Skip to main content

Severe Communication Disabilities in South Africa: Challenges and Enablers

  • Chapter
  • First Online:
Inclusion, Disability and Culture

Part of the book series: Inclusive Learning and Educational Equity ((ILEE,volume 3))

Abstract

Persons with severe communication disabilities in South Africa experience many barriers to their inclusion in society. These barriers occur across contexts and within all levels of the individual’s family and community life. Congruent with the current models of disability, effective and sustainable communication intervention requires a broad systemic and context-relevant approach that addresses the interaction between individual and environment. This chapter will identify the enablers and barriers to inclusion of people with severe communication disabilities in the South African context within different levels of the ecology. Augmentative and Alternative Communication (AAC) intervention as one method to increase levels of engagement and participation for this group of individuals will be discussed. Reflection on the context-relevant practices and considerations for change across different levels of the ecology to ensure feasible, versatile, and sustainable AAC intervention will be highlighted. These include, but are not limited to, adaptations, the cultural appropriateness of graphic symbols used, the cultural and linguistic competence of the professionals who work with families from diverse backgrounds, as well as availability and provision of technology (in particular speech-generating devices).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • African National Congress. (1993). A bill of rights for a new South Africa. Retrieved from http://www.anc.org.za/show.php?id=231

  • Alant, E. (2005a). AAC technology for development. In E. Alant & L. L. Lloyd (Eds.), Augmentative and alternative communication and severe disabilities: Beyond poverty (pp. 192–220). London: Whurr.

    Google Scholar 

  • Alant, E. (2005b). Intervention issues. In E. Alant & L. L. Lloyd (Eds.), Augmentative and alternative communication and severe disabilities: Beyond poverty (pp. 2–9). London: Whurr.

    Google Scholar 

  • Alant, E. (2005c). Support-based AAC intervention. In E. Alant & L. L. Lloyd (Eds.), Augmentative and alternative communication and severe disabilities: Beyond poverty (pp. 155–191). London: Whurr.

    Google Scholar 

  • Alant, E., Du Plooy, A., & Dada, S. (2007). The impact of visual sequencing of graphic symbols on the sentence construction of children who have acquired language. The South African Journal of Communication Disorders, 54, 105–110.

    Google Scholar 

  • Alant, E., Kolatsis, A., & Lilienfeld, M. (2010). The effect of sequential exposure of colour conditions on time and accuracy of graphic symbol location. Augmentative and Alternative Communication, 26, 41–47.

    Article  Google Scholar 

  • American Speech-Language-Hearing Association. (2015). AAC: More than three decades of growth and development. Retrieved from http://www.asha.org/public/speech/disorders/AACThreeDecades/

  • Anderson, K. L., Balandin, S., & Stancliffe, R. J. (2016). “It’s got to be more than that”. Parents and speech-language pathologists discuss training content for families with a new speech generating device. Disability and Rehabilitation. Assistive Technology, 11(5), 375–384. doi:10.3109/17483107.2014.967314.

    Google Scholar 

  • Balcazar, F. E., Suarez-Balcazar, Y., & Taylor-Ritzler, T. (2009). Cultural competence: Development of a conceptual framework. Disability and Rehabilitation, 31(14), 1153–1160.

    Article  Google Scholar 

  • Basson, M., & Alant, E. (2005). The iconicity and ease of learning of picture communication symbols: A study with Afrikaans-speaking children. South African Journal of Communication Disorders, 52, 4–12.

    Google Scholar 

  • Baxter, S., Enderby, P., Evans, P., & Judge, S. (2012). Barriers and facilitators to the use of high-technology augmentative and alternative communication devices: A systematic review and qualitative synthesis. International Journal of Communication Disorders, 47(2), 115–129. doi:10.1111/j.1460-6984.2011.00090.x.

    Article  Google Scholar 

  • Betancourt, J. R., Green, A. R., Carrillo, J. E., & Annaneh-Firembong, O. (2003). Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports, 118(4), 293–302.

