Medicine
Permanent URI for this communityhttp://repository.kln.ac.lk/handle/123456789/12
This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
Browse
8 results
Search Results
Item Developing and pilot-testing an Oropharyngeal Dysphagia Screening Tool for children with cerebral palsy aged 4 – 6 years(Sri Lanka Medical Association, 2020) Hettiarachchi, S.; Ravihari, M.G.I.INTRODUCTION AND OBJECTIVES: Children with Cerebral Palsy (CP) demonstrate a variety of dysphagic symptoms. Speech and language therapists (SLTs) are mainly involved in the diagnosis and management of oropharyngeal dysphagia (OPD). Objectives were to develop a screening tool to detect OPD among children with CP aged 4 – 6 years, Pilot test the OPD screening tool with SLTs for children with CP aged between 4 – 6 years and to identify the test-retest reliability and inter-rater reliability of the developed screening tool. METHODS: The screening tool was developed based on the Dysphagia Disorder Survey (DDS) with the assistance of an expert panel of speech and language therapists (SLTs) and a pilot study. The study included 30 children with CP aged between 4;0 – 6;0 years. The OPD Screening Tool conduct together with expert SLTs to evaluate the inter-rater reliability and the study was conducted initially and 2 hours later by the researcher to evaluate test-retest reliability. RESULTS: The OPD Screening tool was shown to be reliable and applicable in detecting dysphagia amongst children with CP. The content validity was assessed by the five expert SLTs. The test-retest reliability and inter-rater reliability of the OPD Screening Tool was calculated and it was relatively high. CONCLUSION: The screening tool was shown to be a reliable tool and it was found to be a tool that easy administer in clinical setting to detect OPD in young children with CP.Item The Effectiveness of the adapted Box Clever language intervention programme in the development of vocabulary and narrative skills of deaf and hard of hearing children(Taylor & Francis, 2022) Hettiarachchi, S.ABSTRACT: Children who are deaf or hard of hearing (DHH) in Sri Lanka have inadequate access to early amplification and language stimulation. As a result, they are at risk of impoverished language development: spoken language and sign language. Thirty DHH children who use Sri Lankan sign language between the ages of 4;4-7;2 years from three classrooms of a School for the Deaf were included in this study. The culturally-modified Box Clever language-enrichment programme was offered as a whole-class approach twice a week during a 12-week school term through the class teacher. Pre- and post-intervention language measures and statistical analyses of language scores were undertaken of receptive and expressive vocabulary on picture-naming tasks of target vocabulary. In addition, content and syntactic analyses of narrative skills were undertaken using the Elephant Tales Narrative Assessment, an informal assessment created by the researchers, as no local formal standardised assessments exist currently. There were promising results with statistically significant positive gains in receptive and expressive vocabulary skills on target vocabulary items post-intervention by all the participants. Positive qualitative differences were observed in the content within the target narrative assessment post-intervention by all participants with evidence of the emergence of two to three sign combinations by many of the children. KEYWORDS: Deaf, vocabulary, narrative skills, language intervention, sign-language, Sri Lanka, whole-class, LMICItem The Effectiveness of using multi-sensory children’s stories on vocabulary development in young deaf and hard-of-hearing children(Taylor & Francis, 2021) Hettiarachchi, S.; Ranaweera, M.; Disanayake, H.M.L.N.ABSTRACT: Young deaf and hard-of-hearing children enrolling in school in Sri Lanka often display language delay due to limited amplification and limited language stimulation. The scarcity of speech and language therapy support within the educational context at present necessitates a rethink of service-delivery models to reach more children. Multi-sensory stimuli and traditional children’s stories have been used in speech and language therapy to promote vocabulary development in children experiencing language-learning difficulties. Fifteen deaf or hard-of-hearing children from three different educational contexts were offered a three week “Katha malu” multi-sensory children’s story programme through the class teacher. The programme focused on developing receptive and expressive vocabulary of a set of 30 target words. The programme was offered using a combination of Sri Lankan Sign Language and Spoken Sinhala. The participants' receptive and expressive vocabulary knowledge on the target words was assessed using a specially devised picture-based vocabulary assessment pre- and post-intervention. The results show positive gains at both group and individual levels on receptive and expressive vocabulary skills. There was a positive effect of familiarity with the story with the overall vocabulary gains more