Harsha Kathard - Academia.edu (original) (raw)

Papers by Harsha Kathard

International Journal for Equity in Health

International Journal for Equity in Health

Background For the professions of audiology and speech-language therapy (A/SLT), there continues ... more Background For the professions of audiology and speech-language therapy (A/SLT), there continues be a dire need for more equitable services. Therefore there is a need to develop emerging practices which have a specific focus on equity as a driving force in shifting practices. This scoping review aimed to synthesise the characteristics of emerging practices in A/SLT clinical practice in relation to equity with an emphasis on communication professions. Methods This scoping review followed the Joanna Briggs Institute guidelines and aimed to map the emerging practices in A/SLT to identify the ways in which the professions are developing equitable practices. Papers were included if they addressed equity, focused on clinical practice and were situated within A/SLT literature. There were no time or language restrictions. The review included all sources of evidence across PubMed, Scopus, EbscoHost, The Cochrane Library and Dissertation Abstracts International, Education Resource Information...

International Journal of Speech-Language Pathology

South African Journal of Communication Disorders

Providing equitable support for people experiencing communication disability (CD) globally is a h... more Providing equitable support for people experiencing communication disability (CD) globally is a historical and contemporary challenge for the speech–language therapy profession. A group of speech–language therapists (SLTs) with ongoing and sustained experiences in Majority and Minority World contexts participated in five virtual meetings in 2021. The aim of these meetings was to develop provocative statements that might spur a global discussion among individuals and organisations that support people experiencing CD. The following questions were discussed: What is our vision for the future of the profession globally? What are the global challenges around access to speech–language therapy services?Four main themes emerged: (1) the need to centre people experiencing CD as the focal point of services, (2) participation, (3) equity and (4) community. The themes relate to the need for a process of de-imperialism in the profession. Suggestions were made to develop more suitable terminology...

South African Journal of Communication Disorders

Background: Early classroom communication supports are critical in influencing oral language deve... more Background: Early classroom communication supports are critical in influencing oral language development and emergent literacy skills. It is both support from peers and adults, as well as the environment that impacts the quality and efficacy of language learning. Schools in particular play a key role in communication development, which will be further explored in this article.Objectives: To describe how communication was being supported in the classroom by teachers in the areas of language-learning environment (LLE), language-learning interactions (LLIs) and language-learning opportunities (LLOs) to focus on classroom communication supports to strengthen literacy outcomes for Grade R learners.Method: A cross-sectional descriptive survey of classrooms was conducted using a structured observation method in 136 classrooms. The Communication Supporting Classroom Observation Tool was used to make 223 observations across classrooms of LLE (19 items), LLI (20 items) and LLO (5 items). A de...

Disabilities

This paper investigates the influence of social capital in the training of persons with disabilit... more This paper investigates the influence of social capital in the training of persons with disabilities. The expansion of social networks is regarded as a central principle of the rehabilitation agenda and thus is a central concept that may influence the training experiences of persons with disabilities. Absent from much of social capital research is its influence on skill development and employment opportunities for persons with disabilities. Social capital has the potential to play an important role in the livelihoods of persons with disabilities who are at high risk of being marginalised. The aim of this qualitative study was to explore and critically examine the experiences of persons with disabilities who participated in an auxiliary skill development programme, to determine whether and how it has strengthened and expanded their social capital to advance their opportunities for economic inclusion and/or employment. There is currently no convincing practice available, particularly ...

South African Journal of Communication Disorders

Background: Although distortion product otoacoustic emissions (DPOAEs) are useful in evaluating c... more Background: Although distortion product otoacoustic emissions (DPOAEs) are useful in evaluating cochlear outer hair cell function, determining the optimal stimulus parameters could result in a more reliable, sensitive and specific diagnostic tool across the range of DPOAE applications. Objectives: To identify which stimulus parameters warrant further investigation for eliciting the largest and most reliable DPOAEs in adult humans. Method: A single group, repeated measures design involving a convenience sample of 20 normal-hearing participants between 19 and 24 years of age. Results: Descriptive statistics and mixed model analyses suggested L1/L2 intensity levels of 65/65 dB sound pressure level (SPL) and 65/55 dB SPL, and f2/f1 ratios of 1.18, 1.20 and 1.22 elicited larger and more reliable DPOAEs in both ears. Conclusion: Further investigation of the 65/65 dB SPL and 65/55 dB SPL intensity levels and the 1.18, 1.20 and 1.22 f2/f1 ratios is warranted to determine the stimulus parame...

