South African Journal of Communication Disorders
The South African Journal of Communication Disorders publishes reports and papers concerned with research, and critically evaluative theoretical, philosophical and conceptual issues dealing with aspects of human communication and its disorders, dysphagia, service provision, training and policy.
|Coverage||Vol 63 Issue 1 2016 - current|
Background: Speech-language therapists are specifically trained in clinically evaluating swallowing in adults with acute stroke. Incidence of dysphagia following acute stroke is high in South Africa, and health implications can be fatal, making optimal management of this patient population crucial. However, despite training and guidelines for best practice in clinically evaluating swallowing in adults with acute stroke, there are low levels of consistency in these practice patterns.
Objective: The aim was to explore the clinical practice activities of speech-language therapists in the clinical evaluation of swallowing in adults with acute stroke. Practice activities reviewed included the use and consistency of clinical components and resources utilised. Clinical components were the individual elements evaluated in the clinical evaluation of swallowing (e.g. lip seal, vocal quality, etc.)
Methods: The questionnaire used in the study was replicated and adapted from a study increasing content- and criterion-related validity. A narrative literature review determined what practice patterns existed in the clinical evaluation of swallowing in adults. A pilot study was conducted to increase validity and reliability. Purposive sampling was used by sending a self-administered, electronic questionnaire to members of the South African Speech-Language-Hearing Association. Thirty-eight participants took part in the study. Descriptive statistics were used to analyse the data and the small qualitative component was subjected to textual analysis.
Results: There was high frequency of use of 41% of the clinical components in more than 90% of participants (n = 38). Less than 50% of participants frequently assessed sensory function and gag reflex and used pulse oximetry, cervical auscultation and indirect laryngoscopy. Approximately a third of participants showed high (30.8%), moderate (35.9%) and poor (33.3%) consistency of practice each. Nurses, food and liquids and medical consumables were used usually and always by more than 90% of participants.
Conclusion: Infrequent use of clinical components and high variability in clinical practice among speech-language therapists calls for uniform curricula in the clinical evaluation of swallowing at South African universities and for continued professional development postgraduation. Different contexts and patient symptoms contribute towards varied practice; however, there is still a need to improve consistency of practice for quality health care delivery. A research-based policy for the clinical swallowing evaluation for a resource-limited context is also needed.
Objective: The objective was to determine the preliminary psychometric performance of a new clinical feeding scale to diagnose oropharyngeal dysphagia (OPD) in neonates.
Methods: Twenty neonates with a median gestational age of 35 weeks were evaluated using the Neonatal Feeding Assessment Scale (NFAS) and modified barium swallow studies (MBSS). The results were compared.
Results: Nine of the 20 participants presented with OPD on the NFAS. Comparison of the scale’s results with instrumental MBSS indicated that all participants without OPD were correctly excluded (100% sensitivity). The specificity was 78.6%, indicating that three participants were falsely identified with OPD on the scale. Interrater reliability was determined on 50% (n = 10) of the sample. Substantial agreement (80%) was obtained between two raters in five of the six sections of the scale and on the diagnostic outcome.
Conclusion: The preliminary performance of the scale appears to be promising. A further validation study will take place.
Background: The PA skills of phonological blending and segmentation and auditory word discrimination relate directly to literacy and may be weak in English second language (EL2) learners. In South Africa, literacy skills have been found to be poor in especially EL2 learners.
Objectives: The purpose of this paper is to determine the effects of vowel perception and production intervention on phonemic awareness (PA) and literacy skills of Setswana first language (L1) learners. These learners are English second language (EL2) learners in Grade 3.Method: The present study employed a quasi-experimental, pre-test–post-test design.
Results: The findings of low–literacy skill levels concurred with previous investigations. However, post-test results of intervention in PA seemed to improve the literacy skills of EL2 learners.Conclusion: PA skills should be a crucial part of the literacy curriculum in South Africa.