Handbook of speech-language therapy in sub-Saharan Africa : integrating research and practice

Foreword 1: Regaining a Voice Foreword 2: Revealing the Person Within Foreword 3: My Journey with Aphasia Back to Work Usemaji Aphasia Support Group A Silent Disability “New Normal” My Takeaway Foreword 4: Supporting Children at Risk Foreword 5: Living with Stuttering Foreword 6: The Potential of Rehabilitative Care Experiences at the Centre for Education and Community Based Rehabilitation (CERBBc), North-Eastern DR Congo Alio’s Testimony Introduction Motive History Structure Book Sections Distribution of Chapters Transdisciplinary, Global, and Multi-Level Approach Peer Review, Terminology, and Up-to-Dateness of Data Target Readership Key Subjects Speech-Language Therapy Sub-Saharan Africa History and Status of Speech-Language Therapy in Sub-Saharan Africa Thanks References Contents Authors and Reviewers List of Authors List of Reviewers List of Abbreviations Part I: Introduction: Professionalization 1 Ulrike M. Lüdtke Speech–Language Therapy in Sub-Saharan Africa: The Emergence of a Profession in a Diverse Multilingual and Multicultural Context Abstract Background: All over sub-Saharan Africa (SSA), evidence of the emergence of the profession of speech–language therapy (SLT) can be detected. This development can be illustrated through the availability of SLT in some major cap 2 Karen Wylie, Lindy McAllister, Bronwyn Davidson, and Julie Marshall Speech–Language Therapy in Sub-Saharan Africa: Development and Sustainability of Services for Persons with Communication Disability 3 Julie Marshall, Nana Akua V. Owusu, and Ryann Sowden Maximizing the Benefits and Minimizing the Risks from the Contribution of “Outsiders” to the Development of Services for Persons with Communication Disability in Sub-Saharan Africa 4 Ulrike Schütte, Chantal Polzin, Afizai Vuliva, and Ulrike Lüdtke Clinical Competence of Speech–Language Therapists in Culturally and Linguistically Diverse Contexts: A Qualitative Study of Intercultural Work Experiences Abroad 5 Bea Staley and Emma Shah The History of Speech–Language Therapy in Kenya: A Collective Memory 6 Sylvia Topouzkhanian and Palakiyém Abalo The Development of the Speech–Language Therapy Profession in West Africa: Over 10 Years of Experience 7 Abbie Olszewski, Verena Rossa-Roccor, Veronic Clair, Kate Tairyan, and Erica Frank A Revolution in Training Speech–Language Therapists in Sub-Saharan Countries and Globally 8 Ulrike Lüdtke and Chantal Polzin The Demands of Context: Development of a Relational In Vivo Methodology for Participative Speech–Language Therapy Research in Sub-Saharan Africa 9 Purity M. Nthiga and Eunice A. Nyamasyo Speech–Language Therapy in Kenya: Trends, Challenges, and Opportunities 10 Bea Staley, Ellen Hickey, Rachael Gibson, David Rochus, and Martin Nafukho Obulala Na-maani: Unity Is Strength – Speech–­Language Therapy and Community Engagement in Three Kenyan Communities References 1: Speech-Language Therapy in Sub-Saharan Africa: The Emergence of a Profession in a Diverse Multilingual and Multicultural Context Evidence: Speech–Language Therapy Emerges in Sub-Saharan Africa Needs: The Basics of Africa-Specific Professionalization Chances and Challenges: Cultural Uniqueness in a Global World Excursion in Scientific Theory Establishing Speech–Language Therapy in Sub-Saharan Africa as a Science: The Danger of a Neocolonial Approach Speech–Language Therapy in Sub-Saharan Africa in Crisis: Mismatch Issues in Problem-Solving Speech–Language Therapy in Sub-Saharan Africa in Model Revolution: Emergence of a Genuinely Independent Paradigm Key Concept for the Speech–­Language Therapy Dimension of the Individual Self and Family: Africa-Specific Linguistic Identity Grounded in a Specific Version of Multilingualism Key Concept of the Speech–Language Therapy Dimension of Society: Africa-Specific Cultural and Linguistic Diversity Shaped by Specifics of the Linguistic Market A Key Concept for the Speech–­Language Therapy Dimension of Culture: Africa-Specific Inclusion Tasks: Systematic Establishment of a Sustainable, Multilevel, Cross-Sector Speech–Language Therapy Approach (I) Uniquely Sub-Saharan African Tasks for the Diversity of Persons with Communication Disorders (II) Uniquely Sub-Saharan