Foreword 1: Regaining a Voice
Foreword 2: Revealing the Person Within
Foreword 3: My Journey with Aphasia
Back to Work
Usemaji Aphasia Support Group
A Silent Disability
“New Normal”
My Takeaway
Foreword 4: Supporting Children at Risk
Foreword 5: Living with Stuttering
Foreword 6: The Potential of Rehabilitative Care
Experiences at the Centre for Education and Community Based Rehabilitation (CERBBc), North-Eastern DR Congo
Alio’s Testimony
Introduction
Motive
History
Structure
Book Sections
Distribution of Chapters
Transdisciplinary, Global, and Multi-Level Approach
Peer Review, Terminology, and Up-to-Dateness of Data
Target Readership
Key Subjects
Speech-Language Therapy
Sub-Saharan Africa
History and Status of Speech-Language Therapy in Sub-Saharan Africa
Thanks
References
Contents
Authors and Reviewers
List of Authors
List of Reviewers
List of Abbreviations
Part I: Introduction: Professionalization
1 Ulrike M. Lüdtke
Speech–Language Therapy in Sub-Saharan Africa: The Emergence of a Profession in a Diverse Multilingual and Multicultural Context
Abstract Background: All over sub-Saharan Africa (SSA), evidence of the emergence of the profession of speech–language therapy (SLT) can be detected. This development can be illustrated through the availability of SLT in some major cap
2 Karen Wylie, Lindy McAllister, Bronwyn Davidson, and Julie Marshall
Speech–Language Therapy in Sub-Saharan Africa: Development and Sustainability of Services for Persons with Communication Disability
3 Julie Marshall, Nana Akua V. Owusu, and Ryann Sowden
Maximizing the Benefits and Minimizing the Risks from the Contribution of “Outsiders” to the Development of Services for Persons with Communication Disability in Sub-Saharan Africa
4 Ulrike Schütte, Chantal Polzin, Afizai Vuliva, and Ulrike Lüdtke
Clinical Competence of Speech–Language Therapists in Culturally and Linguistically Diverse Contexts: A Qualitative Study of Intercultural Work Experiences Abroad
5 Bea Staley and Emma Shah
The History of Speech–Language Therapy in Kenya: A Collective Memory
6 Sylvia Topouzkhanian and Palakiyém Abalo
The Development of the Speech–Language Therapy Profession in West Africa: Over 10 Years of Experience
7 Abbie Olszewski, Verena Rossa-Roccor, Veronic Clair, Kate Tairyan, and Erica Frank
A Revolution in Training Speech–Language Therapists in Sub-Saharan Countries and Globally
8 Ulrike Lüdtke and Chantal Polzin
The Demands of Context: Development of a Relational In Vivo Methodology for Participative Speech–Language Therapy Research in Sub-Saharan Africa
9 Purity M. Nthiga and Eunice A. Nyamasyo
Speech–Language Therapy in Kenya: Trends, Challenges, and Opportunities
10 Bea Staley, Ellen Hickey, Rachael Gibson, David Rochus, and Martin Nafukho
Obulala Na-maani: Unity Is Strength – Speech–Language Therapy and Community Engagement in Three Kenyan Communities
References
1: Speech-Language Therapy in Sub-Saharan Africa: The Emergence of a Profession in a Diverse Multilingual and Multicultural Context
Evidence: Speech–Language Therapy Emerges in Sub-Saharan Africa
Needs: The Basics of Africa-Specific Professionalization
Chances and Challenges: Cultural Uniqueness in a Global World
Excursion in Scientific Theory
Establishing Speech–Language Therapy in Sub-Saharan Africa as a Science: The Danger of a Neocolonial Approach
Speech–Language Therapy in Sub-Saharan Africa in Crisis: Mismatch Issues in Problem-Solving
Speech–Language Therapy in Sub-Saharan Africa in Model Revolution: Emergence of a Genuinely Independent Paradigm
Key Concept for the Speech–Language Therapy Dimension of the Individual Self and Family: Africa-Specific Linguistic Identity Grounded in a Specific Version of Multilingualism
Key Concept of the Speech–Language Therapy Dimension of Society: Africa-Specific Cultural and Linguistic Diversity Shaped by Specifics of the Linguistic Market
A Key Concept for the Speech–Language Therapy Dimension of Culture: Africa-Specific Inclusion
Tasks: Systematic Establishment of a Sustainable, Multilevel, Cross-Sector Speech–Language Therapy Approach
(I) Uniquely Sub-Saharan African Tasks for the Diversity of Persons with Communication Disorders
(II) Uniquely Sub-Saharan African Tasks for Future Speech–Language Therapy Practice
(III) Uniquely Sub-Saharan African Tasks for Future Speech–Language Therapy Concepts
(IV) Uniquely Sub-Saharan African Tasks for Future Speech–Language Theory
(V) Uniquely Sub-Saharan African Tasks for a Future Meta-theory of Speech–Language Therapy
Opportunities: International Speech–Language Therapy Research Cooperation Within a Global Ethical Framework
References
2: Speech-Language Therapy in Sub-Saharan Africa: Development and Sustainability of Services for Persons with Communication Disability
Speech–Language Therapy and Rehabilitation Services in SSA
SLT Workforce Sustainability Issues in SSA
SLT Workforce Availability
Accessibility of SLT Services
Acceptability of SLT Services
Accessibility, Acceptability, and Availability of SLT Services: A Workforce Survey
Aim and Objectives
Methodology
Results
Demographics of Respondents
Availability
Job Availability: Permanent and Full-Time Jobs
Service Stability
Motivation and Support Factors: Working Alone
Motivation and Support Factors: Mentoring Availability and Location
Motivation and Support Factors: Strategies for Continuing Professional Development
Motivation and Support Factors: Successes and Challenges in Continuing Professional Development
Accessibility
Structural Barriers: Employment Sector and Service Setting
Geographic Barriers: Location of SLT Services
Economic Barriers: Fee Structures
Acceptability
Cultural Distance
Multilingualism and African Languages
Language of Service Provision
Challenges for the Development and Sustainability of Rehabilitation Services for Persons with Communication Disability
Embedding SLT and Communication Disability in the Political Agenda
Prevention and Intervention Models
Committing to the Development of SLT and Community Workers in SSA
Ensuring Culturally Relevant Services
Limitations
Conclusion
References
3: Maximizing the Benefits and Minimizing the Risks from the Contribution of “Outsiders” to the Development of Services for Persons with Communication Disability in Sub-Saharan Africa
Motive
Introduction
Background
Part 1: A Written Dialogue Between Two Expert Speech–Language Therapists
