A discussion of individual variability, in activity-based interventions, using the niche concept.

BACKGROUND: Activity-based intervention has been defined as a child-directed, transactional approach that uses logically occurring antecedents and consequences to develop functional and generative skills by embedding intervention of children's individual goals and objectives in routine, planned or child-initiated activities. In this approach, clear goals and objectives that are functional and embedded in a play activities or routines are developed. The teacher mediates the child's environment to facilitate learning with the child directing the teacher on the pace, duration spent on the objective. Learning and development in this framework occur through both a carefully planned environment and adult facilitation. Progress made by a child using this approach focuses on observational data that describe if the child is able to respond in functional and generative ways. While activity-based interventions are usually provided for a group of children, progress is measured by describing individual children's responses. Individual variations in the children's progress, despite exposure to the same interventions are an area that is seldom discussed. This article aims to explore the niche concept and its application to explaining this variation between individuals. METHODS: Four children participated in this single-subject, multiple-probe study across four participants. A 3-week long activity-based aided language stimulation programme was developed. The effect of the programme was determined by describing the individual participants understanding of the 24 targeted vocabulary items. RESULTS: The results of the activity-based language programme are presented and the variability among the participants is discussed using the niche concept. The role of the niche concept in individual development is described and the implications thereof are discussed. CONCLUSIONS: Finally, activity-based intervention research is placed in a systems perspective and possible outcome measures of this intervention are discussed from a multidimensional ecological perspective.

Maternal self-efficacy and maternal perception of child language competence in pre-school children with a communication disability.

BACKGROUND: The aim of this study was to describe maternal self-efficacy beliefs within the parenting domain and maternal ratings of pre-school children's language abilities, where the child has a communication disability. The association between these two constructs was also investigated. METHOD: Twenty-five mothers completed a questionnaire consisting of two subsections: parental self-efficacy and maternal rating of child language ability. Convenience sampling was used, and mothers with children attending four special-education schools in the Pretoria area consented to participate in the study. RESULTS: The results revealed that mothers generally had high self-efficacy beliefs within certain parenting roles, in spite of the fact that their child has a communication disability. The lowest competence was reported in discipline and teaching roles. In addition, mothers' reports of patterns of child ability correlated with what has been written in the literature. Correlation statistics generally revealed weak association between the constructs, with the strongest association between the parental domain of discipline and maternal reports of their child's receptive language abilities. CONCLUSIONS: Possible reasons for the weak correlation values are proposed. These include factors that may alter the way parents of children with disabilities construct and maintain self-efficacy beliefs; as well as the fact that the two sections of the questionnaire measure maternal appraisals at two very different levels (objective observations and evaluative self-regulatory processes).

Severe disability: do primary health care nurses have a role to play?

This article focuses on the importance of primary health care nurses' involvement in the identification of children with severe disabilities, early and appropriate intervention that includes referral, as well as the provision of support to the children's caregivers. The use of multiskilling as a strategy to train nurses to fulfil this role is described. The traditional roles of community nurses are explored within the disability paradigm, with specific reference to multi-skilling. Finally, research results following the implementation of the Beginning Communication Intervention Protocol (BCIP), which uses multi-skilling as a training strategy, are described. Recommendations for further research are then provided.

The use of a digital voice output device to facilitate language development in a child with developmental apraxia of speech: a case study.

PURPOSE: The study aimed at describing the language and communication abilities of a child diagnosed with Developmental Apraxia of Speech (DAS), who used a Macaw Digital voice output device. METHOD: This case study describes the training of a mother in the use of a Macaw digital voice output device to give her child with DAS access to higher levels of language functioning. It also provides longitudinal information pertaining to the child's school progress in the three years following the implementation of the device. RESULTS: Results indicate that the use of a digital device is useful in facilitating communication and language development in a young child with DAS. Specific evidence of an increase in the cognitive complexity of questions directed at the child is provided, as well as an increase in the number of questions directed to the child. Regarding the child's responses, it was noted that appropriate answers increased, as did the number of communication modalities and communication attempts. Longitudinal data indicates that the child was able to maintain these positive impacts. CONCLUSIONS: Digital voice output devices can be used as a method to facilitate higher cognitive functioning and has various positive impacts on the functioning of a child with DAS. These devices need to be considered as a tool to facilitate the development of communication and speech development for this population.

Attitudes of children towards augmentative and alternative communication systems.

The purpose of this study was to determine the impact of voice output, as a characteristic of a child's AAC system, on the attitude of unfamiliar peers. The need to develop a suitable tool to measure the attitudes of peers led to the development of the Communication Aid/Device Attitudinal Questionnaire (CADAQ). A descriptive survey design was used and the suitability of the CADAQ was tested in a pilot study. One hundred and fifteen participants, aged 11-13 years, viewed a videotape of a 13-year-old boy with cerebral palsy, communicating with the use of an AAC device. Attitudes were measured according to three dimensions: affective/behavioural, cognitive/belief and communication competence. Data were analysed with a 2 (group) x 2 (gender) x 3 (dimension) analysis of variance (ANOVA) with infinity = .05. An item analysis, Cronbach Alpha's and scale intercorrelations between the 3 dimensions of the CADAQ were computed to determine the internal consistency of the CADAQ. Results reflected more favourable attitudes to the presence of voice output in comparison to the no voice option. Girls held more positive attitudes to the peer with disabilities and little or no functional speech (LNFS). Good internal consistency of the CADAQ was demonstrated.