prominent for the older, more traditional story. The findings of this study highlight the possibility of offering access to language stimulation programmes at classroom-level facilitated by the class teacher, under the guidance of a speech and language therapist. KEYWORDS: Early childhood education, language facilitation, engagement of children with adequate or inadequate amplification, multi-sensory, traditional storiesItem The Effectiveness of using the colourful semantics approach to support language development with children who are deaf or hard-of-hearing(Taylor & Francis, 2019) Hettiarachchi, S.; Ranaweera, M.ABSTRACT: The lack of early identification, suboptimal language stimulation and limited remedial services in Sri Lanka for children who are deaf or hard-of-hearing place them at-risk of language delay. The reality for many preschool and primary school children entering formal education in Sri Lanka is a language delay in spoken language and/or sign language compared to their age-matched hearing peers. The aim of this study was to evaluate the effectiveness of the Colourful Semantics approach as a whole-class language enrichment programme to develop the use and responses to target wh questions. Thirty primary school children who are deaf or hard-of-hearing between the ages of five-ten years were included. The programme was offered once a week for 12 weeks through the class teacher. Individual pre- and post-language measures and statistical analyses were undertaken on receptive knowledge and expressive use of the target wh questions using a picture naming task and tasks based on three local children’s story books. A statistically significant improvement was observed in the understanding of target wh questions post-intervention by all the children. There was also a positive change in the responses to the target wh questions by all the children post-intervention with many combining signs or spoken words with signs. The Colourful Semantics approach has potential as a whole-class language-teaching approach to strengthen the understanding and use of wh question forms. This study emphasizes the benefits of collaborative partnerships between speech and language therapists and teachers in delivering intervention particularly in resource-limited contexts. KEYWORDS: Deaf, children, language delay, Sri Lankan sign language, Colourful SemanticsItem The Effectiveness of a multisensory traditional storytelling programme on target vocabulary development in children with disabilities accessing English as a second language: A preliminary study(SAGE Publications, 2022) Hettiarachchi, S.; Walisundara, D.C.; Ranaweera, M.ABSTRACT: The current deliberations on increasing access to English and the democratization of English in post-war Sri Lanka must extend to students with disabilities. Research evidence from speech and language therapy promotes the use of multi-sensory stimuli to advance the development of communication and language skills in children with intellectual disabilities. In this preliminary study, 3 local children's stories, together with relevant story-making activities, were offered to 7 children with intellectual disabilities in one special school across 12 lessons. Vocabulary measures of word naming of target vocabulary were undertaken pre- and post-intervention using picture-based tasks presented via PowerPoint. A positive difference was found post-intervention on the target vocabulary naming test. The findings of this small preliminary study should be interpreted with caution. However, the findings are suggestive of the potential benefit of using culturally relevant familiar local traditional stories with a range of multi-sensory stimuli and storytelling activities to aid learning of new vocabulary in children with disabilities accessing English as an additional language. Further research using a large sample together with a control group will be required to substantiate the positive trend of vocabulary gains observed within this preliminary study. KEYWORDS: English; intellectual disability; multisensory; stories; traditional.Item Efficacy of a low-cost multidisciplinary team-led experiential workshop for public health midwives on dysphagia management for children with cerebral palsy(VU e-Publishing, Netherlands, 2018) Hettiarachchi, S.; Kitnasamy, G.; Mahendran, R.; Nizar, F. S.; Bandara, C.; Gowritharan, P.PURPOSE: Over the past decade there has been a growing focus on offering appropriate training to healthcare professionals and caregivers to support safe feeding practices for children with cerebral palsy. Early and consistent multidisciplinary intervention is required to minimise the risks of aspiration pneumonia. The high incidence of complications from aspiration pneumonia among children with cerebral palsy in Sri Lanka has made it necessary to conduct low-cost multidisciplinary team-led dysphagia awareness workshops for healthcare professionals and caregivers.METHOD: A group of 38 Public Health Midwives (PHMs) was offered an experiential workshop by a small multidisciplinary team (MDT). To determine changes in knowledge, a