Part 2: Fictitious Case Examples of Insider/Outsider SLT Collaboration
A Successful Example of an Outsider Joining an SLT Education Program in Sub-Saharan Africa
An Unsuccessful Example of an Outsider Joining a Service Delivery Project in Sub-Saharan Africa
A Successful Example of Bringing SLT Students in from a High-Income Country to Volunteer Short Term in a Sub-Saharan African Country
An Unsuccessful Example of a Fly-In-Fly-Out (FIFO) Short-Term Project
Part 3: Insider/Outsider Research in Uganda
Background
Methods
Results
Organizing Theme 1: “Unstable Support”
Organizing Theme 2: “Developing Relationships”
Organizing Theme 3: “Outgrowing Outsider Contributions”
Risks
Risks to Persons with Communication Disability
Risks to Ugandan Services
Risks to Ugandan Professionals
Benefits
Benefits to Persons with Communication Disability
Benefits to Ugandan Services
Benefits to Ugandan Professionals
Discussion
Recommendations and Considerations for Future Insider/Outsider Work
References
4: Clinical Competence of Speech-Language Therapists in Culturally and Linguistically Diverse Contexts: A Qualitative Study of Intercultural Work Experiences Abroad
Introduction: Service Delivery in Culturally and Linguistically Diverse Contexts
Cultural and Linguistic Diversity Due to a Natural Broad Heritage of Indigenous Languages: The Case of Tanzania
Cultural and Linguistic Diversity Due to Recent Migratory Movements: The Case of Germany
Dealing Appropriately with CLD in the SLT Profession: The Global Perspective
Research Findings on Work Stays and Diversity-Sensitive Competences in SLTs
Theoretical Background: Diversity-Sensitive Clinical Competence and Its Acquisition
Clinical Competences in SLT in CLD Contexts
Acquisition of Diversity-Sensitive Clinical Competence
Circular Process of Professionalization of SLTs in the CLD Context
Constructivist Method: Relational Biographical Self-Reflections
Research Questions
Research Method and Design
Participants
Instruments
Relational Biographical Self-Reflections for Data Collection
Qualitative Content Analysis for Data Analysis
Data Collection
Husani’s Biographical Self-Reflection
Claudia’s Biographical Self-Reflection
Data Analysis
Results
Identification of the Most Relevant Challenging Experiences Gained Through Professional Stays in a Foreign Country
Strangeness: “I Am a Stranger!”
Heteronomy: “I Am Powerless!”
Identity Conflict: “I Am Not Myself!”
Professionalization of Diversity-Sensitive Clinical Competence as a Result of Reflecting Challenging Experiences in a Foreign Country
Discussion and Study Limitations
Recommendations for SLT Curricula Worldwide
Implementation of Professionally Supervised Practical Internships Abroad for Promoting Direct Exposure to “Strangers”
Implementation of a Module to Promote DSCC in SLT Training Programs
Toward Intensive Self-Reflection for Dealing Appropriately with “Strangers”
Toward Ethnorelativism for Promoting Acceptance Rather Than Suppression of “Strangers”
References
5: The History of Speech-Language Therapy in Kenya: A Collective Memory
Introduction
Motive
Problem Background
Methodology
Methods: A Qualitative Methodological Pastiche
Situating the Authors
The Development of the Speech–Language Therapy Profession in Kenya
A Collective Remembering
From 1970 to 2000: An Overview
From 1990 to Present: Special Education Professionals (SEP)
From 2000 to 2014: A Building of Momentum
The East African Conference on Communication Disability: 2005–2018
Establishing the Association of Speech and Language Therapists Kenya (ASLTK)
Establishing SLT Training Programs: 2014 Onward
Speech–Language Therapy in Kenya: A Contemporary Perspective
Ongoing Challenges
Issues of Language
Building Awareness About the Profession
Issues of Access
Issues of Payment
Resources and Innovations
Dynamic and Creative SLT Practices
Harnessing Technologies
Looking to the Future: Considering the Next Steps
Research and Material Development
Strengthening and Supporting the Kenyan SLT Community
Conclusions
References
6: The Development of the Speech–Language Therapy Profession in West Africa: Over 10 Years of Experience
Introduction
Project Genesis and Course Design
Implantation of a New Profession Within Western and Central Africa
Professional Development and Growth
Creation of the Fédération des Orthophonistes d’Afrique Francophone
Challenges to Take On
Oral Tradition and the Significance of Cultural Beliefs
Importance of Raising Awareness About Speech–Language Disorders
Advocating for the Recognition of the Profession of Speech–Language Therapy by the Governments of French-speaking African Countries
Regulating Speech–Language Therapy Practice in Africa
Working in Bilingual and Multilingual Settings
Adapting Diagnostic and Therapeutic Materials
Promoting Scientific Research on Speech–Language Therapy in Africa
Conclusion
References
7: A Revolution in Training Speech-Language Therapists in Sub-Saharan Countries and Globally
Introduction
Problem Background
State of Speech–Language Therapy Higher Education in Sub-Saharan Africa
West Africa
East and Central Africa
Southern Africa
eLearning
History of the DOOHICHE Model
High Quality
Accessibility
Affordability
Customizability
Sustainability
The DOOHICHE Model in Practice
The DOOHICHE Model for Speech–Language Therapy
Step 1: Perform a Needs Assessment
Step 2: Competencies
Step 3: Locate Resources
Step 4: Review with Advisory Group
Step 5: Creation of Learning Modules
Step 6: Teaching Platform
Step 7: Locating Potential Students
Step 8: Refine and Research
Current State of the NextGenU.org Speech–Language Pathology Program in Sub-Saharan Africa
Potential Impact
Summary
References
8: The Demands of Context: Development of a Relational In Vivo Methodology for Participative Speech–Language Therapy Research in Sub-Saharan Africa
Introduction: The Necessity of Multilevel Research for Development of the Speech–Language Therapy Profession in Sub-Saharan Africa
Framework of Multilevel Research in Speech–Language Therapy
SLT Research Needs in Sub-Saharan Africa
Multilevel Research Needs in a Sub-Saharan Africa Clinical Context: Adults with Aphasia
Multilevel Research Needs in the Sub-Saharan Africa Educational Context: Children with Autism Spectrum Disorder
Background: Opportunities and Challenges for Research in Sub-Saharan Africa
Opportunities: Uniqueness and a Fresh Start!
