Speech Language Therapy

Speech Language Therapy involves the management and treatment of various conditions affecting a person’s ability to speak, communicate, eat and drink.

Our Speech Language Therapists assess, diagnose, treat and help infants, children and adolescents with disorders or difficulties related to speaking, understanding, using language effectively, feeding and swallowing. We use physical examination, instrumental technology, standardised cognitive-linguistic and speech and language tests to diagnose and guide treatment. A daily home programme is also developed to each individual’s strengths and weakness to facilitate optimal feeding and communication skills.

WHAT TYPICALLY HAPPENS WHEN ATTENDING SPEECH THERAPY

Assessment
At the initial consultation, a Speech Language Therapist will review the child’s medical and social history and obtain any relevant information before conducting an evaluation of the child’s communication, feeding or swallowing skills. This initial assessment serves as the baseline for developing an appropriate individualised treatment plan to meet the needs of the child and family.

Therapy
Treatment programs include development of home programs with parental involvement. Therapy may vary depending on the diagnosis and difficulties the child has. Apart from individual sessions, group therapy sessions maybe recommended for children. For some children who have multiple impairments, functional limitations, disabilities or changes in physical function and health status resulting from injury, disease or other causes, a multi-disciplinary approach involving Occupational Therapists (OT), Physiotherapists (PT), Dieticians, and other professionals is used.

Speech and Language Services

Speech Language Therapy is provided in inpatient and outpatient settings. The following are some of the services we offer.

• Outpatient Speech and Language Services
• Outpatient Feeding and Dysphagia Services
• Inpatient Services
• Instrumental Swallowing Assessments
• Our Key Team

Outpatient Speech and Language Services

Children who have speech and language difficulties may show some of the following:

• Language delays or disorders (difficulty understanding or expressing him/herself at an age-appropriate level)
• Speech sound disorders (mispronunciation or distortion of sounds)
• Stammering/stuttering (disruption to the natural flow of speech)
• Voice disorders (abnormal pitch, loudness or quality of the sound produced)

The following outpatient Speech and Language Services are available.

• Early Language Service
• Articulation Service
• School-age Language Service
• Fluency Service
• Voice Service

Children with language delays or disorders, speech sound disorders, stuttering and/or voice disorders are seen at our outpatient speech and language clinics. Specialised Speech and Language Therapists in each clinic provide therapy for children in an individual or in a group setting.

One of the specialised programs we conduct is the Hanen - It Takes Two To Talk parent training program for young children with language delays. This program teaches parents practical strategies on how to help their children learn and use language in natural, everyday situations. For further information about the content of the program, please refer to www.hanen.org for more details.

Our Speech and Language Therapists are also trained to conduct the Lidcombe Program for children below 7 years who are stuttering or stammering. To find out more about the Lidcombe Program, please visit Australian Stuttering Research Centre at sydney.edu.au/health_sciences/asrc/index.shtml.

Should you have enquiries about the scheduling and other details of our programs at Rehabilitation Centre, please email rehabappt@kkh.com.sg.

Outpatient Feeding and Dysphagia Services

Children with feeding and/or swallowing disorders (dysphagia) have difficulties eating and drinking resulting in poor nutrition, frequent illnesses and increased risk of pneumonia or lung infections.

Feeding and swallowing disorders may arise due to the following reasons:

• Medical problems (e.g. gastric reflux, cardiac anomalies)
• Developmental delay (e.g. global developmental delay)
• Poor nerve or muscle control (e.g. cerebral palsy or muscular dystrophy)
• Lack of positive feeding experience (e.g. force feeding)
• Oral-sensorimotor deficits (e.g. children with autism spectrum disorder)
• Brain injury (e.g. meningitis, traumatic brain injury)

The following are some common signs and symptoms that children with feeding or swallowing disorders present with:

• Irritability or excessive crying during feeding
• Lethargy or lack of alertness during feeding
• Extended feeding times (e.g. more than 30 minutes)
• Coughing or gagging when feeding
• Difficulties sucking on the bottle or breast
• Poor weight gain or growth
• Recurring pneumonia or respiratory infections
• Frequent vomiting
• Picky about different textures of food
• Sensation of food or liquid is sticking in the throat during swallowing

Our Speech Language Therapists are specialists in feeding and swallowing disorders (dysphagia) in infants and children. Our Speech Language Therapists are trained to provide various interventions (e.g. oromotor therapy, Sequential Oral Sensory (SOS) Approach to Feeding, swallowing maneouvers) as appropriate when treating children with feeding and swallowing disorders. We work closely in multi-disciplinary clinics with doctors from a variety of medical specializations, nursing colleagues, allied health professionals as well as with parents and caregivers to provide quality care in both outpatient and inpatient settings.

Inpatient Services

Premature infants may be referred to our Speech Language Therapist during their neonatal stay if they have difficulties coordinating their sucking, swallowing and breathing or if they show signs of swallowing difficulties.

Our Speech and Language Therapists also see children referred by various medical specialties (e.g. Cardiology, Gastroenterology, Neurology, Neurosurgery, Oncology, Otolaryngology, Respiratory Medicine) who require swallowing assessment and/or intervention during their hospital stay.

We also provide assessment and therapy services to children who have acquired communication disorders as a consequence of their medical condition (e.g. after brain injury). Speech Language Therapists are part of various multi-disciplinary teams involved in the care of these children.

Instrumental Swallowing Assessments

Videofluoroscopy Swallowing Study (VFSS)
VFSS is an instrumental swallowing assessment conducted by the Speech Language Therapist, Radiologist and Radiographer under X-ray, to assess your child’s swallowing on different types of food and liquids. It enables the Speech Language Therapist to determine if your child’s swallowing is adequate and recommend food consistencies and feeding techniques to reduce or eliminate the risk of aspiration (when food/drink enters the airway). Your Speech Language Therapist will explain to you in more detail should your child be referred for this service.

Fibreoptic Endoscopic Evaluation of Swallowing (FEES)
FEES is an instrumental swallowing assessment conducted by Speech Language Therapists in conjunction with our Otolaryngologist. This assessment allows the professionals to examine your child's swallowing with different types of food and liquids. During the procedure, food and fluids mixed with blue food colouring will be given to your child. A scope is inserted through your child’s nose to allow the doctor and the Speech Language Therapist to view your child’s throat as your child eats and drinks. Different intervention strategies may be carried out if aspiration (when food/drink enters the airway) is observed. At the end of the session, recommendations will be given to you. Your Speech Language Therapist will explain to you in more detail should your child be referred for this service.

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