Speech Therapy Singapore

Speech, language, and communication are essential in day to day life.

Speech, language, and communication are one of the key traits of humans, distinguishing them from other species. Clear communication is essential in day to day life. Children and adults need to communicate with peers, family members, friends, and teachers.

Speech Therapist teaching a kid

Some individuals have challenges with speech, language, or communication, or possibly all three. A Speech Language Therapist is an allied health professional educated in the study of human communication, its development, and possible disorders. The Speech and Language Therapist helps children with speech, language, or communication difficulties. The Speech Language Therapist can also help with eating or swallowing difficulties.

At Dynamics, we believe in a collaborative approach to help individuals break through any challenges they may have. Our Speech Therapists work closely with teachers, occupational therapists, and psychologists as well as medical doctors and audiologists.

Our speech and language therapists in Dynamics specialise in helping children. By assessing the speech, language, cognitive-communication, and swallowing skills, they can determine what types of communication problems exist and the best way to help overcome these challenges.



For more details please visit our website
www.dynamics-speech.com.sg

Who can benefit from Speech Therapy?

Any child who has challenges with speech, language or communication may benefit from Speech Therapy. Some examples are children with speech delay, unintelligible speech, or articulation and phonology disorders.

Children with Autism Spectrum Disorder (ASD) often have challenges with communication even if they are verbal. For such children, the help is not with speech but with communication as they have social or pragmatic language difficulties.

A speech therapist can also help children with difficulties with swallowing or who are drooling.

Where can I get Speech Therapy in Singapore?

In Singapore, most Speech Therapists work in Hospitals, Schools, or specialised therapy centres such as Dynamics Therapy Centre.

Who is allowed practice of Speech Therapy in Singapore?

Speech therapy is a regulated profession. In order to ensure quality of service, the Ministry of Health has set up the Allied Health Professions Council (AHPC)

All speech therapist at Dynamics are registered with AHPC.

Is it possible for parents to do something on their own?

Yes! To encourage children to speak and communicate, parents can take different approaches, such use games, rewards, and modelling.

What happens in therapy? How do we get started?

Dynamics Approach

In order to help children reach a higher level of communication, we start with an assessment of their current level. The speech, language, and communication assessment is used to determine the strength and weaknesses of the child.

Our speech therapists combine the use of standardised assessment tools with clinical observations in order to determine the strengths and weaknesses of your child. With solid information at hand, they can then proceed to develop an individually customized intervention plan with concrete goals.

An assessment is required prior to commencing intervention for the Speech Therapist to get to know the child, as well as to understand where he or she needs help.

Before the assessment you will be asked to fill out a form to provide information of your child’s developmental history and your concerns about your child. The therapist will also ask you further information, such as whether or not your child has specific difficulties in certain areas of communication or feeding and swallowing issues.

We are also looking at the areas of attention, listening skills, understanding of verbal expression and your child’s expressive language.

Other observations may include oral-motor functions and whether the child is having any sensory sensitivity around the mouth and jaw.

After the assessment, the SLT will analyse the information captured during the formal and informal assessment to identify specific areas of needs to be worked on. Based on the analysis, the SLT will plan tailor-made goals for your child’s therapy sessions. There will be specific exercises targeted for specific areas of need to be worked on in the sessions and at home.

You may request and optional formal assessment report from the therapist. The report is at extra cost and will be provided within 2 weeks of the assessment date.


FAQ's

A: There can be many reasons why a child would need a feeding assessment. If your child has any of the following issues, a feeding assessment might be needed.

  • frequent gagging, choking or vomiting during meals
  • refusal to try new foods
  • picky eater – only eating certain foods
  • food range of less than 20 foods
  • difficult to feed

The symptoms of stuttering typically appear between the ages of 2.5 to 4 years. It is also possible for stuttering to start during primary school. About 5% of children display stuttering behaviours and stuttering is more commonly observed in males than females. Preschoolers may have little or no awareness of their fluency difficulties, especially so when they first start to display stuttering behaviours. However, most people who stutter become increasingly aware of their fluency difficulties and the responses they receive when they do not speak fluently.

It is important to have regular checkups with developmental and hearing specialists to ensure your child’s development is progressing appropriately. Concerns may be raised by your family doctor, professionals who work with your child, e.g. teachers and support staff, or from your friends and family regarding your child’s ability to; understand/follow instructions, communicate their thoughts/feelings/wants/needs or their ability to interact with their peers (social communication).

As parents you may also seek speech and language therapy for your child if you have concerns that your child is not reaching their language and communication milestones in the way that their siblings, friends and peers do. If you have any concerns, our clinicians will be able to perform an initial assessment to determine whether speech and language therapy may be beneficial for your child.

