Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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    Sustainable workforce: South African Audiologists and Speech Therapists.
    (BioMed Central Ltd, 2020-07-01) Pillay M; Tiwari R; Kathard H; Chikte U
    Background Audiologists and Speech Therapists play a vital role in addressing sustainable development goals by supporting people who are marginalised due to communication challenges. The global burden of disease and poor social living conditions impact negatively on the development of healthy communication, therefore requiring the services of Audiologist and Speech therapists. Against this background, we examined the demographic profile and the supply, need and shortfall of Audiologists and Speech Therapists in South Africa. Methods The data set was drawn from the Health Professions Council of South Africa (HPCSA) registers (for 2002–2017) for the speech, language and hearing professions. This demographic profile of the professions was created based on the category of health personnel; category of practice, geographical location, population group (race) and sex. The annual supply was estimated from the HPCSA database while the service–target approach was used to estimate need. Additional need based on National Health Insurance Bill was also included. Supply–need gaps were forecast according to three scenarios, which varied according to the future intensity of policy intervention to increase occupancy of training places: ‘best guess’ (no intervention), ‘optimistic’ (feasible intervention), and ‘aspirational’ (significant intervention) scenarios up to 2030. Results Most (i.e. 1548, 47.4%) of the professionals are registered as Audiologists and Speech Therapists, followed by 33.5% registered as Speech Therapists and 19.1% registered as Audiologists. Around 88.5% professionals registered as Audiologists and Speech Therapists are practising independently, and 42.6% are practising in the Gauteng province. The profession is comprised majorly of women (94.6%), and in terms of the population groups (race), they are mainly classified as white (59.7%). In 2017, in best guess scenario, there is a supply–need gap of around 2800 professionals. In the absence of any intervention to increase supply capacity, this shortfall will remain same by the year 2030. By contrast, in aspirational scenario, i.e. supply is increased by 300%, the forecasted shortfall for 2030 reduces to 2300 from 2800 professionals. Conclusions It is clear that without significant interventions, South Africa is likely to have a critical shortfall of Audiologists and Speech Therapists in 2030. Policy-makers will have to carefully examine issues surrounding the current framework regulating training of these and associated professionals, in order to respond adequately to future requirements.
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    First-language raters’ opinions when validating word recordings for a newly developed speech reception threshold test
    (AOSIS, 2018-03-29) Panday S; Kathard H; Pillay M; Wilson W
    Background: The purpose of this study was to consider the value of adding first-language speaker ratings to the process of validating word recordings for use in a new speech reception threshold (SRT) test in audiology. Previous studies had identified 28 word recordings as being suitable for use in a new SRT test. These word recordings had been shown to satisfy the linguistic criteria of familiarity, phonetic dissimilarity and tone, and the psychometric criterion of homogeneity of audibility. Objectives: The aim of the study was to consider the value of adding first-language speakers’ ratings when validating word recordings for a new SRT test. Method: A single observation, cross-sectional design was used to collect and analyse quantitative data in this study. Eleven first-language isiZulu speakers, purposively selected, were asked to rate each of the word recordings for pitch, clarity, naturalness, speech rate and quality on a 5-point Likert scale. The percent agreement and Friedman test were used for analysis. Results: More than 20% of these 11 participants rated the three-word recordings below ‘strongly agree’ in the category of pitch or tone, and one-word recording below ‘strongly agree’ in the categories of pitch or tone, clarity or articulation and naturalness or dialect. Conclusion: The first-language speaker ratings proved to be a valuable addition to the process of selecting word recordings for use in a new SRT test. In particular, these ratings identified potentially problematic word recordings in the new SRT test that had been missed by the previously and more commonly used linguistic and psychometric selection criteria.
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    A survey of communication supports in Grade R classrooms in the Western Cape, South Africa
    (AOSIS, 2022-10-28) Kathard H; Parusnath P; Thabane L; Pillay M; Jing Hu Z; Le Roux J; Harty M; O Carrol S; Mallick RB
    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 descriptive analysis of frequency of occurrence of items was conducted for each domain. Results: Language-learning environment had more frequently occurring observations, with 12 out of 19 items being observed with a frequency of occurrence greater than 65%, indicating that the environment had adequate basic resources (e.g. good light). Language-learning interactions scores indicated that 3 out of 20 items were observed frequently, while 17 out of 20 items were observed less frequently (56.5%), including interactive strategies (e.g. turn-taking). Language Learning Opportunities scores indicated that teacher-led behaviours (e.g. including children in small group activities) were infrequently observed on all items. Conclusion: While the physical environment was generally supportive, the behaviours in the interactive domains of LLI and LLO were observed less frequently. There is potential for speech–language therapists to work collaboratively with teachers to develop communication supporting classrooms as a critical primary-level intervention for language-literacy learning.
