1
|
Zahir MZ, Miles A, Hand L, Ward EC. Opportunities to Enhance Children's Communication Development at School in Underserved Communities. Lang Speech Hear Serv Sch 2021; 53:104-121. [PMID: 34793257 DOI: 10.1044/2021_lshss-20-00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Alternative service delivery approaches are required to provide support for children with communication difficulties in underserved communities. Schools have a unique set of assets that can be utilized to provide this support. This study explored what the education sector and classrooms in the early years of schooling offer as support for children with communication difficulties in an underserved Majority World country, the Maldives. The objective was to identify opportunities to enhance support provided for these children. METHOD A qualitative multimethod approach was used involving (a) 520 min of classroom observational data from four remote schools, (b) interviews with four special education needs teachers, and (c) an interview with a Ministry of Education official. Classroom observational data were analyzed using the Communication Supporting Classroom Observation Tool. Deductive content analysis was used to analyze the interview data. RESULTS The support system aimed to reflect the Inclusive Education Policy of the Maldives. The Ministry of Education official and teachers raised concerns regarding lack of allied health services such as speech-language therapy in schools. Teachers frequently used certain communication supporting interactions such as imitation in classrooms. Missed opportunities to enhance communication were observed, including limited use of some interaction features such as modeling language, limited planned opportunities for children to interact in class, and limited resources in the environment to develop communication in Grade 1 and 2 compared to preschool. CONCLUSION Findings suggest building capacity among teachers and training teachers on identified classroom communication support areas to enhance support for children with communication difficulties. Supplemental Material https://doi.org/10.23641/asha.17003980.
Collapse
Affiliation(s)
| | | | | | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.,Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Queensland, Australia
| |
Collapse
|
2
|
Hopf SC, Crowe K, Verdon S, Blake HL, McLeod S. Advancing Workplace Diversity Through the Culturally Responsive Teamwork Framework. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1949-1961. [PMID: 34314257 DOI: 10.1044/2021_ajslp-20-00380] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Purpose Diversification of the profession is an important element of combating racism, bias, and prejudice in the speech-language pathology workforce at national and systemic levels. However, national and systemic change needs to be combined with equipping individual speech-language pathologists to adapt to the challenges that they face to engaging in culturally responsive practice. This paper presents four interacting levels of practice within the Culturally Responsive Teamwork Framework (CRTF): (a) intrapersonal practices, (b) interpersonal practices, (c) intraprofessional practices, and (d) the interprofessional practices. Conclusion CRTF is a practical, strengths-based framework that draws on international research and expertise to expand personal and professional practice and describe critical behaviors within the workplace that can be used to promote principles of evidence-based practice and social justice, especially when working with people from nondominant cultural or linguistic groups.
Collapse
Affiliation(s)
| | - Kathryn Crowe
- University of Iceland, Reykjavik, Iceland
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Sarah Verdon
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Helen L Blake
- University of Technology Sydney, New South Wales, Australia
| | - Sharynne McLeod
- Charles Sturt University, Bathurst, New South Wales, Australia
| |
Collapse
|
3
|
Zahir MZ, Miles A, Hand L, Ward EC. Optimising existing speech-language therapy resources in an underserved community: A study of the Maldives. JOURNAL OF COMMUNICATION DISORDERS 2021; 93:106136. [PMID: 34325224 DOI: 10.1016/j.jcomdis.2021.106136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 05/23/2021] [Accepted: 05/31/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND People living in Majority world countries face complex challenges regarding speech-language therapy services. As traditional individualised service delivery approaches may not suit the needs of the population, customised solutions are needed. AIM This study explored speech-language therapy and related resources available in the Maldives, a Majority world country, as seen by local government representatives and service providers. The goal was to identify service delivery approaches for children with communication difficulties that could yield the most out of existing resources. METHOD Semi-structured interviews were conducted with six service providers (three speech-language therapists (SLTs), three representatives from Non-Governmental Organisations (NGOs) related to disabilities) and six local government representatives (atoll councillors) of the Maldives. Interview questions related to services available for children with communication difficulties. The data were analysed via deductive content analysis. RESULTS SLTs predominantly delivered traditional individualised and rehabilitative therapy. Services were unevenly distributed across the Maldives with some atolls receiving no services. Support was available from community groups and atoll councillors in some atolls, for instance to access aids provided by the government. Some NGOs were trialling alternative service delivery approaches by conducting programs for parents and teachers in atolls. Participants suggested several possible measures including increasing awareness of speech-language therapy and communication difficulties amongst communities, engaging active community groups to support interventions and allowing less qualified professionals to provide services. The costs related to access and provide services were noted as a challenge. CONCLUSION While this study discovered limitations, the existing resources that were identified can be better directed to reach more children who require services in the Maldives. The following potential alternative service delivery approaches were derived from the results: focusing on prevention, using public health approaches to train families and teachers, creating awareness, building capacity within the community, and adopting cost-effective approaches to provide services.
