Deaf Child Centre Annual
Report - 1999
| Contents |
INTRODUCTION
SERVICE
DEAF CHILD CENTRE
HEARING ASSESSMENT
OUTPATIENTS
HEARING AID EVALUATIONS
FAMILY TRAINING PROGRAMMES
SPEECH AND LANGUAGE (SPOKE/SIGN)
ASSESSMENTS AND THERAPY |
DEAF CHILD CENTRE PRE-SCHOOL/JUNIOR
SCHOOL
HARK PROJECT
STUDENT CLINICAL TRAINING
RESEARCH
STAFF
FUND RAISING |
1. INTRODUCTION 
The
Deaf Child Centre was established in 1996 in response to the need for aural rehabilitation
for hearing impaired children in the Western Cape. The centre was established under the
auspices of the Departments of Logopaedics, Otolaryngology and the Child Health Unit,
University of Cape Town. It is housed at the Developmental Clinic of the Child Health
Unit, University of Cape Town in Rondebosch. Since its inception, the Deaf Child Centre
has continued to offer a comprehensive service to hearing impaired children and their
families in the Western Cape, training to Logopaedics students from the University of Cape
Town and a suitable setting for research to be undertaken in the field of deafness.
In
the past year much development has occurred at the Deaf Child Centre in terms of the
number of hearing impaired children receiving a service, the nature and scope of the
service provided and the growth and sustainability of the pre-school. In response to the
need for the services offered at the Deaf Child Centre to be made more accessible to the
disadvantaged communities, an outreach community based service, referred to as the HARK
Project was established. Following the formation of a partnership between the University
of Cape Town and the Commonwealth Society for the Deaf (London), the HARK Project directed
by the Deaf Child Centre was implemented in March 1999. This service is provided at
primary and secondary health care levels in the Cape Metropole and the Boland/Overberg
regions. The Deaf Child Centre Pre-School, which previously consisted of one pre-school
class of eighteen hearing impaired children, will as from January 2000 have a total
enrolment of 41 hearing impaired children including a grade 1 class. Furthermore the Deaf
Child Centre Pre-School and Junior School is from January 2000 being subsidised by the
Western Cape Education Department.
2. SERVICE
2.1 DEAF
CHILD CENTRE
2.1.1 HEARING ASSESSMENT
The
Audiology Department at Red Cross Hospital continued to undertake the majority of hearing
assessments and provision of referrals for aural rehabilitation at the Deaf Child Centre.
Hearing assessments are administered at the Deaf Child Centre on a weekly basis in support
of the neuro-developmental assessment clinic of the Developmental Clinic of the Child
Health Unit.
2.1.2 OUTPATIENTS
An
outpatient clinic conducted by three speech pathologists/audiologists and supported by IV
year speech pathology/audiology students (Dept of Logopaedics, UCT) and a deaf adult
signer is held on a weekly basis. In the outpatient clinic initial interviews with the
families of hearing impaired children, hearing aid assessments, speech and language
assessments and counselling are provided. Referrals for additional medical or paramedical
assessments are made and undertaken by staff at the Developmental Clinic. Educational
placements and support for the children in mainstream education is provided.
2.1.3 HEARING
AID EVALUATIONS
Hearing aid evaluations and fittings are
carried out three days per week. Qualified audiologists undertake the evaluations and
fittings. To date, Red Cross Hospital does not have a formal budget for the purchase of
hearing aids. Hence, the Deaf Child Centre has had to rely on the donation of second hand
hearing aids from the USA and the UK. Although these donated hearing aids have allowed for
many children to have the opportunity of receiving amplification, there are some children
who are not fitted with the most appropriate hearing aid and therefore are not deriving
maximum benefit from amplification. Continued appeals will be made to the Department of
Health for the provision of hearing aids for hearing impaired children. All hearing aid
fittings are carefully monitored and follow up rehabilitation sessions are provided.
2.1.4 FAMILY TRAINING
PROGRAMMES
In
acknowledgement of family training programmes being currently hailed as the best service
delivery model for hearing impaired children, the Deaf Child Centre has focused its aural
rehabilitation on the family rather than on the individual child. Family training
programmes are offered on a weekly basis and are very well attended. This programme is
co-ordinated by a qualified speech pathologist/audiologist who is specialising in the
field of parent training and a deaf signing adult. In addition students from the
Department of Logopaedics and an interpreter from Red Cross Hospital provide input into
the programme. The parent training programme has proved to be highly successful and its
component parts include information giving, counselling, development of communicative
strategies, the learning of sign language and educational advocacy. Research measuring the
efficacy of the programme was undertaken and reported on in 1998.
2.1.5 SPEECH AND LANGUAGE (SPOKEN/SIGN) ASSESSMENTS AND
THERAPY
Individual
speech and language (spoken/sign) assessments are undertaken during the outpatient clinic.