Disabilities

Persons with disabilities still experience challenges in obtaining employment even though obligat... more Persons with disabilities still experience challenges in obtaining employment even though obligations associated with their employment are in place in legislative frameworks that strive to support transformation within the labour market. This paper explores employers’ perspectives on the employment of persons with disabilities in South Africa identified in a case study. The influence of social capital on disability inclusive employment was explored from the perspective of two employers who employed trainees who completed an auxiliary training programme for persons with disabilities, which provides opportunities to facilitate pathways to economic inclusion and/or employment. Findings reveal that despite the call for increased labour inclusivity, the development of social capital is not clearly apparent when persons with disabilities are considered for employment. Organisational attitudes and beliefs seem to stem from the obligatory standpoint of the organisations. The paper highlight...

Inclusion, Disability and Culture

Persons with severe communication disabilities in South Africa experience many barriers to their ... more Persons with severe communication disabilities in South Africa experience many barriers to their inclusion in society. These barriers occur across contexts and within all levels of the individual’s family and community life. Congruent with the current models of disability, effective and sustainable communication intervention requires a broad systemic and context-relevant approach that addresses the interaction between individual and environment. This chapter will identify the enablers and barriers to inclusion of people with severe communication disabilities in the South African context within different levels of the ecology. Augmentative and Alternative Communication (AAC) intervention as one method to increase levels of engagement and participation for this group of individuals will be discussed. Reflection on the context-relevant practices and considerations for change across different levels of the ecology to ensure feasible, versatile, and sustainable AAC intervention will be highlighted. These include, but are not limited to, adaptations, the cultural appropriateness of graphic symbols used, the cultural and linguistic competence of the professionals who work with families from diverse backgrounds, as well as availability and provision of technology (in particular speech-generating devices).

BACKGROUND Effective screening is required to facilitate the early identification of central audi... more BACKGROUND Effective screening is required to facilitate the early identification of central auditory processing disorder (CAPD) - a deficit within the central auditory nervous system, which can have a significant effect on a child’s listening, learning and communication. While several screening tools have been proposed, there is a lack of contextually appropriate tools that take the needs of a multilingual society, like South Africa (SA), into consideration. OBJECTIVE This study aims to develop a contextually appropriate CAPD screening protocol for children (aged 7 to 12 years) in SA. The specific study aims are: (1) to develop a contextually appropriate screening protocol for CAPD in primary school children in SA, and (2) to evaluate the feasibility of implementing the developed protocol in primary school children in SA. METHODS The study will follow a developmental, mixed methods research design, implemented in two phases. Phase 1 will be applied to address aim 1. The aim will be...

Disability, Gender and Violence over the Life Course, 2018

African Journal of Disability, 2021

Background: Youth with disabilities are a marginalised group in society. This marginalisation tra... more Background: Youth with disabilities are a marginalised group in society. This marginalisation traps them and prevents their full participation in social and economic development. Objective: This study sought to understand how exposure to the Performing Arts facilitates the inclusion of youth with disabilities. Methods: The study adopted a qualitative research approach, utilising critical ethnography. Primary data consisted of three focus group discussions with youth with disabilities, and an in-depth interview with a performer with disability. Thematic data analysis was conducted. Results: Four themes emerged. Theme 1, Blown away, shares the experiences of youth who attended Artscape Theatre. Theme 2, I can do it, you can do it, describes their career aspirations. Theme 3, Embracing hope, identifies the social and life skills learned through visited Artscape. Theme 4, Long way to go, presents the factors that influence the participation of youth with disabilities in the Performing Arts. While their experiences are diverse, and their impairments are unique, contact with the Performing Arts supported social and economic inclusion, and triggered empowerment of youth with disabilities. Insufficient accessible and available transportation is the most notable barrier to accessing development opportunities. Conclusion: Exposure to the Performing Arts provides important skills development and social opportunities for disabled youth. It is up to the 'keepers' of the Performing Arts-those in administration and management-to realign the Performing Arts in a way that can best benefit everyone.

