Research Articles (Centre for Augmentative and Alternative Communication (CAAC))

Permanent URI for this collectionhttp://hdl.handle.net/2263/1685

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Aphasia telepractice in action : insights and opportunities from Malaysian speech-language pathologists
Onwi, Nadwah; Romli, Muhammad Hibatullah; Singh, Susheel Kaur Dhillon Joginder; Salim, Mazatulfazura Sf; Dada, Shakila; Nazan, Ahmad Iqmer Nashriq Mohd (Routledge, 2026)
BACKGROUND : Telepractice leverages telecommunications technologies to deliver rehabilitation services remotely, offering increased accessibility and flexibility for patients. For individuals with aphasia, it represents as a valuable alternative to conventional in-person therapy, particularly for those facing geographical, mobility, or logistical barriers. As this service model gains global traction, understanding its implementation within specific cultural and healthcare contexts is essential. AIM : This study aimed to explore the practices and experiences of Malaysian speech-language pathologists (SLPs) in delivering telepractice services to individuals with aphasia. METHODS : Semi-structured interviews were conducted with six practicing SLPs from a rehabilitation hospital in Malaysia. The interviews were transcribed verbatim and analyzed using an inductive thematic analysis to identify key themes. RESULTS : Six female therapists (M = 33.83 years, SD = 7.47, range = 29 to 45), all of whom held degrees in the field of speech-language pathology from two local universities and had an average of 10 years of clinical experience, participated in the study. Two major themes emerged: (1) current practices in aphasia telepractice; and (2) systemic and practice-level barriers. A hybrid aphasia therapy model was reported to be use in this facility, allowing individuals to choose between in-person and telepractice sessions. Several challenges were identified, including limited culturally relevant digital resources, insufficient technical support, and unstable internet connectivity. CONCLUSIONS : This study highlights the adaptability and dedication of Malaysian SLPs in delivering telepractice services for aphasia despite notable systemic and technological barriers. Addressing these challenges offers a critical opportunity to enhance service delivery and accessibility of speech-language pathology services for individuals with aphasia.
Participation in the habilitation process, from the perspective of young people
Karlsson, Charlotte; Andersson, Anna Karin; Lundqvist, Lars-Olov; Huus, Karina (Stockholm University Press, 2025-05-14)
Young people have the right to participate in their habilitation process. The aim was to describe how young people with disabilities perceive participation in the habilitation process. Data collection was performed at child and youth habilitation centres in Sweden. A total of four interviews were conducted, two individual interviews and two group interviews. The transcribed data was analysed using inductive qualitative content analysis. The analysis reveals two generic categories: ‘the right prerequisites must be provided to be able to participate’ and ‘adults’ behaviour and attitudes are important for participation in the habilitation process’. The findings reveal that how young people perceive participation in the habilitation process is based on environmental factors, such as information, and that the professionals strive for the young people’s voices to be heard by including them in planning. In conclusion, the important aspects of participation are a young person-friendly environment and individual support from adults. These aspects can provide a source of reference for professionals who want to develop strategies to promote young people’s participation.
Early childhood intervention and inclusion in the Swedish welfare system
Björck, Eva; Åström, Frida; Ohman, Charlotte (Lippincott, Williams and Wilkins, 2026-01)
In this article, early childhood intervention (ECI) and inclusion in the universal Swedish welfare system is in focus. The framework emphasizes a child and family centered approach that focuses on supporting all children’s development and learning in a preschool for all children, child health services welcoming families and children, child habilitation centers for children with disabilities and their families in the ecosystem for ECI. An important principle is proportionate universalism, that is, that every child and family should have equal opportunities regardless of income level, and that they are provided with support in relation to needs. In this article, a special focus is on the universal preschool for all children, which is an important part of ECI. Even though Sweden is regarded as one of the best countries to raise children in the world, a main concern is whether the Swedish welfare system and ECI retain the capacity and capability to provide the support that is required to meet the needs of all children and to live up to consistent and broad criteria for inclusion from a societal to an individual perspective. The conclusion is that Sweden has a robust system for ECI in many ways, but there is a need for integration and coordination of the services in the ecosystem, and a strong growth of research to provide evidence-based knowledge about inclusive practices across the organizations involved.
Fall risk screening : audiologists' perceived knowledge, views and reported practice
McFarlane, Kayla J.; Kanji, Amisha; Naudé, Alida Maryna (AOSIS, 2025-04-23)
BACKGROUND : Treatment success rate is a critical indicator for monitoring the progress of tuberculosis (TB) treatment programmes at both the patient and population levels. It informs decisions about resource allocation and the effectiveness of TB control strategies. This study aimed to determine the level of TB cure rates and the factors associated with treatment success among TB patients receiving TB care in the Collins Chabane municipality, Limpopo province, South Africa. METHODS : Medical records from April 2020 to March 2021 of 289 patients attending primary health care facilities, initiated on anti-TB treatment were reviewed. Descriptive statistics were used to analyse data and modified Poisson regression was used to determine factors associated with treatment success. Statistical software Epi Info was used for analysis. RESULTS : Of the 289 TB cases, 282 (97.6%) were newly initiated on TB treatment. Of these, 37.0% were cured, followed by 29.0% who defaulted treatment, 22.3% who completed the treatment and 11.7% who died during treatment. The likelihood of successful treatment outcomes was significantly associated with marital status, supervised treatment and distance travelled to a health facility. A higher likelihood of success was observed among patients who were single and 27.0% of those had supervised treatments. CONCLUSION : Tuberculosis patients continue to die in the course of treatment. Supervised treatment is a predictor of successful treatment outcomes. CONTRIBUTIONS : This study highlight the need for heightened advocacy for supervised TB treatment and increased effort to combat the death of patients while on TB treatment.
T+ designers : a case for transdisciplinarity in design higher education by way of a South African case study
Cassim, Fatima; Rath, Kyle A.; Dada, Shakila; Samuels, Alecia E.; Castro-Kemp, Susana (Wiley, 2025)
In recent years, the term ‘transdisciplinarity’ has been widely applied to collaborative design approaches ranging from inter- to multi-disciplinary co-production. While each of these approaches have their place, many of them are labeled, tokenistically, as transdisciplinary. A transdisciplinary model of collaboration, as defined by Toomey et al. (2015) extends beyond academic boundaries to engage in the co-production and use of knowledge from within and outside of the academy. In design, the term ‘T-shaped designers’, championed by IDEO's Tim Brown, is often used when promoting design thinking to tackle complex problems. The vertical leg of the ‘T’ represents disciplinary depth, and the horizontal bar suggests the application of these skills across a breadth of contexts. For this paper, we extend the interdisciplinary nature of the T to a transdisciplinary one: we propose how transdisciplinarity can be used not only to deepen disciplinary design skills but to foster empathetic, reactive designers with a keen sense of inquiry. In this way, as the vertical stem extends upwards, it transforms the T-shape into a plus. We exemplify this transformation by presenting a curriculum-related design project. As a collaboration between [the University of Pretoria (UP), South Africa (SA), and the University of Roehampton (UR), United Kingdom] the project was delivered in a transdisciplinary way, whereby students co-produced a series of accessible and engaging infomotions (information visualizations in motion). The infomotions, which disseminate strategies for effective partnership amongst early childhood intervention practitioners in South Africa. At its core, the project presents transdisciplinarity as one approach to future-proof design education.
