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

Browse

Now showing 1 - 20 of 30

Acquisition of Reading Skills of Sinhala Vowel Modifiers among Pre-School Leavers and Grade One Leavers in Gampaha District
(Faculty of Medicine, University of Kelaniya, 2014) Perera, B.M.R.K.; Williams, C.; Wijeratne, L.
Vowel modifiers are a very important feature in Sinhala written language, which are used with consonants to make different sound syllables. They always appear in word medial or final positions to represent the associated vowel sounds; they can be used before, after, on top, bottom or around the consonant (Dissanayaka, 2005). The main objective of this study was to identify teachers’ expectations in children’s performance, in terms of reading vowel modifiers at pre-school level and grade one leaver level, as well as to identify the actual performance level of children. A quantitative cross-sectional exploratory study was done in four selected schools in the Gampaha District. The sample comprised of forty pre- school leaver level students, eighty grade one leaver level students, eight pre-school teachers and eight grade one teachers. Teachers’ data were collected using a self-administered questionnaire and a record sheet to mark the expected level for the whole class. Children were tested individually using a Sound Blending and Meaning Picture Card Test (SBMPT) with the same record sheet to mark their performance. The results reveal that teachers’ expected level of children’s performance in reading vowel modifiers were 0% and 100% for preschool and grade one leaver levels respectively. Average scores for pre- school children on SBMPT was 0% and most of the grade one children were able to obtain 100% for vowel modifier / ɑ:/ at syllable level. The least performance was noticed with /o: / at 88%. Acquisition of the skills in reading vowel modifiers was not associated with gender, but was significantly associated with age. i.e., when age of the children increased the percentage of vowel modifiers they acquire also increased proportionally. In conclusion, it was found that most of the pre-school leavers have not acquired reading skills in terms of vowel modifiers and the majority of the grade one leavers have mastered most of the vowel modifiers.
Association between Mobile Phone Usage and Hearing Sensitivity among Third Year Students; (of) University of Kelaniya, Sri Lanka
(Faculty of Medicine, University of Kelaniya, 2014) Sivaramalingam, V.; de Silva, D.
With advancement of Global System for mobile (GSM) communication, mobile phones (MP) have become an essential communication tool. Mobile networks operate in frequencies which fall in the microwave range of electromagnetic spectrum. The close proximity of a mobile phone antenna, radio frequency electromagnetic radiation can penetrate into organic tissues causing health hazards. In Sri Lanka, the number of MP users is over 20.3 million and the majority of users are young adults. Up to date, no study has been conducted regarding MP usage and its effects on hearing in Sri Lanka. The objective was to determine the association between MP usage and hearing sensitivity among third year students, University of Kelaniya, Sri Lanka. A descriptive cross sectional study was conducted among 223 students who filled a self-administered questionnaire regarding MP usage and hearing related symptoms. All participants underwent otoscopic examination, and a Distortion Product Otoacoustic Emission (DPOAE) screening at 3 kHz, 4 kHz and 5 kHz frequencies. The mean MP usage hour per day was 1.41 hours (SD 1.22) and the mean MP usage duration was 5.57 years (SD 1.72). The majority of students preferred the right ear for MP conversation, while highest prevalence of hearing loss was observed at 4 kHz (5.6%) and 5 kHz (6.7%) in the right ear. There was no significant difference in hearing loss between the ears of the two sides. A significant association between hearing loss and prolonged usage (more than 5.57years) of MP or excessive usage of MP (more than 1.41 hours per day) could not be found. Symptoms such as warmth, tinnitus, need of repetition and muffled sensation were associated with excess usage of MP.
Audiovisual Segregation in Typically Developing Children
(Faculty of Medicine, University of Kelaniya, 2014) Jayasena, B.N.; Nanayakkara, S.; Illangasighe, C.; Jacob, J.
