The piloting of a specific support programme for Grade R teachers on attention deficit hyperactivity disorder: The process of development.

BACKGROUND:  Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in children and is generally identified and diagnosed during the preschool years. Preschool learners with ADHD are at risk of developing emergent literacy difficulties, crucial for the development of reading and writing. Many teachers have insufficient training to identify and address barriers to learning, such as ADHD. AIM:  The aim of this article was to report on the process followed in the development of a specific support programme for Grade R teachers on ADHD and on the piloting of the programme. METHOD:  An adapted version of the intervention research model provided the structure and phases for the development, implementation and evaluation of the support programme. Current literature on ADHD training programmes, adult learning principles and Bronfenbrenners' ecosystemic framework was explored to develop the programme, training material, manual and method of presentation (Phase 1). Workshops were presented to 65 Grade R teachers working in an urban and semi-rural context (Phase 2). Participants were made aware of the symptoms of ADHD, and early identification and management of specific barriers to learning, such as ADHD, in order to reduce the risk of educational complications. Participants provided feedback (Phase 3) on the training, training material and manner of presentation following the workshops. RESULTS:  The results obtained in phases 1 and 2 of the adapted intervention research model included the compilation of the information presented in the workshops and the training manual, as well as the instructional phase and piloting of the programme. The results obtained for Phase 3 include a summary of the feedback provided by the Grade R teachers on how they experienced the training. Participants' feedback confirmed that the programme was valued and that their training expectations were met. CONCLUSION:  The intervention research model provided a valuable structure for the development and piloting of a specific support programme. This study can be replicated, and may pave the way for future support programmes for teachers. Capacity building of teachers is of the utmost importance in raising education standards in South Africa.

Mixed-methods research: A tutorial for speech-language therapists and audiologists in South Africa.

BACKGROUND:  Mixed-methods research (MMR) offers much to healthcare professions on clinical and research levels. Speech-language therapists and audiologists work in both educational and health settings where they deal with real-world problems. Through the nature of their work, they are confronted with multifaceted questions arising from their efforts to provide evidence-based services to individuals of all ages with communication disorders. MMR methods research is eminently suited to addressing such questions. Objective: The aim of this tutorial is to increase awareness of the value of MMR, especially for readers less familiar with this research approach. Method: A literature review was conducted to provide an overview of the key issues in MMR. The tutorial discusses the various issues to be considered in the critical appraisal of MMR, followed by an explanation of the process of conducting MMR. A critical review describes the strengths and challenges in MMR. Results: MMR is less commonly used or published in the fields of speech-language therapy and audiology. Conclusion: Researchers working in teams can draw on the strengths of different disciples and their research approaches. Such collaborative enterprises will contribute to capacity building. Researchers, SLTs and audiologists are encouraged to make use of MMR to address the complex research issues in the multicultural, multifaceted South African context. MMR makes an important contribution to the understanding of individuals with communication disorders, and in turn, researchers in the two disciplinary fields of speech-language therapy and audiology can contribute to the development of this research approach. MMR is well suited to the complexity of South African contexts and its populations, as it can provide multiple perspectives of a topic.

Ototoxicity management: An investigation into doctors' knowledge and practices, and the roles of audiologists in a tertiary hospital.

BACKGROUND: A significant number of medications that are prescribed by doctors to treat cancers, tuberculosis and infections are ototoxic. Disclosure of ototoxic risks is ethical practice as patients have the right to be properly informed about and involved in decisions about their health care. Often, doctors fail to disclose such information. AIM: This research investigated whether a group of doctors working in a South African academic hospital inform their patients about the ototoxic risks associated with specific medications, and if not, explore the reasons for it. It was determined what the participants' knowledge levels of ototoxicity were as knowledge is seen as a precursor to disclosing information to their patients. A further aim of the research was to determine whether audiologists should expand their role by sharing information with patients and other professionals in the management of ototoxicity and in the hospital. METHOD: There were 90 participants included in the study through convenience sampling, which represented interns, medical officers, registrars and consultants in the neonatal intensive care unit, intensive care unit, ear-nose-throat, and internal and family medicine departments. The research made use of a descriptive survey design that collected mainly quantitative data and a limited amount of qualitative data through questionnaires. The data were descriptively analysed, and the qualitative data were listed and quantified. RESULTS: The research firstly determined the participants' knowledge and understanding of ototoxicity, and it was found that there was room for improvement. With reference to the current practices of doctors in the prescription of ototoxic medicines, it was found that disclosure of ototoxic risks was limited, mostly because of a lack of time and insufficient knowledge. In comparing knowledge and practices between levels of employment, it was found that particular post levels performed better than others. The participants regarded the role of the audiologist as team member important, although very few referred their patients for audiological monitoring when they prescribe ototoxic medication. CONCLUSION: A need for additional support to doctors was identified, which indicates that audiologists should expand their role to include the provision of continued professional development activities and to renew their efforts to advocate their role in the hospital so that doctors are made aware of the importance to refer their patients for ototoxic screening and monitoring.