Challenges: Lack of Cultural Adaptation and (Neo)colonial Shadows
Proposing a Relational In Vivo Methodology for Participative Speech–Language Therapy Research in Sub-Saharan Africa
Conceptual Dimensions of a Relational and Participative In Vivo Research Paradigm
Practical Key Elements of a Relational In Vivo Approach
Studying Persons with Communication Disorders Within the Sub-Saharan Africa Context: The Range of Relational Methods in a Multilevel Research Approach
Epidemiological Studies (Level I): Getting Access to the People and the Field
Intervention Studies on Speech–Language Therapy Practices (Level II): Obtaining Different Perspectives on Daily Service Delivery
Evaluation Studies: Promoting Standards for Evidence-Based Practice in Specific Contexts of Speech–Language Therapy Service Delivery
Basic Research Studies: Investigating Early Communicative Dyads in a Non-Intrusive and In Vivo Way
Epistemological Reflections
Steps Toward a Relational In Vivo Methodology: An Everyday Participatory Research Checklist for Decolonizing SLT Research
References
9: Speech-Language Therapy in Kenya: Trends, Challenges, and Opportunities
Background
Defining Communication Disorders and Speech–Language Therapy
Persons with Communication Disability in Kenya: A Demographic Overview
Research Questions
Methods
Results
SLT Development Trends: Factors and Agencies
Conceptualizing Communication Disability in Kenya
Legal Framework for Disability in Kenya
Advocacy and Professionalization of SLT
Resources and Facilities for Persons with Communication Disability
Challenges Facing SLT in Kenya
Professional Development
Legislative and Policy Frameworks
Inadequate Resources and Facilities
Language and Culture
Access, Awareness, and Cost
Conclusion
Impact
Future Research
References
10: Obulala Na-maani: Unity is Strength
Introduction
Motive
Problem Background
Method
Theoretical Background
The Sustainable Development Goals
Frameworks for Cultural Competence and Cultural Humility
Results
Description of the Projects
Bahari Children’s Therapy Centre
Kilima Children’s Community Centre
Sukari
Lessons Learned
Context Is Imperative
Community Partners and People Are Key
Discussion
Impact
Considerations for the Future
Conclusion
References
Part II: Introduction: Development and Prevention
11: Paradoxical Reflections on Bilingualism and Biliteracy: Relevance for Speech-Language Therapists in Sub-Saharan Africa
Introduction
The Discipline of Communication Disorders
Components of Communication
Theoretical Background: Bilingualism and Biliteracy
Bilingualism
Biliteracy
Relationship Between Language and Literacy
Bilingualism and Language Acquisition
Bilingualism vis-à-vis Language Acquisition
Bilingualism vis-à-vis Literacy Acquisition
Literacy Acquisition in Non-Alphabetic Orthography
Cross-Language and Cross-Script Skill Transfer in Bilingual-Biliterate Children
Service Delivery for Bilingual-Biliterate Children
Language Policy for Service Delivery in Bilingual Countries
A Few Studies on Bilingual Teachers in India
Challenges for SLTs with Bilingual-Biliterate Children
Conclusion: Roadmap of Services to Bilingual-Biliterate Children in the Future
References
12: Typical Phonological Development in Ugandan Language: A Case of Rukiga – A Pilot Study
Introduction
Theoretical Background
Rukiga Language
Phonology of Rukiga
Consonant System
Vowel System
Syllable Structure
Tones
Speech Development Including Phonological Development
General Overview
Speech Development (Including Phonology) in Bantu-Speaking Children
Speech Assessments Including Phonological Development
Independent Analysis
Relational Analysis
Research Questions
Methods
Research Design
Participants
Selection Criteria
Ethical Considerations
Procedure
Stimuli
Task Administration
Data Analysis
Results: Phonological System-Segmental
Consonant Production
Younger Age Group (2;4–3;4 Years)
Older Age Group (3;7–4;1 Years)
Phoneme Acquisition
Younger Age Group (2;4–3;4 Years)
Older Age Group (3;7–4;1 Years)
Patterns and Processes
Younger Age Group (2;4–3;4 Years)
Older Age Group (3;7–4;1 Years)
Variation
Younger Age Group (2;4–3;4 Years)
Older Age Group (3;7–4;1 Years)
Discussion and Conclusions
Developmental Trajectory
Cross-Linguistic Similarities and Differences
Context-Sensitive Voicing
Gliding Pattern
The Backing and Fronting Pattern
Initial Consonant Deletion
Vowel and Syllable Deletion
Assimilation/Reduplication
Affrication of Fricatives
Cluster Reduction
Vowel Development
Word Structure
Impact of this Study
Considerations for Future Work and Research
References
13: The Participatory Potential of Photovoice as a Relational In Vivo Research and Training Method: The Case of a Community-based Prevention Program on Early Communication and Language Disability in Underserved Rural Sub-Saharan Africa
