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Speech Therapy

Introduction

The domains of communication include speech, language, cognitive communication, hearing impairment, fluency and voice.


Our Speech Therapists also provide services for the paediatric population in domains of language, speech and social communication skills.


Swallowing
Difficulty in swallowing liquids and/ or solids.


Language
Difficulty in reading, writing, comprehension and expression of language.


Speech
Difficulty in the production of speech sounds.


Voice
Difficulty in the appropriate use of voice quality, volume and pitch to communicate effectively with others.


Fluency
Difficulty in the flow of speech in the form of repetitions, prolongations and/or blocks, also often known as stuttering.


Hearing Impairment
Difficulty in communication arising from a hearing loss.

What is dysphagia?

Dysphagia is a difficulty in swallowing liquids and/ or solids, which may result in liquids or solids entering the airway and into the lungs. This is common in people with stroke, neurodegenerative disease, respiratory disorder, and head and neck cancer. When left unmanaged, this may lead to chest infections (aspiration pneumonia) which can be life-threatening.

Swallowing Assessment

During an assessment, the Speech Therapist may:

  • Obtain a case history to understand your swallowing difficulty and medical conditions that can contribute to this
  • Assess and evaluate the strength and movement of muscles involved in swallowing
  • Assess and evaluate the safety of swallowing during eating and drinking

If necessary, instrumental assessments like the Videofluoroscopic Swallow Study (VFSS) or Flexible Endoscopic Evaluation of Swallowing (FEES) may also be available for patients requiring these services.

Swallowing Therapy*

During therapy, the Speech Therapist may:

  • Prescribe and review appropriate exercises taught to patients to improve the function of your swallow muscles
  • If suitable, relevant biofeedback devices may also be used in conjunction with swallowing exercises taught to supplement therapy

Instrumental Swallowing Assessments*

Videofluoroscopic Swallowing Study (VFSS)

VFSS is an instrumental swallowing assessment done under X-Ray to assess the patient’s swallowing function across a variety of foods and liquids objectively. This is conducted by the Speech Therapist, the radiologist and the radiographer. Based on the findings, food and fluid consistencies will be recommended together with the appropriate feeding techniques to optimize the swallowing safety of the individual.

Flexible Endoscopic Evaluation of Swallowing (FEES)

FEES is a procedure in which a thin, flexible endoscope is passed through the nose by the Speech Therapist to assess the swallowing function of the patient objectively. During the procedure, the patient may be required to eat and drink various food and fluids of different consistencies coloured with food dye. Based on the findings, the appropriate diet and fluids may be recommended, together with the associated swallowing rehabilitation exercises prescribed to optimise the swallowing function.

Speech and Swallow Airway (SSA) Clinic*

As part of a multi-disciplinary team comprising of doctors and allied health professionals, the speech therapist helps to oversee and manage the swallowing and communication issues that may arise after a tracheostomy. A tracheostomy is a medical procedure done by the surgeon for patients who may need added support to facilitate breathing and tracheal hygiene. This is done by creating an opening at the neck that connects to the airway via a tracheostomy tube. If suitable, the clinical information obtained in the process may also contribute to the weaning off process of the tracheostomy tube for the patients eventually. 

Nutrition and Swallow Clinic*

This is a joint clinic that is held in collaboration with SKH Dietetics Department. Both Speech Therapists and Dietitians will work closely together to optimise our patients’ nutrition and reinforce our patients’ swallow safety within a single clinic setting. Patients who may benefit from this clinic include those who:

  • are currently on transitioning feeding (e.g. tube to oral feeding)
  • requires supplements (e.g. Ensure milk supplements)
  • are transitioning between diets (e.g. completely blended to minced diet)
  • may display poor oral intake

This clinic allows for patients to be co-managed and have their concerns addressed by both professionals in a single setting.

