This study was developed to investigate the readiness or willingness of providers, speech language therapists (SLPs), and patients to participate in telepractice for speech-language therapy services in rural areas of Nevada. Nevada has not ranked high in healthcare for several years and was noted to have low SLP to patient ratios, especially in rural areas of Nevada. A thorough literature review identified international and national studies that have shown resistance to telepractice expressed by patients and providers, but it has also shown an increase in interest post telepractice therapy. Nevada does not have current research on readiness to participate in telepractice medical settings of rural areas of Nevada, therefore a survey was developed to ask providers and patients for their opinions about participating in telepractice. Providers were selected using an online directory search, and patient participants were chosen at the discretion of the providers. A unique survey was presented to each type of participant (provider or patient) in order to compare opinions and readiness of each participant type. Specific questions related to voice and swallowing disorders were addressed. A large sample size was not obtained, but the researcher was able to make some associations to readiness to participate in telepractice and possible factors that may or may not have affected a participant’s opinion. Age of participants, type of internet used, availability of webcam, and area of the state did not appear to have an association with the readiness to participate in telepractice. A positive response rate to engaging in telepractice of 40% was noted across patients and providers. Though the participant sample size was small, there is still some indication that telepractice could be used to address the needs of patients who need speech-language therapy services in rural areas of Nevada.

The primary objective of the current study was to attempt to establish whether there is a need for a dysphagia training programme for nurses and speech-language therapists working with acute tracheostomised patients in critical care units in South Africa. The research design that was adopted for this project was within a mixed methods approach framework. An exploratory descriptive survey design using semi-structured face-to-face interviews was used. The final sample consisted of interviews with 20 speech-language therapists from eight different hospitals with critical care facilities and 12 nurses from four different hospitals with such facilities. Data from the close ended questions were analysed using descriptive statistics, while remaining data from open ended questions were thematically analysed and the constant comparison method was applied. The data demonstrated that all speech-language therapists and 10 out of the 12 nurses were in agreement that there was a need for a dysphagia training programme for nurses in critical care for tracheostomised patients presenting with dysphagia. An important and unexpected result of this study was that speech-language therapists themselves required additional training in this area. The data demonstrated that the majority of speech-language therapists and nurses were of the view that they had received minimal theoretical and practical hours on tracheostomy screening, assessment and management at an undergraduate level. Overall, the results of the current study suggested varied practices in the screening, assessment and management of tracheostomy and dysphagia, particularly with regard to blue dye testing, suctioning protocols and cuff inflation and deflation protocols. The research significance and implications of the study included the need to improve undergraduate training for speech-language therapists and nurses in the area of dysphagia and tracheostomy, to alert professional training bodies regarding institution of additional licensing and qualifications for speech-language therapists and nurses in the area of dysphagia and tracheostomy, and to thereby improve the situation of clinicians practising in dysphagia and tracheostomy management through the development of guidelines, protocols and position papers. An important implication of this research is that it established the need for a dysphagia training programme for both speech-language therapists and nurses in critical care in dysphagia and tracheostomy, and thereby monitoring the efficacy of this programme and measuring/monitoring the outcomes of multidisciplinary teamwork in the assessment and management of dysphagia and tracheostomy in critical care.

This critical review addresses the implications of the Curriculum and Assessment Plan Statement (CAPS) for collaboration between teachers and speech-language therapists (SLTs) in schools. A historical perspective on changes in the roles and responsibilities of SLTs is provided, reflecting a shift from supporting the child to supporting the teacher. Based on the role of SLTs and audiologists in schools, an innovative approach to the support of teachers is conceptualized. The curriculum content and methods support learners who experience challenges and barriers to learning in main stream classrooms. The implementation of the curriculum necessitates close collaboration between teachers and SLTs in order to ensure the best possible outcomes for all learners. This collaboration is reviewed by identifying the benefits of, and barriers to, the process, as well as crucial areas of collaboration. Inclusive education is mandated by White Paper 6, and collaborative support of teachers by SLTs is presented from the learners’ perspective within the context of the curriculum. An example of teacher support through the response to intervention (RTI) approach is described.

