Browsing by Author "Udugama, L."
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Item Documenting norms for typical phonological processes in Sri Lankan Tamil, Sinhala and Sri Lankan English in children aged between 3;0- 3;11 years(Faculty of Medicine, University of Kelaniya, Sri Lanka, 2016) Udugama, L.Sri Lankan Tamil, Sinhala and Sri Lankan English are distinct languages which contain language specific features. In Sri Lanka, to identify typical phonological processes in clinical practice, clinicians use normative data developed for British English-speaking children. It is essential to document normative data for Sinhala, Sri Lankan Tamil and Sri Lankan English as it will be useful in differentially diagnosing between typical phonological processes, phonological delays and disorders. The aim of the studies conducted was to document the phonological processes in 3;0- 3;11 year old typically developing children in different dialects of Sinhala and Sri Lankan Tamil as well as in Sri Lankan English. Three picture-based assessments devised by the researchers and the South Tyneside Assessment of Phonology were used to gain speech samples from 160 Sinhala speaking, 160 Tamil-speaking and 30 Sri Lankan English speaking children between the ages of 3 – 3; 11 years from four geographical locations (Matara, Matale, Kandy district-Akurana and Kandy district- tea estate) for the former two groups and from Colombo for the latter group. The data were phonetically transcribed and the phonological processes were described in relation to word positions. In addition, the data were statistically analyzed using t-tests on SSPS 16.0. The findings indicate a statistically significant influence of age, dialect and gender on the phonological processes produced. In addition, some unclassified phonological processes, language and dialect-specific processes were observed and will be discussed in relation to British English phonology norms and its implications for clinical practice.Item Physiological differences between breast-feeding and bottle-feeding in pre-term infants(University of Kelaniya, Sri Lanka, 2022) Perera, D.T. K.; Dharmarathna, I.; Udugama, L.Background: Infants who breastfeed must have the ability to coordinate their sucking, swallowing, and breathing to achieve their nutritional and hydration needs while protecting their airways. The need for new non-invasive approaches to get objective physiological parameters of suck-swallow-breathe coordination is considerable because the gold standard, videofluoroscopy (VFSS) cannot evaluate breast feeding and FEES cannot evaluate suck-swallow physiology. Objectives: The objectives of the study were to obtain physiological parameters of the suck-swallow-breathe coordination in a cohort of premature milk-sucking infants; describe the physiological differences between breast and bottle feeding in premature infants; and determine the associations of the selected demographic factors with the physiological measures of suck- swallow-breathe coordination in premature infants. Methods: This observational cross-sectional study used a purposive sampling method to recruit sixty-two (n=62) premature (≤ 37 weeks) infants from birth to 12 months who are breastfeeding and/or bottle-fed. One-two minute video recordings of breast-feeding/ bottle-feeding capturing sucking and swallowing movements were obtained. A set of objective physiological parameters of suck-swallow-breathe coordination were measured by analysing the video recordings. Results: Excellent inter-rater reliability was reported for all the physiological parameters used in this study (ICC= .89-.98, 95% CI [.86-.1.00], p< .001). When means were compared, a significant difference was reported in the feed duration between breast-feeding and bottle-feeding (t= 3.667, df=39.765, P=.001). Further, significant differences were reported in the number of pauses (t= 4.011, df=54.813, P<0.001), changes in levels of oxygen saturation during feeding (t= 2.456, df= 59.919, P= .017), changes in heart rate during feeding (t= 2.441, df= 55.919, P= .018), milk intake per minute (t= 6.542, df= 44.636, P<0.001), suck frequency (t= 4.093, df= 52.175 , P<0.001) and swallow frequency (t= 4.339, df=50.867, P<0.001) between breast-feeding and bottle-feeding in premature infants. In the Pearson correlation test, duration of feeding decreased as the gestational age of infant increased (r (61) = -.252, P= .048). Similarly, feeding duration was significantly shorter in infants with a higher gestational week at birth (r (61) =-0.309 P = 0.015). Furthermore, with an increased chronological age of the infants, the number of pauses during feeding decreased significantly (r (61) = -0.308 P = 0.015). Further, in infants with higher gestational weeks at birth (r (61) = 0.351 P = 0.005) and infants with increased weight (r (61) = .273 P = 0.032), milk intake per minute increased significantly. Also, milk intake per minute showed a significant increase in premature infants with increased gestational age at birth (r (61) = .351 P = .005) and with the current weight of the premature infants (r (61) = .273 P = .032). Conclusion: This research showed that bottle feeding, and breastfeeding have been associated with significant physiological changes in premature infants, which is supported by the reviewed research. By providing objectivity to its findings and its interpretation, this study provides a reliable and feasible method for improving the accuracy and reliability of clinical feeding assessments of infants. This unique method is a safe and effective way to gather objective physiological parameters of coordinated suck-swallow-breathe for therapists who do not have access to instrumental swallowing assessment.