BackgroundEpidemiological information on childhood disability provides the basis for a country to plan, implement and manage the provision of health, educational and social services for these vulnerable children. There is, however, currently no population-based surveillance instrument that is compatible with the International Classification of Functioning, Disability and Health (ICF), internationally comparable, methodologically sound and comprehensively researched, to identify children under 5 years of age who are living with disability in South Africa and internationally. We conducted a descriptive pilot study to investigate the sensitivity and specificity of translated versions of the Ages and Stages Questionnaire Third Edition (ASQ-III) and the Washington Group on Disability Statistics/UNICEF module on child functioning (WG/UNICEF module) as parent-reported measures. The aim of our study was to identify early childhood disabilities in children aged 24–48 months in a rural area of South Africa, to determine the appropriateness of these instruments for population-based surveillance in similar contexts internationally.MethodsThis study was conducted in the Xhariep District of the Free State Province in central South Africa, with 50 carers whose children were registered on the South African Social Security Agency (SASSA) database as recipients of a grant for one of the following: Care Dependency, Child Support or Foster Care. The researchers, assisted by community healthcare workers and SASSA staff members, conducted structured interviews using forward–backward translated versions of the ASQ-III and the WG/UNICEF module.ResultsBoth measurement instruments had a clinically meaningful sensitivity of 60.0%, high specificity of 95.6% for the ASQ-III and 84.4% for the WG/UNICEF module, and the two instruments agreed moderately (Kappa = 0.6).ConclusionSince the WG/UNICEF module is quicker to administer, easier to understand and based on the ICF, it can be considered as an appropriate parent-reported measure for large-scale, population-based as well as smaller, community-specific contexts. It is, however, recommended that future research and development continues with the WG/UNICEF module to enhance its conceptual equivalence for larger-scale, population-based studies in South Africa and internationally.

Background and aim: The Beery-Buktenica Developmental Test of Visual-motor Integration 6th edition . The latest editions of these three instruments have been released and are now available for use in South Africa. The Beery VMI-6 was published

ABSTRACT

Background and aim: Previous research investigated the latest versions of the Beery-Buktenica Developmental Test of Visual-motor Integration 6 th edition (Beery VMI-6), Development Test of Visual Perception 3 rd edition (DTVP-3) and Test of Visual Perceptual Skills 3 rd edition (TVPS-3) on five-year-old English-speaking children. This study aimed to extend the investigation, to five-year-old Afrikaansspeaking children, and to compare the results to previous findings on English-speaking children of a similar age. Methods: A quantitative, cross-sectional investigation into the visual perception and visual-motor performance of five-year-old Afrikaans-speaking children (n=52) was conducted at Afrikaans Language of Learning and Teaching (ALOLT) schools in Bloemfontein, by using these tests according to the prescribed procedures, in a specific order and with adequate breaks between tests. Results: Both language groups' performance on the Beery VMI-6 and DTVP-3 compared well to the American normative sample, but below average on all the TVPS-3 composite scores. The Beery VMI-6 motor coordination sub-test yielded statistically significant gender differences. No significant language differences were noted in the three tests. A statistically significant difference was identified between form constancy and visual closure sub-tests of the DTVP-3 and the TVPS-3, and when the Beery VMI-6 visual-motor integration sub-test was compared to the DTVP-3copying sub-test. Conclusions: Occupational therapists are encouraged to consider the suitability of the three tests, and further research in this field is recommended.

Tanya la Cock, B OT (UFS) ** Netske Labuschagne, B OT (UFS) ** Wihanli Lindeque, B OT (UFS) ** Annelize Malan, B OT (UFS) ** Carli Viljoen, B OT (UFS) ** ** Students in the Department of Occupational Therapy at the University of the Free State at the time the study was carried out childhood development during critical periods has been shown to positively contribute to socioeconomic aspects relating to human capital 10,15-17. Yet, the exclusive breastfeeding rate (mothers only breastfeeding with no additional feeding) of only 8% in South Africa is the lowest in the world 18 , directly relating to the unacceptably high rate of 47 000 deaths annually among children younger than five years of age 2,18,19. When dealt with in a transdisciplinary team 20 , breastfeeding has the potential to address this population-based crisis of infant mortality. Although the Occupational Therapy (OTy) profession is grounded on the construct of "supporting and promoting health through participation in occupations" 21:S1,22:507 , including the child rearing co-occupation of breastfeeding, Occupational Therapists (OTs) have not traditionally considered it within the scope of their profession to address breastfeeding in the public health sector (PHS). Consequently, the role of the Occupational Therapist (OT) in this regard, as a member of the transdisciplinary team, is not well described in the literature. Globally and nationally, ample guiding initiatives aim to promote breastfeeding with the aim of alleviating child mortality. The 2005