African Tasks for Future Speech–Language Therapy Practice (III) Uniquely Sub-Saharan African Tasks for Future Speech–Language Therapy Concepts (IV) Uniquely Sub-Saharan African Tasks for Future Speech–Language Theory (V) Uniquely Sub-Saharan African Tasks for a Future Meta-theory of Speech–Language Therapy Opportunities: International Speech–Language Therapy Research Cooperation Within a Global Ethical Framework References 2: Speech-Language Therapy in Sub-Saharan Africa: Development and Sustainability of Services for Persons with Communication Disability Speech–Language Therapy and Rehabilitation Services in SSA SLT Workforce Sustainability Issues in SSA SLT Workforce Availability Accessibility of SLT Services Acceptability of SLT Services Accessibility, Acceptability, and Availability of SLT Services: A Workforce Survey Aim and Objectives Methodology Results Demographics of Respondents Availability Job Availability: Permanent and Full-Time Jobs Service Stability Motivation and Support Factors: Working Alone Motivation and Support Factors: Mentoring Availability and Location Motivation and Support Factors: Strategies for Continuing Professional Development Motivation and Support Factors: Successes and Challenges in Continuing Professional Development Accessibility Structural Barriers: Employment Sector and Service Setting Geographic Barriers: Location of SLT Services Economic Barriers: Fee Structures Acceptability Cultural Distance Multilingualism and African Languages Language of Service Provision Challenges for the Development and Sustainability of Rehabilitation Services for Persons with Communication Disability Embedding SLT and Communication Disability in the Political Agenda Prevention and Intervention Models Committing to the Development of SLT and Community Workers in SSA Ensuring Culturally Relevant Services Limitations Conclusion References 3: Maximizing the Benefits and Minimizing the Risks from the Contribution of “Outsiders” to the Development of Services for Persons with Communication Disability in Sub-Saharan Africa Motive Introduction Background Part 1: A Written Dialogue Between Two Expert Speech–Language Therapists Part 2: Fictitious Case Examples of Insider/Outsider SLT Collaboration A Successful Example of an Outsider Joining an SLT Education Program in Sub-Saharan Africa An Unsuccessful Example of an Outsider Joining a Service Delivery Project in Sub-Saharan Africa A Successful Example of Bringing SLT Students in from a High-Income Country to Volunteer Short Term in a Sub-Saharan African Country An Unsuccessful Example of a Fly-In-Fly-Out (FIFO) Short-Term Project Part 3: Insider/Outsider Research in Uganda Background Methods Results Organizing Theme 1: “Unstable Support” Organizing Theme 2: “Developing Relationships” Organizing Theme 3: “Outgrowing Outsider Contributions” Risks Risks to Persons with Communication Disability Risks to Ugandan Services Risks to Ugandan Professionals Benefits Benefits to Persons with Communication Disability Benefits to Ugandan Services Benefits to Ugandan Professionals Discussion Recommendations and Considerations for Future Insider/Outsider Work References 4: Clinical Competence of Speech-Language Therapists in Culturally and Linguistically Diverse Contexts: A Qualitative Study of Intercultural Work Experiences Abroad Introduction: Service Delivery in Culturally and Linguistically Diverse Contexts Cultural and Linguistic Diversity Due to a Natural Broad Heritage of Indigenous Languages: The Case of Tanzania Cultural and Linguistic Diversity Due to Recent Migratory Movements: The Case of Germany Dealing Appropriately with CLD in the SLT Profession: The Global Perspective Research Findings on Work Stays and Diversity-Sensitive Competences in SLTs Theoretical Background: Diversity-Sensitive Clinical Competence and Its Acquisition Clinical Competences in SLT in CLD Contexts Acquisition of Diversity-Sensitive Clinical Competence Circular Process of Professionalization of SLTs in the CLD Context Constructivist Method: Relational Biographical Self-Reflections Research Questions Research Method and Design Participants Instruments Relational Biographical Self-Reflections for Data Collection Qualitative Content Analysis for Data Analysis Data Collection Husani’s Biographical