To understand the work of a speech and language therapist we spoke to Aalia Thobani Speech-Language Pathologist and Specialist in Learning Disabilities at The Infinity Clinic, Dubai.
What does a speech and language therapist actually do?
The overall objective of speech-language pathology (SLP) services is to optimise an individuals' ability to communicate and swallow, thereby improving quality of life, and success at school. A speech-language pathologist evaluates and treats children and adults who have difficulty speaking, listening, reading, writing, or swallowing.
What can you tell us about your current patients?
As in every society, there are a variety of diagnoses and symptoms that one addresses as a professional in speech and language pathology. My current caseload comprises of children and adults with language delays, articulation delays, disfluencies, auditory processing disorders, voice disorders, and feeding difficulties. In some cases, these are secondary to disorders such as apraxia, autism, Down syndrome, and William syndrome. In my practice, I deal mostly with symptomology rather than labeling children into set categorical diagnoses.
How do children begin therapy?
The severity of symptoms ranges from individual to individual. Generally if it is a critical delay in language, intervention should begin as early as possible. If a child is born with an obvious syndrome such as Downs, therapy should start early in the form of feeding therapy to assist with mouth and oral control. If a child is not born with a syndrome, but is falling behind in his or her speech language milestones, for example, if a child is not babbling at six months, or saying their first word by one, if a child is not putting words together to make sentences by two, then intervention should be sought.
The first aspect to verify is if the child’s hearing is clear. There have been countless kids coming to see me at three years who are not talking, and a hearing assessment reveals that the ears are completely blocked with fluid.
Childrens’ language development is critical from birth to three years. Never take chances, we’d rather be pro-active than take a “see how it goes attitude.”
Consistent and intensive therapy carried out in both the home and school environments, really does give very positive results!
Tell us about your part in the diagnosis and assessment of SEN?
I base my work on symptoms presented, while taking into consideration the family and developmental history. If a child is very young, my assessments are more informal. If a child is three years or older, I conduct more formal assessments. The assessments provide me with an idea of how the child is performing relative to peers and what areas to focus on.
My purpose in assessing is to direct my therapy, and my diagnoses are based on speech, language, and learning symptoms e.g. receptive language delay, expressive language delay, articulation delay, apraxia. I am not mandated to diagnose for example ADHD or autism. That would fall under the jurisdiction of a psychologist or psychiatrist.
What do see as the biggest issues in the field of special education needs?
There is a lack of communication amongst health care workers, teachers, and SLPs. Many doctors and teachers don’t refer children to an audiologist quickly enough. Many doctors have advised clients of mine that it’s OK if their child is not talking by the age of three. SLPs believe strongly in early intervention. We must work closely with doctors and teachers to ensure that we are catching hearing and speech deficits early, as birth to three years is the critical time for language development.
The other issues are a lack of resources and schools that cater to the needs of children that require more assistance or a modified curriculum. This leaves many parents at a dead-end with regards to obtaining appropriate mainstream education and services for their child. This is an issue that requires awareness, funding, and licensing options that allow for regular schools to keep appropriate provisions for children with additional needs (including gifted children), and for individuals in the field to open up schools and centers to assist families and to enhance our children’s quality of learning.
What advice would you give to parents planning on coming to the UAE with a child with special educational needs?
There is a bigger demand for services and school spots, than there is a supply. It is important to plan ahead of your move and to reach out to therapists to add your names to waiting lists. With schools, apply early; apply to several, as it is becoming more unlikely that you’ll get your first-choice of school immediately. If the circumstances allow, choose: small class size, structure, and a solid learning support team, all essential for children with additional needs.
What should parents do and ask about when choosing a speech therapist?
• It’s important to understand the therapists’ background and to be aware of the different licensing requirements in various countries
• Ask not just about education, but work experience too. Success and results in this field depend a lot on experience
• Meet the therapist and see how he/she interacts with your child
• Does the therapist diagnose the child without spending the time to get to know him/her? Is he/she basing the diagnosis simply on your perspective and a check-list? I would be wary of this. It’s important for the therapist to understand your child as the individual he/she is
• Ideally, if possible, go with a therapist that has been recommended to you
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