Learning in typical classrooms with high background noise is often difficult for children, where they may have to lipread the teacher to understand what is being said. In this scenario, it is assumed that a child should possess the ability to separate congruent information from incongruent information in an audiovisual signal. This study was aimed at investigating how well typically developing children can segregate visual information in the presence of auditory distracters, compared to young adults. 12 typically developing primary school children and 11 young adults with normal hearing and vision lipread 120 consonant-vowel-consonant-vowel (CVCV) nonsense syllable words presented in four conditions: (1) visual-only condition, (2) visual stimuli with a multi-talker babble, (3) visual stimuli with reversed speech sounds of the nonsense syllable words, (4) visual stimuli with non-altered speech sounds of the nonsense syllable words. Mean scores of children in all four conditions were lower than that of the adults, and also a significant difference for all the conditions between the two groups was noted. Results suggest that normal-like audiovisual segregation is difficult for young children because of maturation effects. The study findings can be used to encourage further research in audiovisual segregation. Also, if used constructively, these findings will be helpful in highlighting the importance of creating learner-friendly environments with minimal auditory distractions for children.
Caregiver Adherence to Speech and Language Therapists’ Advice on Management of Dysphagia in Children with Neuro-disabilities
(Faculty of Medicine, University of Kelaniya, 2014) de Silva, G.; de Silva, H.
Majority of children with Cerebral Palsy (CP) have feeding difficulties that affects not only their quality of life but also their caregivers and family. As caregivers carry out most feeding interventions, it is important to design an intervention that caregivers find it possible to integrate in to their daily life. The study aimed to determine the care-giver adherence to speech and language therapists’ advice on six selected strategies, in the management of dysphagia in children with neuro-disabilities. Fifteen caregivers of 1 to 10 year old children with moderate to severe CP and feeding difficulties, and whose current feeding methods required interventions were selected as participants. Caregivers were video-recorded while feeding their child pre-intervention and then introduced and demonstrated the six management strategies i.e., head position, trunk position, utensils, food consistency, bolus size, and pacing. They were video-recorded after 4-6 weeks post-intervention. A score was given for the six selected strategies both pre- and post-intervention. Results showed a significant difference between pre- and post-intervention for all six strategies (p<0.005). All care-givers were able to adhere to all six strategies post-intervention. However, some strategies were adhered to better than others; utensils, food consistency, and bolus size. Least adherence was seen for head position. Thus, the current study is expected to help speech and language therapists prioritize their goals in the management of pediatric dysphagia in children with neuro-disabilities.
Challenges Faced by Parents of Children with Autism when Attending Social Functions: A Comparison between Colombo and Kurunegala, Sri Lanka
(Faculty of Medicine, University of Kelaniya, 2014) Weerarathne, L.R.N.C.; Wijerathne, L.
Autism is a much discussed topic in the world today. Children with Autism find social situations very challenging and may avoid interactions altogether (Cumine, et al, 2000). Matson et al (2012) have said, ‘Although the symptoms of Autism Spectrum Disorders are universally accepted; the reported severity of symptoms and the manifestation of symptoms may be sensitive to cultural differences’. Therefore the findings of research that have been conducted in other countries focusing on the social aspect of autism and related parental experiences cannot be generalized to Sri Lanka. However, there is no research available in Sri Lanka focusing this topic. Using the phenomenological qualitative research design, the purpose of this study was to identify the challenges experienced by the parents, when attending social functions with their children who have autism and are in the ‘early communicator stage’ and strategies used to overcome them, in selected areas in Colombo and Kurunegala districts in Sri Lanka. Data were collected through semi structured interviews held at two sites (Colombo & Kurunegala) using eight participants. By using an inductive research approach, two main themes were identified: (1) ‘Challenges Experienced’ by the parents (2) ‘Coping Strategies’. The two sub-themes identified under challenges were ‘challenges related to child’s behaviour’ and ‘challenges related to social inclusion’. The two sub-themes found under coping strategies were ‘self-developed strategies’ and ‘strategies that have been recommended by professionals’. It was found that participants from both districts experienced similar challenges although the strategies that they used to overcome them were different.
Communication related quality of life in oral cancer patients after surgery
(Faculty of Medicine, University of Kelaniya, 2014) Jayasinghe, K.S.D.; Kalupahana, S.
