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Augmentative and alternative communication (AAC) can enhance children’s communication and is recommended to be introduced as soon as problems are identified. The aim of this interview study was to investigate how parents perceive the ComAlong Toddler intervention offered to parents of children with communication difficulties early in the diagnostic process. ComAlong Toddler consists of a 5-session, group-based, parental course, and two home visits that focus on responsive communication, enhanced milieu teaching, and multimodal AAC. Interviews were conducted 1 year after the intervention with 16 parents who had attended ComAlong Toddler. The data were analyzed through qualitative content analysis, resulting in four categories: (a) Development for us and the child, (b) acquiring useful tools, (c) useful learning strategies, and (d) benefits and challenges regarding intervention structure. Findings suggest that parents of toddlers with language or communication disorders learned and appreciated responsive communication and enhanced milieu teaching. All had used multimodal AAC and described its benefits. Parents emphasized the value of learning from other parents as well as from a speech-language pathologist who engaged with their child in the home environment. Parents suggest an enhanced family focus as a potential improvement.

Background: South Africa presents with high preterm birth (PTB) and low birth weight (LBW) rates (14.17%). Numerous conditions characterised by language impairment are associated with LBW and/or PTB. Speech-language therapists may fail to identify older children whose language impairment may have originated from LBW and/or PTB. Objective: To describe the frequency of LBW and/or PTB, in comparison with full-term birth, and associated conditions in children at an early communication intervention (ECI) clinic. Methods: Retrospective data of 530 children aged 3–74 months were analysed, with 91.9% presenting with language impairment. Results: Almost 40% had LBW and/or PTB, and late PTB was the largest category. Factors associated with LBW and/or PTB were prenatal risks, including small-for-gestational age, perinatal risks, including caesarean section, and primary developmental conditions. Secondary language impairment was prevalent, associated with genetic conditions and global developmental delay. Conclusion: The frequency of LBW and/or PTB was unexpectedly high, drawing attention to the origins of language impairment in almost 40% of the caseload at the ECI clinic.

Based on clinical observations, case finding for early communication intervention service delivery in rural areas, such as Ditsobotla sub-district, is limited. The study described the identification process used for infants and young children at risk for communication delay and disorders as part of a proposed incremental implementation of early communication intervention services within the existing primary healthcare package. A descriptive survey design was followed. A rating scale was utilized and interviews were conducted with 20 randomly selected primary healthcare personnel and eight primary healthcare programme managers in Ditsobotla sub-district in North West province. The aims were to describe the early identification methods/processes, resources and limitations and provide guidelines to introduce early communication intervention services in a rural community. The results indicated that the identification process was limited. An incremental implementation of the different early communication intervention functions within the primary health care package appears feasible. Implications of the findings may be applied to initiate early communication intervention services, based on integrated teamwork, in a rural district in South Africa.

The aim of the article is to describe the communication development of a child with Fetal Retinoid syndrome (FRS) from six months to seven years of age. Little is known about this rare acquired syndrome and its long-term implications, especially on a child's communication development. A descriptive, ex post facto research design was used to study the participant's communication development from 1996 when the family enrolled in an early communication intervention programme. Annual serial assessments of the participant and her family were conducted and the data were stored in a research database after each assessment. The results are described according to a 4-level assessment framework and indicated consistent, but moderate to minor delays in the participant's communication development with a mild hearing loss in the right ear, associated with ear anomalies. Although prenatal exposure to isotretinoin may have serious effects on the unborn fetus and even cause death, the participant did not display all the symptoms of FRS described in the literature. The favorable family circumstances, early commencement of intervention, and supporting early educational environments were protecting factors that could have contributed positively to the participant's communication development. The importance of knowledge accumulation about rare syndromes such as FRS in Communication Pathology and Audiology is discussed and guidelines for early identification, assessment and treatment applicable to the case are proposed as an intervention option.

Since preterm and low birth weight infants display a high-risk for communication disorders or delays, the Neonatal Intensive Care (NICU) provides the earliest opportunity where family-centered early communication intervention (ECI) services can be initiated. Extensive knowledge about high-risk neonates exists, but there appears to be limited knowledge about the emergence of early communication skills in these neonates. The aim of the study was to provide a systematic description of the successive communication developmental steps of a high-risk neonate on a weekly basis, from birth to discharge from a NICU, in order to guide further research on a larger scale. An Α-type single case study design was used to collect prospective data over 14 sessions during the participant's 51-day stay in the NICU. Using a comprehensive data-collection protocol, rich data sets were gleaned over time. The results are described as a chronology of events contributing to the participant's risk status and influencing his early communication development. The successive emergence the different components of language skills in the participant provided new insights into the communication development of a preterm neonate and should be further investigated. An ECI programme and guidelines for implementation in the NICU are discussed as a treatment option.

The early identification of infants with communication disorders or at risk for communication delays is still one of the biggest challenges of early communication intervention (ECI) and threatens to compromise its efficacy. Current approaches to the early identification of young children at risk for communication disorders involve strategies aimed at the identification of general developmental delays and may not be sufficiently sensitive and specific enough to detect the early stages of communication disorders. The risks for mortality and health are often identified early in life, but the concomitant risks for communication disorders in the same young children are frequently not identified at that opportune time. The current study involved a descriptive survey, describing the identification of communication disorders in 153 subjects, whose data was stored in and retrieved from a customized ECI database system. The findings revealed that the subjects were assessed at the average age of 18 months, but that identifications of risk conditions occurred prenatally, at birth, after the perinatal period and later in life. The time of identification related to the different communication disorders identified in the subjects and caregivers played a major role in detecting the first signs of communication disorders in their children. In order to provide a guideline for clinical practice, a transdisciplinary conceptual framework towards a coordinated effort for the early identification of risks for communication disorders in young children is proposed.

Infants and toddlers with special needs within the developing context in South Africa are not currently receiving adequate early communication intervention services. The development of a model for service delivery to this population is imperative for the successful implementation of early communication intervention in the developing context in South Africa. The basic model of early intervention service delivery provides a theoretical basis for early intervention service delivery but has certain limitations when applied to the developing context in South Africa. Community-based intervention is proposed as an avenue for the delivery of health care services within primary health care although constraints in the application of community-based intervention exist. An integrated model of early communication intervention service delivery within community-based intervention is proposed and illustrated by presenting a case example.

Key findings of emergent literacy research conclude that emergent literacy experiences correlate with later reading success and that emergent literacy intervention for children with special needs is essential. As a group with special needs, children with Down syndrome require emergent literacy intervention. They may attain functional literacy skills and their language development determines their reading ability. Speech-language therapists have an important role to play in emergent literacy programme development in South Africa. As a first step towards programme development and emergent literacy intervention goal selection, the aim of this study was to determine the applicability of a self-administered questionnaire to describe parental perceptions and practices regarding the emergent literacy development of their young children with Down syndrome. A quantitative research approach was used within a cross-sectional descriptive survey. Fifteen literate parents, with preschool children with Down syndrome aged between two and five years were selected as participants. Data were collected via email and/or facsimile. The results showed that all participants valued emergent literacy development. They appeared to have knowledge about book-reading but not about the broad spectrum of emergent literacy experiences to which they might expose their children. Participants were actively promoting emergent literacy development of their children, but they had certain needs that could potentially be addressed by speech-language therapists working in early communication intervention. The questionnaire proved to be applicable, but changes are required for application with illiterate parents and those with low literacy skills. Based on the results a framework with guidelines for emergent literacy goal selection is provided.