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ACQ
uiring knowledge
in
sp eech
,
language and hearing
, Volume 11, Number 1 2009
27
MULTICULTURALISM AND DYSPHAGIA
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.
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.
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.