The process of migration has resulted in population growth and contributed to the transformation of New Zealand. Migrant and refugee children face many adjustment factors and their ease in resettling in New Zealand is largely dependent on their ability to learn English. Migration stress, change, trauma and loss may result in psychological difficulties which in turn may affect their resettling and learning. The Ministry of Education and other professionals work together to enhance the quality of their service provision to facilitate easier adjustment, resettlement and effective learning for these children. An adequate assessment battery for speech language therapists to assess migrant and refugee children, is presently lacking in New Zealand. Therapists currently use various assessments, with the assistance of interpreters. The New Zealand Speech Therapists’ Association (NZSTA), in accordance with speech therapists in Group Special Education (GSE), strongly supports the need for research with these groups and the development of an appropriate assessment battery. This exploratory study aimed to determine an assessment battery for use in examining English language acquisition in refugee and migrant children and to highlight the benefit of using measurement tools that determine incremental change over time in contrast to the use of monolingual psychometric tests. The study explored a selected assessment battery and gathered data in five main focus areas, namely: cognition, language, trauma, classroom behaviour, developmental and birth information. Eligible children were those who did not have physiologically - impaired cognitive abilities. Eight cases, four refugee and four migrant students, were selected by convenience sampling. All participants were children selected from primary school 1 (three refugees and three migrants) and primary school 2 (one refugee and one migrant) primary schools, aged approximately (5-8 years). Participants included four male and four females, refugee and migrant children, and those with both high and low English ability. Based on the study’s results, recommendations were made to refine the test battery, which included test modification. For example, the use of the trauma measurement tool only if there is prior evidence of trauma, the inclusion of a larger test population who have a common primary language to allow for cost effective interpreter use and to also allow for generalisations to be made, the inclusion of an assessment of the children’s primary language in order to determine the relationship, development and acquisition of the child’s second language with reference to his/her development and skills in his native language. All of the refugee children and 3 migrant children displayed slower processing time during the administration of the tests. Migrant parents were quicker in test completion as compared to refugee parents. They displayed differences in family size, contact with extended family, socioeconomic status and educational level. Migrant children produced sentences that included correct word order and sequence whilst refugee children produced sentences that lacked adequate word order or lacked articles and determiners. The study found the proposed test battery was an effective choice for use in the assessment of both migrant and refugee children, as the battery allows for dynamic assessment of children from diverse groups and this proved to be an unbiased means of assessing their English language and cognitive skills. Recommendations are made for future, more-extensive research. These findings provide information about appropriate and reliable language acquisition tests that measure incremental change with time. This study will contribute to a developing knowledge base for speech-language therapists who work with migrant or refugee children. Effective assessment on which to base tailored language programmes will assist them to optimise their experience in New Zealand schools and enhance their English language skills.

The process of migration has resulted in population growth and contributed to the transformation of New Zealand. Migrant and refugee children face many adjustment factors and their ease in resettling in New Zealand is largely dependent on their ability to learn English. Migration stress, change, trauma and loss may result in psychological difficulties which in turn may affect their resettling and learning. The Ministry of Education and other professionals work together to enhance the quality of their service provision to facilitate easier adjustment, resettlement and effective learning for these children. An adequate assessment battery for speech language therapists to assess migrant and refugee children, is presently lacking in New Zealand. Therapists currently use various assessments, with the assistance of interpreters. The New Zealand Speech Therapists’ Association (NZSTA), in accordance with speech therapists in Group Special Education (GSE), strongly supports the need for research with these groups and the development of an appropriate assessment battery. This exploratory study aimed to determine an assessment battery for use in examining English language acquisition in refugee and migrant children and to highlight the benefit of using measurement tools that determine incremental change over time in contrast to the use of monolingual psychometric tests. The study explored a selected assessment battery and gathered data in five main focus areas, namely: cognition, language, trauma, classroom behaviour, developmental and birth information. Eligible children were those who did not have physiologically - impaired cognitive abilities. Eight cases, four refugee and four migrant students, were selected by convenience sampling. All participants were children selected from primary school 1 (three refugees and three migrants) and primary school 2 (one refugee and one migrant) primary schools, aged approximately (5-8 years). Participants included four male and four females, refugee and migrant children, and those with both high and low English ability. Based on the study’s results, recommendations were made to refine the test battery, which included test modification. For example, the use of the trauma measurement tool only if there is prior evidence of trauma, the inclusion of a larger test population who have a common primary language to allow for cost effective interpreter use and to also allow for generalisations to be made, the inclusion of an assessment of the children’s primary language in order to determine the relationship, development and acquisition of the child’s second language with reference to his/her development and skills in his native language. All of the refugee children and 3 migrant children displayed slower processing time during the administration of the tests. Migrant parents were quicker in test completion as compared to refugee parents. They displayed differences in family size, contact with extended family, socioeconomic status and educational level. Migrant children produced sentences that included correct word order and sequence whilst refugee children produced sentences that lacked adequate word order or lacked articles and determiners. The study found the proposed test battery was an effective choice for use in the assessment of both migrant and refugee children, as the battery allows for dynamic assessment of children from diverse groups and this proved to be an unbiased means of assessing their English language and cognitive skills. Recommendations are made for future, more-extensive research. These findings provide information about appropriate and reliable language acquisition tests that measure incremental change with time. This study will contribute to a developing knowledge base for speech-language therapists who work with migrant or refugee children. Effective assessment on which to base tailored language programmes will assist them to optimise their experience in New Zealand schools and enhance their English language skills.

Le rôle que jouent les services orthophoniques dans l’ajustement des proches de personnes aphasiques ainsi que le contexte dans lequel les orthophonistes mettent en place des interventions auprès de ces proches ne sont actuellement pas connus. La présente thèse a donc pour but de comprendre de quelle manière les relations entre les orthophonistes et les proches de personnes aphasiques, développées en contexte de réadaptation, s’inscrivent dans la trajectoire dynamique des proches et dans la pratique des orthophonistes. Une approche qualitative par théorisation ancrée a été utilisée dans quatre études pour analyser les entrevues effectuées auprès de proches de personnes aphasiques et d’orthophonistes. Dans l’étude 1, les entrevues menées à trois reprises dans la première année suivant l’accident vasculaire-cérébral (AVC), et ce, auprès de quatre filles dont la mère est aphasique, ont été analysées. Un modèle théorique représentant la relation mère-fille a été développé. Ce modèle illustre que les perceptions de fragilité, de difficultés et de compétence, qu’ont les filles à l’égard de leur mère, les amènent à adopter des comportements de protection ou de confiance, ce qui génère des réactions de satisfaction ou d’insatisfaction chez la mère, renforçant alors les perceptions initiales des filles. Quatre patterns relationnels peuvent donc coexister au sein d’une même dyade. L’aphasie complexifierait cet ajustement relationnel. Dans l’étude 2, les entrevues effectuées à trois reprises durant la première année suivant l’AVC, auprès d’une fille dont la mère est sévèrement aphasique, ont été analysées. Un modèle théorique représentant l’expérience d’aider a été élaboré. Selon ce modèle, percevoir des difficultés chez sa mère et ressentir que leur relation antérieure est menacée a déclenché le processus d’aide chez la fille. Parallèlement, la reconnaissance de la compétence de sa mère a motivé la