Introduction: Presenting Photovoice as an In Vivo Research and Training Method
Background of Project Implementation: Situational Context and Methodological Approach
Context of the Project: The Situation of OVCs and Concepts on Facing Their Needs
Theoretical Approach of Photovoice: A Participatory Method for Relational In Vivo Research
Method: Evaluation of Photovoice Implementation
Phases of the Photovoice Process
Phase 1: “Planning”
Phase 2: “Preparation”
Phase 3: “Shooting Photos”
Phase 4: “Selecting Significant Pictures and Printing”
Phase 5: “Photo Presentation and Moderated Group Discussion”
Phase 6: “Reflection and Plan for Further Action”
Phase 7: “Follow-Up” (Evaluation)
Phase 8: “Accompanying Research”
Results: Identified Participatory Involvement of Community Participants
Discussion: Successes and Limitations of the Participatory Involvement
References
14: A Network of Knowledge: Participatory Development of Culturally Sensitive Information, Education, and Communication Materials for the Prevention of Communication Disability in Rural Tanzania
Introduction: Generating Local Knowledge and Resources for the Prevention of Communi- cation and Language Disability
Project Outline
The Role of Prevention in Underserved Regions
Background: Participatory Development and the Creation of Information, Education, and Communication Resources
Participatory Development and Sustainability
Information, Education, and Communication Materials in the Context of Communication and Language Development in SSA
Methodology: Project Background and Evaluation Criteria
Methodological Background of IEC Material Development in the Project
Participatory Feedback Loops
Project Team and Participants
Methodology for the Evaluation of IEC Material Development in This Chapter
Leading Question
Derivation of Evaluation Criteria
Definition of Result Levels
Results: IEC Materials from and for the Local Communities
Activity: Phases and Steps of Material Development in Participatory Feedback Loops
Step 1: Suggestion of Relevant Content from a Minority World Perspective
Step 2: Joint Reflection and Adaptation of Content in the Bi-cultural Project Team
Step 3: Presentation of Content to the Network of Multipliers in Multiple Training Sessions
Step 4: Reflection of Content in Group Discussions
Step 5: Adaptation of Content in Light of the Planned Materials
Step 6: Material Production and Presentation
Step 7: Pilot Test of Counseling Using the Developed Materials
Step 8: Follow-Up Meeting and Discussion of Changing Needs
Step 9: Continuing Counseling Activities with Regular Exchange Meetings
Output: Information, Education, and Communication Materials Developed in the Project
Primary Materials: Flyers, Posters, and Workbook
Secondary Materials: First Care Bag and ID Badge
Outcome: Counseling Settings and Strategies Based on the Developed Materials
Discussion: Successes, Challenges, and Indicators for Long-Term Impact and Sustainability
Activity: A Structured, Participative Method of Developing Information, Education, and Communication Materials
Successes
Challenges
Output: Culturally and Contextually Appropriate Information, Education, and Communication Materials
Successes
Challenges
Outcome: Fruitful Counseling Strategies Based on the Developed Materials
Successes
Challenges
Conclusions: Directions Toward Sustainability
Outlook: Future Perspectives for Sub-Saharan Africa
References
15: Pediatric HIV/AIDS and Communication and Developmental Disorders in South African Children
Introduction
Medical Background
Developmental and Cognitive Manifestations of Pediatric HIV
World Health Organization Early Diagnosis
Oral-Motor Development and Oropharyngeal Lesions and Infections
Dysphagia and Feeding
Otologic and Hearing Issues
Preverbal and Language Development and Disorders
Neurodevelopmental Studies of South African Children
Intervention Services for Children with HIV/AIDS
Challenges
Outlook: Tasks Ahead for Speech–Language Therapists Working with Children with HIV/AIDS
Case Study
References
16: Hear Africa! Improving Language Development, Education, and Participation of Children with Severe Sensorineural Hearing Loss in Tanzania
Introduction
Background
Hearing Impairment
Frequency and Clinical Presentation
Classification and Causes of Hearing Impairment
Audiometric Diagnostics
Subjective Tests
Objective Tests
Impact of Hearing Impairment on Language Development, Education, and Participation
Speech–Language Therapy for Hearing-Impaired Children as an Interdisciplinary Care Approach
Speech–Language Therapy
Technical Devices for Hearing Support: Hearing Aids and Cochlear Implants
Special Needs Education
Information Technology Support for Remote Service Delivery
Advantages of an Interdisciplinary Approach
Methodology of a Multi-centered Cross-Method Project: Hear Africa!