Strangers in the house? Communication between mothers and their hearing impaired children who sign.

Many hearing impaired children rely on signing as a method of communication and are educated through this medium at school. While there is a paucity of information on the use of signing in the home, the impression in the literature is that these children are often unable to communicate through this medium in their homes. This has serious implications for family relationships as well as the personal well-being, educational success and social integration of the child. The present study explored the signing experience of 45 mothers of children in the junior primary phase at schools for the deaf in the Durban region of Kwa-Zulu Natal as a reflection of the use of signing within the home. A descriptive survey design, using two researcher administered questionnaires, was used to obtain information on the signing practice of mothers, exploring aspects related to the extent to which signing is used, the type of signing used and signing proficiency. The findings revealed mothers' signing skill to be inadequate in terms of their own assessment on rating scales and descriptions of their signing. They signed less frequently than their children did, using speech more often, and with the vast majority using simultaneous communication when they did sign. Signing ability was judged to be below that of their children, with sign vocabularies of between 0-50 words for 85% of the participants. It appears that sign learning by hearing parents of deaf children in this region needs to be actively promoted. The implications of these findings are discussed to address the communication needs of signing deaf children and their families within the South African context.

The impact of a digital speaker on a teacher's interaction with a child with limited functional speech.

This paper describes the impact of the implementation of a digital speaker and teacher training on the quality of a teacher's interaction with an AAC user. The data was obtained by recording and analysing classroom story time interactions. The types of utterances directed at each child in the class, the types of questions used as well as the messages recorded onto the digital speaker were determined for each research phase. There were four major phases in the research, namely, a pre-implementation phase, a post-implementation phase, a post-training phase and a post-withdrawal phase. The results indicated that the implementation of the digital speaker and the training of the teacher resulted in certain changes in the way that the teacher interacted with the AAC user. Utterance types such as answering and imitating were used more frequently after the implementation of the device. There was also a much greater variety in the teacher's use of questions as well as in the messages that were recorded onto the digital speaker after the five training sessions were completed. This study highlighted the importance of formal training for the communication partners of the AAC user. One of the most important communication partners of the school-aged AAC user is the classroom teacher.

Augmentative and alternative communication: the role of community nurses in the rehabilitation of people with severe disabilities.

This article focuses on the importance of community nurses' involvement in the identification and early referral and intervention of children and adults who have very little or no speech. The use of Augmentative and Alternative Communication strategies with nonspeaking children and adults are described in terms of the different kinds of systems that can be used as well as the general principles involved in working with people with severe disabilities. In conclusion, it is emphasized that close collaboration between community nurses and rehabilitation specialists is vital in ensuring that a difference is made in the lives of people with severe disabilities in this country.

Culturally valid assessment tools: northern Sotho translation of the Peabody Picture Vocabulary Test-Revised.

There is currently a great demand for service provision for the African language speakers in South Africa. The difficulties associated with assessing speakers in the absence of assessment tools in the indigenous languages is, therefore, also a pertinent concern. Within the current socio-economic climate in South Africa where test translation and adaptation is often cited as a more viable option than that of developing new tests, very few guidelines exist for the development or adaptation of valid assessment tools for culturally and linguistically diverse population groups. This article is aimed at describing the process which took place when existing English test material, in this instance, The Peabody Picture Vocabulary Test--Revised (PPVT-R) (Dunn & Dunn, 1981) was translated and culturally adapted for the Northern Sotho population in Pretoria and surrounding areas. The findings of the research include practical examples of methodological considerations which should be taken into account while translating and undertaking cultural adaptation of test material. The newly adapted test material was also applied to a sample of 152 North-Sotho speaking pupils in the study area and the test results are discussed.

Interaction between a teacher and the non-speaking as well as speaking children in the classroom.

This study examined the verbal interactions which occurred between a teacher and two groups of children (children who were non-speaking as well as children who were speaking). Descriptive data, generated by analysing ten lessons, suggested that the teacher's interaction with the children who were non-speaking differed, in terms of quantity and quality. She directed approximately 10% less interaction at each of the three non-speaking children, when compared with the number of interactions that she directed at each of the five speaking children. However, she did not spend an equal amount of time interacting with each of the non-speaking children. Her interaction with the non-speaking children was dominated by questions, attention directing and requesting. Verbalization types, such as answering and imitating did not occur at all in the teacher's interaction with the non-speaking children. This implies that the non-speaking children's learning experiences in the classroom differed from the speaking children's learning experiences. Possible reasons for these discrepancies were proposed, namely that the teacher's attitudes, skill and knowledge played a role, but the non-speaking children's lack of access to communication was also considered to be a factor in determining the amount and type of interaction.

The teaching of Blissymbols as a bridge into literacy for children with cognitive impairments: a comparison of two training approaches.