Children who stutter exhibit poorer educational and social outcomes than their normally fluent peers; it is therefore of importance to commence with therapy to reduce stuttering behaviours. Clinical evidence shows that children who stutter can benefit from treatment provided by speech therapists. Intervention approaches that appear to have the greatest efficacy for reducing the frequency of stuttering behaviours in children include behavioural treatments (e.g. Lidcombe Program).

Amounts and frequency of therapy varies greatly between each child and can last from weeks to many years. It is rarely possible to give an exact time frame for intervention as this changes due to the cause of communication difficulties, the child’s ability to build new skills and the severity of the delay or disorder.

Following the initial assessment, the therapist will plan both long and short term goals for your child. They will also seek you input for these goals. The therapist will then work with the child on achieving these goals which will be reviewed when necessary. This way, both the therapist and family can monitor the child’s development in a meaningful way, ensuring all skills are achieved before moving to the next stage of communication.

Each children develops in his own pace. The following table describes the age by which most children will accomplish various speech-related skills (taken from ASHA website).

Hearing and Understanding Talking

Birth-1 Months

  • Startles to loud sounds.
  • Quiets or smiles when spoken to.
  • Seems to recognize your voice and quiets if crying.
  • Increases or decreases sucking behavior in response to sound.

Birth-1 Months

  • Makes pleasure sounds?(cooing, gooing)
  • Cries differently for different needs.
  • Smiles when sees you.

4-6 Months

  • Moves eyes in direction of sounds.
  • Responds to changes in tone of your voice.
  • Notices toys that make sounds.
  • Pays attention to music.

4-6 Months

  • Babbling sounds more speech-like with many different sounds, including p, b and m.
  • Vocalizes excitement and displeasure.
  • Makes gurgling sounds when left alone and when playing with you.

7 Months-1 Year

  • Enjoys games like peek-o-boo and pat-a-cake.
  • Turns and looks?in direction of sounds.
  • Listens when spoken to.
  • Recognizes words for common items like "cup", "shoe," "juice."
  • Begins to respond to requests ("Come here," "Want more?").

7 Months-1 Year

  • Babbling has both long and short groups of sounds such as "tata upup bibibibi."
  • Uses speech or non-crying sounds to get and keep attention.
  • Imitates different speech sounds.
  • Has 1 or 2 words (bye-bye, dada, mama) although they may not be clear.

1-2 Years

  • Points to a few body parts when asked.
  • Follows simple commands and understands simple questions ("Roll the ball," "Kiss the baby," "Where's your shoe?").
  • Listens to simple stories, songs, and rhymes.
  • Points to pictures in a book when named.

1-2 Years

  • Says more words every month.
  • Uses some 1-2 word questions ("Where kitty?" "Go bye-bye?" "What's that?").
  • Puts 2 words together ("more cookie," "no juice," "mommy book").
  • Uses many different consonant sounds of the beginning of words.

2-3 Years

  • Understands differences in meaning ("go-stop," "in-on", "big-little," "up-down").
  • Follows two requests ("Get the book and put it on the table.").

2-3 Years

  • Has a word for almost everything.
  • Uses 2-3-word "sentences" to talk about and ask for things.
  • Speech is understood by familiar listeners most of the time.
  • Often asks for or?directs attention to objects by naming them.

3-4 Years

  • Hears you when call from another room.
  • Hears television or radio at the same loudness level as other family members.
  • Understands simple, "who?," "what?," "where?," "why?" questions.

3-4 Years

  • Talks about activities at school or at friends' homes.
  • People outside family usually understand child's speech.
  • Uses a lot of sentences that have 4 or more words.
  • Usually talks easily without repeating syllables or words.

4-5 Years

  • Pays attention to a short story and answers simple questions about it.
  • Hears and understands most of what is said at home and in school.

4-5 Years

  • Voice sounds clear like other children's.
  • Uses sentences that give lots of details (e.g. "I like to read my books").
  • Tells stories that stick to topic.
  • Communicates easily with other children and adults.
  • Says most sounds correctly except a few like l, s, r, v, z, ch, sh, th.
  • Uses the same grammar as the rest of the family.

If you observe your child’s tongue going past his/her teeth as he says words such as “sea” or “zebra”, he/she might have an interdental lisp. Those two sounds, ‘s’ and ‘z’ respectively, are quite tricky to produce and tend to develop quite late. Therefore, it is ok for children to produce them with the tongue popping out at a young age. However, if this persists past the age of 4½, seeking a speech therapist’s assistance will be necessary to teach a correct production. Be mindful of those ‘s’ sounds produced in a “noisy” way, when you feel that you are hearing saliva bubbles forming, or just too much air coming out, specially from the sides of the mouth. This might be a “lateral lisp”, which is not a typical error in the sound development continuum. A speech therapist’s assessment and assistance will be required, the earlier the better.