Aims
Sustainability
First Steps and Outcomes
Aim 1: Clinical Research and Data Collection
Aim 2: Professional Education and Capacity Building
Aim 3: Building Up Speech–Language Therapy and Audiological Infrastructures Including Remote Care
Aim 4: Political Work and Community Empowerment
Challenges
The Way Forward: Digital and Remote Alternatives for Care Supply and Culturally Sensitive Adaptation
References
11 Prema K. S. Rao
Paradoxical Reflections on Bilingualism and Biliteracy: Relevance for Speech–Language Therapists in Sub-Saharan Africa
12 Precious Ahabwe and Sara Howard
Typical Phonological Development in Ugandan Language: A Case of Rukiga—A Pilot Study
13 Kirsten Beta, Chantal Polzin, Afizai Vuliva, Julia Wu, and Ulrike M. Lüdtke
The Participatory Potential of Photovoice as a Relational In Vivo Research and Training Method: The Case of a Community-Based Prevention Program on Early Communication and Language Disability in Underserved Rural Sub-Saharan Africa
14 Julia Wu, Chantal Polzin, Afizai Vuliva, Enna M. Mdemu, Kirsten Beta, Kirsten Beta, and Ulrike M. Lüdtke
A Network of Knowledge: Participatory Development of Culturally Sensitive Information, Education, and Communication Materials for the Prevention of Communication Disability in Rural Tanzania
15 Elise Davis-McFarland
Pediatric HIV/AIDS and Communication and Developmental Disorders in South African Children
16 Ulrike M. Lüdtke, Angelika Illg, Louisa Johanningmeier, Enica Richard, Reema Ruparellia, Lars Rumberg, Jörn Ostermann, Thomas Lenarz, and Anke Lesinski-Schiedat
Hear Africa! Improving Language Development, Education, and Participation of Children with Severe Sensorineural Hearing Loss in Tanzania
References
Part III: Introduction: Assessment and Treatment
17: Development of Speech-Language Therapy Assessments for the Languages of South Africa
Background
Current Challenges
The Languages of South Africa
Assessment
A Review of Current Assessments
Description of Assessments by Language
Description of Assessments by Clinical Domain
Description of Assessments by Methodology
Discussion and Future Plans
References
18: Assessing Language in South Africa: Use of the Passive Construction
Motive
Theoretical Background
Passive Constructions
Reversible Passives
Negative/Malefactive Passives
Non-actional Passives
Inanimate Passives
Impersonal Passives
Short and Long Passives
Passive Constructions in Bantu Languages Spoken in South Africa
Bantu Languages in South Africa
Passive Constructions in Sesotho
Age of Passive Acquisition in Bantu Languages
Methods for Assessing Passive Constructions
Comprehension Picture Selection Tasks
Elicited Production Tasks
Elicited Imitation Tasks
Methods
Research Questions
Design
Research Materials
Comprehension Picture Selection Task
Elicited Production Task
Elicited Imitation Task
Additional Qualitative Data Sources
Pilot Testing
Criteria for the Selection of Children
Setting
Ethical Clearance
Data Analysis
Results
Developmental Passive Abilities in Different Assessment Tasks
Elicited Imitation Task
Comprehension Picture Selection Task
Elicited Production Task
Understanding and Production of Various Passive Categories
Children’s Capabilities in Terms of Short and Long Passives
Adult Verifier Protocol
Service-Learning Reflection Journals
Discussion: Usefulness of the Passive Construction as an Assessment Tool for Setswana-Speaking Children
Impact
Examination of the Passive in All Bantu Languages
The Development of Appropriate Assessment Materials
Elicited Imitation
Elicited Imitation and Parent’s and Teacher’s Report
Considerations for Future Work, Research, and Politics
References
19: Methods for Devising a Standardized Language Assessment for isiZulu Preschoolers: Implications for Sub-Saharan Africa
Motive
Research Questions
Problem Background
Theoretical Motivation
Importance of Standardized Language Assessment
Epidemiology of Language Problems
Features and Psychometric Criteria Necessary for Standardized Language Tests
Structure of isiZulu
Semantic Origin
Agreement
Subject and Object Prefixes
Adjectives and Relatives
Verb Morphology
Varieties of isiZulu
Methods
Research Design
Ethical Clearance
Participants
Research Assistants
Data Collection
Procedure
ZERLA Materials
Treatment of Data: Coding and Analysis
Statistical Analysis
Qualitative Analysis
Results and Discussion
Item Analysis
Norms
Impact
Language Acquisition
Epidemiological Implications
Psychometric Results of the ZERLA
Clinical Implications: Examiner Qualifications
Considerations for Future Work, Research, and Politics
Standardization of Assessments in Bantu Languages
Rural Areas
Development of a South African Multilingual and Multicultural Database
References
20: Using Acoustic Phonetics in the Assessment and Treatment of Speech Disorders
Introduction
Background
Speech–Language Therapy Services in Kenya
Perceptual Assessment of Dysarthria
Acoustic Assessment of Dysarthria
Articulatory Gestures
Research Question
Methods
Study Population
Speech Materials
Oral Diadochokinesis Test (DDK)
Telephone Number Test
Recordings and Data Annotation
Measurements
Voice Onset Time
Fundamental Frequency (F0)
Results
Voice Onset Time
Fundamental Frequency (F0)
Discussion
Voice Onset Time
Fundamental Frequency
Impact on Speech–Language Therapy Practitioners and Researchers in Sub-Saharan Africa
Considerations for Future Work, Research, and Politics
References
21: The Capacity to Assess and Treat Communication Disability in Kenya: Field-Based Evidence
Introduction
Communication Disabilities as Secondary Disabilities
High Incidence of Communication Disabilities Versus Only Nascent Growth of Speech–Language Therapy Services in Kenya
Theoretical Background
Conceptualizing (Communication) Disabilities with Particular Focus on Kenya
Assessment and Treatment of Communication Disabilities
Educational Assessment and Resource Centers in Kenya
Research Questions
Methods
Research Design
Study Population
Inclusion Criteria
Exclusion Criteria
Methods of Data Collection
Interview Schedule
Questionnaire
Observation Schedule
Document Review
Data Analysis
Ethical Clearance
Results
Sample Size Determination
Training
EARC Officers
Teachers (SNE)
SLTs
Facilities, Equipment, Tools, and Resources for Assessment/Intervention
Facilities
Technical Equipment
Assessment and Intervention Methods
Cost and Funding From the Government