This study compares the learning of Blissymbols by six mildly cognitively impaired children by means of a global and an analytic approach. Training consisted of two stages. The first was the training of eight compound symbols and the second the training of seven single configuration symbols. The study concludes that Blissymbols as an entrance into literacy can be taught successfully to cognitively impaired individuals by means of either an analytic or a global approach. The analytic approach seems to have greater long-term benefits, as the subjects instructed by the analytic approach consistently performed better in the generalization and re-evaluation procedures. The analytic approach, however, was much more time consuming than the global approach in terms of the length of training required. The implications for literacy development and augmentative and alternative communication systems are discussed.

The development of a screening schedule for use by teachers to describe the communication abilities of children with severe disabilities.

The study developed a screening schedule for teachers to describe the communication abilities of children with severe disabilities. Teachers were trained in the use of such an assessment procedure. Both the schedule as well as the training were evaluated. Results indicated that the schedule can be regarded as adequate for future use as teachers found it easy to use and applicable to their situation. Scoring the schedule requires more practise and training as this is a more advanced skill. Specific issues had an effect on the results, e.g., the teachers' familiarity with the type of disability observed, their qualifications and experience.

Nonspeaking children in schools for children with severe mental disabilities in the greater Pretoria area: implications for speech-language therapists.

The aim of this study was to describe children enrolled in registered schools for children with severe mental disabilities in the greater Pretoria area in order to compile a profile of nonspeaking children. Emphasis was placed on the prevalence of nonspeaking children as well as on their functioning in different skill areas in order to assess the need for service delivery. Two questionnaires were developed; the first for obtaining biographical data from teachers; the second for obtaining information on the communication and related abilities of children between 3-12 years. The particular teachers completed the questionnaires in conjunction with fieldworkers. Results indicated a high prevalence (38%) of nonspeaking children in schools for children with severe mental disabilities in the Pretoria area and also indicated that they were a heterogeneous group regarding communication and related abilities. This survey was the first step in determining prevalence and describing nonspeaking children in schools for children with severe mental disabilities in South Africa. Results also indicated that these children are in great need of additional service delivery with special reference to augmentative and alternative communication (AAC) strategy implementation.

Communication intervention in an adolescent with profound cognitive impairment and autistic features.

The service delivery model currently used with a large proportion of profoundly cognitively impaired (PCI) persons, results in the under-utilization of their potential and often contributes to social isolation. By providing communication and independence training the self-actualisation potential and the right to power and control, is recognised. This single case study describes the implementation of a communication intervention model with a PCI adolescent. His mother was trained in the use of picture symbol task analysis as well as positive reinforcement to promote change in the adolescent's communication skills and independence. Results indicated significant changes in the skills of both participants and highlighted the mother's need for support to meet the demands of change.

The development of precursors to literacy in mentally disabled children.

This study aimed to investigate metalinguistic precursors to literacy in mentally handicapped children, with a view to improve literacy training in this population. Language proficiency and environmental literacy factors were explored, and an analysis was made of proficiency in several metalinguistic tasks (i.e., higher level language awareness skills). Six children who are educable mentally retarted, with mental ages between five and seven years (chronological ages between six and sixteen years) were assessed. Results showed that environmental factors of literacy socialisation and print awareness were adequate, with reasonable exposure to literacy artifacts and events. Language abilities were also adequately developed. Isolated metalinguistic skills (e.g., phonemic segmentation) had developed in those children who had received reading instruction, however, most metalinguistic precursors were not adequately developed for their mental ages and were below a five year level.

The use of Bliss symbols as a first step into literacy with four children with Down syndrome.

This study describes the use of Bliss symbolics as a first step into literacy with four children with Down syndrome in a preschool setting. Initial stages of the intervention programme are discussed as well as the children's ability to read Bliss symbols six months after commencement of the programme. Symbol errors are analyzed and implications for further research discussed.

Augmentative and alternative communication in South Africa: accessibility and implementation.

This paper deals with the development of a community-based service for the implementation of augmentative and alternative communication (AAC) strategies for people with severely limited verbal expression. The concept of community-based intervention is explained and the process of training as done in the Centre for Augmentative and Alternative Communication (CAAC) is described. Data of pre- and post-training evaluations is discussed as well as follow-up data obtained in the various training contexts. Finally, critical issues related to the follow-up data are discussed.

The application of symbol systems to severely handicapped children with limited verbal output.

The use of augmentative and alternative communication strategies in cognitively restricted persons with limited verbal ability has received much attention in the literature over the last decade in South Africa. The use of these strategies has, however, been implemented on a small scale only. This article deals with the process involved in the introduction and implementation of a symbol system for cognitively restricted children with limited verbal output. Various problems are identified in order to provide the reader with some background and guidelines for the application of symbol systems within this context.

Language intervention at schools: changing orientations within the South African context.

The role of the speech therapist in the school has changed drastically over the last decade. The reasons for these changes originate from a growing realisation of the importance of contextualising intervention within a particular community. This article aims at providing an analysis of the present school population in South Africa with specific reference to the Black schools as a basis for discussion on the role of the speech and language therapist within this context. The problems of second language learning and teaching are highlighted and the role of the language therapist as a consultant within the Black school system is emphasized.