Oral cancer patients undergone surgery, experience communication difficulties due to poor functioning of articulators. A study of communication related quality of life (CRQOL) of oral cancer patients was not found in Sri Lanka. Hence this study was planned to assess the variation of their communication following surgery and identifying the affected areas. This is helpful in identifying the potential targets for individuals and setting aims to improve their CRQOL. A cross sectional descriptive study was undertaken to assess CRQOL in oral cancer patients after surgery. The questionnaire was modified, adopted and pilot tested. 100 patients (35- 84 years age range) who had undergone surgery for oral cancer completed the questionnaire. The effect on CRQOL on patients undergone surgery was not statistically significant. Only 7% of people had impact on their CRQOL after surgery for oral cancer when their overall score is considered. In a higher portion of patients with oral cancer, the emotional status regarding communication was affected than the physical and functional status. Functional communication scored better when compared to the physical status. The total score and physical status regarding communication score strongly correlate with the site of the tumor. The site of the tumor also correlates with the emotional and functional status. Patients who have undergone surgery for oral cancer have an impact on their communication related quality of life. Emotional status and physical status regarding communication were the most affected. People who have posterior tumors have worse impact on their CRQOL than people who have anterior tumors.
A Comparison of errors in languages spoken by Sinhala-English bilinguals with post-stroke Aphasia
(Faculty of Medicine, University of Kelaniya, 2014) Dharmarathna, I.; Atapattu-Bakmeewewa, A.D.S.
Bilinguals are defined as those who use two languages in daily communication. Aphasia as an acquired language disorder virtually affects all languages of the bilingual speaker, often in varying degrees. The Clinical picture of the bilingual aphasic is of great interest to researchers, as the bilingual population of the world continues to increase. Many studies have focused on the language recovery patterns and comparison of language errors in bilingual aphasia in overseas contexts. As a multi- ethnic country, bilingualism continues to grow in Sri Lanka. The knowledge of multiple languages has led to the functional elaboration of all languages known especially in Sinhala-English bilinguals. Yet, there is a severe dearth of bilingual aphasic literature in the Sri Lankan Speech & Language Therapy context. This descriptive cross-sectional study analyzed the language errors in twelve (n=12) Sinhala- English bilinguals with aphasia post stroke in order to determine the more preserved language. It also discussed the determination of language preference of the participants for Speech & Language Therapy (SLT). A language assessment was administered to elicit the required language samples in Sinhala and English including four major linguistic components; discourse/spontaneous speech, confrontational naming, repetition and translation. The test stimuli were adapted from Western Aphasia Battery (Kertesz, 1982) for English and Pre-AphSL (2012) for Sinhala. Data were used to compare and analyze the errors across the two languages. The results showed no significant difference between Sinhala and English language performances. Neologisms, paraphasias, circumlocutions and perseverations were observed in both languages. The study results revealed a significant effect of age at onset on word finding difficulties. Other variables indicated notable trends, yet failed to demonstrate statistical significance.
Current Clinical Practice on Dysphagia Management in Sri Lankan Context: Speech - Language Therapists’ Perspective
(Faculty of Medicine, University of Kelaniya, 2014) Priyadarshani, K.W.K.N.; Ratnayake, S.
The field of speech language therapy is a relatively new, developing service in Sri Lanka. Since the establishment of the service, no researches have been conducted to identify Speech-Language Therapists’ (SLT) perception of the practice on dysphagia management. The objectives of the study were to identify training and current clinical practice on dysphagia management, to describe the challenges faced by the SLTs when managing dysphagic clients and to describe the coping strategies used by SLTs to overcome the challenges they faced when managing dysphagic clients. A descriptive cross-sectional study design was implemented. All SLTs who were practicing in Sri Lanka were included. A semi-structured, self-administrative questionnaire that included both qualitative and quantitative components was used. Among 44, 86%, (n=38) of SLTs saw clients with dysphagia in their caseload. Thirty-two (32) SLTs saw adults, 28 SLTs saw paediatrics and only seven (7) SLTs saw neonates with dysphagia. Assessing neonates was the most significantly challenging area. Lack of clinical exposure, limited recognition of SLT service among medical professionals and lack of awareness among clients and families on the gravity of the problems associated with dysphagia were also identified as significant challenges. Only 47.5%% (n=18) SLTs had participated in CPDs to improve their skills relevant to dysphagia and 13.88% (n=5) liaised with overseas SLTs. Adding a section or module for neonatal dysphagia management in the academic curriculum, developing a recognized body to conduct training to enhance the SLTs’ skills and knowledge, establishing a formal framework to gain internationally required clinical norms of practicing in Sri Lanka, continuing awareness programs with relevant professionals for the benefit of the society and continuing further researches on the particular area were recommended.
