Moroe Nomfundo, Masuku Khetsiwe, Shirame Lebogang
Department of Speech Pathology and Audiology, University of the Witwatersrand, Johannesburg, South Africa.
BMC Med Educ. 2022 Mar 21;22(1):194. doi: 10.1186/s12909-022-03258-1.
Early diagnosis and management of children who are deafblind is important to alleviate the effects of deafblindness on the development of the child who is deafblind and their families. However, children who are deafblind are often misdiagnosed or diagnosed late. The misdiagnosis or late diagnosis has been attributed to many factors, one of which is the competence and confidence of healthcare professionals in differentially diagnosing deafblindness from other conditions, in most cases, autism spectrum disorder (ASD). The study therefore aimed to establish the competence and confidence of rehabilitation healthcare professionals in differentially diagnosing deafblindness from ASD in the South African context.
A cross-sectional survey design was employed for the study. An online questionnaire was distributed to rehabilitation healthcare professionals (N = 78) via Survey Monkey. Data were analyzed using descriptive and inferential statistics. Ethical clearance and permission were obtained from relevant stakeholders prior to the commencement of the study.
Regarding the rehabilitation healthcare professionals in this study, 54% were competent in diagnosing ASD, while only 35% could correctly diagnose deafblindness. In some instances, symptoms were classified as associated with both ASD and deafblindness, when they were just those of deafblindness. Of all the rehabilitation healthcare professionals in this study, speech language therapists displayed the most knowledge of deafblindness. Furthermore, healthcare professionals who had between one and nine years of working experience had more knowledge of deafblindness than other professionals with more or less experience.
Deafblindness is often underdiagnosed or misdiagnosed as ASD. This is due to the lack of competence and confidence of rehabilitation healthcare professionals in diagnosing it. The findings therefore highlight the need for training of rehabilitation healthcare professionals. Training on deafblindness could be included as part of the curriculum in the various undergraduate programs. Deafblindness could also form part of the Continuous Professional Development (CPD) training programs at various healthcare facilities. A team approach to the training would be ideal as it would facilitate peer learning and support. More research is required as it would inform evidence-based assessment, and management and support strategies for children who are deafblind and their families.
对聋盲儿童进行早期诊断和管理对于减轻聋盲对聋盲儿童及其家庭发展的影响至关重要。然而，聋盲儿童常常被误诊或诊断较晚。误诊或诊断延迟归因于许多因素，其中之一是医疗保健专业人员在鉴别诊断聋盲与其他病症（在大多数情况下为自闭症谱系障碍（ASD））方面的能力和信心。因此，该研究旨在确定南非背景下康复医疗保健专业人员在鉴别诊断聋盲与ASD方面的能力和信心。
本研究采用横断面调查设计。通过Survey Monkey向康复医疗保健专业人员（N = 78）分发了在线问卷。使用描述性和推断性统计分析数据。在研究开始前，已获得相关利益相关者的伦理批准和许可。
在本研究的康复医疗保健专业人员中，54%能够胜任ASD的诊断，而只有35%能够正确诊断聋盲。在某些情况下，当症状仅是聋盲的症状时，却被归类为与ASD和聋盲都相关。在本研究的所有康复医疗保健专业人员中，言语治疗师对聋盲的了解最多。此外，有一至九年工作经验的医疗保健专业人员比其他经验或多或少的专业人员对聋盲有更多的了解。
聋盲常常未被充分诊断或被误诊为ASD。这是由于康复医疗保健专业人员在诊断方面缺乏能力和信心。因此，研究结果凸显了对康复医疗保健专业人员进行培训的必要性。关于聋盲的培训可纳入各种本科课程的课程设置中。聋盲也可成为各种医疗机构持续专业发展（CPD）培训计划的一部分。采用团队方式进行培训将是理想的，因为这将促进同伴学习和支持。需要进行更多研究，因为这将为聋盲儿童及其家庭的循证评估、管理以及支持策略提供依据。
