CONVERSATIONS WITH… A Speech Therapist

If you suspect junior might have a speech or eating problem, a speech therapist might ease your worries.

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Yang Huilin has always liked helping people. During her stint at National Junior College, the senior speech therapist was a member of her school’s Interact club and did a lot of social work. Little wonder then that Huilin decided to specialise in speech therapy after graduation.

Indeed, anything related to communication interests her as she has always loved languages, etymology and reading. So, when the opportunity to study speech pathology in Australia came up, she seized it ― and hasn’t looked back since.

Huilin says, “It is quite a good combination of social work and applied science, which also allows me to learn more about language and communication.”

She works at Kaleidoscope Therapy Centre, which offers various forms of therapy including occupational, art, psychomotor and speech therapy. Helping mostly preschoolers from ages 2 to 5, she helps to run an early intervention programme called “Ready Let’s Go” three times a week. This programme, which is led by a group of occupational and speech therapists, provides intensive therapy to help preschoolers develop their communication, motor and social skills. After that, Huilin either sees clients, meets other therapists to discuss their clients' progress or catches up on her paperwork.

But this doesn’t mean there is a specific age where problems will definitely start to happen, because each child is different and unique.”

At what age do speech issues typically make an appearance?
Children vary in their development of speech and language skills. However, they follow a natural progression for mastering communication skills. In terms of speech and language development, there are milestones that we can anticipate as children celebrate each birthday. As a rule of thumb, children say their first word around their first birthday. By their second birthday, they start putting two to three words together to form phrases such as “baby milk” or "I want milk". Between three to four years old, children usually form short sentences such as “baby drinking milk” or "I don't want ball". It is important to keep track of how your child is developing. But this doesn’t mean there is a specific age where problems will definitely start to happen, because each child is different and unique. As professionals, what we can do is to provide an assessment if the parent has concerns about their child’s speech and language skills, and thereafter advise them about their child’s needs and strengths, and whether they require therapy.

What speech impairment signs should parents look out for in their children?
Keep track of your child's speech and language developmental milestones. Research has indicated that early detection and intervention of communication issues is important. Do consider seeking professional help if your child experiences a lack of babbling, or does not use gestures like waving and pointing to communicate their needs during the infant stage. Other important signs to look out for include the child having difficulties understanding what other people are saying, or following simple routines and instructions such as "come here". Saying only a few words or sounds and having trouble putting words together by the time they are 2 years old, not playing and talking to other children, or not showing any interest in other people can also indicate difficulties with communication.

What are the top five common speech issues affecting Singaporean children?
A lot of factors can contribute to speech and language delay. There is ongoing research about the various causes and prevalence of communication disorders. In my clinical experience, most of the children have been diagnosed with Autism or other developmental disorders, genetic disorders such as Down syndrome, and hearing loss. Stuttering, where they have problems speaking fluently, voice disorders, and feeding difficulties are some of the other issues. I personally don’t attend to children with feeding difficulties often, but some of my colleagues specialise in helping children who have feeding disorders or are fussy eaters.

Find out how parents can communicate if their kids have speech issues…next!


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Any advice for parents on supporting their child’s treatment and recovery process?

Early intervention is important, so if you have any concerns about your child, go and find a specialist as early as you can. Speak to them about your concerns, so that they can advise you about doing an assessment for your child and whether he or she needs therapy. It is very important to not give up, and to help the child learn in a fun way while they are going through some of these difficulties.

How can parents communicate effectively with their kids despite their speech issues?
With parents, we often encourage them to talk and play with their child. Get involved in their play and go down to their level, so that you are face to face with your child. This allows them to look at your facial expressions and helps them to stay engaged with you during the play activity. Follow your child’s lead and provide more opportunities for them to interact with you or other children.

It is also very important to use books to promote interaction between parents and their children. Reading to your child every day can help to develop their vocabulary.

What is the first thing you do with a new patient?
When we get a new client, we get their parents to fill a questionnaire which will provide us with information such as their medical history, developmental milestones, their concerns, as well as any other feedback from teachers they would like to share with us.

I would also like to find out about the child’s interests, so that I can incorporate some of them during the session. For some children, coming to a new place and having to be assessed can be very stressful and we want to use some of the things that they like to make it a little more playful and enjoyable.

Can you share with us one of your most memorable experiences?
There was this 3-year-old boy whose parents had a lot of concerns about him playing alone, not making any eye contact and saying only one or two words. When they first came to see me, the child would hide behind his parents or cry, but as the therapy went on, he started to greet me with "good morning" or "bye". Once, when another child fell, he reached over to try and comfort his friend, which is definitely not something we would have seen a few months ago.

The parents were really happy to see his progress, share the same space with his friends, call out their names, play simple games like catching, throwing the ball and balloon, and really laughing and smiling more. Other kids do this every day, but to some parents, being able to see their child develop these skills is really amazing.

Other kids do this every day, but to some of these parents, being able to see their child develop these skills is really amazing.

Any common misconceptions about speech therapy you would like to clear?
Speech therapists not only help people who have difficulties articulating words clearly ― we also help people with difficulties understanding and using language, dysphagia (swallowing problems), stuttering and even voice disorders.

What do you love the most about your job?
I love seeing children develop and gain confidence, so that they start to speak with other people, and also the joy that the parents feel when their child does that. Celebrating firsts of any kind is always very exciting for parents, and being able to be a part of when the child does something new, or something different ― that’s really incredible.

What’s the hardest part about your job?
I used to work at a hospital helping mostly elderly patients with swallowing problems. They suffered from health issues such as stroke or Parkinson’s disease, which resulted in them having difficulties with swallowing and communication. Our roles as Speech Therapists often include helping them make modifications to their lifestyle and diet and/or undergo a period of rehabilitation to develop their swallowing or communication skills.

What I found the most challenging was when I had to tell the patients or their family members that they could not swallow, or that their swallowing problem was so severe that they needed tube feeding, so they would not able to safely consume the same types of food they used to enjoy. In Singapore where there is such a strong culture of using food to show love and bonding through meals, it was quite difficult for some of the families to accept the fact that it might not be safe for their loved one to swallow, as it could lead to other serious problems such as chest infections.

What does it take to be a speech therapist in Singapore?
The regulations have changed over the last few years. The Allied Health Professions Council (AHPC) has a list of recognised qualifications from universities all over the world. You will need a bachelor’s or a master’s degree in Speech Pathology, as well as fulfill a certain set of criteria in order to be registered. There are different types of registrations ― the full registration involves following the supervisory framework to accumulate a breadth of experience working in speech therapy related services.

It is important to regulate speech therapy practice in Singapore, so that people who seek help from speech therapists are seen by professionals who are governed by a regulatory body.

If you did not become a speech therapist, you would be…
… This is tricky, but probably a chef. I do love making good food to feed other people and trying new recipes. My husband and I host parties at our house, so we try, as much as we can, to make something simple for the guests. I think that really adds a special touch to inviting other people into your home. I also keep a journal of all the recipes I have tried, so that I can pass it on and share with other people.

Photos: Yang Huilin

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