Access
Creating Awareness
Easy Reach of Services
Networks
Discussion
Facilities and Equipment
Accessibility of Speech–Language Therapy Services in Different Areas and at Different Ages
Professional Speech–Language Therapists and Materials
Impact
Considerations for Future Work, Research, and Politics
References
22: Linguistically and Culturally Diverse Children with Language Disorders in Sub-Saharan Africa: Approaches to Service Delivery
Motive
Growing Up with Multiple Languages in Sub-Saharan Africa
Language Disorders in Multilingual Children
Issues in Language Intervention with Linguistically and Culturally Diverse Children with Language Disorder
Approaches to Language Intervention Including Typically Developing Peers
Peer-Assisted Intervention with Trained Peer Communication Partners
Peer-Assisted Intervention with Untrained Peer Communication Partners
Applying SLT-Mediated Interactions to Clinical Practice
Action Points for Practice and Research
References
23: Speech, Language, and Swallowing Difficulties in Neurology: A Sub-Saharan African Perspective
Introduction
Methods
Neurological Disorders
Central Nervous System Disorders
Stroke
Cerebral Palsy
Parkinson’s Disease
Peripheral Nervous System Disorders
Myasthenia Gravis
Myopathy/Myositis
Combination of Central and Peripheral Nervous System Disorders
Motor Neuron Disease
Pitfalls
Unusual Speech and Swallowing
Background
Mutism
Hypophonia/Aphonia
Stammer
Vocal Tics
Globus Sensation
Dysphagia
Culturally Determined Pitfalls
Background
Uvulectomy
Frenulotomy
Implications
Discussion
References
24: Active Aging with Aphasia: A Case of Kiambu County, Kenya
Motive/Research Question
Problem Background
Theoretical Background
Global Overview of Aphasia and Aged Adults
Types of Aphasia
Aphasia in the Sub-Saharan African Context
Methods
Research Design
Participants and Sampling Methods
Instruments
Questionnaires
Data Collection
Data Analysis
Results of the Study
Demographic Information of the Respondents
Sampled Respondents by Gender
Age of the Respondents
Severity and Type of Aphasia by Gender
Ways in Which Aged Adults Receive Information and Interact with Others Without Aphasia
Age Variations and the Methods Used for Receiving Information and Interacting
Participation in the Community
Economic Determinants and Their Influence on the Participants
Discussion
Gender and Aphasia
Ways in Which Aged Adults Receive Information and Interact with Others Without Aphasia by Age Group
Participation in the Community
Economic Factors Influencing Persons with Aphasia
Considerations for Future Work, Research, and Politics
Improving the Well-Being of Aging by the Government
Future Research
References
25: Development of a Mobile SLT Clinic: A Case of East Africa
Background: Lack of SLT Service Delivery in Rural SSA
The General Concept of Mobile Clinics for Underserved Rural Areas in Majority World Countries
Development of a Model Mobile SLT Clinic for the Rural East African Context
Potential Outcomes and Functions
Adapted Methodology
Requirements for Design and Setup of SLT Clinic
Conceptual Setup of a Mobile SLT Clinic
Conceptual Areas
Clinical Guidelines: ASHA Manuals for Different Communication, Swallowing, and Hearing Disorders
Equipment Setup of a Mobile SLT Clinic
General Setup for Mobile SLT Service Delivery
Sustainability of the Mobile SLT Clinics
Policy Guidelines
Reflection and Recommendation
Mobile Clinic Approach as an Outcome of an International Development Cooperation
Mobile SLT Clinics as a Promising CBR Approach for Underserved (Rural) Communities in SSA
References
26: The Organization of Cochlear Implant Programs in Tanzania: Assessment of Needs and Challenges
Introduction
Theoretical Background
Pathophysiology
Therapy Options
Hearing Systems
Outcome in Terms of Speech and Education
Methods
Universal Newborn Hearing Screening
Hearing Aid Fitting Observed by Speech-Language Therapists, Specialized in Hearing Impairment
Complete Audiological and Radiological Diagnostic Procedures, Independent from Age
Cochlear Implant Indication
Cochlear Implant Surgery
Cochlear Implant Basic Speech-Language Therapy
Lifelong Care
Discussion
Socioeconomic Aspects
Hearing Disorders and Hearing Systems
Development of a Countrywide Strategy
Challenges
Cochlear Implant Therapy
Conclusion
References
17 Michelle Pascoe and Shajila Singh
Development of Speech–Language Therapy Assessments for the Languages of South Africa
18 Mellissa Bortz
Assessing Language in South Africa: Use of the Passive Construction
19 Mellissa Bortz
Methods for Devising a Standardized Language Assessment for isiZulu Preschoolers: Implications for Sub-Saharan Africa
20 Mathew Kinyua Karia
Using Acoustic Phonetics in the Assessment and Treatment of Speech Disorders
21 Phyllis W. Mwangi and Gatitu Kiguru
The Capacity to Assess and Treat Communication Disability in Kenya: Field-Based Evidence
22 Ulla Licandro, Tom Abuom, and Dennis Omari
Linguistically and Culturally Diverse Children with Language Disorders in Sub-Saharan Africa: Approaches to Service Delivery
23 Ines Said, Anke Bulsink, and Marieke Dekker
Speech, Language, and Swallowing Difficulties in Neurology: A Sub-Saharan African Perspective
24 Stephen Musila Nzoka, Elizabeth Wangui Kamau, Paul Kamau Mbugua, Molly Merrab Ogalloh, and Joyce Achieng Ogogo
Active Aging with Aphasia: A Case of Kiambu County, (Kenya)
25 Lawrence Eron, Nelly Otube, Mathew Karia, Edward Kija, Becky Isanda, Charles Mugisa, Stuart Robert Oyesigye, Marlene Küthe, Rieke Meinen, Steffen Gremmelt, Geoffrey Karugu, and Ulrike M. Lüdtke
Development of a Mobile SLT Clinic: An Example from East Africa
26 Anke Lesinski-Schiedat, Enica Richard, Rachel Mkumbo, Rukiya A. Mohamed, and Angelika Illg
The Organization of Cochlear Implant Programs in Tanzania: Assessment of Needs and Challenges
References
Part IV: Introduction: Inclusion
27: Communication, Disability, and Human Rights: Exploring the Role of the Sustainable Development Goals
Introduction
Methods
SDG 3: Good Health and Well-Being
Scoping Review of Children’s Pain Vocabulary: Implications for AAC (Johnson et al., 2017b)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
An Exploration of Pain-Related Vocabulary: Implications for AAC Use with Children (Johnson et al., 2016)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