    Article  Google Scholar 

  • Beukelman, D. R., & Mirenda, P. (2013). Augmentative and alternative communication: Supporting children and adults with complex communication needs (4th ed.). Baltimore: Paul H. Brookes.

    Google Scholar 

  • Biegon, J. (2011). The promotion and protection of disability rights in the African human rights system. In I. Grobbelaar-du Plessis & T. van Reenen (Eds.), Aspects of disability law in Africa (pp. 231–260). Pretoria: Pretoria University Law Press.

    Google Scholar 

  • Binger, C., Kent-Walsh, J., Berens, J., Del Campo, S., & Rivera, D. (2008). Teaching Latino parents to support the multi-symbol message productions of their children who require AAC. Augmentative and Alternative Communication, 24(4), 323–338. doi:10.1080/07434610802130978.

    Article  Google Scholar 

  • Blackstone, S. W., Williams, M. B., & Wilkins, D. P. (2007). Key principles underlying research and practice in AAC. Augmentative and Alternative Communication, 23(3), 191–203. doi:10.1080/07434610701553684.

    Article  Google Scholar 

  • Blake Huer, M., Parette, H. P., & Saenz, T. I. (2001). Conversations with Mexican Americans regarding children with disabilities and augmentative and alternative communication. Communication Disorders Quarterly, 22(4), 197–205.

    Article  Google Scholar 

  • Bornman, J., & Alant, E. (2002). Community nurses’ perceptions of and exposure to children with severe disabilities and their primary caregivers. Health SA, 7(3), 32–55.

    Google Scholar 

  • Bornman, J., & Donohue, D. K. (2013). South African teachers’ attitudes toward learners with barriers to learning: Attention-deficit and hyperactivity disorder and little or no functional speech. International Journal of Disability, Development and Education, 60(2), 85–104.

    Article  Google Scholar 

  • Bornman, J., Alant, E., & Du Preez, A. (2009). Translucency and learnability of Blissymbols in Setswana-speaking children: An exploration. Augmentative and Alternative Communication, 25(4), 287–298.

    Article  Google Scholar 

  • Brekke, K. M., & Von Tetzchner, S. (2003). Co-construction in graphic language development. In S. Von Tetzchner & N. Grove (Eds.), Augmentative and alternative communication: Developmental issues (pp. 176–210). London: Whurr.

    Google Scholar 

  • Camphina-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13(3), 181–184.

    Article  Google Scholar 

  • Carlhed, C., Björck-Åkesson, E., & Granlund, M. (2003). Parent perspectives on early intervention: The paradox of needs and rights. The British Journal of Developmental Disabilities, 49, 69–80.

    Article  Google Scholar 

  • Dada, S., & Alant, E. (2001). Teachers’ attitudes towards learners’ with little or mo functional speech using two AAC devices. South African Journal of Education, 21(2), 199–203.

    Google Scholar 

  • Dada, S., & Alant, E. (2002). A comparative study of the attitudes of teachers at special and educationally inclusive schools towards learners with little or no functional speech using communication devices. South African Journal of Education, 22(3), 213–218.

    Google Scholar 

  • Dada, S., & Alant, E. (2009). The effect of aided language stimulation on vocabulary acquisition in children with little or no functional speech. American Journal of Speech-Language Pathology, 18(1), 50–64.

    Article  Google Scholar 

  • Dada, S., Huguet, A., & Bornman, J. (2013). The iconicity of picture communication symbols for children with English additional language and mild intellectual disability. Augmentative and Alternative Communication, 29(4), 360–373. doi:10.3109/07434618.2013.849753.

    Article  Google Scholar 

  • Davis, R. (2013). SA’s shifting language landscape. Retrieved from http://www.dailymaverick.co.za/article/2013-04-24-sas-shifting-language-landscape/#.Ujv9KX_4KqD

  • De Klerk, H. M., Dada, S., & Alant, E. (2014). Children’s identification of graphic symbols representing four basic emotions: Comparison of Afrikaans-speaking and Sepedi-speaking children. Journal of Communication Disorders, 52, 1–15. doi:10.1016/j.jcomdis.2014.05.006.