At that age, you would expect your child to start playing with other children. If he/she interacts better with you, it might be because you provide a better structure, understand his/her non-verbal communication and easily know what he/she means, while the other children he/she plays with will not. He/she should be able to request from peers “gimme ball” and comment on situations eg “bear fell down”. A speech therapist will assist with the development of language and social skills.

“Augmentative and Alternative Communication” (AAC) encompasses all forms of communication (other than speech) that are used to express an individual’s wants, needs, opinions and ideas. AAC can be divided into 2 main categories – unaided communication systems and aided communication systems. Unaided communication systems include: body language, gestures, sign language (and Key Word Signing). Aided communication systems include: using pictures, writing, communication books or boards, switches, and also speech generating devices (both specialised devices and apps). Use of AAC can help reduce communication breakdown and frustrations. Research currently demonstrates that use of AAC will not keep a child from learning to talk. Children will choose the most effective method to communicate, whether that be speech or AAC or a combination.

Speech and language therapy may begin at any age. In babies, it may be needed to address feeding or swallowing difficulties which can cause difficulties in early development and well being. Communication (understanding and using language) therapy for children whose language is delayed from an early age will typically begin from 18-24 months, though children are often seen at a later stage as difficulties become more apparent. Children with speech difficulties are usually seen from the age of 3 years, though this depends on the nature of the difficulty.

If you have concerns with your child’s speech, language and communication at any point in their development we recommend you have an appointment with one of our clinicians to learn more.

Both Hanen programs are delivered by a Hanen Certified Speech-Language Therapist. They can be delivered in individual therapy sessions or in group sessions. Both programs focus on communication in the everyday environment and using daily routines and activities to support communication.

The “It Takes Two to Talk” Program is designed specifically for parents/caregivers of young children (birth to 5 years of age) who have been identified as having a language delay. Parents/caregivers are supported to interact in ways that support the development of their child’s language and interaction.

The “More Than Words” Program is designed specifically for parents of children ages 5 years and under on the autism spectrum. The program provides parents/caregivers with tools, strategies and support to help their children reach their full communication potential. The program does this by teaching strategies to help improved social communication and back-and-forth interactions, improved play skills and improved imitation skills.

Pragmatics or the rules for social language is another area in which speech and language therapists may work with children. Pragmatics involves using language for specific purposes, such as greeting, informing, demanding, promising, or requesting; changing language according to the needs of the listener or situation, such as talking differently to a peer than to an adult or giving context to an unfamiliar listener; following rules for conversations and storytelling, such as taking turns in conversation, introducing topics, or rephrasing when misunderstood, using appropriate verbal and non verbal gestures , facial expressions and eye-contact.

A child with pragmatic difficulties/disorders may use complex language but still have a communication difficulties such as saying inappropriate or unrelated things during conversations, telling stories in a disorganized way or have little variety in their language use and topics.

The exact cause of stuttering is currently unknown. Recent studies have suggested that genetics plays a role in the development of the disorder and that abnormalities in speech motor control, such as timing and sensory and motor coordination, are implicated.

A: You will be asked to bring certain foods from home to trial in the session with the therapist. After a thorough interview with the therapist, she will observe your child’s feeding and drinking abilities. During the assessment, she might trial some strategies that might improve your child’s feeding skills. Depending on the outcome of the assessment, feeding therapy might be recommended.

PROMPT Therapy

– Prompts for Restructuring Oral Muscular Phonetic Targets
Developed by: Deborah Hayden CCC/SLP


What Is PROMPT therapy?

PROMPT is a language–based treatment approach.

It provides tactile information to the oral musculature (jaw, lips, tongue) in an attempt to guide a child’s movements for speech production.

Sensory feedback from the movements is then stored and progresses as the child is provided multiple opportunities for practice. Muscle memory builds (this takes at least 6-8 weeks), and movement patterns for speech become more and more automatic.

There is a PROMPT for every sound in the language, vowel or consonant.

Why does it work?

Practice and feedback are integrated.

In PROMPT therapy, a child receives tactile cues as well as auditory feedback (two extremely important sensory systems required in learning to talk).

- Motivation is the key! It is very important to encourage a child so that they can maintain attention and effort required to make changes in speech production.
- Target sounds, words and phrases are practiced in a variety of interactions, both in therapy sessions and in the child’s natural environment.

How does it work?

First a motor assessment is carried out by our PROMPT trained therapist (Clare Hegarty at Dynamics Speech).

Target sounds are then selected to be developed and a lexicon (group of words containing these sounds) is then devised and used as the base line for therapy.