fille à offrir de l’aide visant à rendre sa mère heureuse et à favoriser son indépendance. Ce type d’aide a contribué à augmenter l’indépendance de sa mère, à retrouver une relation satisfaisante avec celle-ci et à s’adapter à l’aphasie. Dans l’étude 3, les entrevues de 12 proches de personnes aphasiques ont été analysées. Un modèle théorique représentant l’expérience de l’aphasie et de la réadaptation post-AVC a été développé et illustre que les proches sont centrés sur la personne aphasique et participent à la réadaptation dans le rôle d’aidant. Cette disposition influence alors leurs attentes envers la réadaptation, leurs interactions avec les professionnels, dont les orthophonistes, et leur appréciation de la réadaptation. Dans l’étude 4, les entrevues effectuées auprès de huit orthophonistes travaillant en réadaptation ont été analysées. Un modèle théorique illustrant le processus d’intervention des orthophonistes auprès des proches de personnes aphasiques a été construit. Pour les orthophonistes, le travail avec les proches est majoritairement perçu comme un ajout positif, mais exigeant, à leur pratique de base centrée sur la personne aphasique. Une satisfaction professionnelle peut en découler, mais des idéaux non-atteints peuvent persister. La relation proche-orthophoniste serait donc principalement axée sur le rôle d’aidant que joue le proche, et ce, en raison de leur expérience respective. Un agrandissement du territoire de rencontre entre les orthophonistes et les proches pourrait soutenir les proches dans les ajustements relationnels induits par l’AVC avec aphasie ainsi que permettre aux orthophonistes d’atteindre leurs idéaux. / The role speech-language therapy (SLT) services play in significant others’ adjustment to stroke and aphasia as well as the context in which SLTs offer interventions to significant others are currently unknown. The present dissertation aims to understand how in rehabilitation settings, relationships between SLTs and significant others of persons with aphasia develop, and fit within significant others’ process of change, on one hand, and into SLTs’ practice, on the other hand. A grounded theory approach was used in four studies to analyze interviews conducted with significant others of persons with aphasia and with SLTs. In study 1, four daughters of aphasic women were each interviewed three times over the first year post-stroke and their discourse was analyzed. A theoretical model of the daughter-mother relationship was constructed. This model shows how the daughters’ perception of maternal fragility, problems, and abilities motivated daughters to take on protective and trusting behaviors that resulted in maternal reactions of satisfaction and dissatisfaction that, in turn, reinforced the daughters’ initial perceptions. Four relational patterns may therefore coexist in a given dyad. Aphasia could make relational adjustments more complex. In study 2, three interviews conducted over the period of one year with the daughter of a woman with severe aphasia were analyzed. A theoretical model representing the experience of caregiving was elaborated. This model illustrates that for the daughter, perceiving her mother’s problems and feeling their previous relationship was threatened triggered the caregiving process. In parallel, the daughter’s recognition of her mother’s competence encouraged her to offer care aiming to make her mother happy and to foster her mother’s independence. Increases in her mother’s independence, a renewal of their relationship and adaptation to aphasia were consequences of this type of caregiving. In study 3, the interviews conducted with 12 significant others of aphasic persons were analyzed. A theoretical model representing significant others’ experience of aphasia and rehabilitation following stroke was developed and showed that significant others participated in rehabilitation as caregivers centered on the person who had aphasia. This disposition influenced their expectations of rehabilitation, their interactions with professionals, such as SLTs, and how they appraised rehabilitation. In study 4, the interviews conducted with eight SLTs working in rehabilitation settings were analyzed. A theoretical model representing SLTs’ process of working with significant others of persons with aphasia was elaborated. SLTs mostly perceived work with significant others as a challenging bonus to their fundamental approach centered on the person with aphasia. As a consequence, SLTs felt professional satisfaction while dreaming for something more to offer significant others. The relationship between significant others and SLTs thus mainly seem to focus on the caregiver role endorsed by significant others as a result of the experience of each of them. Expanding the shared territory of SLTs and significant others could support significant others’ adjustment to the relational changes induced by stroke and aphasia and could help SLTs attain their professional dreams.

