Good communication and interpersonal skills are now essential for most jobs as well as for daily life. However, the general public in Hong Kong tends to underestimate the impact of communication problems and is unaware of the possible solutions provided by speech therapy. There is very limited understanding of the field.
It is the main purpose of speech therapy to provide treatment and counselling for people with communication disorders. The problem may be due to some structural reasons such as a cleft lip and palate, says Joyce Chun, a specialist speech-language pathologist at the Cleft Lip and Palate Centre of Prince Philip Dental Hospital. Other cases may be related to developmental delay in children, hearing impairment or brain injury.
There are also less serious cases such as stuttering, which is more a psychological problem, Miss Chun explains, and voice disorder, which many teachers, sales agents and others who do a lot of talking in the course of their work suffer from.
"We have to educate them about voice protection," Miss Chun says, "including some breathing exercises that can help them to better utilise their voice."
Another major duty of speech therapists that is always overlooked by others is to handle swallowing disorder cases, which may involve patients suffered from stroke, brain injuries and structural problems of the oral cavity. "We need to teach patients the safest and the most appropriate swallowing method, and to let their families know the best way of feeding them," says Miss Chun.
Speech therapy treatments vary with individual cases. Speech therapists must first identify the problems. The assessment process usually lasts for 30 to 45 minutes, during which time some standardised tests and informal play is carried out. For example, a child may be asked to describe a picture and perform some tasks by following the instructions of the speech therapist. "During the process, we need to pay attention to every detail such as the social skills, eye contact, facial expression and vocabulary of the child, and to compare his performance with the norm," explains Miss Chun.
Treatment is delivered mainly on an individual basis, for example through modelling and imitation to correct the pronunciation of a patient. There may be group therapy, however, in development of social skills among a small group of children.
There are more than 280 speech therapists in Hong Kong. The largest employer in this field is the Hospital Authority with more than 50. Many are also employed in education, working for special schools or the Education and Manpower Bureau. Pre-school child care services are also common. According to Miss Chun, there are more speech therapists providing private services.
"Those with experience working in the field for more than five years have sufficient patients to justify running their own private clinics."
You get very good exposure, meeting clients with different backgrounds and problems, from children to adults and the elderly
As with most fresh graduates in the discipline, Miss Chun, who decided to become a speech therapist when she was in form six, started her career by serving in public hospitals for three years. She thinks it is a valuable experience with many learning opportunities. "It was busy, and you had to handle as many as 10 cases every day," says Miss Chun, "But at the same time you got very good exposure, meeting clients with different backgrounds and problems, from children to adults and the elderly."
Later, Miss Chun joined the Education and Manpower Bureau, providing services to school children and teachers. Now a part-time clinical lecturer at The University of Hong Kong (HKU), she is studying for a PhD. While the continuous research work can help her acquire the latest techniques in speech therapy, she finds herself most interested in clinical practice and therefore will return to the profession.
Currently no registration of speech therapists is required by law in Hong Kong, although the Hong Kong Association of Speech Therapists believes that registration is necessary for ensuring the quality of services provided by speech therapists and for protecting the public interest.
The Division of Speech and Hearing Sciences at HKU is currently the only organisation that offers university degree programmes for training speech therapists in Hong Kong. The four-year bachelor degree course covers a wide area of knowledge, from linguistics and psychology to physiology and anatomy, and includes practicum of 350 hours.
An essential quality for speech therapists is the ability to be helpful and cheerful. "You must be nice and happy when facing clients. Otherwise, no one will like to see you," says Miss Chun. Speech therapists have to be proactive and patient when interacting with patients and they also need to have an eye for detail.
Although the work of speech therapists does not involve medicine or surgery, it can still be stressful and there is the challenge of dealing with families. "Some parents, for example, are unwilling to send their children to special schools, even though we find that it would be beneficial for them. As a result, we need to educate the parents," she says.
By the same token, Miss Chun finds it most rewarding when she can help not only individual patients but also their families, who are grateful to see their children making progress.
The profession of speech therapy is actually under-developed in mainland China. According to Miss Chun, no specialised services or training are available in the country.
Since speech therapy is very much a localised profession, it is necessary to have a good command of Putonghua to serve on the mainland. Similarly, it is difficult for overseas speech therapists to find employment in Hong Kong unless they speak Cantonese. Otherwise, they would only be able to focus on English-speaking cases.