Self-Reflection Claudia’s Biographical Self-Reflection Data Analysis Results Identification of the Most Relevant Challenging Experiences Gained Through Professional Stays in a Foreign Country Strangeness: “I Am a Stranger!” Heteronomy: “I Am Powerless!” Identity Conflict: “I Am Not Myself!” Professionalization of Diversity-Sensitive Clinical Competence as a Result of Reflecting Challenging Experiences in a Foreign Country Discussion and Study Limitations Recommendations for SLT Curricula Worldwide Implementation of Professionally Supervised Practical Internships Abroad for Promoting Direct Exposure to “Strangers” Implementation of a Module to Promote DSCC in SLT Training Programs Toward Intensive Self-Reflection for Dealing Appropriately with “Strangers” Toward Ethnorelativism for Promoting Acceptance Rather Than Suppression of “Strangers” References 5: The History of Speech-Language Therapy in Kenya: A Collective Memory Introduction Motive Problem Background Methodology Methods: A Qualitative Methodological Pastiche Situating the Authors The Development of the Speech–­Language Therapy Profession in Kenya A Collective Remembering From 1970 to 2000: An Overview From 1990 to Present: Special Education Professionals (SEP) From 2000 to 2014: A Building of Momentum The East African Conference on Communication Disability: 2005–2018 Establishing the Association of Speech and Language Therapists Kenya (ASLTK) Establishing SLT Training Programs: 2014 Onward Speech–Language Therapy in Kenya: A Contemporary Perspective Ongoing Challenges Issues of Language Building Awareness About the Profession Issues of Access Issues of Payment Resources and Innovations Dynamic and Creative SLT Practices Harnessing Technologies Looking to the Future: Considering the Next Steps Research and Material Development Strengthening and Supporting the Kenyan SLT Community Conclusions References 6: The Development of the Speech–Language Therapy Profession in West Africa: Over 10 Years of Experience Introduction Project Genesis and Course Design Implantation of a New Profession Within Western and Central Africa Professional Development and Growth Creation of the Fédération des Orthophonistes d’Afrique Francophone Challenges to Take On Oral Tradition and the Significance of Cultural Beliefs Importance of Raising Awareness About Speech–Language Disorders Advocating for the Recognition of the Profession of Speech–Language Therapy by the Governments of French-speaking African Countries Regulating Speech–Language Therapy Practice in Africa Working in Bilingual and Multilingual Settings Adapting Diagnostic and Therapeutic Materials Promoting Scientific Research on Speech–Language Therapy in Africa Conclusion References 7: A Revolution in Training Speech-Language Therapists in Sub-Saharan Countries and Globally Introduction Problem Background State of Speech–Language Therapy Higher Education in Sub-Saharan Africa West Africa East and Central Africa Southern Africa eLearning History of the DOOHICHE Model High Quality Accessibility Affordability Customizability Sustainability The DOOHICHE Model in Practice The DOOHICHE Model for Speech–­Language Therapy Step 1: Perform a Needs Assessment Step 2: Competencies Step 3: Locate Resources Step 4: Review with Advisory Group Step 5: Creation of Learning Modules Step 6: Teaching Platform Step 7: Locating Potential Students Step 8: Refine and Research Current State of the NextGenU.org Speech–Language Pathology Program in Sub-Saharan Africa Potential Impact Summary References 8: The Demands of Context: Development of a Relational In Vivo Methodology for Participative Speech–Language Therapy Research in Sub-Saharan Africa Introduction: The Necessity of Multilevel Research for Development of the Speech–­Language Therapy Profession in Sub-Saharan Africa Framework of Multilevel Research in Speech–Language Therapy SLT Research Needs in Sub-Saharan Africa Multilevel Research Needs in a Sub-Saharan Africa Clinical Context: Adults with Aphasia Multilevel Research Needs in the Sub-Saharan Africa Educational Context: Children with Autism Spectrum Disorder Background: Opportunities and Challenges for Research in Sub-Saharan Africa Opportunities: Uniqueness and a Fresh Start! Challenges: Lack of Cultural Adaptation and (Neo)colonial Shadows