Communication development of high-risk neonates from admission to discharge from a Kangaroo mother care unit

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dc.contributor.advisor Zsilavecz, Ursula Louise en
dc.contributor.advisor Kritzinger, Alta M. (Aletta Margaretha) en
dc.contributor.postgraduate McInroy, Alethea en
dc.date.accessioned 2013-09-07T06:02:30Z
dc.date.available 2008-08-04 en
dc.date.available 2013-09-07T06:02:30Z
dc.date.created 2007-09-05 en
dc.date.issued 2008-08-04 en
dc.date.submitted 2008-07-21 en
dc.description Dissertation (MCommunication Pathology)--University of Pretoria, 2008. en
dc.description.abstract Advances in neonatology have led to increased numbers of high-risk neonates surviving and intensified interest in the developmental outcomes of this population. In the South African context prematurity and low birth weight are the most common causes of death in the perinatal period and the same risk factors that contribute to infant mortality also contribute to the surviving infants’ increased risk for developmental delays. As a result of the interacting biological and environmental risk factors of prematurity, low birth weight, poverty and HIV and AIDS in the South African context Kangaroo Mother Care (KMC) has been developed as best practice to promote infant survival and to facilitate mother-infant attachment. Mother-infant attachment may lead to synchronous interaction patterns between the mother and infant which forms the basis of early communication development. Early communication intervention (ECI) services are recommended as early as possible as high-risk infants are especially at risk for feeding difficulties and communication developmental delays. It is, however, not clear what the content of an ECI programme should be and how it should be implemented according to the changing communication and feeding developmental needs of the infant while receiving KMC. There appears to be a dearth of research on the earliest stages of communication development in high-risk neonates, which should form the foundation of such a programme. A descriptive survey was conducted to describe the development of 25 high-risk infants and their mothers’ changing needs from admission to discharge from a KMC unit. Each participant and mother dyad was followed up over an average of 11 days of data collection with three to four data collection sessions. Data was collected by means of direct observation during routine care-giving activities. The different developmental subsystems of the participants’ feeding, communication, neuro-behavioural organization and mother-neonate interaction were described. The results demonstrated that subtle, but definite changes could be observed in the participants’ development. Development in all the different areas occurred over time as the participants progressed through the three developmental states of the in-turned state, coming-out state and reciprocity state. As the participants progressed during the 11 days of data collection and were increasingly able to attend to their environment, they also developed the ability to regulate and organize their own behaviour in order to develop more complex communication, feeding and interaction skills with their mothers. The functioning of the participants’ sensory systems developed in a specific order namely tactile, auditory and then visual. Although the participants developed consistently throughout their stay in the KMC unit, mother-neonate interaction never reached optimal levels. The importance of an individualized training programme for each mother is reflected in the finding that the neonate’s developmental level and progress needs to be considered when implementing the ECI programme. The need for speech-language therapy involvement in KMC is emphasized in the light of a shortage of practicing speech-language therapists in South Africa. It is therefore imperative that the prevention of communication delays and feeding difficulties in high-risk neonates as well as parent training assume priority. en
dc.description.availability unrestricted en
dc.description.department Speech-Language Pathology and Audiology en
dc.identifier.citation a 2007E796 en
dc.identifier.other /ag en
dc.identifier.upetdurl http://upetd.up.ac.za/thesis/available/etd-07212008-110923/ en
dc.identifier.uri http://hdl.handle.net/2263/26481
dc.language.iso en
dc.publisher University of Pretoria en_ZA
dc.rights © University of Pretoria 2007E796 / en
dc.subject Kangaroo mother care en
dc.subject Mother-infant attachment en
dc.subject Kmc en
dc.subject Mother-infant interaction en
dc.subject Low birth weight en
dc.subject Risk factors en
dc.subject Precursors of communication development en
dc.subject Prematurity en
dc.subject Eci en
dc.subject Early communication intervention en
dc.subject Developmentally appropriate care en
dc.subject UCTD en_US
dc.title Communication development of high-risk neonates from admission to discharge from a Kangaroo mother care unit en
dc.type Dissertation en


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