Le rôle que jouent les services orthophoniques dans l’ajustement des proches de personnes aphasiques ainsi que le contexte dans lequel les orthophonistes mettent en place des interventions auprès de ces proches ne sont actuellement pas connus. La présente thèse a donc pour but de comprendre de quelle manière les relations entre les orthophonistes et les proches de personnes aphasiques, développées en contexte de réadaptation, s’inscrivent dans la trajectoire dynamique des proches et dans la pratique des orthophonistes. Une approche qualitative par théorisation ancrée a été utilisée dans quatre études pour analyser les entrevues effectuées auprès de proches de personnes aphasiques et d’orthophonistes. Dans l’étude 1, les entrevues menées à trois reprises dans la première année suivant l’accident vasculaire-cérébral (AVC), et ce, auprès de quatre filles dont la mère est aphasique, ont été analysées. Un modèle théorique représentant la relation mère-fille a été développé. Ce modèle illustre que les perceptions de fragilité, de difficultés et de compétence, qu’ont les filles à l’égard de leur mère, les amènent à adopter des comportements de protection ou de confiance, ce qui génère des réactions de satisfaction ou d’insatisfaction chez la mère, renforçant alors les perceptions initiales des filles. Quatre patterns relationnels peuvent donc coexister au sein d’une même dyade. L’aphasie complexifierait cet ajustement relationnel. Dans l’étude 2, les entrevues effectuées à trois reprises durant la première année suivant l’AVC, auprès d’une fille dont la mère est sévèrement aphasique, ont été analysées. Un modèle théorique représentant l’expérience d’aider a été élaboré. Selon ce modèle, percevoir des difficultés chez sa mère et ressentir que leur relation antérieure est menacée a déclenché le processus d’aide chez la fille. Parallèlement, la reconnaissance de la compétence de sa mère a motivé la fille à offrir de l’aide visant à rendre sa mère heureuse et à favoriser son indépendance. Ce type d’aide a contribué à augmenter l’indépendance de sa mère, à retrouver une relation satisfaisante avec celle-ci et à s’adapter à l’aphasie. Dans l’étude 3, les entrevues de 12 proches de personnes aphasiques ont été analysées. Un modèle théorique représentant l’expérience de l’aphasie et de la réadaptation post-AVC a été développé et illustre que les proches sont centrés sur la personne aphasique et participent à la réadaptation dans le rôle d’aidant. Cette disposition influence alors leurs attentes envers la réadaptation, leurs interactions avec les professionnels, dont les orthophonistes, et leur appréciation de la réadaptation. Dans l’étude 4, les entrevues effectuées auprès de huit orthophonistes travaillant en réadaptation ont été analysées. Un modèle théorique illustrant le processus d’intervention des orthophonistes auprès des proches de personnes aphasiques a été construit. Pour les orthophonistes, le travail avec les proches est majoritairement perçu comme un ajout positif, mais exigeant, à leur pratique de base centrée sur la personne aphasique. Une satisfaction professionnelle peut en découler, mais des idéaux non-atteints peuvent persister. La relation proche-orthophoniste serait donc principalement axée sur le rôle d’aidant que joue le proche, et ce, en raison de leur expérience respective. Un agrandissement du territoire de rencontre entre les orthophonistes et les proches pourrait soutenir les proches dans les ajustements relationnels induits par l’AVC avec aphasie ainsi que permettre aux orthophonistes d’atteindre leurs idéaux. / The role speech-language therapy (SLT) services play in significant others’ adjustment to stroke and aphasia as well as the context in which SLTs offer interventions to significant others are currently unknown. The present dissertation aims to understand how in rehabilitation settings, relationships between SLTs and significant others of persons with aphasia develop, and fit within significant others’ process of change, on one hand, and into SLTs’ practice, on the other hand. A grounded theory approach was used in four studies to analyze interviews conducted with significant others of persons with aphasia and with SLTs. In study 1, four daughters of aphasic women were each interviewed three times over the first year post-stroke and their discourse was analyzed. A theoretical model of the daughter-mother relationship was constructed. This model shows how the daughters’ perception of maternal fragility, problems, and abilities motivated daughters to take on protective and trusting behaviors that resulted in maternal reactions of satisfaction and dissatisfaction that, in turn, reinforced the daughters’ initial perceptions. Four relational patterns may therefore coexist in a given dyad. Aphasia could make relational adjustments more complex. In study 2, three interviews conducted over the period of one year with the daughter of a woman with severe aphasia were analyzed. A theoretical model representing the experience of caregiving was elaborated. This model illustrates that for the daughter, perceiving her mother’s problems and feeling their previous relationship was threatened triggered the caregiving process. In parallel, the daughter’s recognition of her mother’s competence encouraged her to offer care aiming to make her mother happy and to foster her mother’s independence. Increases in her mother’s independence, a renewal of their relationship and adaptation to aphasia were consequences of this type of caregiving. In study 3, the interviews conducted with 12 significant others of aphasic persons were analyzed. A theoretical model representing significant others’ experience of aphasia and rehabilitation following stroke was developed and showed that significant others participated in rehabilitation as caregivers centered on the person who had aphasia. This disposition influenced their expectations of rehabilitation, their interactions with professionals, such as SLTs, and how they appraised rehabilitation. In study 4, the interviews conducted with eight SLTs working in rehabilitation settings were analyzed. A theoretical model representing SLTs’ process of working with significant others of persons with aphasia was elaborated. SLTs mostly perceived work with significant others as a challenging bonus to their fundamental approach centered on the person with aphasia. As a consequence, SLTs felt professional satisfaction while dreaming for something more to offer significant others. The relationship between significant others and SLTs thus mainly seem to focus on the caregiver role endorsed by significant others as a result of the experience of each of them. Expanding the shared territory of SLTs and significant others could support significant others’ adjustment to the relational changes induced by stroke and aphasia and could help SLTs attain their professional dreams.