Proposing a Relational In Vivo Methodology for Participative Speech–Language Therapy Research in Sub-Saharan Africa Conceptual Dimensions of a Relational and Participative In Vivo Research Paradigm Practical Key Elements of a Relational In Vivo Approach Studying Persons with Communication Disorders Within the Sub-Saharan Africa Context: The Range of Relational Methods in a Multilevel Research Approach Epidemiological Studies (Level I): Getting Access to the People and the Field Intervention Studies on Speech–­Language Therapy Practices (Level II): Obtaining Different Perspectives on Daily Service Delivery Evaluation Studies: Promoting Standards for Evidence-Based Practice in Specific Contexts of Speech–Language Therapy Service Delivery Basic Research Studies: Investigating Early Communicative Dyads in a Non-Intrusive and In Vivo Way Epistemological Reflections Steps Toward a Relational In Vivo Methodology: An Everyday Participatory Research Checklist for Decolonizing SLT Research References 9: Speech-Language Therapy in Kenya: Trends, Challenges, and Opportunities Background Defining Communication Disorders and Speech–Language Therapy Persons with Communication Disability in Kenya: A Demographic Overview Research Questions Methods Results SLT Development Trends: Factors and Agencies Conceptualizing Communication Disability in Kenya Legal Framework for Disability in Kenya Advocacy and Professionalization of SLT Resources and Facilities for Persons with Communication Disability Challenges Facing SLT in Kenya Professional Development Legislative and Policy Frameworks Inadequate Resources and Facilities Language and Culture Access, Awareness, and Cost Conclusion Impact Future Research References 10: Obulala Na-maani: Unity is Strength Introduction Motive Problem Background Method Theoretical Background The Sustainable Development Goals Frameworks for Cultural Competence and Cultural Humility Results Description of the Projects Bahari Children’s Therapy Centre Kilima Children’s Community Centre Sukari Lessons Learned Context Is Imperative Community Partners and People Are Key Discussion Impact Considerations for the Future Conclusion References Part II: Introduction: Development and Prevention 11 Prema K. S. Rao Paradoxical Reflections on Bilingualism and Biliteracy: Relevance for Speech–Language Therapists in Sub-Saharan Africa 12 Precious Ahabwe and Sara Howard Typical Phonological Development in Ugandan Language: A Case of Rukiga—A Pilot Study 13 Kirsten Beta, Chantal Polzin, Afizai Vuliva, Julia Wu, and Ulrike M. Lüdtke The Participatory Potential of Photovoice as a Relational In Vivo Research and Training Method: The Case of a Community-Based Prevention Program on Early Communication and Language Disability in Underserved Rural Sub-Saharan Africa 14 Julia Wu, Chantal Polzin, Afizai Vuliva, Enna M. Mdemu, Kirsten Beta, Kirsten Beta, and Ulrike M. Lüdtke A Network of Knowledge: Participatory Development of Culturally Sensitive Information, Education, and Communication Materials for the Prevention of Communication Disability in Rural Tanzania 15 Elise Davis-McFarland Pediatric HIV/AIDS and Communication and Developmental Disorders in South African Children 16 Ulrike M. Lüdtke, Angelika Illg, Louisa Johanningmeier, Enica Richard, Reema Ruparellia, Lars Rumberg, Jörn Ostermann, Thomas Lenarz, and Anke Lesinski-Schiedat Hear Africa! Improving Language Development, Education, and Participation of Children with Severe Sensorineural Hearing Loss in Tanzania References 11: Paradoxical Reflections on Bilingualism and Biliteracy: Relevance for Speech-Language Therapists in Sub-Saharan Africa Introduction The Discipline of Communication Disorders Components of Communication Theoretical Background: Bilingualism and Biliteracy Bilingualism Biliteracy Relationship Between Language and Literacy Bilingualism and Language Acquisition Bilingualism vis-à-vis Language Acquisition Bilingualism vis-à-vis Literacy Acquisition Literacy Acquisition in Non-Alphabetic Orthography Cross-Language and Cross-Script Skill Transfer in Bilingual-Biliterate Children Service Delivery for Bilingual-Biliterate Children Language Policy for Service Delivery in Bilingual Countries A Few Studies on Bilingual Teachers in India Challenges for SLTs with