Speech and Language Therapy Services
To initiate service, a referring physician, teacher or parent, is required to request an assessment based on the child”s individual needs/difficulties. A speech and language evaluation includes testing, and consequently diagnosing communicative disorders that may present. Speech Therapy then commences on a one-to-one basis. Therapy helps clients to gain their independence via language, and to achieve the goals that are set at the start of therapy. The child’s family/care givers are educated, as well as, counseled, with the hope that they will become a major source of encouragement and support for the child. Home programmes are provided for children who reside far from the Centre i.e. East Malaysia. Home/school visit services are also provided when it is required for case management, health assessment, as well as, education and parenting information/support.

Types of disorders treated:
Apraxia/ Oral Motor Planning Difficulties, Auditory Processing Disorders, Augmentative Communication, Autism/Pervasive Developmental Disorder Spectrum, cleft/lip palate/cranio-facial abnormalities, Developmental Speech/Language Delay, Hearing-related Speech and language difficulties, language/learning, speech sound difficulties, stuttering/dysfluency, swallowing/feeding disorders, voice.

Thus, services of assessing the extent of communication disorders and recommendations of appropriate treatments are provided to, these group of clients:

Apraxia/Oral Motor Planning Difficulties Apraxia is a motor disorder is which voluntary movement is impaired without the presence muscle weakness. The ability to select and carry out a sequence of movements is impaired.

a. oral apraxia - affects one ability to move the muscles of the mouth for non-speech purposes. i.e. a person may have difficulty swallowing, coughing or even blowing a kiss on command.

b. Verbal apraxia - is the impairment in the sequencing of speech sounds resulting in inconsistent speech patterns.

Auditory Processing Disorders
This interferes with a person1s ability to analyze or make sense of information that is heard. This has nothing to do with any form of hearing loss/impairment but it effects how information is interpreted or processed by the brain. A auditory processing impairment can interfere with speech, language and all areas of learning, especially reading and writing.

Difficulties comprehending, storing and retrieving speech. Word finding difficulties and literal paraphasia are usually associated with auditory processing difficulties.

Augmentative Communication
Augmentative (alternative) communication assist people with severe communication disabilities to participate in their social roles. This would include non-verbal individuals or those with limitations in ability to communicate verbally. Thus, the implementation of alternative communication devices is carried out, to achieve communication when speech is not possible. There are a number of different systems that can be used, these systems can be very simple (like using pictures) or more technologically advanced devices (computer devices) depending on the requirements and capabilities of the child.

Autism
Autism and Pervasive developmental Disorder are developmental disabilities that share many of the same characteristics. Usually evident by age 3;00 both disorders are neurological disorders and results in cognitive impairment, language deficit and the inability to relate to others. A positive diagnosis for Autism is made when an individual displays 6 or more of the 12 symptoms listed across three major areas. These area1s are: social interaction, communication and behaviour. When children display similar behaviour but do not meet all the criteria, Pervasive Developmental Disorder is made.

Delayed Speech Development
Some children have difficulties learning to produce certain sounds correctly. Their speech can be very difficult to understand.

Delayed Oral Language Development
Some children (i.e. Downs Syndrome, Attention Deficit Disorder etc.), have difficulties following directions because they do not understand what is being asked of them. Other children have difficulties learning how to put words together to make a phrase, a sentence and to communicate in general.

Cleft lip/palate, craniofacial abnormalities and other diseased/traumas
These abnormalities affect the facial parts necessary for speaking thus communication is effected.

It is common for children who are born with a cleft palate to have speech problems at some time in their lives. Over half of them will require speech therapy at some point during childhood. However, many children who are born with a cleft palate develop normal speech by the age of 5 years of age.

Cerebral palsy, head injuries, brain tumors etc.
All of these conditions can make communication difficult.

Voice impairments or loss:
Some individuals have voices that sound very harsh or raspy. For a small number of individuals, this change in their voice is due to a change to their vocal folds. This change can be growth of some kind or damage due to overuse or misuse of the vocal folds. As well, some individuals may speak using unusual pitch or nasality.

Stuttering or other fluency disorders:
Stuttering is defined as sound or syllable repetitions or prolongations that bring attention to an individual1s speech, and can cause a person to encounter difficulties communicating.

Learning disabilities or communication disorders
As a result of being mentally challenged, learning and communication abilities are sometimes impaired.

Deaf or hard of hearing individuals.Being hearing impaired, no matter how slight or severe the impairment is, has a significant impact on a person1s communication skills, particularly if the impairment exits from birth.

Languages used in therapy
English and Bahasa Malaysia.

Frequently Asked Questions

1. How to know if/when my child requires therapy?
   If your child is experiencing difficulty with some aspect of his/her communicative abilities or if your child1s teacher has noted difficulties in school, then it is best to have your child evaluated by a qualified and certified speech-language pathologist.
2. Do I consult the Pediatrician?
   Always consult your pediatrician first. It is possible that there maybe an underlying medical or physiological issue associated with your child/s communicative delay. Your child1s pediatrician can confirm or rule out any of these other causes and give you a referral for a full speech-language evaluation, as well as, other treatments that maybe necessary.
3. Who is the speech-language pathologist?
   A speech-language pathologist is a professionally trained person who is able to advise, diagnose and work with children, as well as, adults who have a communication disability. They usually work in a variety of settings. In Malaysia they can be found in some hospitals, a few special schools and in private practices.
4. What services does a speech-language pathologist provide?
   A speech-language pathologist is able to provide the following:
   - testing and diagnosing communicative disorders in infants, children and adults.
   - Working with these client groups who require speech-language services
   - Selecting and implementing augmentative and alternative communication devices.
5. What happens during a speech and language evaluation?
   During an evaluation, your child1s communicative skills are measured. This would include a set of communication abilities that your child should have obtained by his/her chronological age, at the time of the evaluation. A full evaluation should encompass: receptive language skills (understanding) all aspects of expressive language skills (production of communication).At the end of the evaluation session, the therapist should be able to formulate a specific therapy plan of care and present this to the client1s caregivers. A full speech-language evaluation should always be followed by a complete written report.
6. What happens during therapy sessions?
   The therapist uses a variety of methods and strategies to help the child to achieve the specific goals set out in the speech evaluation's plan of care. The therapist will also train and counsel the parent/caregiver on techniques to help generalize the skills learnt during therapy sessions at home. The parent/caregiver usually sits in during the session so that he/she may observe the tasks being carried out, so they are able to obtain a better understanding of task goals and methodology of how to carry out the targets at home.
7. How long will therapy last?
   The amount of time the child spends during therapy is determined by what is necessary to achieve the goals determined after the speech evaluation. Thus, the answer to this question can only be provided accurately after an evaluation is carried out and the nature of the problem/difficulty is determined.
8. In a multilingual environment, what language should be used during therapy?
   Intervention should be carried out in the child's first language. That is the language that is used by the client in his/her daily routine, particularly the child's home language.