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    Feasibility and first results of a prospective cohort study to investigate cisplatin-associated ototoxicity amongst cancer patients in South Africa
    (BioMed Central Ltd, 2021-07-16) Paken J; Govender CD; Pillay M; Ayele BT; Sewram V
    Background Cervical cancer, one of the most common cancers affecting females in South Africa, commonly requires a cisplatin-based-treatment regimen, which has been associated with ototoxic side effects. However, cisplatin-associated ototoxicity is largely under-reported in South Africa, despite its impact of hearing loss having serious overt ramifications on the quality of life of these patients. Hence, a prospective cohort study was undertaken to assess the audiological changes in female cervical cancer patients receiving cisplatin therapy. Objective To present details of the feasibility study and initial results on hearing patterns in cervical cancer patients receiving cisplatin chemotherapy. . Methods Fifty cervical cancer patients commencing with cisplatin chemotherapy underwent audiological assessments at a hospital in South Africa at various time intervals. Assessments included case history, otoscopic examination, immittance audiometry, pure tone audiometry (including high-frequency audiometry), speech audiometry, and distortion product otoacoustic emission testing. Data analysis involved the use of descriptive statistics and the Cochran-Armitage trend test for a linear trend in proportions. Results Fifty participants, aged between 32 and 79 years (Mean: 53 years; SD = 11.00), were recruited. Clinical findings revealed an incidence of 100% ototoxic hearing loss at the one-month post-treatment, i.e., 98% after three cycles of cisplatin and 2% at one-month post-chemotherapy. Sensorineural hearing loss and high-frequency tinnitus were most common. Deterioration in hearing thresholds was more evident in the extended high-frequency range, with the number of “no-responses,” from 11,200 Hz to 20,000 Hz, increasing with each successive audiological evaluation. This study further indicated that recruitment and follow-up of study participants within a limited resource setting are possible. However, cognizance must be given to a multidisciplinary approach and constant engagement with participants through regular contact either telephonically or via a short-message-system. Conclusion Exposure to cisplatin treatment contributed to hearing loss in females with cervical cancer, highlighting the need for ototoxicity monitoring during chemotherapy treatments. Furthermore, the results indicate that it is possible to conduct prospective cohort studies, using a multidisciplinary approach in limited-resource environments with appropriate planning and training strategies, as this study was able to achieve its aim successfully.
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    The internal and external consistency of a speech reception threshold test for isiZulu speakers with normal hearing sensitivity
    (AOSIS, 2018-06-25) Panday S; Kathard H; Pillay M; Wilson W
    Background and objectives: This study investigated reliability, particularly the internal and external consistency, of a new isiZulu speech reception threshold (SRT) test. Methods: To examine internal consistency, 21 adult isiZulu speakers with normal hearing sensitivity completed the SRT test using the first and second halves of the SRT wordlist in the same test session. To examine external consistency, a separate 23 adult isiZulu speakers with normal hearing sensitivity completed the SRT test, using the whole word list on two occasions 4 weeks apart. Consistency of SRT test scores in these test conditions was measured using intraclass correlation coefficient analyses (a measure of the consistency or reproducibility of different observations of the same quantity) and Bland and Altman analyses of agreement (a comparison of measurement error with the expected variation amongst subjects). Results: Intraclass correlation coefficient values ranged from 0.69 to 0.79, showing the isiZulu test scores were highly consistent between the test and retest conditions used in this study. Bland and Altman analyses showed that isiZulu speakers with normal hearing sensitivity can be expected to return isiZulu SRT test scores that differ by no more than 7.5 dB HL – 8.7 dB HL between original and repeat assessments. Conclusion: The isiZulu SRT test was reliable, showing high internal and external consistency, when used to assess first-language speakers of isiZulu with normal hearing sensitivity. These findings warrant continued development of the isiZulu SRT test for eventual clinical use. This development should include validating this test on first-language speakers of isiZulu with and without hearing loss.