Bilingual-Biliterate Children Conclusion: Roadmap of Services to Bilingual-Biliterate Children in the Future References 12: Typical Phonological Development in Ugandan Language: A Case of Rukiga – A Pilot Study Introduction Theoretical Background Rukiga Language Phonology of Rukiga Consonant System Vowel System Syllable Structure Tones Speech Development Including Phonological Development General Overview Speech Development (Including Phonology) in Bantu-Speaking Children Speech Assessments Including Phonological Development Independent Analysis Relational Analysis Research Questions Methods Research Design Participants Selection Criteria Ethical Considerations Procedure Stimuli Task Administration Data Analysis Results: Phonological System-Segmental Consonant Production Younger Age Group (2;4–3;4 Years) Older Age Group (3;7–4;1 Years) Phoneme Acquisition Younger Age Group (2;4–3;4 Years) Older Age Group (3;7–4;1 Years) Patterns and Processes Younger Age Group (2;4–3;4 Years) Older Age Group (3;7–4;1 Years) Variation Younger Age Group (2;4–3;4 Years) Older Age Group (3;7–4;1 Years) Discussion and Conclusions Developmental Trajectory Cross-Linguistic Similarities and Differences Context-Sensitive Voicing Gliding Pattern The Backing and Fronting Pattern Initial Consonant Deletion Vowel and Syllable Deletion Assimilation/Reduplication Affrication of Fricatives Cluster Reduction Vowel Development Word Structure Impact of this Study Considerations for Future Work and Research References 13: The Participatory Potential of Photovoice as a Relational In Vivo Research and Training Method: The Case of a Community-based Prevention Program on Early Communication and Language Disability in Underserved Rural Sub-Saharan Africa Introduction: Presenting Photovoice as an In Vivo Research and Training Method Background of Project Implementation: Situational Context and Methodological Approach Context of the Project: The Situation of OVCs and Concepts on Facing Their Needs Theoretical Approach of Photovoice: A Participatory Method for Relational In Vivo Research Method: Evaluation of Photovoice Implementation Phases of the Photovoice Process Phase 1: “Planning” Phase 2: “Preparation” Phase 3: “Shooting Photos” Phase 4: “Selecting Significant Pictures and Printing” Phase 5: “Photo Presentation and Moderated Group Discussion” Phase 6: “Reflection and Plan for Further Action” Phase 7: “Follow-Up” (Evaluation) Phase 8: “Accompanying Research” Results: Identified Participatory Involvement of Community Participants Discussion: Successes and Limitations of the Participatory Involvement References 14: A Network of Knowledge: Participatory Development of Culturally Sensitive Information, Education, and Communication Materials for the Prevention of Communication Disability in Rural Tanzania Introduction: Generating Local Knowledge and Resources for the Prevention of Communi- cation and Language Disability Project Outline The Role of Prevention in Underserved Regions Background: Participatory Development and the Creation of Information, Education, and Communication Resources Participatory Development and Sustainability Information, Education, and Communication Materials in the Context of Communication and Language Development in SSA Methodology: Project Background and Evaluation Criteria Methodological Background of IEC Material Development in the Project Participatory Feedback Loops Project Team and Participants Methodology for the Evaluation of IEC Material Development in This Chapter Leading Question Derivation of Evaluation Criteria Definition of Result Levels Results: IEC Materials from and for the Local Communities Activity: Phases and Steps of Material Development in Participatory Feedback Loops Step 1: Suggestion of Relevant Content from a Minority World Perspective Step 2: Joint Reflection and Adaptation of Content in the Bi-cultural Project Team Step 3: Presentation of Content to the Network of Multipliers in Multiple Training Sessions Step 4: Reflection of Content in Group Discussions Step 5: Adaptation of Content in Light of the Planned Materials Step 6: Material Production and Presentation Step 7: Pilot Test of Counseling Using the Developed Materials Step 8: Follow-Up Meeting and Discussion of Changing Needs Step 9: Continuing Counseling