Voice for All - 2014

Permanent URI for this collectionhttp://repository.kln.ac.lk/handle/123456789/10377

Papers presented at the country’s first-ever international Conference on Speech Language Therapy, Audiology and Disability organized by the Department of Disability Studies in 2014

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Developing and validating a Sinhala phonology assessment for children aged between 3 to 6 years: trends observed and lessons learnt
(Faculty of Medicine, University of Kelaniya, 2014) Nonis, P.D.M.; Ranaweera, M.; Saleem, S.; Udugama, K.L.L.G.; Lokubalasuriya, T.; Hettiarachchi, S.
Clinical experience of speech and language therapists working in Sri Lanka has put into question the current reliance on norms for English (Grunwell, 1985) to determine a child’s speech skills and phonological acquisition in Sinhala. Cross-linguistic studies have revealed differences in ‘universal principles’ and ‘language-specific’ aspects (Amayreh & Dyson, 1998). At present, there is an urgent need to develop and validate formal language-specific standardized assessments for speech and phonology for Sinhala. The aims of the study were; 1)to develop and validate test items for a Sinhala speech and phonology assessment for children aged between 3;0 to 6;0 years, 2)to document the typical phoneme acquisition and typical phonological processes in Sinhala-speaking children aged between 3;0 to 6;0 years. The ‘Sinhala Speech and Phonology Assessment’ was devised based on the Diagnostic Evaluation of Articulation and Phonology (Dodd et al. 2002) and administered to 250 Sinhala-speaking children between the ages 3;0 to 6;00 years. The use of test items were determined by measures of content validity, test-retest reliability and inter-rater reliability. The trajectory of Sinhala speech sound acquisition showed universal sound acquisition sequences and language-specific features in both the order and rate of speech sound development. The sequence of speech sound acquisition for Sinhala showed early acquisition of plosives and some nasals with comparatively later acquisition of fricatives, the palatal nasal and flap/tap sound. Language-specific phonological processes of lateralization and denasalisation of prenasalised stops were also evident. The test items demonstrated effectiveness at generating target speech data and typical phoneme and phonological development in children between 3;0 to 6;0.
Effect of an Experiential Dysphagia Workshop on Caregivers’ Knowledge, Confidence, Anxiety and Behaviour during Mealtimes
(Faculty of Medicine, University of Kelaniya, 2014) Kitnasamy, G.; Bandara, M.M.M.K.; Subajini, A.A.N.; Hettiarachchi, S.
Children with cerebral palsy who have associated feeding difficulties are at risk of aspiration and poor nutrition. This study aimed to measure the changes in knowledge, confidence and anxiety among 21 Sri Lankan caregivers with responsibility for feeding children diagnosed with cerebral palsy, after they attended an experiential workshop. Data collection was done through pre- and post-workshop questionnaires, observations and semi-structured interviews. There was a significant improvement in reported levels of knowledge and confidence and a decrease in the caregivers’ level of anxiety during mealtimes. The qualitative data analysis indicated changes in participant knowledge, particularly about the signs of aspiration and positioning during mealtimes. Observations showed better adherence to recommendations on communication, bolus size and utensils. The findings support the utility of experiential training for caregivers, to ensure that children with cerebral palsy are fed safely.
‘Giving Voice’: The Effectiveness of an experiential workshop to increase the knowledge and use of alternative augmentative communication (AAC) devices among teachers
(Faculty of Medicine, University of Kelaniya, 2014) Bandara, M.M.M.K.; Subajini, A.A.N.; Kitnasamy, G.; Udugama, K.L.L.G.; Dharmarathna, I.; Hettiarachchi, S.
Many children/ adults who use AAC need to develop the ability to socialize, answer yes/no questions, respond to a wide variety of questions, offer and request for assistance, and express views, feelings and attitudes (Glennen & DeCoste, 1998). Children/ adults who require access to AAC may be at risk of reduced social opportunities, isolation, psycho-social issues and poor quality of life (Hamm & Mirenda, 2006). There is a need to address conceptual explanations of ‘communication’, ‘disability’ and ‘AAC’ and the over-reliance on speech therapy sessions within teacher-caregiver training to create communication opportunities for AAC users. This study was assessed the effectiveness of an experiential training workshop on AAC for teachers. The workshop was offered to 20 teachers from a Special School and 10 teachers from a Special Centre and it covered the right to communicate, modes of communication and communication devices available at present in the country and. Participants’ interaction with children using AAC devices was observed within the classroom before and after the workshop and their knowledge and use of AAC measured through a questionnaire pre- and post-workshop. The results indicated a significant increase in awareness of the concept of AAC, the right to communicate and different modes and AAC devices available at present. There was also an increase in the interaction of participants with children using AAC devices in the classroom immediately following the workshop. The key qualitative finding is a clearer understanding of the right to communicate using any means available. Post-workshop follow-up is required to ascertain whether the knowledge and skills gained from the workshop are carried over into practice with time.
Language Skills of 2-5 Year Old Children with Profound Hearing Loss Undergoing Auditory-Oral Education Compared to Typically-Developing Peers.
(Faculty of Medicine, University of Kelaniya, 2014) Waidyasekara, C.; Rajapaksha, N.; Herath, K.; Hettiarachchi, S.