Using secondary data analysis to compare core vocabulary lists and elicitation duration of two data sets of typically developing preschool Afrikaans-speaking children
Winter, Petria; Van der Linde, Jeannie; De Wet, Febe; Graham, Marien Alet; Bornman, Juan (Karger Publishers, 2025)
INTRODUCTION : Core vocabulary lists provide an evidence-based method for describing the vocabulary of individuals across various age groups, categorised by different parts of speech. Despite its value, there is a paucity of core vocabulary lists in nonmainstream languages. Resource limitations contribute to this paucity; therefore, more efficient methods for developing core vocabulary lists are needed. This study aimed to compare two sets of previously collected language samples from typically developing 5–6-year-old Afrikaans-speaking children to compare two different elicitation methods for developing a core vocabulary list. We also compared the duration of the language samples to inform the duration required for accurate and representative language samples for the development of core vocabulary lists. METHODS : Using secondary data analysis, we compared the core vocabulary lists from two existing data sets in terms of the number of different words, the frequency of use of each of these words, type-token ratio, and parts of speech used by typically developing 5–6-year-old Afrikaans-speaking children. RESULTS : The average recording time for data set A was 60 min in a single session. The corresponding value for data set B was 250 min, recorded over a period of 1–3 days. A perfect positive Spearman correlation was observed between the results for the two data sets for all parts of speech except interjections and enclitics. Code switching formed part of data set B’s core words but did not appear in data set A’s core word list. CONCLUSION : The findings demonstrate that similar core vocabulary lists can be obtained for 5–6-year-old children using a less invasive and time-effective 60-min elicited method for language samples compared to naturalistic samples collected over 1–3 days. Proposing a more robust and less time- and resource-intensive method of developing vocabulary lists may further support the development of core word lists across ages and in other languages.
Agreement between children with neurodevelopmental disorders and their primary caregivers on participation : attendance, involvement, and perceived important activities
Kang, Lin-Ju; Granlund, Mats; Huus, Karina; Dada, Shakila (Taylor and Francis, 2025)
PURPOSES : To investigate item-level agreement between children with neurodevelopmental disorders (NDD) and their primary caregivers regarding perceived participation attendance and involvement, and identify differences in their selections of the important activities to children. MATERIALS AND METHODS : The participants included 143 children with NDD aged 6 to 12 years and their primary caregivers (n = 130). Each completed the Picture My Participation (PmP) separately. Weighted Kappa coefficients and absolute agreement/disagreement were calculated to assess agreement between child–primary caregiver dyads in attendance and involvement ratings. Frequencies of items selected as one of the three most important activities were analyzed. RESULTS : Slight to moderate agreement was found between children and primary caregivers in perceived attendance (κ = 0.10 − 0.47, p < 0.05) and involvement (κ = 0.12 − 0.48, p < 0.05) at the item level. Children more frequently identified social activities, caregiving for others or animals, personal care, and school learning as important compared to their primary caregivers. CONCLUSIONS : The relatively low agreement between children with NDD and their primary caregivers highlights the importance of including children’s perspectives in collaborative goal-setting. Clinicians should tailor tools and strategies to address children’s and caregivers’ differences in perceived participation and important activities to facilitate the co-construction of participation goals. IMPLICATIONS FOR REHABILITATION • Clinical decision-making around participation primarily relates to specific activities. • Children with neurodevelopmental disorders and their primary caregivers had relatively low agreement in their perceived participation, particularly concerning children’s involvement in activities related to socialization, caregiving, personal care, and school learning. • Children’s perceptions of involvement and activity importance are essential to measure for the co-construction of participation goals, ensuring goals are grounded in the activities important to children. • Clinicians should implement tools and strategies to bridge the discrepancies in children’s and caregivers’ perceptions, tailoring interventions to address needs from both perspectives.
Stakeholder insights and policy recommendations from the InnoFoodAfrica Project on traditional African foods
Smith, Katherine Alice; Emmambux, Mohammad Naushad; Dada, Shakila (Academy of Science of South Africa, 2025-08)
SIGNIFICANCE : Supporting systems that provide healthy and safe food ingredients and products and environmentally sustainable nutrition and food security solutions are key local priorities. To achieve these priorities in South Africa, multilevel and multiagency support is needed by smallholder farmers to expand the cultivation, growing, distribution, marketing, and production of indigenous and traditional African food crops (ITFC) and ingredients, as well as the sale, acceptance, and consumption of ITFCs. Public education is required to transform local perspectives on protein intake and the benefits of ITFCs. The government must exempt ITFCs from VAT to promote their mainstream commercial viability.