Activities with Regular Exchange Meetings Output: Information, Education, and Communication Materials Developed in the Project Primary Materials: Flyers, Posters, and Workbook Secondary Materials: First Care Bag and ID Badge Outcome: Counseling Settings and Strategies Based on the Developed Materials Discussion: Successes, Challenges, and Indicators for Long-Term Impact and Sustainability Activity: A Structured, Participative Method of Developing Information, Education, and Communication Materials Successes Challenges Output: Culturally and Contextually Appropriate Information, Education, and Communication Materials Successes Challenges Outcome: Fruitful Counseling Strategies Based on the Developed Materials Successes Challenges Conclusions: Directions Toward Sustainability Outlook: Future Perspectives for Sub-Saharan Africa References 15: Pediatric HIV/AIDS and Communication and Developmental Disorders in South African Children Introduction Medical Background Developmental and Cognitive Manifestations of Pediatric HIV World Health Organization Early Diagnosis Oral-Motor Development and Oropharyngeal Lesions and Infections Dysphagia and Feeding Otologic and Hearing Issues Preverbal and Language Development and Disorders Neurodevelopmental Studies of South African Children Intervention Services for Children with HIV/AIDS Challenges Outlook: Tasks Ahead for Speech–Language Therapists Working with Children with HIV/AIDS Case Study References 16: Hear Africa! Improving Language Development, Education, and Participation of Children with Severe Sensorineural Hearing Loss in Tanzania Introduction Background Hearing Impairment Frequency and Clinical Presentation Classification and Causes of Hearing Impairment Audiometric Diagnostics Subjective Tests Objective Tests Impact of Hearing Impairment on Language Development, Education, and Participation Speech–Language Therapy for Hearing-Impaired Children as an Interdisciplinary Care Approach Speech–Language Therapy Technical Devices for Hearing Support: Hearing Aids and Cochlear Implants Special Needs Education Information Technology Support for Remote Service Delivery Advantages of an Interdisciplinary Approach Methodology of a Multi-centered Cross-Method Project: Hear Africa! Aims Sustainability First Steps and Outcomes Aim 1: Clinical Research and Data Collection Aim 2: Professional Education and Capacity Building Aim 3: Building Up Speech–Language Therapy and Audiological Infrastructures Including Remote Care Aim 4: Political Work and Community Empowerment Challenges The Way Forward: Digital and Remote Alternatives for Care Supply and Culturally Sensitive Adaptation References Part III: Introduction: Assessment and Treatment 17 Michelle Pascoe and Shajila Singh Development of Speech–Language Therapy Assessments for the Languages of South Africa 18 Mellissa Bortz Assessing Language in South Africa: Use of the Passive Construction 19 Mellissa Bortz Methods for Devising a Standardized Language Assessment for isiZulu Preschoolers: Implications for Sub-Saharan Africa 20 Mathew Kinyua Karia Using Acoustic Phonetics in the Assessment and Treatment of Speech Disorders 21 Phyllis W. Mwangi and Gatitu Kiguru The Capacity to Assess and Treat Communication Disability in Kenya: Field-Based Evidence 22 Ulla Licandro, Tom Abuom, and Dennis Omari Linguistically and Culturally Diverse Children with Language Disorders in Sub-Saharan Africa: Approaches to Service Delivery 23 Ines Said, Anke Bulsink, and Marieke Dekker Speech, Language, and Swallowing Difficulties in Neurology: A Sub-Saharan African Perspective 24 Stephen Musila Nzoka, Elizabeth Wangui Kamau, Paul Kamau Mbugua, Molly Merrab Ogalloh, and Joyce Achieng Ogogo Active Aging with Aphasia: A Case of Kiambu County, (Kenya) 25 Lawrence Eron, Nelly Otube, Mathew Karia, Edward Kija, Becky Isanda, Charles Mugisa, Stuart Robert Oyesigye, Marlene Küthe, Rieke Meinen, Steffen Gremmelt, Geoffrey Karugu, and Ulrike M. Lüdtke Development of a Mobile SLT Clinic: An Example from East Africa 26 Anke Lesinski-Schiedat, Enica Richard, Rachel Mkumbo, Rukiya A. Mohamed, and Angelika Illg The Organization of Cochlear Implant Programs in Tanzania: Assessment of Needs and Challenges References 17: Development of Speech-Language Therapy Assessments for the Languages