Background: This study investigated the impact of an intensive early-intervention programme, the Developmental Resource Stimulation Programme (DRSP), on Down syndrome (DS) children younger than 42 months in the South African context. The DRSP is a unique, child-parent specific, one-on-one, integrated developmental programme for children with Down syndrome from birth to 42 months.Aim: The aim of this study was to investigate the impact of the DRSP on Down syndrome children younger than 42 months in the South African context.Methodology: A non-randomised control group pre-test-post-test design was followed. The Bayley Scales of Infant and Toddler Development, 3 rd edition was used. Thirty children with the general characteristics of DS, specifically Trisomy 21, were included in the study. There were two groups, namely the intervention group (n = 16) and the control group (n = 14) which were studied over a period of six months.Results: This study showed that a specifically designed programme, with participation of a parent, has a positive impact on the development of the child with Down syndrome.Conclusion: Contrary to the existing literature, there were positive changes in the fine-motor development and language of the intervention group overall and in the gross-motor development of children older than 9-months with Down syndrome.

BACKGROUND: Global and national changes in healthcare create challenges in providing suitable and quality fieldwork placements for the skills training of undergraduate health professions students. The department of occupational therapy (OT) at a Higher Education Institute (HEI) in South Africa decided in 2013 to incorporate simulated learning experiences as part of the new curriculum for second-year occupational therapy students. Two staff members of the Department of OT trained by an international institution of higher education in the use of simulation during teaching were involved. The aim of this study was to explore and describe the experiences of those students who had benefitted from simulated learning in the Clinical Skills Unit (CSU) to improve on this method of obtaining clinical assessment skills. METHODS: A qualitative methodology was used to describe the reflections of the second-year occupational therapy students of the years 2013 and 2014 (81 students) on the simulated learning of assessment procedures which took place in the CSU RESULTS: Four themes and ten sub-themes were identified from the content analysis of the reflections, namely (i) personal experience (personal emotions, initial stress, confidence) (ii) Teaching and Learning clinical assessment skills (communication, occupational performance components [OPC] and occupational performance activities [OPA]); (iii) professional skills (therapeutic use of self, cooperative learning) and (iv) benefits and challenges of presenting simulated learning experiences (benefits, criticisms). CONCLUSIONS: Occupational therapy students reported a positive experience and satisfaction with learning from the simulated experiences, which succeeded in creating a "safe" learning environment for them and opportunities to hone their clinical assessment skills prior to their first clinical fieldwork placement. Challenges associated with simulated learning experiences (SLE) were found to be: the need for clearer instructions; the number of assessments covered and the provision of a time frame to complete each task. There was consensual agreement in the department that SLE in the CSU will supplement fieldwork placements and contribute to attainment of assessment skills prior to fieldwork placements. It is recommended that current occupational therapy lecturing staff, trained in the use of simulation techniques, develop a manual for the planning of SLE and present training sessions to other staff. The manual may also be of value to other institutions of higher learning in South Africa. Keywords: Simulated learning experiences, clinical skills learning, undergraduate education

INTRODUCTIONAccording to the literature there are few effective early-intervention programmes for children with developmental problems in South Africa [1][2][3][4] . There is a need to ascertain, not only the effectiveness of an intervention programme, but also, at what age intervention should start, what the duration of the intervention should be, and what the frequency of intervention sessions should be 5 . This study, investigated the impact of the Developmental Resource Stimulation Programme (DRSP) on children with Down syndrome and provided the opportunity to establish the specific duration and frequency of intervention required by children with DS to achieve an occupational performance activity.The DRSP is a unique, child-parent-specific, one-on-one integrated programme for children with DS from birth to 42 months and spans seven age bands 6,7 . It was developed in order for both the parent and child to be actively involved during activity participation at home. The DRSP activities manual is easy to understand and/or read and consists of 85 activities. The activities cover cognitive, language, fine-motor and gross-motor development. The activities also utilise occupations such as play and social participation of the child. The manual consists of detailed sketches, descriptions of occupational activities for participation and clearly stipulates the outcomes (goals) of the programme. The materials used are everyday household objects such as three plastic mugs, four teaspoons and a facecloth. These objects are durable, inexpensive and they do not exclude any socio-economic group 8,9 . It is a systematic programme consisting of exercises and activities designed to address developmental delays experienced by children with DS in different age bands [10][11][12] . It was developed to assist parents of children with DS in developing countries. The development of the programme is described in more detail in the article "The impact of the "Development Resource Stimulation Programme on children with Down syndrome" published in this journal 13 . Background: The duration of an intervention session for an intensive early-intervention programme, the Developmental Resource Stimulation Programme (DRSP), for Down syndrome (DS) children younger than 42 months, was investigated as part of a larger research

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INTRODUCTION: In rural South Africa, inadequately trained Early Childhood Development practitioners and inequity of access have been placed as top priorities to address. Enabling occupation is the primary goal and core competency of occupational therapists and supporting the services of ECD practitioners may address these problems. The Crosstrainer Programme aims to do this by training and equipping ECD practitioners. ECD practitioners were therefore approached to reflect on the occupational enablement through the Cross-trainer Programme METHOD: Demographic questionnaires and semi-structured interviews were utilised. The data were analysed through the cyclical process of coding. RESULTS: Three major themes emerged from the data analysis, namely The Great Imbalance, Enabling Occupation, and Disabling Occupation. The participants expressed the difficulty of fulfilling the need for their services in their communities. The CTP relieves these difficulties and enables the work of ECD practitioners through increased knowledge, confidence, creative alternatives to resources, and guidance in managing their time, incorporating all six enablement foundations. The CTP disables their occupation of work through the language barrier, unclear scaling of the activities, and insufficient involvement. CONCLUSIONS: The CTP enables the occupation of the ECD practitioners and the children. Through translating the programme, adding more activities, and increasing involvement and mentoring, enablement through the CTP will improve.