This research describes the development of communicative intention of young children with cochlear implants in order to study the relationship between the early communicative intention of these children and their later verbal communication. Five children under the age of three years with cochlear implants were selected from the records of the University of Stellenbosch, Tygerberg Academic Hospital’s Cochlear Implant Unit, Cape Town as subjects. Video recordings of each of the five subjects in unstructured free play interaction with their caregivers, before cochlear implantation and each six months after cochlear implantation over a period of two years were used to identify the development of their communicative intention. The Communicative Intention Inventory (Coggins&Carpenter, 1981) was used to classify the communicative behaviour of the subjects according to the types of communication functions that were used, as well as the way in which they expressed the functions of communication. Results of the study show that the development course of the functions of communication that the subjects used over a two-year period, were consistent with the development patterns found in younger children with normal hearing. There was however marked individual differences between the subjects during the transition from nonverbal to dominantly verbal ways of communication as far as the rate of development of verbal communication was concerned. A strong relationship was found among the five subjects regarding the use of the nonverbal communication functions, request for object or action and protest before cochlear implantation and their total verbal communication two years after cochlear implantation, which could account for these individual differences in the rate of verbal communication development after cochlear implantation. Indications for clinical application and future research were identified on the basis of these conclusions. The data collected during the research is seen as meaningful in clinical decision-making regarding the suitability of young children under the age of three years with a profound hearing loss for cochlear implantation and their therapeutic management. / Dissertation (M (Communication Pathology))--University of Pretoria, 2006. / Speech-Language Pathology and Audiology / Unrestricted

The primary goal of this study was to develop a preliminary tool to determine caregivers’ needs regarding the management of a person with a traumatic brain injury (TBI), during the acute rehabilitation period. The potential impact of TBI on family dynamics, interpersonal relationships and functional independence is well documented.To facilitate achievement of the main goal this study was divided into two phases. In the first phase, caregivers’ needs were determined by means of both qualitative and quantitative measurements in the form of structured and unstructured observations, the implementation of a “Needs Questionnaire”, a focus group and semi-structured interviews. The results obtained during this phase indicated that caregivers have needs for support from professionals and the community, as well as needs regarding the general management of the person with a TBI and the management of the potential communication difficulties associated with TBI. Based on these needs, a preliminary tool, namely the “Needs questionnaire for caregivers of a person with a traumatic brain injury”, was developed. During the second phase of the study, this tool was administered to caregivers of individuals with TBI before and after the presentation of a workshop to determine whether there is a change in caregivers’ needs once they have received information. A pretest-posttest, experimental design was thus implemented during the second phase of this study. Although further research is required for the qualitative and quantitative validation of this tool, the use of this tool has implications for providing a better understanding of caregivers’ needs during the acute rehabilitation period after TBI. The results of this study further emphasize that improved service delivery in the South African context is reliant on the early identification, by the professional team, of the needs that caregivers of individuals with TBI have. / Dissertation (M (Communication Pathology))--University of Pretoria, 2007. / Speech-Language Pathology and Audiology / unrestricted