Hearing impairment is the most frequent sensory defect that leads to communication difficulties and critical to speech and language development, communication, and learning. The objectives were to compare the language skills of children with profound hearing loss using digital amplification and undergoing intensive Auditory Oral education with typically developing peers and to determine the correlation between the time period of receiving Auditory Oral education and language outcomes. Twenty-two children with profound hearing loss using bilateral Behind- The- Ear hearing devices, were selected from an Auditory Oral pre-school. 44 children whose age, gender and geographical area matched were selected from mainstream pre-schools. All participants were assessed using the informal assessment tool. Median scores of receptive vocabulary skills are higher than scores of expressive vocabulary skills in both groups. The difference was statistically significant between the two groups. Receptive vocabulary, understanding of quality, understanding of spatial concept, understand of sequencing concept, understand of sentence structure (syntax) and integrative thinking revealed significant (p<0.05) for each age range 2;0 – 2;11, 3;0 – 3;11 and 4;0 – 5;0. There is a significant difference in seventeen out of twenty linguistic components between the two groups (p<0.05). Only three categories; initiating (p=0.157), producing syllables (p=0.157) and expressing negations (p=0.157) did not show significance. There is a significant (p<0.01) correlation among the time period of having AO education and language skills. The study concluded that there is a significant difference in language skills compared to the typically developing peers. Increased language skills were observed with the early attendance of Auditory Oral education and with appropriate hearing aid. Hence, the children with hearing loss need effective intervention to enhance their language skills in spoken language.
A Normative Study on Phonological Error Patterns Exhibited by 3 (3; 0-3; 11) Year Old Sinhala-Speaking Children in the Matale District
(Faculty of Medicine, University of Kelaniya, 2014) Udugama, K.L.L.G.; Hettiarachchi, S.
In Sri Lanka, very limited research has been conducted on Sinhala phonological development. In the studies conducted, some language-specific features have been identified that are different to English (Nonis et al 2013).Therefore, it is essential to document normative data for Sinhala as it will be useful in the differential diagnosis of phonological delays from professional disorders. The study was carried out as a descriptive cross-sectional study to document phonological error patterns in 80 monolingual Sinhala-speaking children in two age bands of 3; 0-3;5 and 3;6- 3; 11 year olds (Male /Female ; with siblings /without siblings) in mainstream preschools in the Matale district. An informal picture assessment tool based on all phonemes in all word positions expect for pre-nasalied stops which do not occur in this word positions. The Transcend MP330 recording device was used for audio recording. A statistical analyses was conducted using Independent t-tests on SPSS 16.0 Eight typical phonological error patterns were identified in relation to word positions. All error patterns were observed only in word medial position, except for cluster reduction which included initial and final word positions as well. Denasalization of pre-nasalized stops and Lateralization were identified as language-specific error patterns. Both female and male participant groups indicated similar error patterns while children without siblings showed more error patterns than children with siblings. Statistically significant differences (p<0.05) were only identified for age comparisons. Phonological error patterns decrease with age. Most of the error patterns identified were similar to English normative data. Two language-specific error patterns were identified for Sinhala. There was no significant impact of gender and having sibling on phonological acquisition. These results can be used as tentative norms during the clinical evaluation of Sinhala-speaking children for this age range instead of English norms.
Views of Teachers, Caregivers and Children with Cerebral Palsy on the Understanding and Use of Augmentative and Alternative Communication Systems in Sri Lanka
(Faculty of Medicine, University of Kelaniya, 2014) Saleem, S.; Bandara, M.M.M.K.; Subajini, A.A.N.; Udugama, K.L.L.G.; Dharmaratne, I.; Kitnasamy, G.; Hettiarachchi, S.
Every child’s and adult’s right to communicate is a basic human right, promoted by the Disability Rights Movement. However, the use of Augmentative and Alternative Communication (AAC) modes remains ambiguous, possibly dependent on socio-cultural and economic factors influencing the understanding of and access to AAC devices. The findings from a UK-based project (2013) stressed the need to provide AAC training and learning provision to all stakeholders. The aim of this study was to uncover the current understanding of and use of AAC among 30 teachers, 30 caregivers and 10 children with cerebral palsy. Qualitative and quantitative data were gathered via a survey and open-ended interviews with the AAC users encouraged to use available communication devices and artwork. Although a majority of special education teachers had heard of AAC systems, mainly of Bliss symbols, in contrast to Mainstream teachers, overall, there was a propensity towards favoring oral communication. There was a limited understanding of the concept of AAC and a persons’ right to use alternative and augmentative communication modes by a majority of teachers and caregivers. The use of AAC systems is very limited, based on the awareness and access to a speech therapist and if used, mainly limited to the speech therapy sessions in the school. The child participants favored the BigMac switches and the attention-seeking bells on low-tech AAC devices where available. While the younger children used the communication charts during speech therapy sessions, the older children were less enthusiastic about using low-tech communication boards and books.