    Article  Google Scholar 

  • De Villiers, A. J. (2015). Stories of being back at school following traumatic brain injury (TBI): The experiences of children, their parents and educators. Unpublished master’s thesis, University of Cape Town, South Africa.

    Google Scholar 

  • Department of Education. (2005). Conceptual and operational guidelines for the implementation of inclusive education: Special schools as resource centres. Pretoria: Department of Education. Retrieved from http://www.education.gov.za/LinkClick.aspx?fileticket=wHOV7lRtQlA=

  • Department of Education. (2007). Guidelines to ensure quality education and support in special schools and special school resource centres. Pretoria: Department of Education. Retrieved from http://www.google.co.za/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CB8QFjAA&url=http://www.thutong.doe.gov.za/resourcedownload.aspx?id=37716&ei=NYaOVbjWOOKa7gbF1YP4DA&usg=AFQjCNGnk392PP1WTa_kzhnTQzQC-VJavA&sig2=0s0vUo9xbff2zgsIy7gs2Q

  • Department of Education. (2010). Guidelines for inclusive teaching and learning. Pretoria: Department of Education.

    Google Scholar 

  • Department of Health. (2000). Rehabilitation for all. National rehabilitation policy. Pretoria: Department of Health.

    Google Scholar 

  • Emmett, T. (2005). Disability and poverty. In E. Alant & L. L. Lloyd (Eds.), Augmentative and alternative communication and severe disabilities: Beyond poverty (pp. 68–94). London: Whurr.

    Google Scholar 

  • Gevarter, C., O’Reilly, M. F., Rojeski, L., Sammarco, N., Lang, R., Lancioni, G. E., & Sigafoos, J. (2013). Comparing communication systems for individuals with developmental disabilities: A review of single-case research studies. Research in Developmental Disabilities, 34(12), 4415–4432. doi:10.1016/j.ridd.2013.09.017.

    Article  Google Scholar 

  • Grice, P. (1975). Logic and conversation. In P. Cole & J. Morgan (Eds.), Syntax and semantics. 3: Speech acts (pp. 41–58). New York: Academic.

    Google Scholar 

  • Grobbelaar-du Plessis, I., & van Eck, S. (2011). Protection of disabled employees in South Africa: An analysis of the constitutions and labour legislation. In I. Grobbelaar-du Plessis & T. van Reenen (Eds.), Aspects of disability law in Africa (pp. 231–260). Pretoria: Pretoria University Law Press.

    Google Scholar 

  • Hanley, J. (1999). Beyond the tip of the iceberg: Five stages toward cultural competence. Reaching Today’s Youth, 3(2), 9–12.

    Google Scholar 

  • Hanson, M. J., Wolfber, P., Zercher, C., Morgan, M., Gutlerrez, S., Barnwell, D., & Beckman, P. (1998). The culture of inclusion: Recognizing diversity at multiple levels. Early Child Research Quarterly, 13(1), 185–209.

    Article  Google Scholar 

  • Harty, M., Alant, E., & Opperman, S. (2002). Adolescents: Typically developing siblings and siblings with severe disabilities. Social Work, 38(1), 62–70.

    Google Scholar 

  • Harty, M., Alant, E., & Uys, C. J. E. (2007). Maternal self-efficacy and maternal perception of child language competence in pre-school children with a communication disability. Child: Care, Health and Development, 33(2), 144–154.

    Google Scholar 

  • Haupt, L., & Alant, E. (2002). The iconicity of picture communication symbols for rural Zulu children. The South African Journal of Communication Disorders, 49, 40–49.

    Google Scholar 

  • Helander, E. (2003). A critical review of the international classification of functioning (ICF). Paper presented at Bucharest, Romania. Retrieved from http://www.einarhelander.com/critical-review

  • Herold, M., Alant, E., & Bornman, J. (2008). Typing speed, spelling accuracy and the use of word prediction. South African Journal of Education, 28, 117–134.