International Journal of Qualitative Methods, 2020

Case study and narrative inquiry as merged methodological frameworks can make a vital contributio... more Case study and narrative inquiry as merged methodological frameworks can make a vital contribution that seeks to understand processes that may explain current realities within professions and broader society. This article offers an explanation of how a critical perspective on case study and narrative inquiry as an embedded methodology unearthed the interplay between structure and agency within storied lives. This case narrative emerged out of a doctoral thesis in occupational therapy, a single instrumental case describing a process of professional role transition within school-level specialized education in the Western Cape, South Africa. This case served as an exemplar in demonstrating how case study recognized the multiple layers to the context within which the process of professional role transition unfolded. The embedded narrative inquiry served to clarify emerging professional identities for occupational therapists within school-level specialized education in postapartheid Sout...

The purpose of this video-based Fluency assessment of an eight year old female conducted in isiXh... more The purpose of this video-based Fluency assessment of an eight year old female conducted in isiXhosa is to provide a reflective learning opportunity for students as well as qualified Speech-language therapists. The video is accompanied by a reflection from the therapist as well as examples of incisive questions to facilitate clinical learning. Given the importance of culturally and linguistically relevant assessment, the video presents an opportunity to deliberate on several issues speech-language therapists must consider when developing practices which embrace diversity. The questions included with this video should be regarded as initial learning triggers and users are advised to add to the bank of questions as a means of extending and sharing this learning opportunity

The International Journal of Learning: Annual Review, 2006

International Journal of Qualitative Methods, 2021

In this paper, we engage in productive resistance through exploring the application of an arts-ba... more In this paper, we engage in productive resistance through exploring the application of an arts-based method in expanding the critical research methodology repertoire in the profession of speech-language pathology. There is a specific focus on the value of painting in the data representation process. We explore how a playful, creative analysis deepened the critical interpretative meaning-making process. In particular, we explain how artful representations in the data analysis process can broaden communication in research beyond the written modality to generate alternative knowledges. We use the concepts of productive ambiguity and unknowing as key conceptual tools to reimagine the data analysis process with particular focus on the process of data representation. We conclude that embracing the uncertainty of creative ways of knowing create possibilities for new meanings and knowledges to emerge.

Professions and Professionalism, 2019

As a profession, speech-language pathology (SLP) continues to struggle with equitable service del... more As a profession, speech-language pathology (SLP) continues to struggle with equitable service delivery to both people with communication challenges and disabilities. SLP clinical practice in its traditional form has an individual focus and therefore cannot adequately serve the large population in need, which, in South Africa is the majority population. Using the concept of social embeddedness of professions as a guiding frame, the article explores the history of the profession and the influence of the medical model and coloniality in shaping SLP profession’s knowledge and practices. As such, we argue that professionalisation in its current form perpetuates injustice. The article proposes innovation across clinical practice, education and research as leverage points for imagining new practices.

South African Journal of Communication Disorders, 2018

Background: While randomised controlled trials (RCTs) are considered the gold standard of researc... more Background: While randomised controlled trials (RCTs) are considered the gold standard of research, prior study is needed to determine the feasibility of a future large-scale RCT study. Objectives: This pilot study, therefore, aimed to determine feasibility of an RCT by exploring: (1) procedural issues and (2) treatment effect of the Classroom Communication Resource (CCR), an intervention for changing peer attitudes towards children who stutter. Method: A pilot cluster stratified RCT design was employed whereby the recruitment took place first at school-level and then at individual level. The dropout rate was reported at baseline, 1 and 6 months post-intervention. For treatment effect, schools were the unit of randomisation and were randomised to receive either the CCR intervention administered by teachers or usual practice, using a 1:1 allocation ratio. The stuttering resource outcomes measure (SROM) measured treatment effect at baseline, 1 and 6 months post-intervention overall an...

