Objectives: This study addresses a gap from a South African urban perspective on the knowledge and emotional responses of caregivers with children diagnosed with Down's syndrome (DS). The study is an initial step towards informing health professionals who adopt a biopsychosocial approach, in an effort to improve interventions for both caregivers and children. Methods: A simple descriptive survey was utilized with 57 participants who were caregivers of children with DS. Data was analyzed descriptively using the Statistical Package for Social Scientists (SPSS) (version 21). Results: The caregivers' initial reactions when discovering that the child had DS included shock, sadness and anxiety. When considering the etiology of Down's syndrome, findings reflected that caregivers understood DS as a medical condition relating to chromosomal abnormalities rather than attribution of the syndrome to a fault of their own. Despite the immediate reactions, the caregivers' initial emotions toward the child rather than the situation were positive and unchanged by the subsequent challenges in caring for the child. The caregivers indicated feelings of love toward the child notwithstanding the diagnosis. Conclusion: This study allowed for the subjective experience, perceptions and attitudes of caregivers to be investigated, and raised further questions into the deeper meanings and experiences of caregivers towards assisting practitioners in understanding the dynamics surrounding care-giving that may influence holistic interventions.

AIM: The study aimed to explore Occupational therapy clinicians' current splinting practises in hand function intervention for children with neurological impairments within the South African context. METHODOLOGY: A quantitative cross-sectional design with use of an electronic questionnaire served to address the objectives of this study. The sample included occupational therapists working within the paediatric neurology field in South Africa. The study sample was accessed via convenience and snowball sampling in order to target therapists specifically working in the area of paediatric neurology. RESULTS AND DISCUSSION: Forty therapists from around South Africa (majority from KwaZulu Natal) completed the survey in its entirety. Therapists splint for various reasons and splints are considered effective in neurological cases. The three most prevalent splints were the functional resting, thumb abductor and anti-spasticity splint with the purpose of splinting mainly reported to maintain or improve range of motion (ROM). In this study, therapists appeared to consider knowledge, competency and experience prior to the availability of resources when rationalising the choice to splint. CONCLUSIONS: This study provides insight into the splinting practices amongst occupational therapists who work with neurologically impaired children. Despite the controversy that surrounds splinting in neurology, therapists are using splints in their management with a number of factors considered during the decision-making process. Key words: Splinting, paediatrics, neurology, occupational therapy

Background: There are various infant massage programmes designed for infants born without complications, but there are limited options available for caregivers with high-risk infants from a resource-constrained context. Aim: This study aimed to develop a caregiver-initiated infant massage programme specific for high-risk infants in a resource-constrained context to facilitate the bonding and attachment process between this dyad. Method: A three-round Delphi study was conducted with purposively selected physiotherapists and occupational therapists with experience in the field of high-risk babies in a resource-constrained context. The design of the round one survey was informed by the available literature, and the subsequent two rounds of surveys were designed based on the prior rounds. Iteration of results was provided prior to the subsequent rounds. Results: Attrition between rounds occurred from an initial 14 participants in round one to 8 participants in round three. Consensus on 19 massage strokes were achieved in addition to considerations for implementation of the programme with this population. Conclusion:The implication of attrition requires further study. Notwithstanding this, an infant massage programme for high-risk infants was developed with the inclusion of considerations for this dyad's social and medical context.

Background The newborn infant is a complexly organized, competent being, who plays an active role in shaping their environment through their increasing skills in autonomic regulation, motor control, regulation of state and social interaction. Infants born to HIV positive mothers, are exposed to HIV and antiretroviral therapy inutero, and may experience adverse effects from this. Methods A cross-sectional study of 132 mother-infant dyads from a large public health hospital in South Africa. Infants were assessed using the Neonatal Behavioural Assessment Scale on day two of life, and mothers mental health assessed using the Edinburugh Postnatal Depression Scale. Medical and demographic data on mothers and infants was collected, including maternal age, HIV status, length of time on antiretrovirals, relationship status, employment status, gravid status, mode of delivery, infant anthropometrics and infant gender. Data was input into IBM SPSS statistics 21, where frequencies and percentages for descriptive analysis, and Chi-square and student’s two sample t-tests were run to compare data from HIV infected-exposed and HIV uninfected-unexposed mothers and infants. Results HIV exposed infants were smaller than HIV unexposed infants, even though low birth weight was an exclusion criteria. Statistically significant differences were found between HIV exposed and unexposed infants in neurobehavioiral items of social interaction (p = 0.00), motor system (p = 0.00) and state organization (p = 0.01), with HIV exposed infants performing less optimally in these domains. HIV exposed infants also presented with more abnormal reflexes. Infants born to depressed mothers showed superior motor skills, state organization and state regulation than infants born to mothers who did not score in the possibly depressed range. Conclusions HIV exposed infants have inferior neurobehavioural functioning, which may affect their quality of life and ability to develop a reciprocal relationship with a primary caregiver. This may have an effect on development, behaviour and mental health in later childhood. HIV exposed infants shoud be monitored closely and their functioning in autonomic stability, motor control, resualtion of state and social interaction assessed regularly. Guidance for caregivers in incorporating strategies into the care of these infants is essential to buffer the possible long term negative effects on development.

Background: There is a paucity of literature on knowledge translation (KT) interventions for occupational therapists (OTs) in assessing and caring for the neonate and at-risk infant. Care at this stage of life is paramount, requiring a shift from the survival of the neonate, to the quality of survival. Consequently, clinicians working with neonates have a crucial role in ensuring optimal development and preventing long-term adverse developmental outcomes.Aim: This study aimed to explore experts’ opinions on KT interventions for OTs working with neonates and at-risk infants in South Africa.Setting: This study was located in South Africa. Due to the virtual nature of data collection, no geographical limitations within the country were imposed.Method: A two-round Delphi study with a multidisciplinary expert panel (n = 20; n = 18) was conducted. The round one survey was developed based on a literature review, findings from a preceding focus group, and a pilot study. The subsequent round was based on the data and comments generated from the first round. Results were pooled and presented to participants following both rounds.Results: Consensus on 127 items out of 130 was achieved. These included consensus on the definition of KT in neonatal care, the knowledge that OTs should possess, professional competencies, skills required, professional values, and characteristics. Further agreement was reached on the KT process, the usefulness of KT modalities, recommended courses in neonatal care, barriers to KT, best-practice and requirements for undergraduate training.Conclusion: Knowledge translation required for OTs working with neonates and at-risk infants were established in this study.Contribution: This study may be useful for consideration in contextually relevant KT interventions for clinicians working in neonatal care.