Although some of the assessments include the use of formal standardised assessment tools,
more informal methods of assessments, which are culturally and linguistically sensitive,
are undertaken. The need for further development of culturally appropriate assessment
tools is well recognised and research in this area will be undertaken at the Deaf Child
Centre in 2000.
Individual
and group therapy is provided on a weekly basis to hearing impaired children who present
with delayed speech and language skills. In addition children presenting with central
auditory processing difficulties receive therapy. Therapy is provided by qualified speech
pathologists/audiologists and by IV year speech pathology/audiology students.
2.1.6 DEAF CHILD CENTRE
PRE-SCHOOL/JUNIOR SCHOOL
The
Deaf Child Centre Pre-School has shown much growth and development in this past year. In
January 1999, as a result of an increased number of children attending the school, the
need arose for the school to be moved from its base at the Child Health Unit to an
educational setting. The principal, staff and governing body of Mary Kihn School for the
Hearing Impaired supported the needs of the Deaf Child Centre Pre-School and agreed to it
being housed on their property. Accommodation for these children was made possible by the
very generous donation of a container converted into a classroom by Rotary Le Cap De
Tempetes. Further donations made by Le Cap De Tempetes allowed for the fitting of air
conditioners and heating.
During
1999 the pre-school consisted of one pre-school class of eighteen, severe-profoundly deaf
children ranging in the age from three – six years. Although there was a waiting list
of an additional eighteen children for the pre-school in 1999, they were unable to be
accommodated due to a lack of funds and physical space.
In
the beginning of 1999, a very generous donation was made by D.G. Murray Trust to the Deaf
Child Centre, which funded the employment of a qualified pre-school teacher and a deaf
signing teacher assistant. The dedication, commitment and enthusiasm displayed by the
pre-school teacher and the assistant resulted in a very successful year, with six of the
children showing sufficient linguistic and cognitive development to be able to
commence with formal primary schooling in January 2000. Throughout the year much emphasis
was placed on linguistic stimulation and development and all children were taught using
sign language as the primary mode of communication.
The
children attending the school are from financially disadvantaged families and hence the
Deaf Child Centre provided transport to and from the school on a daily basis. The majority
of the funding for the transport was donated by a matching grant from a Rotary
Organisation Essen Ost in collaboration with Rotary Le Cap De Tempetes .
For
the past three year a primary objective of the Deaf Child Centre has been to move towards
sustainability of the pre-school. Hence repeated discussions have been held with the
Western Cape Education Department concerning their role in sustaining the school. During
1999, the Deaf Child Centre was very much involved in the Strategic Planning of the
Hearing Impairment Interest Group which was concerned with the re-structuring of the
schools for hearing impaired children in the Western Cape. In November 1999 the Western
Cape Education Department agreed to fund the salaries of three teachers (nursery,
pre-primary and grade 1), a deaf signing assistant and a significant portion of the
transport costs. As a result, in the year 2000, the Deaf Child Centre Junior school will
be able to accommodate 41 hearing impaired children, including eighteen children who have
been attending the school and twenty three children who are currently on the waiting list.
At present the school will function as a satellite school of Mary Kihn School for the
Hearing Impaired. The Deaf Child Centre will continue to provide therapeutic services to
the children.
Although
the Western Cape Education Department has agreed to subsidise the Deaf Child Centre Junior
School, there is no available accommodation for the children and the Deaf Child Centre
together with the Western Cape Education Department are actively seeking a solution.
2.2 HARK PROJECT
In
February 1999, the University of Cape Town and the Commonwealth Society for the Deaf
(London) entered into a three year partnership with the aim of providing a community based
audiology service in the Western Cape. The project referred to as HARK is directed and
co-ordinated by the Deaf Child Centre.
The
Commonwealth Society for the Deaf provided funding for a vehicle fully equipped with
audiological equipment and salaries for two audiologists/speech pathologists for a three
year period.
The
Deaf child Centre has implemented the project within the Primary Health Care Approach and
has adopted a phased in approach, establishing the project in two regions of the Western
Cape, namely the Cape Metropole and the Boland/Overberg regions. Core principles of the
Primary Health Care Approach have been adopted in the establishment of the project.
These include:
· Interdisciplinary and intersectoral collaboration
· Maximum community participation in health and health care services
· Consumer accessibility to health and health services
· Appropriate use of technologies
· Health promotion and prevention of illness and disability
An
advisory committee comprising of members from various sectors has been established and has
been instrumental in determining the vision and objectives of the projects and monitoring
of the progress of the project.
