ACQ Vol 11 No 1 2009

MULTICULTURALISM AND DYSPHAGIA

Many primary and secondary schools have trained “special needs officers” who provide learning support to students identified with learning difficulties. Additionally, some students are referred to external therapists for further therapeutic intervention. Alternatively, special education is available for children who are unable to fully participate in a mainstream school. These schools offer a low teacher-to- student ratio to give increased individual attention to each child. They may provide both academic programs and non-academic programs such as teaching independent living skills or pre- vocational training to prepare students for future employ­ ment. Students may also receive additional support from professionals such as speech-language therapists, occupational therapists, social workers and psychologists. Some special schools cater for specific client populations. For example, there are specialised schools for children with autism spectrum disorder, intellectual disabilities or cerebral palsy. These specialised schools also offer more training and educational resources for parents of children with those conditions. History of speech therapy in Singapore The history of speech therapy in Singapore is not well documented but interviews with key pioneers in the profes­ sion dates the start of the profession to be from the early 1960s, when a few expatriate speech-language therapists arrived in Singapore. The government noted the shortage of this profession and scholarships for overseas education as a speech-language therapist were awarded in the mid-1960s. The first speech therapy department was set up in the Singapore General Hospital in 1968. Subsequently, speech therapy departments were set up in a few hospitals in Singapore. These departments were mostly a one-staff set-up, and were mainly involved in speech and language intervention for children. As the profession evolved, the scope of the speech-language therapist grew to include dysphagia assessment and manage­ ment in the 1990s. Another monumental change occurred in 1994. A professional association – the Speech-Language and Hearing Association, Singapore (SHAS) – was created that year. In 2003 to 2004, the executive committee drew up the Code of Ethics and Scope of Practice with endorsement by the members. These documents serve as reference for the associ­ ation and employers in Singapore. Since the 1960s, local speech-language therapists had to train overseas as there were no local speech therapy programs. They would go mainly to universities in Australia, United Kingdom and the United States of America. This trend is slowly changing as Singapore has most recently started a local Graduate Entry Masters Programme. In 2007, after several years of preparation by a group of senior speech- language therapists and discussion with relevant government bodies and the National University of Singapore, the Master of Science in Speech and Language Pathology was launched at the National University of Singapore under the Division of Graduate Medical Studies. This two year full-time program is based on La Trobe University’s curriculum and uses a problem-based approach in its teaching. The program accepted 20 applicants in its first intake. The intake is biennial due to the limited number of local clinical placements available for the students. The first group of students will graduate at the end of 2008. Most of the students applied for and received scholarships from major health care organisations, community health care organisations and special schools in Singapore. Upon graduation, these scholars will take up a speech-language therapist position in their respective organisations and serve out a bond period.

A mentorship program is currently being drawn up and will be available in time to guide these students when they begin their new careers in speech therapy next year. The next intake of students has been selected and will commence their studies in January 2009. Demographics of speech-language therapists Speech-language therapists in Singapore are commonly called “speech-language therapists” or “speech and language therapists” (SLT). There are 125 practising SLTs in Singapore. The largest portion, 40%, are employed by hospitals, while 24% are in community-based services, 30% are in the private sector and 6% are employed in private schools (Membership statistics obtained from the Speech-Language and Hearing Association Singapore, September 2008). The full spectrum of speech pathology services is available in Singapore, providing services to clients throughout the lifespan. Places of practice may be categorised roughly into five categories, as described below.

Special schools SLTs in special schools provide speech and language support to students enrolled in these schools. They may adopt a classroom- based intervention model or pull-out model, depending on the needs of the child. They may also be involved in managing feeding issues for students with severe physical disabilities. Further, SLTs work closely with the school teachers to facilitate the child’s learning in the classroom. Restructured hospitals SLTs in the six restructured hospitals offer a wide range of services to both inpatient and outpatient clients, focusing on specific client populations. KK Women’s and Children’s Hospital caters mainly to the paediatric patient population, offering services in cleft and craniofacial anomalies, developmental speech and language disorders and paediatric feeding. Singapore General Hospital and National University Hospital offer both paediatric and adult services. The remaining three hospitals cater only to the adult population. Services in all these hospitals typically include those for voice disorders, acquired speech and language disorders, swallow­ ing disorders, fluency disorders and head and neck cancer management. With advances in skill, SLTs in these centres also offer fibreoptic endoscopic evaluation of swallowing (FEES) in the diagnosis and management of swallowing disorders.

ACQ uiring knowledge in sp eech , language and hearing , Volume 11, Number 1 2009

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