Nurses’ Perspectives Towards Patient Communication Using a Low-Technology Communication Board in an Intensive Care Setting (Gropp et al., 2019)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
Message Banking: Perceptions of Persons with Motor Neuron Disease, Their Significant Others, and Clinicians (Oosthuizen et al., 2018)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
Impact of the Presented Studies on SDG 3: Good Health and Well-Being
SDG 4: Inclusive and Quality Education and Lifelong Learning
The Challenges of Realizing Inclusive Education in South Africa (Donohue & Bornman, 2014)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
South African Teachers’ Attitudes Toward the Inclusion of Learners with Different Abilities in Mainstream Classrooms (Donohue & Bornman, 2015)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
South African Teachers’ Attitudes Toward Learners with Barriers to Learning: Attention-Deficit and Hyperactivity Disorder and Little or No Functional Speech (Bornman & Donohue, 2013)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
The Awareness of Primary Caregivers in South Africa of the Human Rights of Their Children with Intellectual Disabilities (Huus et al., 2016)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
The Effect of an Aided Language Stimulation Programme on Subtraction Word-Problem Solving for Children with Intellectual Disabilities: A Preliminary Study (Naudé et al., 2020)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
Comparing Two Response Modes in a Mathematics Test for Learners in Foundation Phase with Severe Physical Disabilities: A South African Example (Bornman et al., 2016)
Introduction
Aim of the Study
Research Methodology
Results
Limitations and Future Research
Implications for Implementation
Impact of the Presented Studies on SDG 4: Quality Education and Lifelong Learning
Conclusion
References
28: Access to Early Childhood Development and Inclusive Education Services for Refugee Children with Communication Disability in Rwanda
Introduction
Background
Refugees in Rwanda
Disability and Humanitarian Response
ECD and Education for Children with Disabilities in Sub-Saharan Africa
Education Services
Early Childhood Development Services
Services for Children with Disabilities
Inclusion in ECD and Education for Refugee Children
ECD and Education Services for Refugee Children with Disabilities in Rwanda
Refugees with Communication Disability: Access to Services
Listening to the People
Motive
Aims, Objectives, and Research Methods
Ethical Considerations
Potential Impact of this Research
Considerations for Future Developments
Summary and Conclusion
References
29: Inclusion of Children with Social Communication Disorder in Kenya
Introduction
Motive and Research Question
Theoretical Background
Global Overview of Social Communication Disorder
Social Communication Disorder and Education
Primary Education in Africa
Primary Education in Kenya
Methods
Results
Literature Related to Social Communication Disorder in Sub-Saharan Africa
Characteristics of Social Communication Disorder in Sub-Saharan Africa
Perception of Causes of Social Communication Disorder in Sub-Saharan Africa
Supernatural Causes
Biomedical Causes
Inclusion of Children with Social Communication Disorder in Schools in Kenya
Intervention Measures
Discussion
Characteristics of Social Communication Disorder
Causes of Social Communication Disorder
Inclusion of Learners with Social Communication Disorder in Kenyan Schools
Intervention Measures and Educational Accommodations
Impacts of the Study on Persons with Communicative Disabilities in Sub-Saharan Africa
Considerations for Future Work, Research, and Politics
References
30: Promoting Social Communication: Teaching Strategies for Students with Autism Spectrum Disorder in East Africa
Introduction
Teaching Students with Autism Spectrum Disorder in Tanzania
Theoretical Background
Challenges in Assessing Children for Autism in Eastern Africa
The Role of the Community in Teaching Students with Autism Spectrum Disorder
Didactic Methods
Collaborative Strategic Reading to Provide Opportunities for Communication in the Classroom
Communication Strategies for Children with ASD Who Are Minimally Verbal or Nonverbal
Using Social Stories, Modeling, and Meaningful Activities to Improve Social Communication in Children with ASD
Music Combined with Social Narratives to Address Communication Skills
Conclusions
References
31: Navigating Communication Difficulties Faced by Children with Autism Spectrum Disorder: Evidence From Kenya
Introduction
Problem Background
Theoretical Background
Motive
Methods
Participant Selection
Data Collection
Data Analysis
Ethical Clearance
Results
The Number of Children with Autism Spectrum Disorder in the Sampled Schools
The Number, Qualifications, and Experience of Teachers of Children with Autism Spectrum Disorder in the Schools
Support Given to Teachers of Children with Autism Spectrum Disorder
Challenges of Teaching Children with Autism Spectrum Disorder
Communication Difficulties Faced by Children with Autism Spectrum Disorder
Countering Communicative Difficulties
The Effectiveness of These Strategies
Discussion
Communicative Difficulties That Children with Autism Spectrum Disorder Face
Strategies Used to Help Children with Autism Spectrum Disorder Navigate Communication Difficulties
Individualized Educational Program
Peer Learning
Information and Communications Technology
Multimedia Approach
Challenges Faced in the Teaching of Children with Autism Spectrum Disorder
Suggestions on Areas of Improvement
The Impact of Interventions Used to Help Children with Autism Spectrum Disorder Navigate Communication Difficulties
Considerations for Future Work, Research, and Politics
References
32: Using Augmentative and Alternative Communication Strategies in Schools in Namibia
Introduction
Understanding the Namibian School Context
Educational Opportunities in Namibia
Challenges Within the Namibian Educational Context
Classroom Size and Composition
Lack of Teaching Assistants
Lack of Trained Teachers in Special Education
Limited Special Schools/Lack of Special Schools in Rural Areas
Language Barriers/Suitability of the Educational Program
Opportunity Barriers
An Introduction to Augmentative and Alternative Communication
What Is Augmentative and Alternative Communication?
