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28 Sp eech Pathology Australia
MULTICULTURALISM AND DYSPHAGIA
community-based step-down care (ILTC) to service elderly
clients.
Further, with increasing awareness of special needs in some
children, more SLTs are needed to provide intervention to
children in younger age groups. More SLTs are also needed to
support children attending mainstream schools, and to
provide education and guidance for teachers to identify and
help students with speech-language difficulties. This is also a
reason why the local Masters program in speech and language
pathology has been eagerly anticipated, as it will help to
provide a constant stream of qualified SLTs to meet the
increasing demand for speech therapy services in Singapore.
Increased staffing will also allow SLTs to attend continuing
professional development programs to upgrade and update
their skills and knowledge, and to venture into the realms of
research. Since the clientele of SLTs tends to come from bi­
lingual backgrounds, it is frequently difficult to apply inter­
national (Standard English) norms to assessment and intervention.
Hence local research is important to build up a base of
evidence for language assessment and intervention.
On the professional front, there is a need to standardise
practices and look into ethical issues surrounding the practice
of speech therapy across sectors and organisations in
Singapore. The professional body, SHAS, is fronting these
efforts in a bid to protect the profession and ensure high pro­
fessional standards in Singapore. There is also the continuing
need to increase awareness about our profession’s roles and
scope of practice to the public and other health care professionals.
These efforts are again being driven by SHAS, with the
formation of a new sub-committee that looks into outreach
activities. The inaugural Speech Therapy Day was declared
on 1 November 2008. All speech-language therapists were
encouraged to participate actively in this event. This move
was exciting as it earmarked another chapter in our pro­
fession’s young but vibrant history.
References
Ministry of Health. (2007). Heathcare financing . Retrieved
September 2008 from
hcfinancing.aspx?id=104
Ministry of Information, Communication and the Arts.
(2008). Country profile: People. Retrieved September 2008 from
Intermediate and long-term care
(ILTC) facilities
ILTC facilities include rehabilitation centres, daycare centres
and residential nursing homes. SLTs in rehabilitation centres and
daycare centres may serve either paediatric or adult clients,
depending on the facility’s programs. Most rehabilitation
centres schedule hourly therapy sessions for clients on a regular
basis, whereas daycare centres provide day-long programs for
clients up to 5 days a week. SLTs are typically involved in man­
agement of speech, language and swallowing issues. They
also work closely with clients’ caregivers on how to continue
the management plan at home. In contrast, SLTs working in
nursing homes serve a largely elderly clientele and often
spend a significant amount of time working with care staff in
the areas of feeding and swallowing management.
Specialised centres
Some SLTs in Singapore work in highly specialised areas, such
as assistive technology. They are involved in recommending
appropriate augmentative and alternative communication
devices and training clients to use them. SLTs in such centres
typically work very closely with other professionals such as
occupational therapists.
Private practices
Most of the private practitioners in Singapore offer services to
children for developmental speech and language disorders. A
small group also offers services to adults for acquired
language disorders and swallowing disorders. They also
provide services to community-based health care providers.
Professional development
To ensure that local SLTs continually upgrade their skills, a
range of professional development courses are organised
throughout the year through three sources. Firstly, SHAS
organises an average of three professional development
courses involving internationally renowned speakers in the
field every year. These workshops are open to all SLTs in
Singapore and the region. In recent years, more special
interest groups have also started to increase opportunities for
sharing of experiences and discussion of ideas in specific
professional areas in Singapore. Private training providers
also organise varied training events for health care
professionals throughout the year. Often, these are workshops
targeting management of children with special needs and
developmental speech and language disorders.
The restructured hospitals are the third source of training
providers, filling in the gaps for training that caters towards
management for the adult population. Singapore’s Ministry
of Health allocates funds each year towards bringing in
overseas experts to update the skills and knowledge of the
local speech-language therapists under the Health Manpower
Development Plan (HMDP). Over the years, experts like Dr
Jacintha Douglas, Dr Pam Enderby, Dr Giselle Mann, Dr
Maggie-Lee Huckabee and Dr Leonard LaPointe, to name just
a few, have visited Singapore under this scheme to train local
SLTs in their areas of specialty.
Challenges
The demand for SLTs is increasing in all sectors and caseloads.
Increased SLT numbers will be needed to allow lower
therapist-to-client ratios and shorter waiting times for clients.
In particular, manpower is needed in elderly care to meet the
demands of an ageing population in Singapore. The
restructured hospitals were recently granted substantial
funding by the Ministry of Health for additional staff over the
next five years. Likewise, more SLTs will be needed in
Elizabeth Jane Teh received her degree from Macquarie
University, Sydney, and is now working with clients with
physical disabilities at the Society for the Physically
Disabled. She is also the Vice President of the Speech
Language and Hearing Association Singapore.
Melissa Hui Ling Chua graduated from University
College London and heads the Speech Therapy
Department at Singapore General Hospital.
Correspondence to:
Elizabeth Jane Teh
Speech Language and Hearing Association Singapore
Killiney Road Post Office
PO Box 2142, Singapore 912353
phone: +65 6326 5481
fax: +65 6326 5497
email:
Melissa Hui Ling Chua
Head, Speech Therapy Department
Singapore General Hospital
Outram Road, Singapore 169608
phone: +65 6321 4549
fax: +65 6326 5497
email: