Use of an intelligent tutoring system for a curriculum on augmentative and alternative communication: Feasibility for implementation.

BACKGROUND: Over 8 million children with disabilities live in Africa and are candidates for augmentative and alternative communication (AAC), yet formal training for team members, such as speech-language therapists and special education teachers, is extremely limited. Only one university on the continent provides postgraduate degrees in AAC, and other institutions provide only short modules at an undergraduate level. The need for an introductory training course on AAC that is accessible by university students continent-wide was identified. An online programme, namely an intelligent tutoring system (ITS), was identified as a possible option to facilitate interactive learning without the need for synchronous teaching. The use of an ITS is shown to be effective in developing knowledge and clinical reasoning in the health and rehabilitation fields. However, it has not yet been applied to student teaching in the field of AAC. AIM: To determine both the feasibility of an ITS to implement an AAC curriculum for students in four African countries, and the usability and effectiveness of such a system as a mechanism for learning about AAC. METHOD & PROCEDURES: The study included two components: the development of a valid AAC curriculum; and using the ITS to test the effectiveness of implementation in a pre- and post-test design with 98 speech-language therapy and special education students from five universities. OUTCOMES & RESULTS: Statistically significant differences were obtained between pre- and post-test assessments. Students perceived the learning experience as practical, with rich content. CONCLUSIONS & IMPLICATIONS: The findings suggest that the ITS-based AAC curriculum was positively perceived by the students and potentially offers an effective means of providing supplementary AAC training to students, although modifications to the system are still required. WHAT THIS PAPER ADDS: What is already known on the subject Professionals typically lack formal training in AAC. In Africa, this presents a serious challenge as there are over 8 million children who are candidates for AAC. A need for an introductory training course on AAC, which can be accessed by university students continent-wide, was identified. What this paper adds to existing knowledge An AAC curriculum was developed and integrated into an ITS, an online programme allowing interactive learning through asynchronous teaching. Students from four African countries completed the AAC ITS curriculum. The curriculum was positively received by the students and statistically significant changes in knowledge were identified. What are the practical and clinical implications of this work? This feasibility study shows that the use of an ITS is an effective means of providing AAC training to university students in these African countries. The results provide a valuable contribution toward ensuring the equitable distribution of AAC training opportunities in the African context. This will have a significant positive impact on those who are candidates for AAC.

Exploring clinical reasoning in child language assessment through decoloniality.

PURPOSE: Clinical reasoning has been taught, practised, and researched under Western epistemologies, which have been fallible in addressing the complexity of clinical reasoning within Indigenous cultures and societies. We explored how speech-language pathologists in Sri Lanka negotiate and value Indigenous and Western perspectives in clinical reasoning within a decolonial framework. METHOD: This study used participatory research methodology within the decolonised qualitative research paradigm to produce data collaboratively with eight Sri Lankan speech-language pathologists. Oral history narratives and object-based textual reflections generated the necessary data for the study. Systematic visual-textual analysis and reflexive thematic analysis were carried out iteratively, and the data analysis and interpretation were undertaken collaboratively with the participants. RESULT: We generated four key themes about professional education, individuality in practice, holistic thinking, and balancing interests and priorities. The results demonstrate that social, political, and economic forces impact practitioners' clinical reasoning. CONCLUSION: Practising science in its original form within Indigenous contexts is challenging. Colonial roots and imperialism impact the delivery of appropriate services in socially and politically marginalised communities. Practitioners' self-awareness about authentic identities and practical wisdom can develop culturally relevant knowledge for equitable practice.

Speech-language therapy educator reflections on the planning and implementation of education and training during the COVID-19 pandemic.