Trials, 2018

Background: Classroom-based stuttering intervention addressing negative peer attitudes, perceptio... more Background: Classroom-based stuttering intervention addressing negative peer attitudes, perceptions, teasing and bullying of children who stutter (CWS) is required as part of holistic stuttering management because of its occurrence in primary school. This study was conducted in 2017, in 10 primary schools in the Western Cape, South Africa within lower (second and third) and higher (fourth and fifth) quintiles. Objectives: The primary objective of this study was to determine treatment effect at six months after intervention of grade 7 participants (Classroom Communication Resource [CCR] intervention versus no CCR) using global Stuttering Resource Outcomes Measure (SROM) scores in school clusters. The secondary objective was to determine grade 7 participant treatment effect on the SROM subscales including Positive Social Distance (PSD), Social Pressure (SP) and Verbal Interaction (VI). The subgroup objective was to determine any difference in the primary outcome between schools between and across quintile clusters (lower and higher). Methods: Once schools were stratified into lower and higher quintile (which are defined according to geographical location, fee per school and resources) subgroup clusters, schools were assigned randomly to control and intervention groups consisting of grade 7 participants who were typically aged ≥ 11 years. Teachers received 1 h of training before administering the single-dose CCR intervention over a 60-90-min session. The CCR intervention included a social story, role-play and discussion. All participants viewed a video of a CWS and stuttering was defined at baseline. The SROM measured peer attitudes at six months after intervention. Randomisation was stratified by quintile group using a 1:1 allocation ratio. Full blinding was not possible; however, the outcome assessor was partially blinded and the analyst was also blinded. Generalised estimating equations (GEE) was used assuming an exchangeable correlation structure to analyse the data adopting an intention-to-treat principle. Multiple imputation was used to handle missing data. Criterion for statistical significance was set at alpha = 0.05.

South African Journal of Communication Disorders, 2011

Basic education in South Africa faces a crisis as learners fail to achieve the necessary outcomes... more Basic education in South Africa faces a crisis as learners fail to achieve the necessary outcomes in the related areas of language and literacy. The aims of this paper are twofold. Firstly, we aim to describe and discuss the education crisis by outlining the educational landscape, relevant policy imperatives and implementation challenges in post-apartheid education. The systemic factors contributing to the literacy crisis are emphasised. Secondly, we argue that speech language therapists and audiologists (SLTAs) have a role to play in supporting basic education in South Africa through developing language and literacy. It is suggested that the professions of speech-language pathology and audiology must be socially responsive and population-focused in order to make meaningful contributions to development in South Africa. The potential roles of SLTAs are discussed with suggestions for further actions required by the professions to enable a contextually relevant practice in a resource-c...

International Journal for Equity in Health

International Journal for Equity in Health

Background For the professions of audiology and speech-language therapy (A/SLT), there continues ... more Background For the professions of audiology and speech-language therapy (A/SLT), there continues be a dire need for more equitable services. Therefore there is a need to develop emerging practices which have a specific focus on equity as a driving force in shifting practices. This scoping review aimed to synthesise the characteristics of emerging practices in A/SLT clinical practice in relation to equity with an emphasis on communication professions. Methods This scoping review followed the Joanna Briggs Institute guidelines and aimed to map the emerging practices in A/SLT to identify the ways in which the professions are developing equitable practices. Papers were included if they addressed equity, focused on clinical practice and were situated within A/SLT literature. There were no time or language restrictions. The review included all sources of evidence across PubMed, Scopus, EbscoHost, The Cochrane Library and Dissertation Abstracts International, Education Resource Information...

International Journal of Speech-Language Pathology

South African Journal of Communication Disorders

Providing equitable support for people experiencing communication disability (CD) globally is a h... more Providing equitable support for people experiencing communication disability (CD) globally is a historical and contemporary challenge for the speech–language therapy profession. A group of speech–language therapists (SLTs) with ongoing and sustained experiences in Majority and Minority World contexts participated in five virtual meetings in 2021. The aim of these meetings was to develop provocative statements that might spur a global discussion among individuals and organisations that support people experiencing CD. The following questions were discussed: What is our vision for the future of the profession globally? What are the global challenges around access to speech–language therapy services?Four main themes emerged: (1) the need to centre people experiencing CD as the focal point of services, (2) participation, (3) equity and (4) community. The themes relate to the need for a process of de-imperialism in the profession. Suggestions were made to develop more suitable terminology...