A Descriptive Study on Profile of Clients with Dysphagia Referred to Speech Therapy Units in Two Government Hospital Settings
(Faculty of Medicine, University of Kelaniya, 2014) Weerasinghe, W.A.M.A.; Ratnayake, S.
The study was aimed at identifying commonly presented initial symptoms and feeding method on the initial session of dysphagic clients. A descriptive cross-sectional study design was used with a retrospective chart review. Data of 100 completed records of dysphagic patients who were above the age of 12 years were studied. Participants included patients referred to speech therapy units of two hospital settings within a 6-month period. Mean and standard deviation of age of the participants was 61.12 years and 14.36 years respectively. Median time duration between on set to referral is 11 days. Most prevalent cause for dysphagia was cerebrovascular accident (79%). Additionally, progressive neurological disorders and ‘other’ causes were observed. 32% were in severely dysphagic, while another 32% were moderately severe and 9% were mild. Of all the participants, oral and pharyngeal phase was affected in 52% of participants. At the time of admission to the speech therapy unit, 58% of patients relied only on non-oral feeding methods. Commonly presented symptoms were impaired trigger (63%), coughing (52%) and voice quality changes (29%). According to chi square test, there was no association between presence / absence of dysarthria and severity of dysphagia. Most of the clients were older and referrals were taking a long duration. The study findings suggest the importance of early referral and also the need to generate awareness about the symptoms to help in early identification. Recommendations are made such that screening assessment should be done for all stroke clients to identify any risk of aspirations.
Developing a word list to assess articulation skills in Sinhala speaking children with cleft lip and palate: age range between 3 Years to 3 ½ Years
(Faculty of Medicine, University of Kelaniya, 2014) Bandara, M.M.M.K.; Lokubalasuriya, T.; Udangamuwa, S.; Sell, D.
Cleft lip and palate (CLP) cause disordered articulation, which is defined as cleft type errors (CTC). Currently in Sri Lanka, speech and language therapists conduct informal assessments to assess cleft type errors. However, there is no consistency between these measures used. In this context, developing a culturally and linguistically appropriate assessment to identify cleft errors is a great necessity. This need was addressed at a primary level by developing a word list to assess articulation skills for Sinhala speaking children with cleft lip and palate for the age range of 3-3½years. 30 typically developing children were selected as participants from a preschool setting. The word list comprised of 24 words for 18 consonants in word initial and medial position. Each word was represented by a toy or an object. The competency analysis was identified based on Templin’s 75 % assigning criterion guidelines. All 30 subjects were able to produce all sounds in initial position within the attempts of spontaneous, first repeat or second repeat. 28 subjects were able to produce all sounds in medial position within the spontaneous attempts, first repeat or second repeat. Only 2 subjects were unable to produce sound /r/ in medial position. The study findings suggest that all 18 consonant sound and all 24 words used in sound initial and medial position can be use to assess articulation skills of Sinhala speakers within the age range of 3 to 3 ½ years. For future directions, the word list could be standardized as a formal assessment by validating among children with and without CLP.
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.
Evaluating an AAC Training Program for Special Education Teachers Based in a Developing Country
(Faculty of Medicine, University of Kelaniya, 2014) Muttiah, N.; Drager, K.D.R.
There is limited research conducted on Augmentative and Alternative Communication (AAC) in developing countries (Srinivasan, Mathew, & Lloyd, 2011). We have only a limited understanding of how best to support the development of knowledge and skills of individuals who provide AAC support in developing countries with low resource settings. Research has documented that providing AAC training to communication partners can equip them with strategies that can facilitate increasing both the frequency and quality of communication interactions with children who have Complex Communication Needs (CCN). The current study evaluated the effectiveness of implementing training best practices identified by Muttiah et al. (2014) for special educators in Sri Lanka. The training was based on principles of adult learning. A one-group interrupted time series design was utilized with nine teacher-children dyads to measure the effectiveness of the AAC training. The special education teachers were taught to promote interactions with children who have CCN by providing evocative communication opportunities that included asking an open-ended question, comment or choice, providing a means for the child to respond, and waiting five seconds or more for a response. Results of the study indicated that teachers provided an increased number of evocative communication opportunities following the training. An increase was also seen in the number of communication turns that were taken by children with CCN. The results of this study provide preliminary evidence for a training framework that could be implemented in developing countries and other low-resource communities. The training content and format identified in this study can serve as a guide for others planning trainings in similar contexts. In addition, this study adds to the limited research base on AAC in developing countries.
