Thursday, 11 April 2013

Surviving Marian Ridge - Week One (9 April - 11 April 2013)


Week One (9 April - 11 April 2013)

Tuesday (9 April 2013)

Armed with what knowledge we had gleaned from our last block (Severe Developmental Communication Disorders), the student Speech Therapy students descended on the bus stop, having no clue what to expect. I had all heard our peers talk about the CBR block and I'd read as much as I could about the community, but actually going into the setting is rather daunting. This block brings a range of firsts which I was excited about. It was the first time I had ever got to work with the OTs, the first time working in a low-income community and the first time I've had freedom to get involved and help set up projects that I'm passionate about. 

Just travelling through Marian Ridge, you can see that the community would benefit from whatever services we can provide. I had read that there was a lot of unemployment in the area, but I don't think I expected to see as many people walking around the community as I did. Arriving at Ridge Cafe, we were able to go through the handover file with the OTs and find out what had been done and what their plans were. We were later joined by Dr Flack who gave us a quick introduction and set out the basic plan for the week. Something I think the speechies all appreciated was that she explained how important the speechies contact hours were to the OTs, especially as the speechies didn't know that speechie and OT hours were calculated differently. I noticed throughout the week that this changed the OTs' attitude toward us and they have tried to help us by including us in the screening they were doing at the clinic. 

After Dr Flack left, the speechies went to introduce themselves to the principle, HOD and teacher of the grade Rs at Marian Ridge Primary School. The HOD, Mrs Zulu, seemed extremely interested in what our profession involved and we explained to her how speech therapy can help those children who have learning difficulties. We also explained the importance of early intervention for these children. We joined the OTs up at the clinic, which was packed with parents and little children. We introduced ourselves briefly to the staff and they gave us permission to use one of the empty rooms in the clinic to screen some of the children who were in the waiting room. As the room was far too small to accommodate all of us, we split into two with two OTs and Stella screening in the room and the rest of us screening outside on the corridor. Within a matter of minutes we had a few children join us, interested to see what we were doing. I managed to screen two children, a three year old and a seven year old. I think by screening the children while their parents were waiting in the queue for the clinic, we provided the children with something to do and therefore we held their attention much easier than what we would have done if they had been waiting in a queue to see us. The only disadvantage was that we were outside in a corridor where people walked passed frequently. Perhaps, next time we could find a better place to work. 

On the way back to Ridge Cafe, we met up with one of the women who were at the clinic. She was extremely interesting to talk to as she had recently moved back into the area after living in Gauteng for a few years. She explained how the area had changed and it was great to get a resident's perspective of what the community needs and where the problems lie. Many of the problems she raised included drug abuse, unemployment, teen pregnancy and domestic violence.

Wednesday (10 April 2013)

 After planning for the group therapy session with the grade Rs at Marian Ridge Primary the previous day, we were all much more prepared for what we were going to face. Unfortunately, the weather was our biggest enemy. We had planned to use as much movement as possible in the activities, but it was freezing cold and raining, and so we scaled our activities down to make them more "classroom friendly". 

We had planned and integrated our activities with the OTs so that in each activity the children were learning and using more than one skill. First, the OTs played "Simon Says" with the children, starting off at a basic instruction level with visual cues and then gradually minimizing the cues and increasing the complexity of the activity. It was clear that some of the children struggled further along in the activity, especially when there were no visual cues and there were two or more parts to the instruction. The activity may have worked better if there was more space and if the children were split into smaller groups (as was originally planned), however due to the weather this was impossible. From there, the OTs started the tabletop activity where the children were required to make pictures of themselves, cutting out a paper template and sticking it onto another piece of paper. Once again, space was an issue as the clinicians tried to fit between the children to help where needed. Once that was done, the speechies took over and got the clients to glue and stick parts of the face onto their paper template. These included eyes, a nose, a mouth and ears. The children were asked to point to where their eyes/nose/mouth/ears were and say what each part did, including verbs into the activity. As each speechie sat between two tables and helped and asked the children from both tables questions, each child got a chance to answer questions. I sat at the back of the class with the quieter children and noticed that they were more reluctant to answer questions than those at the front of the class. I was quite impressed with the resources available to the children in the class.

As it was pouring with rain and there was no electricity, the library, where the stroke group meet, was closed. Therefore, the stroke group had to be cancelled. The OTs called their supervisor and it was decided that they would go back to campus and that we would join them after we screened some of the children as I had taken my car to Marian Ridge. After break, the speechies went to screen a few of the grade 1s and speak to Mrs Zulu (HOD) and a few of the teachers about the Library Literacy Program which we were planning to set up. We had heard from the previous group of speechies that the program had once been running at the library, but the teachers were not happy with it as the materials used were not what were being used at the school. Therefore we wanted to try and get as much input as possible from the teachers as well as make them feel as if they are also involved in the project and not feel that we are trying to take over. Mrs Zulu and Mrs Van Wyk (a teacher) seemed enthusiastic about the project and shared some concerns about some of the children at the school. They mentioned that many of the students cannot speak English and that they are unsure what to do with them. We got the impression that they did not know how to educate these multilingual children and that they were seeing their inability to speak English competently as being a disorder. We managed to screen six children in the staff room which was a great venue in terms of it being warm and quiet. 

After we were finished, we made our way out of the community (with the help of my GPS which we would have never have managed to do without) and went back to campus for a tut with the OT supervisor, Cgantelle. 

Thursday (11 April 2013)

After an interesting bus-ride, during which the bus driver got lost and started to take us towards Kwa-Ndengezi, the speechies and audios (and one OT) were situated at Rainbow Crèche for the morning. It was an amazing venue to work in purely because of the space available to us. We had planned the previous day what we were going to do and had prepared to split up, aiming at expanding vocabulary (animals, colours, shapes and common items), following directions,  facilitating the use of prepositions (in and out, up and down) and understanding time concepts (before and after - fast and slow). The activities used included "Simon Says", standing inside and outside hoola hoops, book reading, singing songs, going up and down the rungs of the jungle gym, looking at pictures and explaining the vocabulary in it as well as finding the real item in the environment. It was good to work with the audios as they had experience in the venue and with the children. 

There were a few problems which we encountered during the morning. Firstly, we had chosen a book which we thought the children could handle, using the grade Rs from the previous day as a measure. It quickly became apparent that these children were on an entirely different level to those at Marian Ridge Primary, and therefore we had to downgrade the book we were using. Another difficulty was that many of the children could not speak English and there is no Zulu speaker in our entire group, thus when the children wanted to speak to us in Zulu we couldn't understand them and no teacher was available to translate. This has been a problem since the previous block as there is no speechie within the entire block who can speak Zulu fluently. While we try to speak Zulu to the best of our ability, the Zulu narratives, which the children were trying to express today, were impossible for us to understand and at one stage I had to ask one of the English-speaking children to tell me what one of her friends had said. While I understand that we need to develop our Zulu skills, perhaps in future the Zulu speakers could be shared out equally between the blocks. Another thing that could have been improved, and which has been raised in the afternoon tut, was that we should have made those who were more capable do more advanced things in the activities. I noticed that the children did not know the alphabet and were generally under stimulated in terms of developing early literacy skills. This will have to be worked on during the therapy sessions. 

On the way back up to the bus we encountered a few guys smoking weed. It struck me as being strange that they were so free and open with their drug use, showing how different their attitudes are about those issues. 

Overall, the week has been an eye opening experience where we've all been trying to find our feet in the community. I'm looking forward to seeing what progress can be made and if that progress will be as sustainable as what we aim for it to be. 

- Kirsty Wheeler

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