SmartParents chats to Elizabeth Mui on using her expertise to better the lives of children struggling with autism.

Elizabeth Mui, a Senior Speech and Language Therapist at Thomson Kids Specialised Learning, has worked with clients facing a wide range of developmental disorders like Autism Spectrum Disorder (ASD), ADHD, dyslexia, speech and language delay and more. 

Her passion for the vocation was sparked back in university.  During one of her linguistics modules, a speech therapist was invited to share about her profession. Finding her talk interesting and insightful, Elizabeth decided to pursue a career in the field. After obtaining her bachelor’s degree in linguistics at the University of Western Australia, Elizabeth graduated from the University of Melbourne with a master’s degree in speech pathology in 2014. She then started her speech therapy career in a voluntary welfare organisation, working with students in special education schools. At present, she works with paediatric populations under Thomson Kids. 

Elizabeth sheds light on her work helping children with ASD, the challenges and rewards of her job and how parents can provide support.

How exactly does a speech and language therapist help children with autism?

As a speech therapist, I work with a large number of children with ASD. The process of speech therapy begins with an assessment to evaluate a child’s speech, language and social communication skills. The assessment is what informs an intervention plan for the child.

The child will then attend regular, individual therapy sessions to work towards specific goals. Many children with ASD tend to struggle with language and social skills. One-to-one therapy sessions with a child can involve a wide range of activities, including but not limited to play-based tasks, structured games, picture-based tasks, books and video-modelling. 

For children aged 6 and under, parents are often encouraged to join in therapy sessions to observe and learn strategies for stimulating language development.

What do you love the most about your job and working with children with autism?

I enjoy working with clients of different ages and profiles. When working with children with ASD, I find it delightful seeing progress in their ability to communicate and connect with others.

What are some of the challenges you face?

With the pandemic, there have been disruptions when clients test positive. The lockdowns and school closures have also affected therapy sessions as teletherapy may not be suitable for clients with ASD, who tend to participate better in face-to-face sessions with hands-on activities.

Another challenge is ensuring that “therapy” for a child continues at home so he or she can practice skills targeted in their home environment. This can be quite challenging as most families tend to have both parents working and there is little time (or energy) for caregivers to follow up with strategies or homework at night. I can definitely empathise with this, so I do my best to keep follow-up recommendations structured and simple.

How do you conduct an autism assessment?

Assessments for diagnosing autism are done by a multidisciplinary team of healthcare professionals, which may include a paediatrician, a child psychiatrist or psychologist and a speech or occupational therapist.

At Thomson Kids, our psychologist interviews parents to get a detailed history of a child’s developmental history and behaviour. Standardised assessment tests such as the Autism Diagnostic Observation Schedule (ADOS) and Autism Diagnostic Interview-Revised (ADI-R) are used.

Speech therapists conduct assessments which may be both formal and informal, depending on a child's needs and abilities. The assessment will help determine if a communication disorder is present, and if so, the severity of it as well. 

Informal assessments typically consist of parent interviews and play-based assessment. Formal assessment would include the use of standardised assessments such as the Clinical Evaluation of Language Fundamentals – Preschool 3 (CELF-P3) and Clinical Evaluation of Language Fundamentals 5 (CELF-5) for older children.

What are some key signs of autism?

ASD is characterized by deficits in social communication and social interaction and the presence of restricted, repetitive behaviours.

By 12 months, infants at risk for ASD often demonstrate atypical eye gaze and less social smiling. The use of fewer joint attention gestures and behaviours as infants and toddlers is another sign of autism.

The loss of earlier learned words, delayed acquisition of words such as actions and people's names, and the use of echolalia (repeating others' words or sentences) are other signs of autism.

What are some misconceptions about autism?

A common misconception about ASD is the belief that parents may have done something to “cause” it, or that it only affects kids and children can “outgrow” the condition.

Autism is a lifelong neuro-developmental condition that does not have one specific cause. Most children with autism appear to be caused by a combination of genetic and environmental factors influencing early brain development. It is not caused by a child’s upbringing or social circumstances. Vaccines do not cause autism.

As it is a lifelong condition, children do not outgrow autism. The symptoms of autism may change or lessen when a child receives appropriate interventions and develops, but autism does not go away when children are older. Difficulties with social communication and interaction often persist into adulthood and can have impacts across various life domains such as work and independent living.

How does autism therapy work and help children with ASD?

Individuals with ASD present with different communication difficulties at different stages in life. For toddlers and younger children, therapy may focus and help to develop prerequisite skills for communication, such as eye contact, joint attention, play skills and imitation skills. Therapy is also often focused on training parents and caregivers to equip them with strategies for building up the foundations for communication.

For school-aged children, therapy can help to improve language and communication skills, such as developing their receptive and expressive vocabulary, oral grammar, sentence structure and literacy skills. Therapy can also focus on developing a child’s social communication skills to help a child learn to join in conversations, maintain a topic and make friends.

What type of therapy is best for autism? 

Rather than one “best” therapy for autism, I believe interventions that are evidence-based, grounded in research and individualised to the client’s needs to work towards specific goals. This will work best in helping a child to develop.

Can you share a memorable anecdote about working with a client?

Years ago, I worked with a teenager with autism who was minimally verbal. He struggled greatly with eye contact and had very poor motivation to engage in therapy activities. One day, he expelled flatulence in the loudest way imaginable and grinned while staring at me for a long time. 

It was then I discovered he paid attention best to funny noises, and we had many fun and engaging sessions thereafter with the use of silly games and videos with funky noises used as motivators to keep him engaged. 

What are some practical tips for parents to support and help children with autism? 

If you suspect that your child may be lagging behind in developing communication skills, bring up your concerns with your child paediatrician and consult a child psychologist or speech therapist as early as possible. Results are better when a child receives intervention early. 

For children who are older, I always tell their parents that it is never too late to start therapy. Although older children may take a longer time to see progress, there is potential to improve at any stage of development.

Working in a challenging field, how do you de-stress and strike a good work-life-balance?

I think it’s important to maintain work-life balance by leaving work behind at work and to not let it spill over into home life. To de-stress, I spend my time grocery shopping, maintaining my aquariums at home and playing with my dog. I enjoy tropical fishkeeping, and I’m subscribed to aquascaping, birdkeeping and rabbit channels on YouTube.

What inspires and motivates you? 

Seeing my clients develop new skills and gain confidence from their improvements never fails to inspire me to keep doing what I do.

What valuable lessons have you learnt along the way, being in this profession? 

Every person is unique and develops at their own pace. It’s important to celebrate small steps taken, look beyond a child’s weaknesses or differences, and instead focus on their strengths and small improvements.

Complete these sentences…

- The one superpower I would like to have is… the ability to manipulate time.

- I am happiest when… seated at a buffet table with friends and family. 

- My favourite vacation destination is… Penang, Malaysia.

- If I wasn’t a therapist, I would be a… police officer.

If you suspect your child is struggling with autism, consider seeking an autism assessment for them and specialised therapy at centres like Thomson Kids Specialised Learning. Visit Thomson Kids’ website for more info or to book an appointment for an official assessment. 

Photos: iStock

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