Collaborative goal-setting approaches to support participation of children with special educational needs
Liao, Hua-Fang; Liao, Ya-Tzu; Chen, Li-Chiou; Wu, Yen-Tzu; Kang, Lin-Ju; Granlund, Mats; Björck, Eva (Lippincott Williams and Wilkins, 2025-07)
PURPOSE : To compare the participation ratings between children with special educational needs and their primary caregivers and investigate the activities children desire to change and their participation-based goals. METHODS : Twenty children with special educational needs aged 8 to 12 years were interviewed using the Functioning Scale of the Disability Evaluation System—Child to measure participation frequency and independence and select desire-to-change activities. The International Classification of Functioning, Disabilities, and Health-based Collaborative Problem Solving was used to form participation-based goals. RESULTS : Children reported participation differently from their primary caregivers. Nineteen children identified desire-to-change activities mostly related to the home and community settings and indicated a desire to change participation frequency. Children’s participation-based goals reflected their desires to do their preferred activities more often. CONCLUSIONS : Children with special educational needs had unique perspectives different from those of their caregivers, and they could identify desired activities and set participation goals with semi-structured methods.
Brainstem auditory evoked responses : objective hearing threshold assessment in Holstein cows
Naudé, Alida Maryna; Erasmus, Lize-Mari; De Swardt, Liesl; Bornman, Juan; Van Marle-Koster, Este (AOSIS, 2024-10-21)
BACKGROUND : Animal audiology utilizes brainstem auditory evoked responses (BAER) as a non-invasive tool to assess hearing in animals, including Holstein dairy cows. Understanding cows’ auditory capabilities is critical for their welfare, especially given their exposure to farm noise. OBJECTIVES : This study provides preliminary normative BAER data for Holstein cows by focusing on absolute and interpeak wave latencies. The objective is to assess the impact of farm noise and expand audiologists’ practice scope. METHOD : Ten Holstein cows were tested using monoaural broadband click stimuli with contralateral masking. Earphones with foam ear tips were used to minimize environmental noise interference. The BAER responses were recorded via subdermal needle electrodes placed at standardized locations on the cows’ heads. The data were analysed using descriptive statistics to determine auditory thresholds and wave latencies. RESULTS : The cows exhibited auditory thresholds at 90 dB SPL (55 dB nHL). Detailed wave and interpeak latencies were recorded at intensities from 85 to 105 dB SPL. At 90 dB SPL, the average latency for wave V was 5.17 ms, marking the auditory threshold for Holstein cows. CONCLUSION : These findings provide key insights into the auditory sensitivity of Holstein cows, highlighting BAER’s potential for monitoring auditory health and evaluating the effects of noise pollution on animal welfare. This research underscores the value of integrating animal audiology into the audiologist’s scope, ultimately enhancing both animal welfare and farming sustainability. CONTRIBUTION : This study adds to the limited literature on farm animal auditory health and suggests strategies to improve welfare through better auditory management.
Challenges experienced by South African police officers when taking statements from victims with a communication disability
Viljoen, Erna; Bornman, Juan; Tonsing, Kerstin Monika (Institute for Security Studies, 2023-12)
Police officers increasingly come into contact with persons with a communication disability in their line of duty. This study describes the challenges officers face when taking statements from such victims. Focus group discussions were conducted with South African police officers. Findings showed that they face a myriad of challenges in the statement-taking process. These could be categorised under four main themes: the transactional nature of communication, lack of resources to support communication during statement-taking, the vulnerability of complainants with communication disabilities, and police pessimism. The article recommends that disability sensitivity training, as well as training on communication disability, be provided to police officers.
Collaboration in early childhood intervention services
Kyarkanaye, Thilendree; Dada, Shakila; Samuels, Alecia E. (Lippincott, Williams and Wilkins, 2025-07)
Collaboration is a sophisticated activity requiring knowledge, technical competencies, and interpersonal skills. Many professionals lack experience in collaboration and therefore face challenges in forming and sustaining early childhood intervention (ECI) teams. There is a paucity of research on collaboration within ECI teams, especially within healthcare settings in resource-constrained nations marked by linguistic and cultural diversity, such as South Africa. Participants included 34 professionals who completed a survey. The results revealed that professionals possess a good understanding of collaboration and perceive families to be integral members of the team. Professionals emphasized the importance of resources, efficient communication, mutual respect, and the sharing of information. These results are discussed, with the limitations of the study, as well as future recommendations, outlined.