The effects of HIV/AIDS and subsequent opportunistic infections and/or associated conditions on the development of infected children are substantial. Considerable delays and/or disorders in communication development have been noted in the HIV/AIDS infected child, as well as the need for Early Communication Intervention (ECI) services for this population. A dearth of locally relevant data regarding the speech, language and hearing development of HIV/AIDS infected children within the South African context currently exists. The objective of this study was to describe the characteristics of a group of HIV/AIDS infected children being managed at an outreach clinic of regional hospital in Gauteng. A cross-sectional, retrospective, non-experimental, descriptive, quantitative research design was used in this study. The main objective was achieved by analysing the clinic records of 203 children infected with HIV/AIDS between the ages of 0 – 5 years 11months through the use of a pre-designed checklist. A questionnaire completed by four medical doctors practicing at the HIV/AIDS clinic within the hospital was also used. This allowed for the perceptions and practices of the medical doctors to be described. Results revealed that the majority HIV/AIDS infected children being managed at the outreach clinic were significantly immunocompromised and diagnosed with Stage III or Stage IV HIV/AIDS infection. Furthermore, results indicated the presence of several opportunistic infections and HIV/AIDS associated conditions (such as Tuberculosis, Candidiasis and Encephalopathy). A positive finding was that 76% of the HIV/AIDS infected children (n=153) were receiving Highly Active Antiretroviral Therapy (HAART) at the time of data collection. The most outstanding finding was that very few of the children with HIV/AIDS being managed at the outreach clinic were recorded as having speech, language and/or hearing delays and/or disorders. Similarly, referrals to other professionals as recorded in the children’s hospital records seemed to be limited to Social Workers and Dietitians, with only one child recorded as being referred to a Speech-Language Therapist and Audiologist for further management. It was unclear whether more children were in fact referred for additional intervention by other professionals and this was simply not recorded in the children’s records, or whether these referrals were in fact not made. Results from the questionnaires completed by the medical doctors working with the pediatric HIV/AIDS population within the outreach clinic were significant. Findings indicated that the majority of the respondents believed that HIV/AIDS infected infants were more at risk for developmental and communicative delays and/or disorders than the general population, and that this population would likely benefit from Speech-Language Therapy and/or Audiology intervention services. Respondents indicated that medical doctors working with the pediatric HIV/AIDS population were often not adequately informed regarding the effects of HIV/AIDS on communication development and that they would benefit from further training in this regard. The need for further research regarding the characteristics of the pediatric HIV/AIDS population, particularly on a larger sample, was described. This would assist in the development of a guideline for ECI service delivery for children infected with HIV/AIDS. The need for further training of other professionals regarding the effects that HIV/AIDS has on the communication development of the infected child, to assist with necessary referrals and teamwork, was also highlighted. AFRIKAANS : Suid-Afrika is een van die lande ter wêreld, wat die hoogste voorkoms van Menslike Immuniteitsgebrekvirus/ Verworwe Immuniteitsgebreksindroom (MIV/VIGS), toon - met die pediatriese