Lecturer Develops Evidence-Based Clinical Algorithm to Assess Children with Hypotonia
UKZN Occupational Therapy Lecturer, Dr Pragashnie Govender, was awarded her PhD after developing a new evidence-based clinical algorithm to assess children presenting with decreased muscle tone that results in hypotonia (floppiness).
Her study was published in eight journals, some of them high impact and positioned within the greater goal of child health and presented in Spain, Japan, the USA and Africa. The study, focused on ‘early detection for early intervention’ in children who present with a symptom of hypotonia, also found in a number of neurological and genetic conditions.
The clinical assessment of hypotonia remains contentious and continues to pose dilemmas for clinicians in the field, given that the initial assessment is often subjective in nature and that the presentation of hypotonia can be either a benign or malignant sign, Govender observed.
‘Currently, there are no standardised assessment tools for children and the incidence is difficult, given that it is a symptom of a number of conditions or disorders. There is a need for the scientific community to establish a level of consensus on the initial clinical assessment of hypotonia and move towards more accurate assessment and diagnosis to implement appropriate management.’
Govender said following a qualitative critique, and revisions, the evidence-based clinical algorithm was constructed prior to being exposed to an appraisal process to assess the quality of the algorithm. ‘Accurate assessment for early detection and intervention in childhood diagnoses remain a priority for all clinicians involved in the field of paediatrics with findings of this study responding to the need for more evidenced-based assessment, thus advancing goals related to child health with respect to early detection and intervention.’
‘I was fortunate enough to have had opportunity to present at a roundtable session at a Mixed Methods Conference in San Antonio in 2015, and to engage with leaders in the field such as John W Creswell, David Morgan, A Onwuegbuzie and M Sandelowski to name a few,’ said Govender – the second UKZN staffer to graduate with a PhD in OT since the Discipline’s operation.
Govender has been accepted onto a two-year medical education fellowship with the sub-Saharan Africa FAIMER Regional Institute; is actively involved in postgraduate supervision of both master’s and PhD candidates within and across disciplines, and continues with interdisciplinary research initiatives in the School of Health Sciences.
Govender received numerous scholarships and grants which helped her complete her PhD and early dissemination of research findings. She is the first generation graduate in her family. She gave special thanks to her supportive husband saying their union coincided with the beginning of the PhD journey.
‘I am actively engaged in my community and church activities especially working with young adults. I was groomed by a grandmother with no formal education and a mother who did not have the opportunity to complete secondary education due to the family’s socio-economic status at the time and historical systems that prevailed,’ Govender shared.
She was thrilled to graduate with her an OT Masters student and staff member that she supervised while doing her PhD, Ms Lauren Hepworth, whose study was titled: “Current Trends in Splinting the Hand for Children with Neurological Impairments”.
‘I look forward to developing a research portfolio and engaging in research that can be translated to the communities that we work with whilst simultaneously advancing health professions education in order to improve global health,’ said Govender.