‘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.
The Impact of Dysphagia and its Management Strategies on Clients’ Life Style; Clients’ Perspective
(Faculty of Medicine, University of Kelaniya, 2014) Panterlyon, N.; Ratnayake, S.
Dysphagia refers to difficulty with delivering food from the mouth to the stomach (Logemann, 1998). Clients’ perceptions and their level of awareness of the condition needs to be explored in Sri Lanka in order to understand more effective methods of service delivery. A descriptive cross sectional study with both quantitative and qualitative components was undertaken with thirty-two participants. A semi-structured, interview administered questionnaire was used to gather data, which was developed with five speech therapists, currently practicing dysphagia in the Sri Lankan context, and ‘Swallowing quality of life questionnaires’ were referred to (SWAL-QOL and MDAI) during the process. According to their level of understanding, the dysphagia management focuses on improving general health, to improve swallowing function in particular and to prevent a life threatening risk. The mean score for the impact of dysphagia on ADL was 47.88 (SD=16.50) out of 100. The degree of impact on a client’s ADL does not depend on gender or the onset of the condition. Dysphagia has an impact on their emotional, functional and social life. Clients expect the speech therapists to help accelerate the recovery. The implications include organizing client supportive groups and workshops to minimize the emotional, functional and social impact.
Intervention Procedures and Outcome Measures of Neurogenic Dysphagic Clients seen by Speech and Language Therapists in Two Hospital Settings
(Faculty of Medicine, University of Kelaniya, 2014) Perera, K.D.R.D.; Ratnayake, S.
Dysphagia is a common problem in clients with neurological impairments. In Sri Lanka, managing dysphagic clients by speech therapists is a new and emerging field in the healthcare sector. However, no in-depth analyses concerning intervention procedures for neurogenic dysphagic clients have yet been conducted in the Sri Lankan context. Intervention procedures, outcome measures in use, and the discharge criteria of adult neurogenic dysphagic clients were studied retrospectively using 80 records of neurogenic dysphagic clients from two hospital settings. Semi-structured interviews were also conducted with the speech and language therapists working in the two selected hospital settings to identify their views on the intervention processes of managing dysphagic clients. Both compensatory and therapeutic modalities were used to manage 35 (43.75%) of clients whereas 29 (36.25%) of clients were managed using compensatory strategies only. Among the compensatory procedures, texture modification (n= 65, 81.25%) was identified as the most common strategy and swallow maneuvers were recommended less frequently (n=8, 10%). Outcomes were measured mainly through subjective measurements on level of aspiration, respiratory status, food intake, weight gain and hydration. The clients were discharged from therapy services when they were safe with oral feeds or when an alternative feeding method was recommended for a long duration. Intervention procedures were mainly based around a compensatory approach. Despite the limited resources in these settings, the speech therapists have been able to provide intervention for dysphagic clients and gain positive outcomes.
Knowledge, Attitudes and Practices on Noise Induced Hearing Loss among Factory Workers of Two Dairy Product Manufacturing Factories in Gampaha District, Sri Lanka
(Faculty of Medicine, University of Kelaniya, 2014) Hansajie, S.T.K.; Jayasena, B.N.; Chathurika, L.K.E.