    Google Scholar 

  • Hershberger, D. (2011). Mobile technology and AAC Apps from an AAC developer’s perspective. Perspectives on Augmentative and Alternative Communication, 20(1), 28–33. doi:10.1044/aac20.1.28.

    Article  Google Scholar 

  • Horn, T. (2014). Children’s attitudes towards interaction with an unfamiliar peer with little or no functional speech: Comparing high- and low-technology devices. Unpublished master’s thesis, University of Pretoria, South Africa.

    Google Scholar 

  • Human Rights Watch. (2015). “Complicit in exclusion”: South Africa’s failure to guarantee an inclusive education for children with disabilities. Retrieved from https://www.hrw.org/report/2015/08/18/complicit-exclusion/south-africas-failure-guarantee-inclusive-education-children

  • Johnson, J. M., Inglebret, E., Jones, C., & Ray, J. (2006). Perspectives of speech language pathologists regarding success versus abandonment of AAC. Augmentative and Alternative Communication, 22(2), 85–99. doi:10.1080/07434610500483588.

    Article  Google Scholar 

  • Joseph, L., & Alant, E. (2000). Strangers in the house? Communication between mothers and their hearing impaired children who sign. The South African Journal of Communication Disorders, 47, 15–24.

    Google Scholar 

  • Kagawa-Singer, M., & Chung, X. (1987). Model for culturally-based care. Journal of Medical Education, 55, 200–203.

    Google Scholar 

  • Kathard, H., & Pillay, M. (2013). Promoting change through political consciousness: A South African speech-language pathology response to the world report on disability. International Journal of Speech-Language Pathology, 15(1), 84–89.

    Article  Google Scholar 

  • Kijak, R. J. (2011). A desire for love: Considerations and sexuality and sexual education of people with intellectual disability in Poland. Disability and Sexuality, 29, 65–74.

    Article  Google Scholar 

  • Koppenhaver, D. A. (2000). Literacy in AAC: What should be written on the envelope we push? Augmentative and Alternative Communication, 16, 270–279.

    Article  Google Scholar 

  • Leavitt, R. L. (2002). Developing cultural competence in a multicultural world. Part I and 2. Physical Therapy, 10, 36–47.

    Google Scholar 

  • Lilienfeld, M., & Alant, E. (2005). The social interaction of an adolescent who uses AAC: The evaluation of a peer-training program. Augmentative and Alternative Communication, 21(4), 278–294.

    Article  Google Scholar 

  • Maguvhe, M. O. (2014). Augmentative and alternative communication: Requirements for inclusive educational interventions. International Journal of Educational Sciences, 7(2), 253–260.

    Google Scholar 

  • Mall, S., & Schawartz, L. (2012). Sexuality disability and human rights: Strengthening health care for disabled people. South African Medical Journal, 112, 792–790.

    Article  Google Scholar 

  • Maxwell, G., & Granlund, M. (2011). How are conditions for participation expressed in education policy documents? A review of documents in Scotland and Sweden. European Journal of Special Needs., 26(2), 251–272.

    Article  Google Scholar 

  • McCauley, D., Gorter, J. W., Russell, D. J., Rosenbaum, P., Law, M., & Kertoy, M. (2013). Assessment of environmental factors in disabled children 2–12 years: Development and reliability of the Craig Hospital inventory of environmental factors (CHIEF) for children-parent version. Child: Care, Health and Development, 39, 337–344.

    Google Scholar 

  • McCord, M. S., & Soto, G. (2004). Perceptions of AAC: An ethnographic investigation of Mexican-American families. Augmentative and Alternative Communication, 20(4), 209–227.

    Article  Google Scholar 

  • McLachlan, M., & Schwartz, L. (2009). Disability and international development: Towards inclusive global health. New York: Springer.

