3. Electronic Theses and Dissertations (ETDs) - All submissions
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Item Motor development of children attending creches in the Platfontein community(2017) Steinberg, MariamBackground: The early childhood years, is an important period in a person’s formative life. These are the foundational years for development. There are many intrinsic and extrinsic factors that can negatively affect childhood development. Assessing the development of children is important. If a problem is detected, prompt intervention may prevent further impairments. The Platfontein community is a San bushmen community consisting of the !Xun and Khwe tribes. This is a very poor community that faces many challenges. Of these challenges, many have the potential to hinder healthy childhood development. The current level of development of healthy children in the Platfontein community is not known. This was a descriptive cross sectional study. A sample of convenience was used as all children that attended the crèches in the Platfontein community were invited to participate in the study. The objectives of the study were as follows 1) to determine whether the children that attend the crèches in the Platfontein community present with motor developmental delay 2) to determine the demographics (including morbidities) and anthropometric data of the study participants, 3) to determine the level of motor development in children between the ages of three and six years who attended the local crèches in the Platfontein community, 4) to establish the nature of the relationship between the existing morbidities and the motor development of the children attending the crèches in Platfontein and 5) to establish if there was a difference in motor development of children assessed between the two crèches, the two tribes, 6) to compare the motor development of the children attending the crèches in the Platfontein community to that of children in other national or international studies. Methods: The Movement Assessment Battery for Children-2 (M-ABC2®) was administered to determine the motor development of the children attending the !Xun and the Khwe crèches. Demographic and anthropometric data were also collected. Microsoft Office Excel 2007 and the SAS system statistical programme were used to analyse the data. The Fishers exact test was used to compare the morbidities between the two crèches as well as the association between the morbidities and the M-ABC2® percentile rank. The final M-ABC 2® categories were compared using the Chi-square test. A p-value of≤ 0.05 was deemed statistically significant. Results: Demographic information was obtained for 64 participants, anthropometric data for 63 participants and 54 M-ABC-2® were successfully completed. In total 54% (n=29) participants did not have a risk for motor developmental delay, 24% (n=13) were at risk for motor developmental delay and 22% (n= 12) had a definite motor developmental delay. The test result of the manual dexterity subcategory was the task of most concern as 68.5% of the sample scored at or below the 5th percentile of the M-ABC2® manual dexterity components. Statistical analysis revealed no relationship between the following morbidities: malnutrition [p=0.19], stunting [p= 1.00] and a history of Tuberculosis (TB) [p=0.49] and motor development. There was no statistical significant difference between the M-ABC-2® scores of the children attending the Khwe and the !Xun crèches. Comparing these results too other South African studies, this sample scored much lower. Buys (2014) reported that 85% did not have a risk for developmental delay and that 15% were at risk for, or had a developmental delay. Gritzman (2012) reported that 80% did not have a risk for motor developmental delay and that 20% were at risk or impaired. The socio economic statuses of the samples in both studies were of a higher status than those of the Platfontein sample. Comparing the results to Brazilian studies, this sample also scored lower. Valentini et al (2012) reported that 64.2% of children in the study population did not have a risk for developmental delay and that 35, 8% were at risk for or had a developmental delay. Valentini, Clark and Whitall (2014) reported that 63.3% of children in the study population did not have a risk for developmental delay and that 36.7% were at risk for or had a developmental delay Conclusion: There is a motor developmental delay of the children attending the crèches in the Platfontein community as measured by the M-ABC-2® and when compared to national and international studies. An intervention programme is advised.Item Early and subsequent life stress: physiological responses, moderating events and outcome(2015-03-27) Muller, Denise Margaret54 225: crimes against children reported in 2010/2011 28 128: sexual offences 30% of the sexual offences occurred in children younger than ten years. These figures are a stark reminder of the growing number of children who experience deprivation, abuse and maltreatment in South Africa (Unicef, 2013). Although controversy exists with the reporting methods and the accuracy of recall in adult patients, it remains evident that a significant number of female children are sexually abused. Associations between early life stress and later life dysregulation of the hypothalamic-pituitary-adrenal axis hormone, cortisol, and the immune system cytokine, interleukin 6, have been found in adult patients and in animal studies. Importantly, although there is also evidence that early life stress results in later life neurobiological changes, we have to date, no identifiable biological markers to assist with diagnosis or to inform treatment strategies in