South African Journal of Communication Disorders

Background: Early classroom communication supports are critical in influencing oral language deve... more Background: Early classroom communication supports are critical in influencing oral language development and emergent literacy skills. It is both support from peers and adults, as well as the environment that impacts the quality and efficacy of language learning. Schools in particular play a key role in communication development, which will be further explored in this article.Objectives: To describe how communication was being supported in the classroom by teachers in the areas of language-learning environment (LLE), language-learning interactions (LLIs) and language-learning opportunities (LLOs) to focus on classroom communication supports to strengthen literacy outcomes for Grade R learners.Method: A cross-sectional descriptive survey of classrooms was conducted using a structured observation method in 136 classrooms. The Communication Supporting Classroom Observation Tool was used to make 223 observations across classrooms of LLE (19 items), LLI (20 items) and LLO (5 items). A de...

Disabilities

This paper investigates the influence of social capital in the training of persons with disabilit... more This paper investigates the influence of social capital in the training of persons with disabilities. The expansion of social networks is regarded as a central principle of the rehabilitation agenda and thus is a central concept that may influence the training experiences of persons with disabilities. Absent from much of social capital research is its influence on skill development and employment opportunities for persons with disabilities. Social capital has the potential to play an important role in the livelihoods of persons with disabilities who are at high risk of being marginalised. The aim of this qualitative study was to explore and critically examine the experiences of persons with disabilities who participated in an auxiliary skill development programme, to determine whether and how it has strengthened and expanded their social capital to advance their opportunities for economic inclusion and/or employment. There is currently no convincing practice available, particularly ...

South African Journal of Communication Disorders

Background: Although distortion product otoacoustic emissions (DPOAEs) are useful in evaluating c... more Background: Although distortion product otoacoustic emissions (DPOAEs) are useful in evaluating cochlear outer hair cell function, determining the optimal stimulus parameters could result in a more reliable, sensitive and specific diagnostic tool across the range of DPOAE applications. Objectives: To identify which stimulus parameters warrant further investigation for eliciting the largest and most reliable DPOAEs in adult humans. Method: A single group, repeated measures design involving a convenience sample of 20 normal-hearing participants between 19 and 24 years of age. Results: Descriptive statistics and mixed model analyses suggested L1/L2 intensity levels of 65/65 dB sound pressure level (SPL) and 65/55 dB SPL, and f2/f1 ratios of 1.18, 1.20 and 1.22 elicited larger and more reliable DPOAEs in both ears. Conclusion: Further investigation of the 65/65 dB SPL and 65/55 dB SPL intensity levels and the 1.18, 1.20 and 1.22 f2/f1 ratios is warranted to determine the stimulus parame...

Disabilities

Persons with disabilities still experience challenges in obtaining employment even though obligat... more Persons with disabilities still experience challenges in obtaining employment even though obligations associated with their employment are in place in legislative frameworks that strive to support transformation within the labour market. This paper explores employers’ perspectives on the employment of persons with disabilities in South Africa identified in a case study. The influence of social capital on disability inclusive employment was explored from the perspective of two employers who employed trainees who completed an auxiliary training programme for persons with disabilities, which provides opportunities to facilitate pathways to economic inclusion and/or employment. Findings reveal that despite the call for increased labour inclusivity, the development of social capital is not clearly apparent when persons with disabilities are considered for employment. Organisational attitudes and beliefs seem to stem from the obligatory standpoint of the organisations. The paper highlight...

Inclusion, Disability and Culture

Persons with severe communication disabilities in South Africa experience many barriers to their ... more Persons with severe communication disabilities in South Africa experience many barriers to their inclusion in society. These barriers occur across contexts and within all levels of the individual’s family and community life. Congruent with the current models of disability, effective and sustainable communication intervention requires a broad systemic and context-relevant approach that addresses the interaction between individual and environment. This chapter will identify the enablers and barriers to inclusion of people with severe communication disabilities in the South African context within different levels of the ecology. Augmentative and Alternative Communication (AAC) intervention as one method to increase levels of engagement and participation for this group of individuals will be discussed. Reflection on the context-relevant practices and considerations for change across different levels of the ecology to ensure feasible, versatile, and sustainable AAC intervention will be highlighted. These include, but are not limited to, adaptations, the cultural appropriateness of graphic symbols used, the cultural and linguistic competence of the professionals who work with families from diverse backgrounds, as well as availability and provision of technology (in particular speech-generating devices).