Collapse
Affiliation(s)
| | - Anna Miles
- The University of Auckland, Auckland, New Zealand
| | - Linda Hand
- The University of Auckland, Auckland, New Zealand
| | - Elizabeth C Ward
- The University of Queensland, School of Health and Rehabilitation Sciences, Queensland, Australia; Centre for Functioning and Health Research, Metro South Hospital and Health Service, Queensland, Australia.
| |
Collapse
|
4
|
Zahir MZ, Miles A, Hand L, Ward EC. Speech language therapy services for children in Small Island Developing States – the situation in the Maldives. SPEECH LANGUAGE AND HEARING 2020. [DOI: 10.1080/2050571x.2020.1776948] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Mariyam Z. Zahir
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Anna Miles
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Linda Hand
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Elizabeth C. Ward
- The University of Queensland School of Health and Rehabilitation Sciences, Brisbane, Australia
- Centre for Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Australia
| |
Collapse
|
5
|
Chu SY, Tang KP, McConnell G, Mohd Rasdi HF, Yuen MC. Public perspectives on communication disorders and profession of speech-language pathology. SPEECH LANGUAGE AND HEARING 2019. [DOI: 10.1080/2050571x.2019.1570705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Shin Ying Chu
- Speech Sciences Programme, Centre for Rehabilitation & Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Keng Ping Tang
- Speech Sciences Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Grace McConnell
- Communication Sciences and Disorders College of Health and Human Services, Rockhurst University, Kansas City, MO, USA
| | - Hanif Farhan Mohd Rasdi
- Occupational Therapy Programme, Centre for Rehabilitation & Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Man-Ching Yuen
- Department of Information Technology, Hong Kong Institute of Vocational Education, Hong Kong
| |
Collapse
|
6
|
Sprunt B, Marella M. Measurement accuracy: Enabling human rights for Fijian students with speech difficulties. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:89-97. [PMID: 29466096 DOI: 10.1080/17549507.2018.1428685] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE The Universal Declaration of Human Rights enshrines the rights to communication and education and measuring access to these rights for children with disabilities is fundamental. The UNICEF/Washington Group Child Functioning Module (CFM) is being promoted to measure progress against the Sustainable Development Goals for children with disabilities. This cross-sectional diagnostic accuracy study in Fiji compares parent and teacher CFM responses to the Intelligibility in Context Scale for 463 primary-aged students with and without speech difficulties. METHOD Receiver operating characteristic curves were constructed to analyse CFM accuracy and determine optimal cut-off points; inter-rater reliability between teachers and parents was calculated. RESULT Parent responses to the CFM speech questions achieved an area under the curve of 0.98, indicating "excellent" diagnostic accuracy. Teachers achieved 0.92 ("very good"). The Youden Index identified the optimal cut-off as "some difficulty". CONCLUSION The CFM appears effective when used by parents or teachers for distinguishing between children with and without speech difficulties. While identified as the optimal cut-off statistically, the "some difficulty" category identifies too many children without speech difficulties to be simplistically applied to funding eligibility. The CFM should be used as a screening tool, followed by further assessment to confirm eligibility.