populasie op die voorfront van hierdie epidemie. Die effek wat MIV/VIGS en opeenvolgende opportunistiese infeksies en/of ander geassosieerde toestande op die ontwikkeling van kinders het, is verreikend. Internasionale literatuur beskryf agterstande en/of akwykings in die kommunikasie ontwikkeling van kinders wat met MIV/VIGS geinfekteer is. Die behoefte vir Vroeë Kommunikasie Intervensie (VKI) vir hierdie populasie word ook gemeld. Daar bestaan egter slegs ‘n beperkte hoeveelheid relevante, plaaslike literatuur met betrekking tot die spraak-, taal- en gehoorontwikkeling van kinders met MIV/VIGS binne die Suid-Afrikaanse konteks. Die doelwit van hierdie studie was om die kenmerke van ‘n groep kinders, wat met MIV/VIGS besmet is en by ‘n streekshospitaal in Gauteng behandel word, te beskryf. ‘n Kwantitatiewe, nie-eksperimentele, terugwerkende, dwarsdeurige, beskrywende navorsingsontwerp is gebruik. Die hoofdoelwit was bereik deur die kliniekrekords van kinders wat met MIV/VIGS besmet is, te analiseer deur van ‘n vooraf-ontwerpte merklys gebruik te maak. Data is ook ingesamel deur middel van vraelyste wat deur mediese dokters, wat by MIV/VIGS klinieke binne die hospitale werk, voltooi is. Dit het toegelaat dat die persepsies en praktyke van die mediese dokters ook beskryf kon word. Resultate het getoon dat die meerderheid kinders met MIV/VIGS, wat by klinieke behandel word, se immuunsisteme ernstig onderdruk was en dat hulle met stadium III of stadium IV van MIV/VIGS gediagnoseer was. Die resultate het verder ook die voorkoms van verskeie opportunistiese infeksies en MIV/VIGS geassosieerde toestande aangedui. ‘n Positiewe bevinding was dat 76% van die kinders (n=153), wat met MIV/VIGS geinfekteer was, tydens die proses van data-insameling reeds Hoogsaktiewe Antiretrovirale Terapie (HAART) ontvang het. Die mees uitstaande bevinding was dat slegs ‘n geringe hoeveelheid kinders met MIV/VIGS by die kliniek, as met ‘n agterstand en/of afwyking in spraak, taal en/of gehoor, aangeteken is. Beperkte verwysings na ander professionele persone is ook in die kliniekrekords opgemerk. Verwysings was beperk tot Maatskaplike Werkers en Dieëtkundiges. Daar was slegs een aantekening van ‘n kind wat vir behandeling na ‘n Spraak- en Taalterapeut en Oudioloog verwys is. Dit is egter onduidelik of daar werklik meer verwysings na ander professionele persone gemaak is, maar net nie in die kinders se kliniekrekords aangedui is nie, of dat daar werklik min verwysings na ander professionele dissiplines gemaak is. Bykomend, was die resultate van voltooide vraelyste deur mediese dokters, wat met die pediatriese MIV/VIGS populasie in die kliniek werk, insiggewend. Bevindings dui aan dat die meerderheid proefpersone, wat aan die studie deelgeneem het, van mening is dat kinders wat met MIV/VIGS besmet is wel ‘n hoër risiko toon vir ontwikkelings- en kommunikasie agterstande en/of afwykings in vergeleke met die algemene populasie. Die proefpersone is verder ook van mening dat hierdie populasie wel van spraak- en taalterapie en/of oudiologiese intervensie sal baatvind. Proefpersone het verder aangedui dat mediese dokters, wat met die pediatriese MIV/VIGS populasie werk, nie ten volle ingelig is omtrent die effek van MIV/VIGS op kommunikasie ontwikkeling en dat hulle van verdere opleiding sal baatvind. Die behoefte vir verdere navorsing in die veld van pediatriese MIV/VIGS en kommunikasie ontwikkeling, binne die Suid-Afrikaanse konteks, word in hierdie studie beskryf. Dit sal as riglyn vir VKI dienslewering aan hierdie populasie dien. Daar is ook ‘n groot behoefte vir verdere opleiding van ander mediese professionele persone met betrekking tot pediatriese MIV/VIGS en die effek wat die op die kind se kommunikasie ontwikkeling het. / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / unrestricted