Introduction:The Developmental Test of Visual Perception second Edition (DTVP-2) is frequently used by South African (SA) occupational therapists, despite the suitability of its US-based norms for SA children being questioned, and the 2014 release of the updated DTVP-3. This study investigated the suitability of the DTVP-2 norms for SA English-speaking children aged 5y 6mo-5y 11mo. SA sample scores were compared to American norms. Motor-reduced subtest scores were compared with and without the stop rule. Gender differences were tested. Methods: A quantitative, descriptive study used 134 English speaking children. Motor-enhanced subtests were administered as prescribed, but motor-reduced subtests were administered without the prescribed stop rule, allowing prescribed and adapted scores to be computed. Results: Scores of SA children varied from American norms, especially in visual closure, visual-motor speed and form constancy. Better visual closure scores were obtained when the stop rule was excluded. Boys and girls differed only on figure-ground, where girls scored higher. Conclusion: The DTVP-2 is valuable, but caution is recommended when measuring visual perceptual skills for this age band. Alternative instruments should be used, or local norms, or even more contextually relevant instruments, must be developed locally. At least, occupational therapists should apply US norms with care.

BACKGROUND: The occupation of education prepares children for adulthood. Each child has the right to education, which has the power to end intergenerational cycles of poverty and inequality. However, poor access to and quality of education at early childhood development (ECD) centres continue to prevail in marginalised communities in South Africa AIM: This study aimed to identify the challenges experienced by ECD practitioners and coordinators regarding the quality of their ECD programme METHODS: A qualitative, descriptive enquiry was conducted with six purposively sampled participants from an ECD organisation in South Africa. Semi-structured interviews were conducted with practitioners from under-resourced ECD centres from Bloemfontein, rural towns, and the organisation's ECD coordinator. Audio recordings of the interviews were transcribed verbatim. Deductive content analysis was used to analyse the data RESULTS: Four themes were identified from interview data: (i) teaching and learning; (ii) management and leadership; (iii) ECD environment; and (iv) ECD legislation and policies. Practitioners indicated that they wanted to improve their qualifications and have access to a contextually relevant programme with appropriate resources CONCLUSION: If the expressed challenges were addressed on an inter-professional collaborative platform, the quality of this ECD service could be improved Keywords: Teaching and learning; early childhood development; ECD policy and legislation; ECD practitioners; ECD programme; occupational therapy; South Africa.

Introduction: The transition between inpatient rehabilitation and discharge of survivors of stroke from private rehabilitation services in South Africa is often challenging. After the stroke survivor is discharged, caregivers have an important role as an extension of rehabilitation, although the occupation of caregiving is often unplanned. This study investigated the factors associated with the burden of care experienced by patients' caregivers. Methods: A quantitative descriptive study was conducted with 63 patients and 63 caregivers, using a consecutive, non-randomised sampling method. Patients' Functional Independence Measure (FIM) scores upon discharge were obtained. Telephonic interviews were conducted with the caregivers two months after the patients' discharge, using the Modified Caregiver Strain Index (MCSI) and a demographic data questionnaire to obtain their perceived burden of care. Results: Patients' median FIM score at discharge was 86, indicating that they needed minimal assistance. After discharge, caregivers experienced minimal to moderate strain (burden of care) according to the MCSI score. The associated factors that were identified included financial, physical, psychological and social aspects, of which financial strain was encountered most regularly. Caregivers also seemed to have unbalanced occupational profiles. Conclusions: Better caregiver training and support should be provided by private rehabilitation services for better integration of stroke survivors into the community.