BACKGROUND Effective screening is required to facilitate the early identification of central audi... more BACKGROUND Effective screening is required to facilitate the early identification of central auditory processing disorder (CAPD) - a deficit within the central auditory nervous system, which can have a significant effect on a child’s listening, learning and communication. While several screening tools have been proposed, there is a lack of contextually appropriate tools that take the needs of a multilingual society, like South Africa (SA), into consideration. OBJECTIVE This study aims to develop a contextually appropriate CAPD screening protocol for children (aged 7 to 12 years) in SA. The specific study aims are: (1) to develop a contextually appropriate screening protocol for CAPD in primary school children in SA, and (2) to evaluate the feasibility of implementing the developed protocol in primary school children in SA. METHODS The study will follow a developmental, mixed methods research design, implemented in two phases. Phase 1 will be applied to address aim 1. The aim will be...

Disability, Gender and Violence over the Life Course, 2018

African Journal of Disability, 2021

Background: Youth with disabilities are a marginalised group in society. This marginalisation tra... more Background: Youth with disabilities are a marginalised group in society. This marginalisation traps them and prevents their full participation in social and economic development. Objective: This study sought to understand how exposure to the Performing Arts facilitates the inclusion of youth with disabilities. Methods: The study adopted a qualitative research approach, utilising critical ethnography. Primary data consisted of three focus group discussions with youth with disabilities, and an in-depth interview with a performer with disability. Thematic data analysis was conducted. Results: Four themes emerged. Theme 1, Blown away, shares the experiences of youth who attended Artscape Theatre. Theme 2, I can do it, you can do it, describes their career aspirations. Theme 3, Embracing hope, identifies the social and life skills learned through visited Artscape. Theme 4, Long way to go, presents the factors that influence the participation of youth with disabilities in the Performing Arts. While their experiences are diverse, and their impairments are unique, contact with the Performing Arts supported social and economic inclusion, and triggered empowerment of youth with disabilities. Insufficient accessible and available transportation is the most notable barrier to accessing development opportunities. Conclusion: Exposure to the Performing Arts provides important skills development and social opportunities for disabled youth. It is up to the 'keepers' of the Performing Arts-those in administration and management-to realign the Performing Arts in a way that can best benefit everyone.

International Journal of Qualitative Methods, 2020

Case study and narrative inquiry as merged methodological frameworks can make a vital contributio... more Case study and narrative inquiry as merged methodological frameworks can make a vital contribution that seeks to understand processes that may explain current realities within professions and broader society. This article offers an explanation of how a critical perspective on case study and narrative inquiry as an embedded methodology unearthed the interplay between structure and agency within storied lives. This case narrative emerged out of a doctoral thesis in occupational therapy, a single instrumental case describing a process of professional role transition within school-level specialized education in the Western Cape, South Africa. This case served as an exemplar in demonstrating how case study recognized the multiple layers to the context within which the process of professional role transition unfolded. The embedded narrative inquiry served to clarify emerging professional identities for occupational therapists within school-level specialized education in postapartheid Sout...

The purpose of this video-based Fluency assessment of an eight year old female conducted in isiXh... more The purpose of this video-based Fluency assessment of an eight year old female conducted in isiXhosa is to provide a reflective learning opportunity for students as well as qualified Speech-language therapists. The video is accompanied by a reflection from the therapist as well as examples of incisive questions to facilitate clinical learning. Given the importance of culturally and linguistically relevant assessment, the video presents an opportunity to deliberate on several issues speech-language therapists must consider when developing practices which embrace diversity. The questions included with this video should be regarded as initial learning triggers and users are advised to add to the bank of questions as a means of extending and sharing this learning opportunity

The International Journal of Learning: Annual Review, 2006

International Journal of Qualitative Methods, 2021

In this paper, we engage in productive resistance through exploring the application of an arts-ba... more In this paper, we engage in productive resistance through exploring the application of an arts-based method in expanding the critical research methodology repertoire in the profession of speech-language pathology. There is a specific focus on the value of painting in the data representation process. We explore how a playful, creative analysis deepened the critical interpretative meaning-making process. In particular, we explain how artful representations in the data analysis process can broaden communication in research beyond the written modality to generate alternative knowledges. We use the concepts of productive ambiguity and unknowing as key conceptual tools to reimagine the data analysis process with particular focus on the process of data representation. We conclude that embracing the uncertainty of creative ways of knowing create possibilities for new meanings and knowledges to emerge.