BACKGROUND:  Universities across the world experienced lockdown and closure of all learning institutions around March 2020 because of the advent of the coronavirus disease 2019 (COVID-19). This lockdown and closure presented challenges to the traditional pedagogical approaches in the health sciences, which typically include both campus-based and clinical site-focused activities involving face-to-face interactions and work integrated learning. The onset of the COVID-19 pandemic resulted in a shift to emergency remote teaching (ERT) and learning. OBJECTIVES:  This study aimed to explore speech-language pathology (SLP) educators' experiences of the planning and implementation of ERT and learning during the COVID-19 pandemic. METHOD:  A qualitative, descriptive narrative design was adopted to meet the objectives of the study. Seven SLP educators from a single university in South Africa participated in this study by constructing narratives on their experiences. The narratives were analysed using thematic analysis. RESULTS:  Five themes emerged from the data analysis, and these included (1) uncertainty, (2) educator feelings, (3) capacity development, (4) influence of circumstances on teaching, learning and assessment and (5) troubleshooting. Current findings provide insight into the challenges encountered and strategies utilised by educators in planning and implementing ERT and learning. CONCLUSION:  Beyond the COVID-19 pandemic, most educators believe that a hybrid model would address some concerns identified, such as that of missing face-to-face contact, but that it would still allow for the full exploitation of online activities for teaching, learning and assessment required during clinical training.

The impact of modification techniques on the rheological properties of dysphagia foods and liquids.

Modifying food and the textures of food has been done for decades within the food science and technology field. More recently, modifying the texture of foods has been used to manage swallowing disabilities (dysphagia). Swallowing disabilities are often associated with dehydration and malnutrition, thus nutritional intervention has formed part of serving texture-modified diets. The question remains whether these modification techniques are viable for individuals with swallowing disabilities living in majority world countries. This study used two modification methods on a widely used specialized nutritious food (SNF) to determine whether it may be modified and used in dysphagia management. The techniques had to be ergonomic and economically appropriate for individuals with swallowing disabilities living in majority world countries. The International Dysphagia Diet Standardization Initiative's (IDDSI) standards were used to determine whether the texturally modified SNF is safe for swallowing. Rheological measurements were performed to determine apparent viscosity and structure recovery of each sample. The effects of two modification techniques, aeration and particle separation, on the rheological properties of the SNF were also measured and analyzed. It was determined that both milk and water could be used with this SNF to create a dysphagia diet, but only under certain conditions. The overall results indicated that heating the samples increased the apparent viscosity and exacerbated lumping. Room temperature samples had less lumps and could be classified to the desired levels of the IDDSI (Level 2 and Level 4). Using a whisk to aerate the samples reduced lumps significantly and using a sieve to separate particles of liquid samples eliminated lumps. This study provides new data on how texture modification techniques and the IDDSI framework could be adapted to individuals living in majority world countries. By using modification techniques that are ergonomic and economically viable and an SNF with longevity, this study could be useful in guiding future training of nursing staff and caregivers of individuals living in poverty or resource-constrained communities. This study also adds to the data on the rheological properties of dysphagia foods, although this study did not make use of commercial thickeners generally used in the modification of diets.

Identity construction following traumatic brain injury: a case study.

This construction of self-identity pre- and post-Traumatic Brain Injury (TBI) in a single case study is described. A life history research methodology was employed to explore the experience of a survivor of TBI, using a single case study design. The participant was a 31-year-old White South African male who sustained TBI while on duty in the army. Multiple interviews were conducted with the participant to allow in-depth exploration of his self-identity formation pre- and post-TBI. Data analysis entailed transcribing the interviews, crafting a research story (narrative analysis) and an analysis of the narrative. The results illuminated the emergence and development of a resistance identity as a product of early pre-TBI experience, the loss of self following TBI as well as the emergence of a positive self-identity. The embedded issues of communication and self-identity are explained. The participant's narrative espoused a hopeful optimism, strongly challenging the dominant disability discourse. The specific strengths and limitations, and potential value of using life histories as both a methodological and clinical tool when working with TBI survivors is described. Implications for research and clinical practice in the field of Speech and Language Therapy (SLT) is also provided.