Practice Makes Perfect!

There are two types of practice:

Drill Practice - Sounds, syllables and words are practiced with high levels of repetition at the beginning of therapy sessions to stimulate a motor warm up
Distributed Practice – Retrieval of the sounds, syllables and words in a functional context (home and school etc)

Stuttering is a fluency disorder. It is also known as ‘stammering’ in some parts of the world. Stuttering is characterized by disruptions in the production of speech sound, which may be in the form of repetitions, prolongations or blocks. One or any combination of these behaviours may be observed consistently or variably. The frequency, duration, type, and severity of disfluencies vary greatly from child to child and from situation to situation.

There is no single right way to raise a bilingual child. Sometimes parents are advised to separate the two languages when talking to their children. For example, when parents talk with their children, one parent speaks one language and the other speaks in another. Although children can learn more than one language in this way, this is not the only option. It is also recommended that when speaking to a child that the parent/carer does not “code switch”. This means that you complete your conversation/sentence in one language and do not change mid conversation. This allows the child to build up a mental dictionary of words specific to the language but also to learn the grammar and sentence structures for this language. What really helps is to surround your child with a rich and valuable language.

In general, children who grow up in the U.S. learn English quickly because they have been exposed. However, learning the language of the home can be more difficult. It is important to offer children frequent opportunities to use their native language in meaningful and enjoyable ways.

Quite often parents and teachers will report concerns about a “speech delay”. However, during assessment it may become clear that the child has a language delay. Are they not the same thing? No. Speech and language are very different.

Language is made up of socially shared rules that include the following:

  • What words mean (e.g., “star” can refer to a bright object in the night sky or a celebrity)
  • How to make new words (e.g., friend, friendly, unfriendly)
  • How to put words together (e.g., “Peg walked to the new store” rather than “Peg walk store new”)
  • What word combinations are best in what situations (“Would you mind moving your foot?” could quickly change to “Get off my foot, please!” if the first request did not produce results)

Speech consists of the following:

– Articulation
How speech sounds are made (e.g., children must learn how to produce the “r” sound in order to say “rabbit” instead of “wabbit”).

– Voice
Use of the vocal folds and breathing to produce sound (e.g., the voice can be abused from overuse or misuse and can lead to hoarseness or loss of voice).

– Fluency
The rhythm of speech (e.g., hesitations or stuttering can affect fluency).

In general, children who grow up in the U.S. learn English quickly because they have been exposed. However, learning the language of the home can be more difficult. It is important to offer children frequent opportunities to use their native language in meaningful and enjoyable ways.

Before you attend your first appointment/assessment, have a think about your child’s developmental history and complete the Child History Questionnaire (CHQ). Some of the questions you will be asked in the assessment would be:

  • When did your child first babble/use first words/string 2 words together?
  • Has your child received any diagnosis?
  • Is there a history of speech and language difficulties in the family?
  • Have they attended speech and language therapy before?

If your child has attended an assessment or therapy elsewhere (another speech and language therapist, occupational therapist, psychologist, etc), it would be useful for you to bring reports or share the information from such sessions with your speech and language therapist also.

Speech is the ability to use your lips, tongue and other parts of your mouth to produce sounds. To produce clear speech children need to be able to produce the different sounds of speech, as well as understand the rules for putting those sounds together in their language.

Most children have mastered the following sounds by the following ages:

  • around 3 years: b, p, m, n, h, d, k, g, ng (sing), t, w, f, y
  • around 4-5 years: f, sh, zh, ch, j, s
  • around 6 years: l, r, v
  • around 7-8 years: th, z

Most children make mistakes in their speech during the first few years of speech development. But by about three years, most children can be understood by their main caregivers.

If you’re worried that your child might have a speech disorder, think about how often people who don’t know your child have trouble understanding your child.

  • around 2 years about 50% of your child’s speech should be understood by a stranger
  • around 3 years about 75% of your child’s speech should be understood by a stranger
  • around 4 years about 100% of your child’s speech should be understood by a stranger

It’s best to consider seeking help if your child:

  • is six months or more behind the approximate age ranges for using speech sounds
  • uses speech patterns that are delayed for his/her age, or speech sounds that are immature compared with peers
  • gets frustrated about speaking – for example, he/she gets upset when he/she isn’t understood and has to repeat himself/ herself frequently.

No. There are some common myths about multilingual development. It is been said to many parents that multilingualism will cause children to develop language at a slower pace. But there is no scientific evidence to support that belief. Many children around the world learn more than one language at the same time and don’t show language delays.

A social conversation requires many areas, all of which we are supporting your child in developing. These areas are not limiting but include, vocabulary, concepts, memory, organizing, sequencing skills, to support your child in being able to have a conversation.


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