    Book  Google Scholar 

  • McNaughton, D., & Light, J. (2013). The iPad and mobile technology revolution: Benefits and challenges for individuals who require augmentative and alternative communication. Augmentative and Alternative Communication, 29(2), 107–116.

    Article  Google Scholar 

  • Milberger, S., Israel, N., LeRoy, B., Martin, A., Potter, L., & Patchak-Schuster, P. (2003). Violence against women with physical disabilities. Violence and Victims, 18, 581–591.

    Google Scholar 

  • Mpofu, E., Ukasoanya, G., Mupowase, A., Harley, D., Charema, J., & Nthinds, K. (2011). Counseling people with disabilities. In E. Mpofu (Ed.), Counseling people of African ancestry (pp. 294–309). Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • Mueller-Johnson, K., Eisner, M., & Obsuth, I. (2014). Sexual victimisation of youth with a physical disability: An examination of prevalence rates and risk and protective factors. Journal of Interpersonal Violence, 29(17), 3180–3206.

    Article  Google Scholar 

  • Opperman, S., & Alant, E. (2003). The coping response of the adolescent siblings of children with severe disabilities. Disability and Rehabilitation, 25(9), 441–454.

    Article  Google Scholar 

  • Parette, P., Blake Huer, M., & Wyatt, T. A. (2002). Young African American children with disabilities and augmentative and alternative communication issues. Early Childhood Special Education, 29(3), 201–206.

    Article  Google Scholar 

  • Phew Research Centre. (2015). Cell phones in Africa: Communication lifeline. Retrieved from http://www.pewglobal.org/2015/04/15/cell-phones-in-africa-communication-lifeline/

  • Pickl, G. (2011). Communication intervention in children with severe disabilities and multilingual backgrounds: Perceptions of pedagogues and parents. Augmentative and Alternative Communication, 27(4), 229–244.

    Article  Google Scholar 

  • Pillay, M., & Kathard, H. (2015). Decolonizing health professionals’ education. African Journal of Rhetoric, 7, 193–227.

    Google Scholar 

  • Sanders, D., & Chopra, M. (2006). Key challenges to achieving health for all in a inequitable society: The case of South Africa. American Journal of Public Health, 96, 73–79.

    Article  Google Scholar 

  • Simeonsson, R. J. (2006). Classification of communication disabilities in children: Contribution of the international classification of functioning, disability, and health. Geneva: WHO.

    Google Scholar 

  • Simeonsson, R. J. (2009). ICF-CY: A universal tool for documentation of disability. Journal of Policy and Practice in Intellectual Disabilities, 6(2), 70–72.

    Article  Google Scholar 

  • Slabbert, S., & Finlayson, R. (2000). “l’m a cleva!”: The linguistic makeup of identity in a South African urban environment. International Journal of the Sociology of Language, 144(1), 119–135. doi:10.1515/ijsl.2000.144.119.

    Article  Google Scholar 

  • Smith, M. M., & Connolly, I. (2008). Roles of aided communication: Perspectives of adults who use AAC. Disability and Rehabilitation, 3(5), 260–273. doi:10.1080/17483100802338499.

    Article  Google Scholar 

  • Soto, G., & Yu, B. (2014). Considerations for the provision of services to bilingual children who use augmentative and alternative communication. Augmentative and Alternative Communication, 30(1), 83–92. doi:10.3109/07434618.2013.878751.

    Article  Google Scholar 

  • South African Goverment. (1996). Constitution of the Republic of South Africa, Chapter 2: Bill of rights. Retrieved from http://www.gov.za/documents/constitution/chapter-2-bill-rights, 28 August 2015.

  • Statistics South Africa. (2011). Midyear population estimates. Pretoria: Statistics South Africa.

    Google Scholar 

  • Statistics South Africa. (2013). Statistical release P0302: Midyear population estimates 2013. Retrieved from http://www.statsa.gov.za/publications/P0302/P03022013.pdf

  • Stobbart, C., & Alant, E. (2008). Home-based literacy experiences of severely to profoundly deaf preschoolers and their hearing parents. Journal of Developmental and Physical Disabilities, 20(2), 139–153.