Professions and Professionalism, 2019

As a profession, speech-language pathology (SLP) continues to struggle with equitable service del... more As a profession, speech-language pathology (SLP) continues to struggle with equitable service delivery to both people with communication challenges and disabilities. SLP clinical practice in its traditional form has an individual focus and therefore cannot adequately serve the large population in need, which, in South Africa is the majority population. Using the concept of social embeddedness of professions as a guiding frame, the article explores the history of the profession and the influence of the medical model and coloniality in shaping SLP profession’s knowledge and practices. As such, we argue that professionalisation in its current form perpetuates injustice. The article proposes innovation across clinical practice, education and research as leverage points for imagining new practices.

South African Journal of Communication Disorders, 2018

Background: While randomised controlled trials (RCTs) are considered the gold standard of researc... more Background: While randomised controlled trials (RCTs) are considered the gold standard of research, prior study is needed to determine the feasibility of a future large-scale RCT study. Objectives: This pilot study, therefore, aimed to determine feasibility of an RCT by exploring: (1) procedural issues and (2) treatment effect of the Classroom Communication Resource (CCR), an intervention for changing peer attitudes towards children who stutter. Method: A pilot cluster stratified RCT design was employed whereby the recruitment took place first at school-level and then at individual level. The dropout rate was reported at baseline, 1 and 6 months post-intervention. For treatment effect, schools were the unit of randomisation and were randomised to receive either the CCR intervention administered by teachers or usual practice, using a 1:1 allocation ratio. The stuttering resource outcomes measure (SROM) measured treatment effect at baseline, 1 and 6 months post-intervention overall an...

Trials, 2018

Background: Classroom-based stuttering intervention addressing negative peer attitudes, perceptio... more Background: Classroom-based stuttering intervention addressing negative peer attitudes, perceptions, teasing and bullying of children who stutter (CWS) is required as part of holistic stuttering management because of its occurrence in primary school. This study was conducted in 2017, in 10 primary schools in the Western Cape, South Africa within lower (second and third) and higher (fourth and fifth) quintiles. Objectives: The primary objective of this study was to determine treatment effect at six months after intervention of grade 7 participants (Classroom Communication Resource [CCR] intervention versus no CCR) using global Stuttering Resource Outcomes Measure (SROM) scores in school clusters. The secondary objective was to determine grade 7 participant treatment effect on the SROM subscales including Positive Social Distance (PSD), Social Pressure (SP) and Verbal Interaction (VI). The subgroup objective was to determine any difference in the primary outcome between schools between and across quintile clusters (lower and higher). Methods: Once schools were stratified into lower and higher quintile (which are defined according to geographical location, fee per school and resources) subgroup clusters, schools were assigned randomly to control and intervention groups consisting of grade 7 participants who were typically aged ≥ 11 years. Teachers received 1 h of training before administering the single-dose CCR intervention over a 60-90-min session. The CCR intervention included a social story, role-play and discussion. All participants viewed a video of a CWS and stuttering was defined at baseline. The SROM measured peer attitudes at six months after intervention. Randomisation was stratified by quintile group using a 1:1 allocation ratio. Full blinding was not possible; however, the outcome assessor was partially blinded and the analyst was also blinded. Generalised estimating equations (GEE) was used assuming an exchangeable correlation structure to analyse the data adopting an intention-to-treat principle. Multiple imputation was used to handle missing data. Criterion for statistical significance was set at alpha = 0.05.

South African Journal of Communication Disorders, 2011

Basic education in South Africa faces a crisis as learners fail to achieve the necessary outcomes... more Basic education in South Africa faces a crisis as learners fail to achieve the necessary outcomes in the related areas of language and literacy. The aims of this paper are twofold. Firstly, we aim to describe and discuss the education crisis by outlining the educational landscape, relevant policy imperatives and implementation challenges in post-apartheid education. The systemic factors contributing to the literacy crisis are emphasised. Secondly, we argue that speech language therapists and audiologists (SLTAs) have a role to play in supporting basic education in South Africa through developing language and literacy. It is suggested that the professions of speech-language pathology and audiology must be socially responsive and population-focused in order to make meaningful contributions to development in South Africa. The potential roles of SLTAs are discussed with suggestions for further actions required by the professions to enable a contextually relevant practice in a resource-c...