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Background: This paper investigates the perceptions of medical interns regarding the usefulness of non-mother tongue communication skills taught during the undergraduate curriculum at the University of Cape Town in South Africa. In 2003, the university decided to incorporate Afrikaans and IsiXhosa communication skills into the new MBChB curriculum in order to meet the Faculty of Health Sciences goals to promote quality and equity in healthcare, and to prepare graduating health practitioners for multilingual communities where they would be serving. Despite annual internal evaluations and reviews of the languages courses, the usefulness, if any, of the additional languages in the working clinical environment had not been determined., Methods: Data were collected during the second year of medical internship across a five-year period through survey questionnaires, as well as focus group interviews conducted in the Western Cape, South Africa. Surveys were conducted from 2009 to 2013., Results: The study shows that the usefulness of each of the probed categories was not consistent across both languages. The interns expressed a need for an overall improvement of the isiXhosa course offering, while the outcomes for the Afrikaans language were more positive across all categories except for cultural understanding., Conclusion: The study indicates a positive trend amongst the interns towards developing usefulness in communication skills in Afrikaans and isiXhosa to communicate with their patients., (© 2024. The Author(s).)

Cross-cultural adaptation is an important part of using validated questionnaires across countries and settings. Here we describe the cross-cultural process adopted in the STRiDE (STrengthening Responses to dementia in DEveloping countries) program. We adopted a cross-cultural adaptation process including forward translation, back translations, and cognitive interviews of the STRiDE toolkit. In total, 50 older adults and 41 carers across sites in Indonesia and South Africa participated in cognitive interviews; field notes and verbatim quotes are reported. We describe the cross-cultural adaptation process of the STRiDE toolkit. During the process, issues were identified with the translated toolkit, including aspects related to cultural appropriateness, terminology equivalence, and timings. The data demonstrate that a rigorous, yet pragmatic, cross-cultural adaptation process can be achieved even with limited resources. Our process should help the design and conduct of future dementia research in various contexts., Competing Interests: There are no conflicts of interest to declare., (© 2022 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.)

Children with LI are at a disadvantage because they typically have smaller vocabularies than their TD peers. However, children from low-SES households often also have smaller vocabularies and can thus be misdiagnosed with LI. The purpose of this study was to compare the fast-mapping (FM) skills of 3 groups of 4- to 9-year-olds: typically developing (TD) children with low socioeconomic status (SES) and mid SES, and mid-SES children with language impairment (LI), to ascertain whether FM is affected by SES. The FM items of the Diagnostic Evaluation of Language Variation were administered to 253 TD mid-SES children, 75 TD low-SES children, and 36 children with LI. On FM with novel verbs, the TD groups differed significantly ( p = .001) as did the TD mid-SES and LI groups ( p = .046), but not the TD low-SES and LI groups ( p = 1.00). On a comparable task with real verbs, the TD mid-SES group also differed significantly from the TD low-SES ( p < .001) and LI group ( p = .018), with no significant difference between the latter two groups ( p = 1.00). FM has been proposed as a non-SES-sensitive measure but, unlike previous studies, we found FM to be affected by SES, rendering it an insufficiently unbiased measure for our sample of children. Further thought should be given to measures that can successfully differentiate between children with LI, and children from low-SES backgrounds, possibly rendering scores adjusted for SES, so that targeted intervention can be offered.

The present study examines the relationship between the two grammars of bilingual speakers, the linguistic ecologies in which the L1 and L2 become active, and how these topics can be explored in a bilingual community undergoing L1 attrition. Our experiment focused on the production of intervocalic phonemic voiced stops for L1-Afrikaans/L2-Spanish bilinguals in Patagonia, Argentina. While these phonemes undergo systematic intervocalic lenition in Spanish (e.g., /b d ɡ/ > [β ð ɣ]), they do not in Afrikaans (e.g., /b d/ > [b d]). The bilingual participants in our study produced target Afrikaans and Spanish words in unilingual and code-switched speaking contexts. The results show that: (i) the participants produce separate phonetic categories in Spanish and Afrikaans; (ii) code-switching affects the production of the target sounds asymmetrically, such that L1 Afrikaans influences the production of L2 Spanish sounds but not vice versa; and (iii) this L1-to-L2 influence remains robust despite the instability of the L1 itself. Altogether, our findings speak to the persistence of a bilingual's L1 phonological grammar despite cross-generational L1 attrition., (© 2021 Walter de Gruyter GmbH, Berlin/Boston.)

