Caregiver Perceptions of Children who have Complex Communication Needs Following a Home-based Intervention Using Augmentative and Alternative Communication in Rural Kenya: An Intervention Note

Abstract

A high level of unmet communication need exists amongst children with developmental disabilities in sub-Saharan Africa. This study investigated preliminary evidence of the impact associated with a home-based, caregiver-implemented intervention employing AAC methods, with nine children in rural Kenya who have complex communication needs. The intervention used mainly locally-sourced low-tech materials, and was designed to make use of the child's strengths and the caregiver's natural expertise. A pretest-posttest design was used in the study. Data were gathered using an adapted version of the Communication Profile, which was based on the International Classification of Functioning, Disability, and Health (ICF) framework. The non-parametric Wilcoxon signed-rank test was applied to data from the first two sections of the Communication Profile-Adapted. Qualitative analysis was conducted on the final section. The data provided evidence of statistically significant positive changes in caregiver perceptions of communication at the levels of Body Structure and Function, and Activities for Communication. Also, analysis of the Participation for Communication section revealed some expansion to the children's social activities. The potential impact of the home-based intervention would benefit from investigation on a larger scale. Limitations of the study are discussed.

Empowering self-help groups for caregivers of children with disabilities in Kilifi, Kenya: Impacts and their underlying mechanisms

“…Closely connected to this was the caregiver's changing perception of their child's disability and their personal situation. The caregivers perceived their child's disability as less severe, which is consistent with Bunning et al [59], even though no direct intervention was applied to the children. Furthermore, this extended to the caregiver's revised view that there was sufficient time and support to carry out their domestic duties.…”

“…Communication Disability Profile (CDP) [52]: Caregiver perceptions of the severity of their child's disability and extrinsic factors affecting their own capacity for caregiving, were captured. Adapted and shortened for an earlier study (CDP-brief version: see Bunning et al, 2014), it had been translated into Swahili and Giriama (local language) previously. Selected sections focusing on general domains rather than communication-specific content, were used.…”

“…Whilst saturation checks on the analysis of interview data were carried out, limited project resources meant that follow-up interviews could not be planned A lack of tools for measuring impacts that had been standardised on the population meant that quantitative instruments had to be devised for use. Whilst the CDP had been developed in Uganda and used in previous studies in Kenya [59], the MSPSS [53], originally developed in Europe, had to be adapted, translated, back-translated and piloted.…”

Early Intervention and AAC: What a Difference 30 Years Makes

“…Aspects of these issues have been raised in the AAC fi eld in general (e.g., Bunning, Gona, Newton, & Hartley, 2014). Going forward, it will be important to address the roles of more than one language and diverse cultures on the use of AAC for infants and young children.…”

Autism spectrum disorder in sub‐saharan africa: A comprehensive scoping review

“…Eleven intervention studies were identified from SSA, nine from South Africa, one from Kenya, and one from Nigeria. Studies included single subject experimental designs [Akande, ; Travis & Geiger, ], pre‐post quasi‐experimental designs [Akande, ; Bunning, Gona, Newton, & Hartley, ; Pansegrouw & Alant, ; Silver, ], within‐subjects design with repeated measures [Alant et al, ], non‐experimental descriptive group designs of medication use [Louw, Bentley, Sorsdahl, & Adnams, ; Wong et al, ], and one qualitative design [Geils & Knoetze, ]. The sample sizes for experimental studies were very small with eight of the nine non‐pharmacological intervention studies having fewer than 10 participants.…”