The main purpose of this study was to describe dairy product manufacturing factory workers’ knowledge, attitudes and practices on Noise Induced Hearing Loss. A cross-sectional study was conducted involving 187 factory workers in two factories in the Gamapaha District. A self-administered questionnaire was used to obtain information pertaining to knowledge, attitudes and practices related to Noise Induced Hearing Loss. In the study, it was found out that knowledge on risk factors of NIHL (23.5%) and symptoms of NIHL (38%) was weak. Even though most of the workers (76.5%) perceive noise as a usual phenomenon in the working area, 77% of the workers were willing to seek medical attention if the hearing starts to deteriorate. The overall practice level was not satisfactory. 80.2% of the workers have never used hearing protection devices (HPD) while working. 98.9% of the workers have never undergone a hearing evaluation and 99.5% of the workers have never attended to a hearing conservation program. 95% of the workers reported that the occurrence of hearing deterioration due to high level of noise was worrying. Only 0.5% of the workers reported wearing HPD while working. 80.2% of the workers never used HPD during work. There was a significant association between aspects of work experience and HPD usage (2= 5.193, p= 0.02). In conclusion, it was discovered that there is a need to have a hearing conservation program that stresses on the use of hearing protective devices to prevent the occupational noise induced hearing loss in the particular setting.
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.
Managing and Caring for Clients with Dysphagia: Caregivers’ Perspective
(Faculty of Medicine, University of Kelaniya, 2014) Dissanayake, D.M.S.K.; Ratnayake, S.
Dysphagia has been identified as a life threatening problem in many health care settings. The management of dysphagia usually involves a multidisciplinary team approach where caregivers, clients and various professionals contribute to the management. Caregivers came across a number of barriers during the caring process of dysphagia clients. The perception of the caregivers about the dysphagia, knowledge received by the professionals, effects and adaptations on social and personal life are important to consider as they have an impact on the management procedure in relation to dysphagia. A descriptive cross- sectional study design was implemented. Forty caregivers of neurogenic dysphagic clients who had been referred to the speech therapy unit in the last six months were recruited to the study using purposive sampling. The study consists of both qualitative and quantitative components. The data was collected through an interview administered through a semi structured questionnaire, which was analyzed using frequency analysis and thematic coding analysis. Majority (50%) of the professionals involved in advising caregivers were doctors and speech therapists. 18 doctors and 25 SLTs gave advice orally. Majority (n=14) of the caregivers preferred a combination of giving oral, written and practical advice. The frequency of following the adaptations on feeding techniques was limited as the caregivers thought it was not necessary to always follow the adaptations. Health, occupation, economy and social functions were found to be affected and required adaptations in the caregivers’ life. As most professionals in SL give advice orally, it is important to consider caregivers’ preferences. The importance of increasing awareness in following the adaptations on feeding and nutritional values among the caregivers is indicated in the study findings. The effects on caregivers’ social and personal life should also be considered in dysphagia management procedures.
Managing and Caring for Clients with Dysphagia: Caregivers’ Perspective
(Faculty of Medicine, University of Kelaniya, 2014) Kuruppu, K.A.S.S.; Jayawardana, K.A.S.
Dysphagia has been identified as a life threatening problem in many health care settings. The management of dysphagia usually involves a multidisciplinary team approach where caregivers, clients and various professionals contribute to the management. Caregivers came across a number of barriers during the caring process of dysphagia clients. The perception of the caregivers about the dysphagia, knowledge received by the professionals, effects and adaptations on social and personal life are important to consider as they have an impact on the management procedure in relation to dysphagia. A descriptive cross- sectional study design was implemented. Forty caregivers of neurogenic dysphagic clients who had been referred to the speech therapy unit in the last six months were recruited to the study using purposive sampling. The study consists of both qualitative and quantitative components. The data was collected through an interview administered through a semi structured questionnaire, which was analyzed using frequency analysis and thematic coding analysis. Majority (50%) of the professionals involved in advising caregivers were doctors and speech therapists. 18 doctors and 25 SLTs gave advice orally. Majority (n=14) of the caregivers preferred a combination of giving oral, written and practical advice. The frequency of following the adaptations on feeding techniques was limited as the caregivers thought it was not necessary to always follow the adaptations. Health, occupation, economy and social functions were found to be affected and required adaptations in the caregivers’ life. As most professionals in SL give advice orally, it is important to consider caregivers’ preferences. The importance of increasing awareness in following the adaptations on feeding and nutritional values among the caregivers is indicated in the study findings. Moreover, the effects on caregivers’ social and personal life should be considered in dysphagia management procedures.