Working
group committees within the Cape Metropole and the Boland/Overberg regions assisted in
determining the sites and nature of the service to be provided at the sites. The project
is established at eleven sites in the two regions. The sites are as follows:
Cape
Metropole
· Blaauwberg (Tableview and Atlantis)
· City of Cape Town (Brown’s Farm)
· Helderberg (Somerset West)
· Oostenberg (Kraaifontein and Kleinvlei)
Boland/Overberg
· Ceres
· Ashton
· Hermanus
· Swellendam
· Grabouw
· Worcester (Eben Donges Hospital)
The
audiology service provided at the sites includes:
· Hearing screening
· Diagnostic audiology
· Hearing aid evaluation and fitting
· Counselling
· Parent training
· Educational support
· Training of other professionals
· Public awareness
In
the past eight months, much progress has been made concerning the establishment of the
project. Collection, storage and analysis of data have been undertaken using the software
package of “Statistica”. This has allowed for quantitative analysis of results
to be undertaken in an effective and rapid manner. Qualitative evaluations of the sites
and the nature of the service provided at the sites are carried out at regular intervals.
Detailed
biannual progress reports on the HARK Project are available from the Deaf Child Centre.
3. STUDENT CLINICAL TRAINING
Clinical
training of IV year Logopaedics students from the University of Cape Town
has continued to play an important role at the Deaf Child Centre. The students are
involved in all aspects of the outpatient clinic and the parent training programme. In
addition III year Logopaedics students (UCT) are involved in elective training in the HARK
Project. The Deaf Child Centre is proving to be a very useful and productive clinical
training site for the students and in turn their contribution to the centre has allowed
for an increased number of children and families to receive a service.
As
from January 2000, students from the University of Stellenbosch studying in the field of
Speech Pathology/Audiology will receive clinical training from the HARK project and will
be based at Eben Donges Hospital- Worcester. In addition they will receive clinical
training in the parent training programme. This will allow for additional children and
their families to receive a service.
4 RESEARCH
Much
research has emanated from the Deaf Child Centre this year, including studies in the
following areas:
· The development of a sign language assessment tool (undergraduate research)
· Measurement of communicative skills in deaf children (undergraduate)
· Intervention in parent training programmes (postgraduate)
· The efficacy of solar powered hearing aids in a developing country
· Sign language impairments in atypical signers
· An objective measure of developmental limb apraxia in deaf signing children
(postgraduate)
· A MSc (Logopaedics) student recently completed a detailed project of a very high
standard, while completing a module in Health Services Management (Community
Health). This project entailed a detailed organisational analysis of the Deaf Child
Centre and has provided much valuable information, which is to be employed
immediately by the Centre with regard to strategic processing.
Research
to be undertaken in the following year includes:
· The study of the role of interpreters in the field of speech pathology/audiology
· The differential diagnosis of Central Auditory Processing Disorders (CAPD),
Attention Deficit Disorder (ADD) and Learning Disabilities (LD)
· The clinical effectiveness of the Developing Screening Tool for screening of the
hearing (0-18 months)
· The development of culturally appropriate assessment tools
· The use of the Communicative Signing Profile (Ogilvy and Fox, 1999) as a
therapeutic tool with deaf signing children
· The measurement of communicative skills in deaf signing children
· The use of visual pictures of fingerspelling in the acquisition of the written word
Much of the research mentioned above involves the collaboration of researchers across
departments and disciplines.
5. STAFF
· Three speech pathologists/audiologists from the University of Cape Town and
Groote Schuur Hospital have continued to provide a part time service to the Centre.
· Three volunteer speech pathologists/audiologists have assisted the centre on a
weekly basis for the past year. Their services provided much assistance and were
greatly appreciated.
· The Deaf Child Centre Pre-School was staffed by a pre-school teacher and a deaf
signing adult which were privately funded.
· Two speech pathologists/audiologists were employed on a full time basis for the
HARK Project and funded by the Commonwealth Society for the Deaf.
6. FUND RAISING
Much effort was placed
on fund raising during the year. This was primarily motivated by the staff at the Deaf
Child Centre. The Development Office at University of Cape Town have forwarded two appeals
for funds on behalf of the HARK Project. Larger donations made to the Deaf Child Centre in
1999 were as follows:
· D.G Murray Trust Fund: R120 000 (used to fund the salaries of the pre-school
teacher and the deaf signing adult)
· Rotary International via Rotary Le Cap Des Tempetes: R107 000 (used to fund the
purchase of audiology equipment including an otoacoustic emission machine,
tympanometer, mould material and hearing aids)
· Rotary Le Cap Des Tempetes (matching grant –Rotary Essen Ost): R40 000 (used
to fund the transport costs for the pre-school children and the conversion of the
container)
· Trenchor Holdings: R10 000 ( used for the transport of parents involved in parent
training programmes and administrative costs for the Deaf Child Centre)
Continued efforts to raise funding will be made in 2000. Further funding is required for:
· The salary of a cultural broker to assist the staff of the HARK Project and the Deaf
Child Centre in the interpreting of linguistic and cultural issues
· Petrol for the HARK vehicles
· The salary of a support teacher for the pre-school and junior school
· Part-time speech pathologist/audiologist to direct and co-ordinate the parent
training programmes offered at the Deaf Child Centre and the eleven sites in the
Cape Metropole and Boland/Overberg Regions
· Funding to construct pre-fabricated classrooms for the Deaf Child Centre
Pre-School and Junior School |