young children who present with early life stress such as sexual abuse or maternal neglect. Thus, there is a growing imperative to establish whether the potential precursor biomarkers are evident in early in development following adverse life conditions. Therefore the research focus of the thesis was to investigate (1) whether dysregulation of the HPA axis is evident in young children who are exposed to the traumatic stress of abuse, (2) whether there is evidence that inadequate maternal care, during the neonatal stage of development, has an impact of HPA and immune function and consequently onItem The developmental motor outcomes of infants with hypoxic ischaemic encephalopathy II and III between the ages of 12-14 months at Chris Hani Baragwanath academic hospital(2013) Sukha, NeelamThis study determined outcomes for motor developmental delay in infants, 12-14 months, diagnosed with HIE II and III, at Chris Hani Baragwanath Academic Hospital. Twenty nine infants diagnosed with HIE II and nine infants diagnosed with HIE III were assessed using the Peabody Development Motor Scale- 2, at their corrected age. Demographic, antenatal and perinatal factors similar to those in other studies were found for this sample. Infants with HIE III had significantly more developmental delay (p=0.01) than infants with HIE II. Fifty two percent of infants with HIE II had no delay while a 100% of infants with HIE III presented with disability. A greater percentage of infants had delay in fine motor skills. Infants with severe and moderate disabilities were receiving intervention whereas those mild disabilities were often missed in screening clinics. It is vital to ensure these infants are assessed and followed up to remediate difficulties as soon as they arise.Item The influence of household fluidity on the health and well-being of the child(2013) Fleetwood, Stella AngelaResearch indicates that there is a strong association between household composition and household stability, and child well-being. Black South African family life has historically been affected by the social, political and economic pressures of colonialism, the migrant labour system, and Apartheid policies. It has been shown that Black households have been in a constant state of flux as members move between rural and urban households, as well as, within urban environments. This situation of intense household fluidity and household compositional changes continues to persist. High rates of urbanisation, the fluid job market, and fast social change are all associated with high levels of mobility and household compositional change. Kin networks remain a significant informal safety net for households in order to absorb change. The movement of children between family members, or child fostering is an important mechanism for maintaining networks of support. Children are frequently moved between different households in urban areas so as to maximise their care and education. These changes could potentially influence their overall well-being and, in particular, their academic performance.Item Developmental delay in HIV-exposed infants in Harare, Zimbabwe(2013-04-11) Hutchings, JennaThe aim of this cross-sectional study was to determine the difference in development (cognition; receptive and expressive language; and fine and gross motor) of Human Immunodeficiency Virus (HIV) -exposed infected (HEI) infants with the development of HIV-exposed but uninfected (HEU) infants using the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III). Sixty infants were enrolled in the study; 32 (53.33%) HEU infants and 28 (46.67%) HEI infants. The two groups were well-matched for infant demographics, anthropometry at birth, maternal demographics, as well as socioeconomic status. Statistically significant differences were found in anthropometry and development between the HEI and HEU group. The HEI infants had malnutrition, were stunted and had smaller head circumferences than HEU infants. The BSID-III showed that the mean developmental delay for the HEI group was approximately two months below their mean chronological age for all scales (cognitive; receptive and expressive communication; and, fine and gross motor age). The HEI group showed that 64.29% had cognitive delay, 60.71% had language delay and 53.57% had motor delay, all of which was significantly different from the development of the HEU group for all domains (p<0.001). In addition to using the BSID-III, the majority of mothers were able to correctly indicate whether their child was developing at the same, or at a slower rate of development than children of the same age. This study demonstrates that infants who are HIV-exposed and infected are at risk of developmental delay.Item The effect of a two-week sensory diet on infants with Regulatory Sensory Processing Disorder(2013-03-19) Jorge, JacquelineThis research aimed to determine the effect of educating parents on Regulatory Sensory Processing Disorder (RSPD) and implementing an Ayers-SI sensory diet over a two-week period. Twelve infants who met the criteria for RSPD were subdivided into two groups: 7-12 and 13-24 months. The data was obtained from a telephonic interview and completion of the Infant Toddler Symptom Checklist (ITSC). Following the two-week intervention, the ITSC was completed again and results were compared using the Wilcoxin Signed Rank Test. Although the research sample was small, findings indicate that the Ayers-SI sensory diet was effective in reducing signs of fussiness. The research group showed a significant change (p=0.0024) over the two-week period, with a greater change evident in the 7-12 month group. Selfregulation and attachment showed the most significant change. Difficulties