self-administered questionnaire that included a video-based client scenario was administered pre- and post-workshop. The data were analysed statistically using non-parametric within-participant t-tests.RESULTS: The post-workshop responses to the questionnaire indicated a significant increase in the level of knowledge. This included positive changes in the understanding and knowledge of cerebral palsy (t (37) =-7.44, p=.000), effects of cerebral palsy on eating and drinking skills (t (37) =-3.91, p=.000), positioning (t (37) = -9.85, p=.000), aspiration (t (37) =-3.46, p=.001), food categorisation (t (37), -3.85, p=.000) and client video observation (t (37)-3.91, p=.000) at a p=.05 level of significance. While there was also an increase in the knowledge on general guidelines during mealtimes, this did not reach statistical significance.CONCLUSION: The low-cost MDT-led experiential workshop was effective in increasing knowledge of feeding and dysphagia-related issues in cerebral palsy among a group of PHMs. This workshop could serve as a model for training PHMs and Community-Health Workers across the country in order to reach the Sustainable Development Goal of ‘good health and well-being’ for children with cerebral palsy and all children experiencing feeding difficulties. Follow-up workshops and continued professional development courses for midwives on dysphagia care are strongly recommended, in addition to collaborative clinical practiceItem "Now I am a techie too" - parental perceptions of using mobile technology for communication by children with complex communication needs in the global south.(Informa Healthcare, 2020) Hettiarachchi, S.; Kitnasamy, G.; Gopi, D.PURPOSE:Parental perceptions are key to the uptake of augmentative and alternative communication (AAC) devices for their children with complex communication needs. This study aimed to explore the perceptions of parents in a resource poor Global South country on the use of mobile technology as AAC devices. MATERIALS AND METHODS:Sixteen participants (11 female; 5 male) were included in the study. Focus group discussions, face-to-face interviews and telephone interviews were conducted with the aid of an interview guide. The interview data were analysed using the key principles of Framework analysis and through the lens of critical disability studies. RESULTS: Six broad themes emerged. Most participants indicated a penchant for mobile technology, though its current use with their children was mainly as a teaching tool rather than a communication device. Concerns were raised about the cost of mobile technology, which if used within communication, was only as a temporary stop-gap measure with limited knowledge. The power of mainstream technology to challenge prevalent notions of disability was also highlighted by the participants. CONCLUSIONS: There is an openness to using mainstream mobile technology by parents with their children with complex communication needs. This use is currently reserved mainly for educational purposes while its power to challenge disability-related stereotypes is acknowledged. More parent training is required to encourage the use of mobile technology as AAC devices for communication. Implications for rehabilitation Current parent perspectives on mobile technology as AAC devices must be explored, given its potential impact on the uptake of these devices to support communication in their children with complex communication needs. Mainstream mobile technology could challenge perceptions of disability and therefore, be more acceptable to parents for their children with complex communication needs. Parental training is required to increase knowledge on the use of mobile technology as AAC devices for communication to enable informed choice-making.Item The Effectiveness of colourful semantics on narrative skills in children with intellectual disabilities in Sri Lanka(SAGE Publications, 2016) Hettiarachchi, S.BACKGROUND: Children diagnosed with intellectual difficulties experience difficulties with narrative skills, due to limited syntactic knowledge. The Colourful Semantics approach with thematic roles and a colour coding system may encourage syntactic development in children experiencingintellectual disabilities. AIM: To evaluate the effectiveness of using the Colourful Semantics approach to develop narrative skills in Sri Lankan Tamil-speaking childrendiagnosed with intellectual difficulties. METHODS: Thirty Sri Lankan Tamil-speaking children identified with intellectual difficulties were included. The Colourful Semantics approach was offered twice a week for 6 weeks, facilitated by the class teachers. Pre- and post-intervention narrative skill assessments were undertaken and analysed for content and syntactic structures. RESULTS: The results indicate positive changes post-intervention on the qualitative and quantitative narrative skills measures undertaken on content and syntactic structures. CONCLUSIONS AND IMPLICATIONS: The Colourful Semantics approach is an effective therapy approach to support development of narrativeskills in children with intellectual difficulties.