Sociocultural influences on the development of child language skills have been widely studied, but the majority of the research findings were generated in Northern contexts. The current crosslinguistic, multisite study is the first of its kind in South Africa, considering the influence of a range of individual and sociocultural factors on expressive vocabulary size of young children. Caregivers of toddlers aged 16 to 32 months acquiring Afrikaans ( n = 110), isiXhosa ( n = 115), South African English ( n = 105), or Xitsonga ( n = 98) as home language completed a family background questionnaire and the MacArthur-Bates Communicative Development Inventory (CDI) about their children. Based on a revised version of Bronfenbrenner's (1977) ecological systems theory, information was obtained from the family background questionnaire on individual factors (the child's age and sex), microsystem-related factors (the number of other children and number of adults in the child's household, maternal level of education, and SES), and exosystem-related factors (home language and geographic area, namely rural or urban). All sociocultural and individual factors combined explained 25% of the variance in expressive vocabulary size. Partial correlations between these sociocultural factors and the toddlers' expressive vocabulary scores on 10 semantic domains yielded important insights into the impact of geographic area on the nature and size of children's expressive vocabulary. Unlike in previous studies, maternal level of education and SES did not play a significant role in predicting children's expressive vocabulary scores. These results indicate that there exists an interplay of sociocultural and individual influences on vocabulary development that requires a more complex ecological model of language development to understand the interaction between various sociocultural factors in diverse contexts., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Southwood, White, Brookes, Pascoe, Ndhambi, Yalala, Mahura, Mössmer, Oosthuizen, Brink and Alcock.)

Background: Augmentative and alternative communication (AAC) can enable individuals with little or no functional speech to communicate functionally in a variety of communication contexts. AAC systems for individuals who are not (yet) fully literate often require that the vocabulary for the system be preselected. By including the most commonly- and most frequently-used words (core vocabulary) in an AAC system, access to novel utterance generation can arguably be facilitated. At present, no Afrikaans core vocabulary list based on children's speech samples exists., Objectives: This study aimed to identify the most frequently- and commonly-used words of South African Afrikaans-speaking Grade R learners without disabilities., Method: Spontaneous speech samples were collected from 12 Afrikaans-speaking Grade R learners during regular preschool activities. Samples were transcribed and analysed to determine the number of different words used, the frequency with which each word was used, as well as the commonality of word use across the 12 participants., Results: A total of 239 words met the criteria for inclusion in the core vocabulary (words used with a frequency of more than 0.05% in the sample, and used by at least half of the participants). These words accounted for 79.4% of words used in the entire speech sample., Conclusion: The established core vocabulary consists of a relatively small set of words that was found to represent a large proportion of speech. AAC team members may consider including these words on Afrikaans AAC systems that are intended to give access to a measure of novel utterance generation.

Background: Language barriers between doctors and patients have been shown globally to negatively affect the quality of health care and infringe on basic patient rights. In response to these challenges, the Division of Family Medicine at the University of Cape Town (UCT) integrated career-oriented Afrikaans and Xhosa communication skills classes into the MBChB degree programme in 2003., Aim: To measure students' perceptions of the effectiveness of the language communication skills classes in creating multilingual medical practitioners in the South African context and compare these perceptions between the Afrikaans and Xhosa courses., Setting: The study was conducted on the Health Sciences campus of the University of Cape Town, South Africa., Methods: The study was a cross-sectional survey. During March 2017, access to an online structured questionnaire was provided to 600 randomly selected medical students from second to sixth year at the UCT., Results: The response rate was 43.7%, and students reported a much higher baseline level of Afrikaans compared to Xhosa (99.0% vs. 42.7%). Respondents reported a lack of confidence in the clinical sphere for both languages (Afrikaans 51.5%; Xhosa 60.0%) and a lack of communicative ability (Afrikaans 35.3%; Xhosa 67.2%) as major barriers to patient communication., Conclusions: Respondents overwhelmingly agreed that second language learning is valuable for their future as medical practitioners, but did not feel that they are developing sufficient communicative competence. The courses need to be re-evaluated to account for the lower level of pre-MBChB Xhosa exposure, as compared to Afrikaans. Increased time allocated to languages, increased attention to cultural issues and informal variants, and redesigning assessments to better reflect students' abilities are all potential recommendations.

English is one of eleven official languages in South Africa, but there is limited information on children's acquisition of English and other languages in this context. This paper describes speech development in 308 children aged 3;0-5;11 acquiring South African English in Cape Town. The study focused on English speech acquisition, although children were grouped by language background into monolingual, isiXhosa bilingual, Afrikaans bilingual and trilingual groups. The primary objective was to describe phonetic and phonological acquisition (percentage consonants and vowels correct (PCC and PVC); phonetic inventory and phonological processes) by children's age and language background. As a secondary objective we described the prevalence of speech disorders in the sample using Dodd's (2005) framework. The Diagnostic Evaluation of Articulation and Phonology was used to assess participants with modified scoring criteria appropriate for the context. Phonological processes and inventories were broadly comparable to normative data for English speech acquisition documented in the literature, and a progression was observed with increasing age. PCC and PVC were similar for children within age bands despite different language backgrounds. Bilingual children showed aspects of English phonological development linked to their L1, and some differences in phonological processes were observed. Approximately 9% of children (n = 28) had speech difficulties, with 75% of this group having a speech delay. The study highlights the importance of adapting speech assessments for use with populations that differ from the originally intended audience. This work contributes to knowledge of typical speech development in South Africa and in multilingual contexts more generally.