with sensory processing for example, tactile, vestibular and auditory sensitivities appeared to persist, indicating a possible need for direct sensory integrative therapy to address them. In addition, the findings indicate that there is a lack of referral for Ayers-SI occupational therapy. This research adds value to the body of research which indicates the need for early intervention for possible prevention of later developmental difficulties.Item A study to evaluate the performance of black South African urban infants on the Bayley Scales of Infant Development III(2012-01-25) Rademeyer, Vanessa Kathleen MaySouth Africa (SA) needs a suitable tool to evaluate child development as no such tool exists at present. Well known standardised tests are designed in First World Countries but pose problems when used on different populations. The Bayley Scales of Infant Development, a tool designed and normed in the United States of America (USA) is considered to be the gold standard in infant assessment. The revised and updated, 3rd edition was published in 2006. No studies have been done on its use on populations other than the USA. The USA and SA populations are very different and therefore may perform differently on developmental tests since previous research has shown that African infants perform better than USA infants. The main aim of this study was to use the Bayley Scales of Infant and Toddler Development III (Bayley-III) to evaluate the performance of a cohort of black urban African infants in South Africa, in an effort to determine whether it is a suitable tool for use on this population. The Hypothesis was that SA and USA children perform similarly on the test. Other objectives included assessing whether gender or anthropometric indicators influence performance. The revised 3rd edition of the Bayley Scales of Infant Development (Bayley-III) was used to assess the performance of 122 black African infants at several urban clinics in Gauteng, South Africa. The sample consisted of infants falling into four age categories; 3, 6, 9 and 12 months. SA scores were compared to USA norms. Scores were compared across age groups, subtests and sex. Height, weight and head circumference was also measured, converted into z-scores and correlated with test scores. Overall the SA mean score was 103.4, which is statistically significantly higher (p=0.0007) than the USA mean of 100.For subtests, the mean score was 99.7 for the cognitive, 106.8 for the language and 103.5 for the motor subtests as opposed to 100 for the USA. Therefore the results of this study showed that SA scores were statistically significantly higher than the USA norms. Gender differences in scores for specific subtests were found, indicating that girls and boys perform differently developmentally at different ages. However this analysis was at subgroup level with individually small numbers and further research is required to investigate this. Anthropometric indicators such as height, weight and head circumference were found to have no significant association with scores on the test, indicating that growth had no effect on development in this population Although the overall SA mean (103. 4) was statistically significantly higher than the USA mean (100), clinically the difference is small when one considers the variability of development. Developmental milestones can be reached within a range of months and can vary considerably. The Bayley-III is therefore a suitable tool to use on this population. More research is recommended to assess a larger more diverse group, including all age groups for which the Bayley-III caters, as well as on all population groups in SA.Item Early childhood care and development: The missing link, a challenge for Swaziland(2008-05-20T13:05:40Z) Ntuli, Zethu EugeniaThis study explored the current practices implemented by Early Childhood Care and Development (ECCD) caregivers / preschool teachers in Swaziland. It further investigated how the lack of an appropriate policy on Early Childhood Care and Development impacted on the delivery of services to the sector. The research was conducted using a qualitative methodology, eliciting responses through semistructured interview schedules. In order to conduct a more in-depth analysis, eight interviews were held at various early childhood care and development sites. The criteria for selection depended on whether the participating caregiver had direct, hands-on experience of the day-to-day care and running of ECCD sites. They also had to be involved in a full-time preschool teaching programme and were purposively selected from the geographical location of Manzini, in Swaziland. The sites could be distinguished into three categories, namely: community (non-profit making), private and church or missionrun centres. The results showed that caregivers implemented diverse and uncoordinated practices and that there was no uniformity in terms of professional training, classroom practice and curriculum application. It was evident that the participants did not link the theory of their training to their practice, leaving gaps in the provision of services and educational programmes to the children. The study concluded that unless the government of Swaziland and the ECCD unit at the national level of Education made a concerted effort to formulate a national ECCD policy, Education for All would remain a pipedream. The study recommended that government should formulate national ECCD policy guidelines to encourage uniformity in practice and provision of ECCD sites. Not only should government accelerate the development of the guidelines but they should also support the caregivers by continuous professional development activities.