Department of Audiology, Speech and Language

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    Community service providers' roles in supporting communication disability rehabilitation in Majority World contexts: An example from Ghana
    (International Journal of Speech-Language Pathology, 2019-08-22) Wylie, K.; Davidson, B.; Marshall, J.; Bampoe, J.O.; Amponsah, C.; McAllister, L.
    Purpose: In Majority World countries, where speech-language pathology services are extremely limited, people with communication disabilities (PWCD) may seek help from a range of service providers. This qualitative research aimed to explore the nature of community services offered to people with communication disabilities who seek help in Accra, Ghana. Method: Semi-structured interviews were conducted with nine individuals from three professions: pastors (3), doctors (3), and herbalists (3) exploring services that they may offer to PWCD seeking help. Interviews were analysed using Thematic Network Analysis. Result: Six global themes described beliefs about communication disability, types of intervention, explanations provided to people with communication disabilities, promoting communication, processes for selecting treatments, and links between service providers. Interventions encompassed physical, spiritual, psychosocial and environmental approaches, with the notion of plural beliefs interwoven through a number of themes. Conclusion: In Ghana, and other Majority World contexts, service providers in sectors not commonly associated with communication disability rehabilitation may have important roles to play in supporting people with communication disabilities. Understanding the contributions of other service providers may assist the growing profession of speech-language pathology to collaborate across sectors, to develop specific, culturally responsive approaches to service development.
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    Interregional Newborn Hearing Screening via Telehealth in Ghana
    (Journal of the American Academy of Audiology, 2019-03) Ameyaw, G.A.; Ribera, J.; Anim-Sampong, S.
    BACKGROUND: Newborn hearing screening is a vital aspect of the Early Hearing Detection and Intervention program, aimed at detecting hearing loss in children for prompt treatment. In Ghana, this kind of pediatric hearing service is available at only one health care facility located in the Greater Accra Region. The current practice in effect has virtually cut-off infants in the other regions from accessing hearing screening and other pediatric audiological services. This has prompted a study into alternative methodologies to expand the reach of such services in Ghana. The present study was designed to assess the feasibility of using telehealth to deliver newborn hearing screening across Ghana. PURPOSE: To assess the feasibility of using telehealth to extend newborn hearing screening services across the ten regions of Ghana. RESEARCH DESIGN: A correlational study was designed to determine the extent of association between test results of telehealth and the conventional on-site methods (COMs) for conducting newborn hearing screening. The design also allowed for testing duration between the two methods to be compared. STUDY SAMPLE: Fifty infants from the Brong-Ahafo Regional Hospital (BARH) were enrolled. The infants aged between 2 and 90 days were selected through convenience sampling. There were 30 males and 20 females. PROCEDURE: Newborn hearing screening using distortion product otoacoustic emissions were performed via telehealth. By adopting the synchronous telehealth model, an audiologist located at the Korle-Bu Teaching Hospital conducted real-time hearing screening tests over the internet on infants who were at the BARH. The former and latter hospitals are located in the Greater Accra and the Brong-Ahafo Regions, respectively. As a control, similar hearing screening tests were conducted on the same infants at BARH using the conventional face-to-face on-site hearing screening method. DATA COLLECTION AND ANALYSIS: The test results and testing duration of the telehealth method and the conventional on-site approach were compared and subjected to statistical analysis. Here, the Spearman's correlation coefficient (rs) was used to determine the level of correlation between the test results, whereas the paired t-test statistic was used to test the level of significance between the testing duration of the two methods. RESULTS: Analysis of the test results showed a significantly high positive correlation between the telehealth and the COMs (rs = 0.778, 0.878, 0.857, 0.823, p < 0.05 @ 2.0, 3.0, 4.0, and 5.0 kHz respectively). Also, the difference in testing duration of the two methods was not statistically significant [t(99) = 1.309, p > 0.05]. The mean testing duration (in seconds) of telehealth was 27.287 (standard deviation = 27.373) and that of the COM was 24.689 (standard deviation = 27.169). CONCLUSION: The study showed the feasibility of establishing an interregional network of newborn hearing screening services across Ghana using telehealth. It is more efficient to deploy telehealth for pediatric hearing services than to have patients travel many hours to the Greater Accra Region for similar services. Poor road network, high transportation costs, and bad weather conditions are a few of the reasons for avoiding long distance travel in Ghana.
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    Development of a Language-Independent Functional Evaluation
    (Archives of Physical Medicine and Rehabilitation, 2009-12) Haig, A.J.; Jayarajan, S.; Maslowski, E.; Yamakawa, K.S.; Tinney, M.; Beier, K.P.; Juang, D.; Chan, L.; Boggess, T.; Loar, J.; Owusu-Ansah, B.; Kalpakjian, C.
    Haig AJ, Jayarajan S, Maslowski E, Yamakawa KS, Tinney M, Beier KP, Juang D, Chan L, Boggess T, Loar J, Owusu-Ansah B, Kalpakjian C. Development of a language-independent functional evaluation. Objective: To design, validate, and critique a tool for self-report of physical functioning that is independent of language and literacy. Design: Software design and 2 prospective trials followed by redesign. Setting: United States and African university hospitals. Participants: Outpatient and inpatient competent adults with diverse physical impairments. Interventions: (1) Software design process leading to a Preliminary Language-Independent Functional Evaluation (Pre-L.I.F.E.); (2) patient surveys using a printed Pre-L.I.F.E. and a computer-animated Pre-L.I.F.E. tested in random order, followed by a questionnaire version of the standard Barthel Index; and (3) software redesign based on objective and qualitative experiences with Pre-L.I.F.E. Main Outcome Measures: Validation of the general concept that written and spoken language can be eliminated in assessment of function. Development of a refined Language-Independent Functional Evaluation (L.I.F.E.). Results: A viable Pre-L.I.F.E. software was built based on design parameters of the clinical team. Fifty Americans and 51 Africans demonstrated excellent (Cronbach α>0.8 Americans) and good (α>.425 Africans) reliability. In general, the relations between Pre-L.I.F.E. and Barthel scores were excellent in the United States (interclass correlation coefficient for stair climbing, .959) but somewhat less good in Africa, with elimination functions very poorly related. The computer-animated Pre-L.I.F.E. was faster and trended to be more reliable than the printed Pre-L.I.F.E. in both the United States and Africa. Redesign meetings corrected statistical and qualitative challenges, resulting in a new tool, the L.I.F.E. Conclusions: Literacy and language translation can be eliminated from some aspects of functional assessment. The new L.I.F.E., based on solid empirical evidence and design principles, may be a practical solution to assessment of function in the global culture. © 2009 American Congress of Rehabilitation Medicine.