Is there a 'universal' core? Using semantic primes to select vocabulary across languages in AAC
Soto, Gloria; Tonsing, Kerstin Monikat (Taylor and Francis, 2024)
Core vocabulary lists and vocabulary inventories vary according to language. Lists from one language cannot and should not be assumed to be translatable, as words represent language-specific concepts and grammar. In this manuscript, we (a) present the results of a vocabulary overlap analysis between different published core vocabulary lists in English, Korean, Spanish, and Sepedi; (b) discuss the concept of universal semantic primes as a set of universal concepts that are posited to be language-independent; and (c) provide a list of common words shared across all four languages as exemplars of their semantic primes. The resulting common core words and their corresponding semantic primes can assist families and professionals in thinking about the initial steps in the development of AAC systems for their bilingual/multilingual clients.
A systematic review of longitudinal trajectories of mental health problems in children with neurodevelopmental disabilities
Danielsson, Henrik; Imms, Christine; Ivarsson, Magnus; Almqvist, Lena; Lundqvist, Lars‑Olov; King, Gillian; Lyngback, Liz Adams; Andersson, Anna Karin; Arnell, Susann; Arvidsson, Patrik; Augustine, Lilly; Brooks, Rob; Eldh, Maria; Engde, Lisa; Engkvist, Helena; Berglund, Ingalill Gimbler; Green, Dido; Huus, Karina; Karlsson, Charlotte; Lygnegard, Frida; Sjodin, Linda; Granlund, Mats (Springer, 2024-04)
To review the longitudinal trajectories – and the factors influencing their development – of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.
Cavernous hemangioma with right vestibulopathy : a case report illustrating multidisciplinary clinical decision-making in vestibular diagnostics
Naudé, Alida Maryna; Brown, Lisa; Kanji, Amisha (Elmer Press, 2024-11)
This paper describes a case study of a 56-year-old male patient with a small cavernous hemangioma and concurrent peripheral vestibular symptoms, initially thought to warrant neurosurgical intervention. A structured, multidisciplinary approach involving audiology, ear, nose and throat, and physiotherapy revealed that peripheral vestibular dysfunction, rather than the central lesion, was the primary cause of symptoms. The report illustrates the diagnostic utility of video head impulse testing (vHIT), caloric testing, and vestibular evoked myogenic potentials (VEMPs) in differentiating central and peripheral vestibular dysfunction, leading to a nonsurgical treatment plan. The case underscores the importance of multidisciplinary collaboration in preventing unnecessary interventions and highlights an effective clinical decision-making framework for similar cases.
Perceived activity competence and participation in everyday activities of children with and without neurodevelopmental disorders
Kang, Lin-Ju; Granlund, Mats; Huus, Karina; Dada, Shakila (Taylor and Francis, 2025-07)
AIM : To compare children with and without neurodevelopmental disorders (NDD) in self-rated activity competence, participation, and the associations between activity competence and participation. METHODS : This cross-sectional study included 126 children with NDD and 115 without NDD, aged 6–12 years, who completed interviews with the Perceived Efficacy and Goal Setting System (PEGS) and Picture My Participation (PmP). Independent t-tests or Mann–Whitney U tests examined group differences in the PEGS and PmP scores. Correlation and regression analyses examined associations between the PEGS and PmP scores. RESULTS : Children with NDD perceived lower physical competence than children without NDD, particularly in self-care (d = 0.80) and leisure (d = 0.66). The two groups did not differ in participation. Both groups demonstrated significant correlations between perceived activity competence and attendance (r = 0.21–0.49) and involvement (r = 0.19–0.53); significantly lower correlations were observed in children with NDD than those without (d = 0.22–0.28). Perceived activity competence significantly influenced attendance (β = 0.365) and involvement (β = 0.391). CONCLUSIONS : Children with NDD perceived less competency than peers without NDD. Children’s perceived activity competence is correlated bi-directionally with perceived participation. Clinicians can support competence to promote participation, or by supporting participation, the competence can be enhanced.
