Background: Research on aspects of neurodevelopment such as feeding and swallowing difficulties in children with Autism Spectrum Disorders (ASD) is limited in low and middle income countries such as South Africa.
Method: A descriptive comparative group design was used to investigate feeding and swallowing difficulties of young children with ASD in comparison to typically developing peers. The Brief Autism Mealtime Behavioural Inventory (BAMBI) was used.
Results: Findings indicated a significant difference in the severity of feeding and swallowing difficulties between the two groups. Difficulties such as food selectivity, sensory processing difficulties, oral-motor difficulties and symptoms of dysphagia were iden- tified. The findings added to the existing global literature on feeding and swallowing difficulties in young children with ASD but provide a unique first perspective on these difficulties in South African children with ASD.
Conclusion: Findings also highlighted the use of the BAMBI as an adjunct clinical tool to encourage comprehensive parental report during feeding assessment in this population. Cultural adaptation of the BAMBI for future use in African countries should be considered. A better local understanding of the parental perspective on the multidimensional nature of the feeding and swallowing difficulties displayed by young children with ASD was obtained.
Keywords: Parent-reported feeding; swallowing difficulties; Autism Spectrum Disorders; South Africa.
To describe the evolution of swallowing and feeding abilities of neonates with hypoxic-ischaemic encephalopathy (HIE) during hospitalisation.Method: A longitudinal cohort study was used. Twenty-nine participants (median age 39.0 weeks [IQR = 2.0 weeks]) with mild (n = 7), moderate (n = 19) and severe (n = 3) HIE were included. Clinical swallowing and feeding assessments were conducted at introduction of oral feeds and at discharge using the Neonatal Feeding Assessment Scale (NFAS). Videofluoroscopic swallow studies (VFSS) supplemented the NFAS before discharge.Result: Approximately two thirds of participants showed symptoms of oropharyngeal dysphagia (OPD) during initial NFAS and VFSS. Significantly fewer OPD symptoms occurred at discharge NFAS (p = 0.004). Endurance during non-nutritive sucking (p < 0.001) and nutritive sucking (p < 0.001) significantly improved. Nine participants (31.0%) demonstrated penetration or aspiration. Most aspiration events were silent (60%). Instrumental assessment identified pharyngeal phase dysphagia more effectively than bedside evaluation. High proportions of participants displayed OPD symptoms regardless of HIE severity. The correlation between OPD severity and the length of hospitalisation (p = 0.052) was not significant.
Conclusion:All grades of HIE should be considered for early intervention by speech-language pathologists before discharge. Findings may be valuable to neonatal feeding teams.
The aim of this article is to compare three subject didactic measuring instruments (the SOM, LEMOSS(II) and LCH questionnaires) with regard to validity. These questionnaires are diagnostic measuring instruments, which teachers can use as an aid in certain didactic situations within the classroom. This includes the specialist planning of a specific learning opportunity, and as point of departure for the discussion of a learner’s learning competency in order to master specific and critical outcomes. High Pearson correlations between the different fields of the three measuring instruments, as well as between the measuring instruments as a whole, were found for grade nine learners in the Tzaneen and Phalaborwa areas. None of the questionnaires can be used as autonomous predictors of respective subject marks. However, the SOM, LEMOSS(II) and LCH questionnaires are diagnostic measuring instruments and therefore it is not of such critical importance for these questionnaires to be extremely accurate predictors of subject marks.
Background. Clear risk profiles of neonates with mild and moderate hypoxic-ischaemic encephalopathy (HIE) are lacking.Objective. To describe and compare factors associated with mild and moderate HIE in South African neonates.Methods. A prospective, comparative design was used to describe factors among South African neonates with mild (n=13) and moderate (n=33) HIE in an urban tertiary academic hospital. HIE diagnosis and encephalopathy grading were conducted using the modified Sarnat stages. Thompson scores were recorded. Participants’ clinical records were reviewed to identify factors. Descriptive data were obtained. Chi-square and Fisher’s exact tests were used to compare categorical data, and Mann-Whitney tests were used to compare continuous data between groups.Results. Significant differences were found between groups’ admission (p<0.001) and highest Thompson scores (p<0.001). The mild group’s APGAR scores were significantly higher than those of the moderate group at five (p=0.012) and ten minutes (p=0.022). Duration of resuscitation (p=0.011) and time to spontaneous respiration (p=0.012) also differed significantly between groups. Significantly more moderate than mild participants received therapeutic hypothermia (TH) (p<0.001).Conclusion. Clinical tests and management factors differed significantly between groups. The findings provided the multidisciplinary team with an increased understanding of the heterogeneous HIE population and add to existing evidence for identifying neonates eligible for TH in resource-limited settings.
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