    Article  Google Scholar 

  • Tervalon, M., & Murray-Garcia, J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), 117–125.

    Article  Google Scholar 

  • Thistle, J. J., & Wilkinson, K. M. (2015). Building evidence-based practice in AAC display design for young children: Current practices and future directions. Augmentative and Alternative Communication, 31(2), 124–136. doi:10.3109/07434618.2015.1035798.

    Article  Google Scholar 

  • Tönsing, K. M. (2015). Supporting the production of graphic symbol combinations by children with limited speech: A comparison of two AAC systems. Journal of Developmental and Physical Disabilities. Early Online, 1–25.

    Google Scholar 

  • Tönsing, K. M., & Dada, S. (2015, November). The implementation of augmentative and alternative communication aids in schools for learners with special educational needs. Poster presented at the annual SASLHA/SAAA/ENT Conference, Durban, South Africa.

    Google Scholar 

  • Tönsing, K. M., Alant, E., & Lloyd, L. L. (2005). Augmentative and alternative communication. In E. Alant & L. L. Lloyd (Eds.), Augmentative and alternative communication and severe disabilities: Beyond poverty (pp. 30–67). London: Whurr.

    Google Scholar 

  • Tregenna, F. (2012). What are the distributional implications of halving poverty in South Africa when growth alone is not enough? Applied Economics, 44, 2577–2596.

    Article  Google Scholar 

  • United Nations. (1989). Convention on the rights of the child. Annual Review of Population Law, 16, 485–501.

    Google Scholar 

  • United Nations Educational, Scientific and Cultural Organization (UNESCO). (2006). EFA global monitoring report: Strong foundations: Early childhood care and education. Paris: UNESCO.

    Google Scholar 

  • Van Niekerk, K., & Tönsing, K. (2015). Eye gaze technology: A south African perspective. Disability and Rehabilitation: Assistive Technology, 10(4), 340–346. doi:10.3109/17483107.2014.974222.

    Article  Google Scholar 

  • Von Tetzchner, S., & Grove, N. (2003). The development of alternative language forms. In S. Von Tetzchner & N. Grove (Eds.), Augmentative and alternative communication: European perspectives (pp. 1–27). London: Whurr.

    Google Scholar 

  • Walker, S. P., Wachs, T. D., Gardner, J. M., Lozoff, B., Wasserman, G. A., Pollitt, E., & Carter, J. A. (2007). International child development steering group child development: Risk factors for adverse outcomes in developing countries. The Lancet, 369(9556), 145–157.

    Article  Google Scholar 

  • Watermeyer, B., & Kathard, H. (2015). To be or not to be: stuttering and the human costs of being “un-disabled”. International Journal of Speech-Language Pathology. Early Online, 1–9. doi:10.3109/17549507.2015.1060528

  • World Bank. (2015a). World development indicators: Children environment and land use. Retrieved from http://wdi.worldbank.org/table3.1

  • World Bank. (2015b). South Africa. Retrieved from http://data.worldbank.org/country/south-africa

  • World Health Organization (WHO). (2001). International classification of functioning, disability, and health. Geneva: World Health Organization.

    Google Scholar 

  • World Health Organization (WHO). (2007). International classification of functioning, disability, and health for children and youth (ICF-CY). Geneva: World Health Organization.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shakila Dada .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Dada, S., Kathard, H., Tönsing, K., Harty, M. (2017). Severe Communication Disabilities in South Africa: Challenges and Enablers. In: Halder, S., Assaf, L. (eds) Inclusion, Disability and Culture. Inclusive Learning and Educational Equity, vol 3. Springer, Cham. https://doi.org/10.1007/978-3-319-55224-8_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-55224-8_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-55223-1

  • Online ISBN: 978-3-319-55224-8

  • eBook Packages: EducationEducation (R0)

Publish with us

Policies and ethics