Establishing a pharmacotherapy induced ototoxicity programme within a service-learning approach.

Pharmacotherapy-induced ototoxicity is growing, especially in developing countries such as South Africa. This highlights the importance of ototoxicity monitoring and management of hearing loss. This article focuses on the establishment of an ototoxicity clinic as a site for the implementation of a service-learning module in the Audiology programme. The clinic offers a unique opportunity of collaboration between pharmacists and an audiologist where pharmacotherapy-induced ototoxicity is uniquely monitored. The Sefako Makgatho Health Sciences University (SMU) provides training to both the disciplines, audiology and pharmacy. The main aim of this article is to describe how ototoxicity monitoring is implemented in the curriculum within such an academic service-learning approach. Through service learning students develop a deeper understanding of course content, acquire new knowledge and engage in civic activity. It simultaneously provides a unique opportunity for interdisciplinary collaboration between the disciplines of audiology and pharmacy. The objectives for this programme are therefore to facilitate learning and to provide a service to the local community by identifying, preventing and monitoring medicine-induced hearing loss in in-hospital and out-patients; as well as to establish inter-disciplinary collaboration between the disciplines and stakeholders for more effective service delivery. The constant interdisciplinary teamwork between the audiologist, pharmacist, physician and nursing staff in the wards results in best practice and management of patients with ototoxic damage.

Continued professional development of teachers to facilitate language used in numeracy and mathematics.

Learners in South African schools have been found to perform poorly in mathematics because they do not understand the language used in solving mathematical problems. In order to improve academic performance teachers need to be made aware of the importance of language in the development of numeracy. A continued professional development (CPD) programme addressed this need. The purpose of the research was to understand how the participants implemented the strategies developed during the programme and how they perceived the support provided by the programme. The research was conducted over 2 years in semi-rural and urban contexts. As part of a more comprehensive mixed method study, the qualitative data referred to in this article were obtained through open-ended questions in questionnaires, focus groups,I reflections in portfolios, and a research diary. Results showed that numeracy terminology was often used by learners that differed from standard terminology prescribed by the curriculum. The participants themselves did not necessarily understand the numeracy terminology and thus found it a challenge to implement curriculum outcomes. Issues related to language use of the participants in teaching numeracy were associated with the lack of resources available in the language of learning and teaching (LoLT). Some of the participants taught numeracy in English, rather than LoLT. The results indicated low teacher expectations of the learners. The CPD programme was considered valuable and effective. SLPs in schools need to be expand their role to provide CPD opportunities for teachers.

Speech-language therapists supporting foundation-phase teachers with literacy and numeracy in a rural and township context.

Language is required for learning, but educators often find it difficult to facilitate listening and language skills while they have to adapt to a new national curriculum with an outcomes-based approach for which they have not necessarily been adequately trained. A multifaceted support programme was developed for foundation-phase educators to facilitate listening and language for literacy and numeracy, with a particular focus on language for numeracy. The aim of the research was to determine the value of this particular support programme for foundation-phase educators in two different contexts (a semi-rural and a township context). A mixed methods approach with a concurrent, equal status triangulation design was used, where qualitative data were transformed to quantitative data in order to be compared in a matrix. The results show that the participants benefited to varying degrees from the programme. The combination of workshops, practical and mentoring components proved to be an effective means of support. The results indicate a need for pre-training selection procedures as more effective support can be provided to homogeneous groups.