Collapse
Affiliation(s)
- Beth Sprunt
- a Nossal Institute for Global Health, Melbourne School of Population and Global Health , The University of Melbourne , Melbourne , Australia
| | - Manjula Marella
- a Nossal Institute for Global Health, Melbourne School of Population and Global Health , The University of Melbourne , Melbourne , Australia
| |
Collapse
|
7
|
Hopf SC. Communication Capacity Research in the Majority World: Supporting the human right to communication specialist services. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 20:84-88. [PMID: 29171294 DOI: 10.1080/17549507.2018.1400101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Receipt of accessible and appropriate specialist services and resources by all people with communication and/or swallowing disability is a human right; however, it is a right rarely achieved in either Minority or Majority World contexts. This paper considers communication specialists' efforts to provide sustainable services for people with communication difficulties living in Majority World countries. The commentary draws on human rights literature, particularly Article 19 of the Universal Declaration of Human Rights and the Communication Capacity Research program that includes: (1) gathering knowledge from policy and literature; (2) gathering knowledge from the community; (3) understanding speech, language and literacy use and proficiency; and (4) developing culturally and linguistically appropriate resources and assessments. To inform the development of resources and assessments that could be used by speech-language pathologists as well as other communication specialists in Fiji, the Communication Capacity Research program involved collection and analysis of data from multiple sources including 144 community members, 75 school students and their families, and 25 teachers. The Communication Capacity Research program may be applicable for achieving the development of evidence-based, culturally and linguistically sustainable SLP services in similar contexts.
Collapse
Affiliation(s)
- Suzanne C Hopf
- a School of Community Health, Charles Sturt University , Bathurst , Australia
| |
Collapse
|
8
|
Wylie K, McAllister L, Davidson B, Marshall J, Amponsah C, Bampoe JO. Self-help and help-seeking for communication disability in Ghana: implications for the development of communication disability rehabilitation services. Global Health 2017; 13:92. [PMID: 29284504 PMCID: PMC5747098 DOI: 10.1186/s12992-017-0317-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 12/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In low and middle-income countries, such as Ghana, communication disability is poorly recognised and rehabilitation services for people with communication disability are limited. As rehabilitation services for communication disability develop, and the profession of speech-language pathology grows, it is important to consider how services can most appropriately respond to the needs and preferences of the community. Understanding the ways in which people currently self-help and seek help for communication disability is central to developing services that build on existing local practices and are relevant to the community. METHODS A qualitative descriptive survey was used to explore likely self-help and help-seeking behaviours for communication disability, in Accra, Ghana. The survey required participants to describe responses to hypothetical scenarios related to communication disability. A mix of theoretical sampling and convenience sampling was used. Qualitative content analysis was used to analyse data and develop categories and subcategories of reported self-help behaviours and sources of help and advice for communication disability. RESULTS One hundred and thirty-six participants completed the survey. Results indicated that community members would be likely to engage in a variety self-help strategies in response to communication disability. These included working directly with a person with a communication disability to attempt to remediate a communication impairment, altering physical and communication environments, changing attitudes or care practices, educating themselves about the communication disability, providing resources, and responding in spiritual ways. Participants indicated that they would seek help for communication disability across a range of sectors - including the Western healthcare, religious, and traditional sectors. CONCLUSIONS Understanding existing community actions to self-help and help-seek may allow emerging communication rehabilitation services, including the profession of speech-language pathology, to build on existing community practices in resource-limited contexts such as Ghana.
Collapse
Affiliation(s)
- Karen Wylie
- Korle Bu Teaching Hospital, ENT Department, PO Box 77, Korle Bu, Accra, Ghana
- Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, NSW 2141 Australia
- Department of Audiology, Speech and Language Therapy, School of Biomedical and Allied Health Sciences, University of Ghana, PO Box 143, Korle Bu, Accra, Ghana
| | - Lindy McAllister
- Faculty of Health Sciences, University of Sydney, 75 East Street, Lidcombe, NSW 2141 Australia
| | - Bronwyn Davidson
- Department of Audiology & Speech Pathology, The University of Melbourne, 550 Swanston Street, Melbourne, VIC 3010 Australia
| | - Julie Marshall
- Health Professions Department, Manchester Metropolitan University, 53 Bonsall Street, Manchester, M15 6GX UK
| | - Clement Amponsah
- Department of Audiology, Speech and Language Therapy, School of Biomedical and Allied Health Sciences, University of Ghana, PO Box 143, Korle Bu, Accra, Ghana
| | - Josephine Ohenewa Bampoe
- Department of Audiology, Speech and Language Therapy, School of Biomedical and Allied Health Sciences, University of Ghana, PO Box 143, Korle Bu, Accra, Ghana
| |
Collapse
|