Promoting autonomy and employment of individuals with intellectual disability : the role of universities
Morcillo, Juana; Bornman, Juan (Center for Disability Services, 2024-10)
A positive correlation exists between having a university degree and being employed. The opportunity to earn a university degree, however, is challenging for students with intellectual disability, as universities are typically not adapted to their unique higher education needs. This negatively impacts those students’ employment opportunities and, consequently, also their autonomy because employment is often a driver of important life decisions. In response, the University of Castilla- La Mancha in Spain embarked on a program, ‘Incluye e Inserta UCLM’ (‘Inclusion and Labour Insertion at UCLM’), to accommodate students with intellectual disabilities by implementing an accessible university qualification for them. Universities are knowledge-generating centers and should also fulfill a social function. To do so, universities must be in contact with society to determine societal needs and provide some solutions. The abovementioned socially responsive university program offers students with intellectual disabilities a unique opportunity to fulfill their academic and personal growth.
Using the ICF to guide inclusion in the African educational context : a scoping review
Naudé, Alida Maryna; Kang, Lin-Ju; Moretti, Marta; Rocha, André de Souza; Maxwell, Gregor R.D.; Bornman, Juan (MDPI, 2024-12)
While the International Classification of Functioning, Disability, and Health (ICF) has significantly contributed to educational research supporting inclusive initiatives worldwide, its application in special education contexts across the African continent remains unclear. This study aims to explore how the ICF is currently used in the field of education in Africa, with an emphasis on children with disabilities, although not restricted to this group. The Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) diagram shows that the 11 African-specific databases that were searched yielded 256 records. These records were uploaded to Rayyan, an online collaborative review platform. First, 158 duplicates were removed. Following title and abstract level screening, six records were eligible at full-text level, of which four were excluded, as they focused on the health context. The findings from the remaining two studies were compared and discussed in terms of similarities and differences. Both articles addressed the interactive nature between an individual’s activities and participation and environmental factors, agreeing on the importance of addressing societal barriers to inclusion. The use of the ICF in educational settings across Africa is still scarce, thus requiring strategies that could drive inclusive education for children with disabilities on the African continent.
Augmentative and alternative communication for individuals with post-stroke aphasia : perspectives of South African speech-language pathologists
Odendaal, Inge; Tonsing, Kerstin Monika (Taylor and Francis, 2025)
This qualitative study aimed to describe speech-language pathologists’ (SLPs’) perspectives on augmentative and alternative communication (AAC) use for people with post-stroke aphasia focusing on: (a) current AAC practice, (b) factors that influence the use of AAC, and (c) the success and relevance of AAC interventions. Semi-structured interviews took place with ten South African SLPs with experience in aphasia intervention. The transcribed interviews were thematically analyzed using a six-phase process of inductive and deductive analysis within a phenomenological framework. All the participants use AAC with their clients, employing a variety of approaches that reflect their diverse settings, experiences, and perspectives on AAC. AAC use is complex, and SLPs make conscious choices considering multiple factors. Barriers to use were often associated with limited resources in the low- and middleincome country (LMIC) context, but most participants retained a positive view of AAC, actively working to circumvent barriers to use. Participants consistently emphasized the vital role of partners in communication interactions, linked to the importance of defining AAC broadly. It is necessary to advance the integration of AAC into rehabilitation plans to improve communication and social participation outcomes for people with post-stroke aphasia, especially in LMICs such as South Africa.
Stuck in old ways : towards transdisciplinary training for healthcare professionals in early intervention
Samuels, Alecia E. (Academy of Science of South Africa, 2024-11)
SIGNIFICANCE : South Africa has a serious shortage of healthcare professionals trained to provide early intervention services for young children with disabilities, especially in the public healthcare sector, accessed by the majority of the South African population. A transdisciplinary approach which requires healthcare professionals to work across and outside their disciplinary boundaries is recommended, but few healthcare professionals in South Africa are trained in this manner. A need exists, therefore, to transform the training of healthcare professionals to ensure that more children with disabilities can receive early intervention services.

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