The speech-language therapist’s role with neonates who have hypoxic-ischaemic encephalopathy

Abstract

Background This survey study aimed to describe the role of a sample of speech-language therapists (SLTs) working with neonates with hypoxic-ischaemic encephalopathy (HIE) in neonatal nurseries in South Africa. Research will allow for better understanding of SLTs’ role, and effective and timely treatment of this population. Method A 21-item previously published online survey was completed by 22 South African SLTs rendering mostly quantitative data. Purposive sampling and snowball sampling were used to recruit participants for the study. Descriptive statistics and qualitative content analysis were used. Results An average of five babies with HIE were admitted to NICUs where participants were working. Whole body cooling was used more often than selective head cooling, with no SLTs reporting involvement during cooling. Reported management of feeding difficulties included direct infant treatment to promote oral feeding skills, and caregiver support for optimal breastfeeding and developmentally appropriate stimulation. Most participants (n=21; 95.5%) provide follow-up services to clients with HIE, largely concerning feeding monitoring. Formal and informal feeding assessment methods were used by participants, with most (n=13; 59.1%) participants using the Neonatal Feeding Assessment Scale. Management is carefully tailored to the infants’ and families’ needs. Treatment was influenced by resources available, within the context of sparse management guidelines. Conclusion The findings reveal the need for standardised protocols to guide management of this population in the NICU. Additionally, SLTs must strive for holistic management of neonates with HIE as early intervention pre- and post-discharge plays a vital role in mitigating adverse neurodevelopmental outcomes. Results may inform the development of guidelines and may be beneficial for SLTs in low- and middle-income countries involved in the NICU.