Abstract
The purpose of this paper is to provide a preliminary, qualitative review of an approach to training centre-based carers in supporting basic communication development and providing communication opportunities for the children with severe and profound disabilities in their care. In South Africa, these children are often the most neglected in terms of planning and providing appropriate interventions. For those with severe communication disabilities, an additional lack is in the area of the basic human right to meaningful interactions and communication. Sustainable strategies to provide opportunities for basic communication development of these children are urgently sought. Several effective international and local parent training programmes have been developed, but the urgent need remains to train centre-based carers who are taking care of groups of diversely disabled children in severely under-resourced settings. Non-profit organisations (NPOs) have been exploring practical centre-based approaches to skills sharing in physical rehabilitation, activities for daily living, feeding and support for basic communication development. As a freelance speech therapist contracted by four NPOs to implement hands-on training in basic communication for centre-based carers of non-verbal children, the author describes a training approach that evolved over three years, in collaboration with the carers and centre managements. Implications for training (for speech therapists and for community-based rehabilitation workers) and for further research are identified.
Highlights
Communication with others is an activity that defines our humanity
Reports confirm increases in severe disabilities in children, secondary to pre, peri- and postnatal birth complications (ACPF 2011; WHO 2011). These are further compounded by the prevailing social and environmental conditions, including poverty, limited access to health and rehabilitation services, as well as the effects of HIV and AIDS (ACPF 2011; WHO 2011). These children, and especially those with severe and profound intellectual disabilities, are often the most neglected in terms of planning and providing appropriate interventions and services (ACPF 2011; Ransom 2009; Saloojee et al 2006; WHO 2011)
In South Africa, children with severe or profound disabilities have been excluded from educational inputs for many years (Western Cape High Court 2011) and regular, formal speech therapy services are often not accessible to these children
Summary
Communication with others is an activity that defines our humanity. Yet, in spite of policy and legislative frameworks emphasising communication as a basic human right (Department of Health 2000; United Nations 2008), it is often overlooked and underestimated as a basic human need. Reports confirm increases in severe disabilities in children, secondary to pre-, peri- and postnatal birth complications (ACPF 2011; WHO 2011) These are further compounded by the prevailing social and environmental conditions, including poverty, limited access to health and rehabilitation services, as well as the effects of HIV and AIDS (ACPF 2011; WHO 2011). These children, and especially those with severe and profound intellectual disabilities, are often the most neglected in terms of planning and providing appropriate interventions and services (ACPF 2011; Ransom 2009; Saloojee et al 2006; WHO 2011). Non-profit organisations (NPOs) have attempted to alleviate this situation by providing much needed but often fragmented ad hoc speech (and other) therapy services, and training and support of carers in the special care centres in and around Cape Town
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