjects with different target pelvic trajectories. Chapter 3 describes a robotic resistive training study using a continuous force on the pelvis to strengthen the weak limbs so that subjects can improve their walking. This study is designed to improve the abnormal gait of children with Cerebral Palsy (CP) who have a crouch gait. Crouch gait is caused by a combination of weak extensor muscles that do not produce adequate muscle forces to keep the posture upright, coupled with contraction of muscles that limit the joint range of motion. Among the extensor muscles, the soleus muscle acts as the major weight-bearing muscle to prevent the knees from collapsing forward during the middle of the stance phase when the foot is on the ground. Electromyography, kinematics, and clinical measurements of the patients with crouch gait show significant improvements in the gait quality after the resistive TPAD training performed over five weeks. Both Chapters 2 & 3 present interventions that are bilaterally applied on both legs. Chapter 4 introduces a training strategy that can be used for patients who have impairments in only one leg which results in manifests as asymmetric weight-bearing while walking. This training method is designed to improve the asymmetric weight bearing of the hemiparetic patients who overly rely on the stronger leg. The feasibility of this training method is tested by experiments with healthy subjects, where the controller creates an asymmetric force field to bring asymmetry in weight bearing during walking. In summary, the present dissertation is devoted to developing new training methods that utilize TPAD for rehabilitation purposes and characterize the responses of different force interventions by investigating the resulting biomechanics. We believe that these methodologies with TPAD can be used to improve abnormal gait patterns that are often observed in cerebral palsy or stroke patients.

The early selection and use of an appropriate amplification system may be the most important aspect in the aural! rehabilitation of children who are hearing impaired. The main goal guiding the selection of hearing aids for children is to maximize their residual hearing through amplification in order to facilitate speech and language development. Seewald, Ross, and Stelmachciwicz (1987) have developed a speech-spectrum based procedure for selecting hearing aid characteristics for children referred to as the Desired Sensation Level Procedure (DSL) approach. This is an objective method which has been developed specifically for use with young pre-verbal children. I The purpose of the present study was to determine how closely the previously fitted amplification systems of profoundly hearing-impaired children approximated the amplification targets that would be prescribed for their hearing losses by the DSL method. The data were used to examine the feasibility and appropriateness of the DSL method for prescribing amplification for children with profound hearing impairments. Twenty amplification systems worn by profoundly hearing-impaired children were electroacoustically evaluated to discover how closely they approximated the DSL fitting criteria. Hearing thresholds were obtained for each subject for the frequencies 250, 500, 1000, 2000, and 4000 Hz using puretone audiometry. The DSL computer program was used to generate prescribed 2 cc. coupler targets at each frequency. The subjects' amplification systems were electroacoustically analyzed to determine the measured 2 cc. coupler response. Means and standard deviations were reported for prescribed and measured gain values at each frequency. Two-tailed t-tests were computed to determine if a difference exists between prescribed and measured gain. The tests were considered significant at the .05 level. A significant difference between the means was found at 2000 and 4000 Hz. Correlation coefficients were calculated at each frequency to determine if a predictable relationship between prescribed and measured gain existed. Correlation coefficients showed weak relationships between the two groups of data. These results showed the difficulty of meeting prescribed amplification targets, particularly in the high frequencies for children with profound hearing impairments.

[Truncared abstract] Introduction: The assessment of any therapy requires not only an understanding of how that therapy works but also how it affects health related quality of life (HRQOL). Botulinum Toxin A(BoNT-A) therapy for upper limb spasticity management in children with hemiplegic cerebral palsy(CP) is currently under trial. Despite its use for over a decade for lower limb spasticity, little is known about the mechanisms involved in improving motor function and the effect on the child and their familys HRQOL. Both central and peripheral mechanisms are hypothesised[1]. Whilst evidence of improved quality of movement and ability to perform tasks is emerging[2-4], this cannot be directly correlated with an improvement in HRQOL. In addition, the traditional method of assessing child HRQOL by parent proxy reports has come under question[5, 6]. The World Health Organisation now recommends the collection of both parent proxy and child self-reports[7]. Aims: 1. Investigate the corticomotor projections to the upper limb in school aged children with hemiplegic CP and the changes that occur with BoNT-A therapy by transcranial magnetic stimulation (TMS). 2. Investigate the effect of upper limb BoNT-A therapy on HRQOL of school aged children with hemiplegic CP by completion of the PedsQL 4.0 Generic Core Scales and 3.0 CP Module. 3. Determine the concordance between Child Self-Report and Parent Proxy Report scores for the PedsQL 4.0 Generic Core Scales and 3.0 CP Module. 4. Determine the concordance between PedsQL scores and function as assessed by the Melbourne Assessment of Unilateral Upper Limb Function (MUUL). Methods: Design: Prospective randomised pilot study. Setting: Department of Paediatric Rehabilitation, Princess Margaret Hospital, and Centre for Neurological and Neuromuscular Disorders, Perth. Participants: 22 school aged children with hemiplegic CP aged 7yr 0mth-13yr 11mth (12 treatment, 10 control). 3 Treatment: One episode BoNT-A injections (dose 1-2U/kg/muscle) into the upper limb for treatment group. The control group received usual care. ... Conclusion: This pilot study provides preliminary evidence of the effects of upper limb BoNT-A therapy at both a central physiological and a broader quality of life level in school aged children with hemiplegic CP. At a central level, corticomotor pathway reorganisation occurs in the setting of BoNT-A. However the reorganisation is not limited to the affected side pathways suggesting a systemic BoNT-A effect or developmental changes. Similarly, in this pilot study, there was no statistically significant effect of upper limb BoNT-A on the childs HRQOL as assessed by the PedsQL although positive trends were observed 4 for a number of physical and psychosocial domains. The collection of both child self-report and parent proxy reports when assessing HRQOL is recommended, and function needs to be assessed independently. Larger studies across the broader CP population, the design of CP specific HRQOL tools appropriate for use in the higher functioning CP cohort, and alternative better tolerated methods of investigating the motor system in children with movement disorders are recommended.

<p>This study aimed at looking at children&rsquo / s perceptions of violence, exploring the experiences on child violence and lastly perceptions of children about intervention strategies in children&rsquo / s homes. The participants were sourced from the rehabilitation centres, at the children&rsquo / s homes in Khayelitsha. A manageable group of between 8 participants was used in the study. The participants were adolescents aged between 14-16 years old. The data was collected through individual interviews and was analysed in terms of thematic analysis. Each interview was tape recorded and transcribed. The ethics was taken into considerations from the onset process of recruitment, and for this reason the consent and assent letters were be provided and signed by both participants and care givers. Counselling support was provided for the participants. The common belief in this study was that the majority of the violence is found in the areas of their origin, which were the townships where they grew up. Generally, the participants held different beliefs on their sense of safety, which was related in the current area in which they live. The ultimate conclusions that have been drawn from the findings, suggest that children experience various difficulties and challenges, in their lives within children&rsquo / s home. Despite these challenges and difficulties that are encountered, participants appear to remain relatively contented with life in the home. Moreover, the participants also appeared to demonstrate a greater preference for living within the home over that of the previous living conditions from which they originate.</p>

published_or_final_version / Music / Master / Master of Philosophy