of South Africa Background Current Challenges The Languages of South Africa Assessment A Review of Current Assessments Description of Assessments by Language Description of Assessments by Clinical Domain Description of Assessments by Methodology Discussion and Future Plans References 18: Assessing Language in South Africa: Use of the Passive Construction Motive Theoretical Background Passive Constructions Reversible Passives Negative/Malefactive Passives Non-actional Passives Inanimate Passives Impersonal Passives Short and Long Passives Passive Constructions in Bantu Languages Spoken in South Africa Bantu Languages in South Africa Passive Constructions in Sesotho Age of Passive Acquisition in Bantu Languages Methods for Assessing Passive Constructions Comprehension Picture Selection Tasks Elicited Production Tasks Elicited Imitation Tasks Methods Research Questions Design Research Materials Comprehension Picture Selection Task Elicited Production Task Elicited Imitation Task Additional Qualitative Data Sources Pilot Testing Criteria for the Selection of Children Setting Ethical Clearance Data Analysis Results Developmental Passive Abilities in Different Assessment Tasks Elicited Imitation Task Comprehension Picture Selection Task Elicited Production Task Understanding and Production of Various Passive Categories Children’s Capabilities in Terms of Short and Long Passives Adult Verifier Protocol Service-Learning Reflection Journals Discussion: Usefulness of the Passive Construction as an Assessment Tool for Setswana-Speaking Children Impact Examination of the Passive in All Bantu Languages The Development of Appropriate Assessment Materials Elicited Imitation Elicited Imitation and Parent’s and Teacher’s Report Considerations for Future Work, Research, and Politics References 19: Methods for Devising a Standardized Language Assessment for isiZulu Preschoolers: Implications for Sub-Saharan Africa Motive Research Questions Problem Background Theoretical Motivation Importance of Standardized Language Assessment Epidemiology of Language Problems Features and Psychometric Criteria Necessary for Standardized Language Tests Structure of isiZulu Semantic Origin Agreement Subject and Object Prefixes Adjectives and Relatives Verb Morphology Varieties of isiZulu Methods Research Design Ethical Clearance Participants Research Assistants Data Collection Procedure ZERLA Materials Treatment of Data: Coding and Analysis Statistical Analysis Qualitative Analysis Results and Discussion Item Analysis Norms Impact Language Acquisition Epidemiological Implications Psychometric Results of the ZERLA Clinical Implications: Examiner Qualifications Considerations for Future Work, Research, and Politics Standardization of Assessments in Bantu Languages Rural Areas Development of a South African Multilingual and Multicultural Database References 20: Using Acoustic Phonetics in the Assessment and Treatment of Speech Disorders Introduction Background Speech–Language Therapy Services in Kenya Perceptual Assessment of Dysarthria Acoustic Assessment of Dysarthria Articulatory Gestures Research Question Methods Study Population Speech Materials Oral Diadochokinesis Test (DDK) Telephone Number Test Recordings and Data Annotation Measurements Voice Onset Time Fundamental Frequency (F0) Results Voice Onset Time Fundamental Frequency (F0) Discussion Voice Onset Time Fundamental Frequency Impact on Speech–Language Therapy Practitioners and Researchers in Sub-Saharan Africa Considerations for Future Work, Research, and Politics References 21: The Capacity to Assess and Treat Communication Disability in Kenya: Field-Based Evidence Introduction Communication Disabilities as Secondary Disabilities High Incidence of Communication Disabilities Versus Only Nascent Growth of Speech–Language Therapy Services in Kenya Theoretical Background Conceptualizing (Communication) Disabilities with Particular Focus on Kenya Assessment and Treatment of Communication Disabilities Educational Assessment and Resource Centers in Kenya Research Questions Methods Research Design Study Population Inclusion Criteria Exclusion Criteria Methods of Data Collection Interview Schedule Questionnaire Observation Schedule Document Review Data Analysis Ethical Clearance Results Sample Size De