Audiology

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Auditory Processing Disorders in children : the perspectives and practices of South African audiologists/STA's.
(2015) Fouché-Copley, Claire.; Khan, Nasim Banu.; Govender, Samantha Marlanie.
Audiologists/ Speech Therapists and Audiologists (STA’s) practicing in the field of Auditory Processing Disorders (APD) globally, encounter several challenges that include but are not limited to conflicting definitions, variable diagnostic criteria, several classification profiles and lack of standardised guidelines for screening, assessment and intervention. In South Africa, audiologists/ STA’s experience further challenges related to working within a diverse multicultural and multilingual context when attempting to manage children with APD. This study investigated the perspectives and practices of South African audiologists/ STA’s in screening, assessing and providing intervention for children with APD. A descriptive survey design, with quantitative methods of analysis, was used to obtain information from audiologists/ STA’s registered with the Health Professions Council of South Africa (HPCSA, 2014), of which 156 responded. The data was analysed using descriptive and inferential statistics. Overall 68% (n = 106) of the participants did not feel adequately prepared to practice in the field of APD. Seventy five percent (p = 0.00) of audiologists and 35% of STA’s reported their level of experience as being ‘limited’, which was statically significant. Forty percent (n = 62) of the sample felt that they were either ‘poorly’ or ‘very poorly’ informed to screen for APD, 44% (n = 68) to assess for APD, and 53% (n = 82) to provide intervention. Sixty percent (n = 93) screened for APD, whilst only 42% (n = 66) assessed for APD. Some of the reasons cited include; lack of exposure to APD during their undergraduate programme, inappropriate screening and assessment material due to cultural and linguistic barriers and limited resources to manage children with APD. Eighty five percent (n = 133) received referrals from other practitioners for the management of APD, yet only 43% (n = 67) of the participants offered intervention. Similar findings were reported in studies conducted locally and internationally. It can therefore be concluded that service provision in the area of APD in South Africa, is limited which is exacerbated by several contextual constraints. Based on the study findings of the current study, relevant research and clinical implications were recommended.
Curriculum engagement: educators’ experiences in Audiology and Speech-Language Pathology at a South African university.
(2020) Inarman, Suraksha.; Pillay, Mershen.; Khan, Nasim Banu.
Educator’s experiences have not been awarded due recognition within the curriculum. If educators are key agents in curriculum change then non-recognition of their experiences, power relations, identity construction and its influence on the curriculum leaves a gap in understanding curriculum engagement. Hence, this study aimed to explore educators’ experiences on curriculum engagement in the Audiology and Speech-Language Pathology (SLP) Disciplines at the University of KwaZulu-Natal (UKZN). Educators’ experiences in relation to students, educators, content, method of engagement and context together with the influence of socio-demographic, socio-emotional and socio-political factors are described. A qualitative study design that was exploratory and descriptive in nature was undertaken. Educators’ experiences were explored via a semi-structured interview method and analysed with the use of a qualitative computer software, NVivo as well as through thematic analysis. Five main themes emanated from 59 codes and 15 categories. The results and discussion are presented per theme and the findings suggest that the political environment impacted greatly on the curriculum in terms of its structure, policies, staff and student profiles. Staff identities and emotional engagement further influenced their interaction with the curriculum and facilitated their role as agents of curriculum change. Whilst validating knowledge by experience may be considered a less orthodox approach, this study has demonstrated that providing Audiologists and SLP’s with a platform to share their personal experiences through narrative may be a way forward in expanding new knowledge, developing skills and gaining competencies as the professions move progressively towards engaging a contextually relevant curriculum.
Early hearing detection and intervention in KwaZulu-Natal: analysis of barriers and facilitators from guideline generation to clinical application.
(2020) Naidoo, Naedene.; Khan, Nasim Banu.
Background: There is slow progress in early hearing detection and intervention (EHDI) services within South Africa. Despite enabling guidelines, such as the Joint committee on Infant Hearing (JCIH) and Health Professionals Council of South Africa (HPCSA), EHDI guidelines supporting EHDI as a standard of care, various barriers hinder the translation of these guidelines into clinical practice, as envisaged. Audiologists are EHDI gatekeepers and can provide valuable insights into these challenges, as well as strengths or opportunities that can progressively move EHDI towards best practice in South Africa. Objective: The study aimed to determine the barriers and facilitators to EHDI in KwaZulu-Natal (KZN) as reported by audiologists/speech therapists and audiologists’ (A/STAs). Method: An exploratory-descriptive qualitative approach was used, by conducting telephonic interviews with 12 A/STAs working in public and private healthcare facilities, within KwaZulu-Natal. Data was analysed using thematic analysis, in conjunction with NVivo software. Results: Five main themes emerged from the data as follows: improving EHDI guidelines; investing in resources and infrastructure for EHDI service provision; facilitating professional development, training and education and strengthening intersectoral collaboration for EHDI services; managing follow-up and evaluating protocols and procedures for screening; and engaging, understanding and supporting caregivers/families. Conclusion: Despite the availability of EHDI guidelines and some progress in service delivery, participants indicated that implementation of EHDI remains a challenge. Strategies such as an increase in resources, further education and training, development of contextually relevant, culturally and linguistically diverse practices and protocols need to be in place to improve EHDI implementation.
The employment of individuals with hearing impairment in the KwaZulu-Natal private sector: current employers’ perceptions and experiences.
(2018) Doolabh, Nishita Ashwin.; Khan, Nasim Banu.
Background: Despite policies and legislation mandating the employment of persons with disabilities, individuals with hearing impairment continue to face barriers and challenges accessing the labour market and have typically experienced higher rates of unemployment or underemployment. In South Africa, the majority of individuals with disabilities remain dependent on social-welfare to meet basic needs and as a result, their potential remains grossly untapped. Misconceptions regarding the capabilities of hearing impaired individuals have resulted in the occupational marginalization of this population. Objective: This study aimed to investigate employers’ perceptions and experiences in recruiting and retaining individuals with hearing impairment in KwaZulu-Natal Provinces’ private sector. Method: A descriptive survey with quantitative methods of analysis was used to obtain information from employers, human resource personnel or management in various industries who have employed individuals with hearing loss. The Chronbach Alpha suggested that the self-administered questionnaire had good internal consistency (p = 0.858). A total of 30 responses were obtained from the 19 companies who agreed to participate. Results: Approximately 75% of participants indicated either a medium or low level of awareness regarding disability. Legislation such as the Employment Equity Act (EEA, no 55 of 1998) and the Skills Development Act (SDA, no 97 of 1998) were considered the most useful legislature, as indicated by 66.7% of participants. Those who indicated that external services or resources, such as the KZN Blind and Deaf Society and eDeaf were used during recruitment and retention were more likely to report to the benefits of employing hearing impaired individuals, this being statistically significant (p < 0.001). Less than half of the participants reported that reasonable accommodations were provided for their employees, and half indicated that they were willing to provide sign language interpreters. Most participants (70%) suggested that communication difficulties, particularly in meetings, contributed towards poor employment rates amongst individuals with hearing impairment. Communication difficulties were further endorsed by 73.3% of participants as a major challenge when recruiting and hiring persons with hearing impairment. Other concerns related to the safety of employees and attitudes of co-workers. Conclusion: The findings suggest that a lack of familiarity of disability and disability legislature can manifest in reliance on erroneous stereotypes that individuals with disabilities are poor job performers and incapable of working independently. However, with the use of reasonable accommodations which includes sign language interpreters and desensitization workshops, employers were able to successfully integrate hearing impaired employees into the workforce.

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