Benefits of Augmentative and Alternative Communication Within the School Context
Augmentative and Alternative Communication Systems and Strategies
Unaided Systems
Five Steps to Teaching Keyword Signing
Aided Systems
Conclusions
References
33: Critical Components in the Inclusion of Learners with Cerebral Palsy and Associated Communication Disorders
Introduction: Cerebral Palsy
Background: Inclusion of Learners with Cerebral Palsy in Sub-Saharan Africa
Research Questions
Method
Desk Review Strategy
Selection of Studies
Exclusion Criteria
Results
The Learning Environment
Attitude Toward Learners with Cerebral Palsy
Therapy
Augmentative and Alternative Communication
Discussion
Learning Environment
Attitudes Toward Learners with Cerebral Palsy
Therapy
Augmentative and Alternative Communication
Considerations for Future Work, Research, and Politics
References
Sampled Reviewed Papers
34: Stuttering’s Hidden Side: The Need for an Empathetic School Climate for Disfluent School-Age Children in Public Primary Schools in Kakamega, Kenya
Introduction
Problem Background: Childhood Stuttering
Characteristics
Psychosocial Challenges
Causes of Disfluent Speech
Genetics
Developmental Factors
Environmental Factors
Prevalence and Incidence
School-Age Children Who Stutter: Psychosocial and Academic Challenges
Psychosocial Effects
Bullying and Teasing
Academic Impact of Stuttering
Research Questions
Methods
Research Design
Participants
Instruments
Data Collection
Data Analysis
Results
Causes of Stuttering Disorder as Perceived by Children Who Stutter
Stuttering Disorder as Perceived by Teachers
Stuttering Prevalence as Reported by Teachers
Effect of the Disorder as Reported by Teachers
Nature of Psychological Experiences Related to Stuttering as Perceived by Children
School-Age Children Who Stutter: Psychosocial Effects and Academic Challenges
Coping Strategies
Discussion
Causes of Stuttering as Perceived by Children Who Stutter
Stuttering Disorder as Perceived by Teachers
Nature of Psychological Experiences Related to Stuttering as Perceived by Children
School-Age Children Who Stutter: Perceptions Related to Psychosocial Effects and Academic Challenges
Coping Strategies
Impact
Study Limitations and Considerations for Future Work, Research, and Politics
References
35: Ugandan Sign Language Interpretation Services for Learners with Hearing Impairment in Inclusive Secondary Schools in Uganda: Challenges and Successes
Introduction
Background
Sign Language Interpreting
Universal Secondary Education
Teacher and Sign Language Interpreter Training
Bilingualism and Language Structure
Motive and Objectives of the Study
Methodology
Design and Setting
Sampling Procedures
Participants
Instruments
Data Collection
Formal Interviews
Participant Observation
Focus Group Discussions
Data Analysis
Ethical Considerations, Validity, and Reliability
Results
Challenges Faced by Sign Language Interpreters During Their Work in an Inclusive School in Uganda
Challenges Arising from Internal Factors
Challenges Arising from Learners
Challenges Arising from Teachers and School Administration
Challenges Arising from the Environment and Context
Influence of These Challenges on the Work of the Sign Language Interpreters in an Inclusive Secondary School in Uganda
Coping Strategies to Minimize the Challenges Encountered by the Interpreters in Inclusive Settings
Discussion
Challenges Faced by Sign Language Interpreters During Their Work in an Inclusive School in Uganda
Challenges Arising from Internal Factors
Challenges Arising from Learners
Challenges Arising from Teachers and School Administration
Challenges Arising from the Environment and Context
Challenges Faced by Sign Language Interpreters and the Influence on Their Work in an Inclusive Secondary School in Uganda
Coping Strategies to Minimize the Challenges Encountered by the Interpreters in Inclusive Settings
Conclusions, Impact, and Considerations for Future Work
References
Epilogue: Speech-Language Therapy in Sub-Saharan Africa Revisited: Visions for Theory, Training, and Practice
27 Juan Bornman
Communication, Disability and Human Rights: Exploring the Role of the Sustainable Development Goals
28 Helen Barrett, Julie Marshall, Juliet Goldbart, and Nathalie Bussien
Access to Early Childhood Development and Inclusive Education Services for Refugee Children with Communication Disability in Rwanda
29 Joyce Achieng Ogogo, Molly Merrab Ogalloh, and Beatrice Bunyasi Awori
Inclusion of Children with Social Communication Disorder in Kenya
30 Diane Rodríguez and Geraldine Arquer Haddock
Promoting Social Communication: Teaching Strategies for Students with Autism Spectrum Disorder in East Africa
31 Martin C. Njoroge and Augustus Nyakundi
Navigating Communication Difficulties Faced by Children with Autism Spectrum Disorder: Evidence from Kenya
32 Juan Bornman, Helindi Gouws, Enid Moolman, Anna Robberts, and Kerstin Tönsing
Using Augmentative and Alternative Communication Strategies in Schools in Namibia
33 Nelly Were Otube and Mathew Kinyua Karia
Critical Components in the Inclusion of Learners with Cerebral Palsy and Associated Communication Disorders
34 Atieno Rose Opiyo
Stuttering’s Hidden Side: The Need for an Empathetic School Climate for Disfluent School-Age Children in Public Primary Schools in Kakamega, Kenya
35 Julius Patrick Omugur
Sign Language Interpretation Services for Learners with Hearing Impairment in Inclusive Secondary Schools in Uganda: Challenges and Successes
References
Index