Device Related Rehabilitation (DRR) Clinic*

Our team of Speech Therapists in DRR Clinic specialises in the teaching of rehabilitation exercises using assistive devices for patients with swallowing difficulties from pre-existing medical conditions. Example of assistive devices include:

  • Surface Electromyography (sEMG) device - it provides visual feedback of a patient’s muscle function, allowing them to self-monitor their performance during swallowing exercises. This enhances the efficacy of prescribed swallowing exercises.
  • Iowa Oral Performance Instrument (IoPI) - it objectively measures the lip and tongue strength via resistance training, providing feedback on patients’ performance during oral motor exercise programs.

What is aphasia?

Aphasia is a communication disorder that results in difficulties speaking, writing and understanding language. Aphasia is common in people with stroke, a head injury or brain tumor.

What is dysarthria?

Dysarthria is a speech disorder caused by muscle weakness. Some characteristics of dysarthria are slurred speech, robotic speech and speaking too quickly or slowly. Dysarthria is common in people with stroke and neurodegenerative diseases such as Parkinson’s Disease.

What is apraxia?

Apraxia of speech is a speech disorder caused by difficulty moving the tongue and lips the right way to say sounds. In some cases, patients might not be able to speak at all. Apraxia is common in people with stroke.

What is cognitive-communication disorder?

Cognitive communication disorder is the difficulty in communicating in social situations as a result of an impairment in a person’s memory, organisation and/or problem solving skills. It is commonly caused by a brain injury.

Communication Clinic

Communication Assessment

During an assessment, our speech therapists will:
- Obtain a case history to understand your communication difficulties and its impact on your activities of daily living
- Assess your communication difficulties with various tools and assessments. We also provide formal assessment reports on request.
- Assess and discuss your communication goals and needs for therapy

Communication Therapy

For therapy, our speech therapists will:
- Provide individualised therapy tailored towards your goals and needs
- Provide communication strategies and techniques for carers
- Provide alternative and augmentative forms of communication such as a picture communication board (i.e. AAC) for suitable candidates
We can provide therapy in English, Mandarin and dialects such as Cantonese, Teochew and Hokkien.

Paediatric Speech and Language Clinic

Our Paediatric Speech Therapy Team specialises in the assessment and management of communication difficulties for the paediatric population (children aged 1 - 18 years old). 

We assess, diagnose and treat children and adolescents with disorders or difficulties related to speaking, understanding and using language effectively. This may include: 

  • Speech sound disorders - distortion and/or mispronunciation of sounds produced
  • Developmental language delays or disorders - difficulty understanding others, and/or expressing him or herself at an age- appropriate level. 
  • Fluency disorders – also known as stuttering, where there are difficulties in the flow of speech. 
  • Social communication disorders – difficulties using verbal and non-verbal communication appropriately in social situations. 

What is a speech sound disorder (SSD)? 

  • It is common for young children learning to speak to make mistakes in their speech sounds during the first few years of speech development. 
  • However, it is not expected as a child gets older. SSD occurs when these mistakes persist past a certain age. 
  • SSD is a collective term, with several subcategories that include articulation disorder, phonological disorder and childhood apraxia of speech. 

What is a developmental language disorder (DLD)?

  •  DLD is a condition that affects children’s ability to learn language skills. 
  • The child may have problems following directions, understanding questions, learning new words and/or saying sentences. 
  • DLD occurs in approximately 7 to 8% of preschool children and is more likely to affect boys than girls.   

What is a social communication disorder (SCD)?

  • Difficulties with the use of verbal and non-verbal language for social purposes. 
  • These include communicating in an appropriate manner for the particular social context, following rules for conversation, and understanding implicit nuances in language for social communication.  

Paediatric Speech and Language Assessment 

During an assessment, our speech therapists will: 

  1. Assess and diagnose your child’s difficulties 
  2. Determine the need for therapy 

Paediatric Speech and Language Therapy

For therapy, our speech therapists will: 

  1. Prepare a specific plan and set goals for your child 
  2. Administer therapy to help your child communicate better  
  3. Teach you activities and give suggestions to help your child practise at home 

Voice 

What is a voice disorder? 
A voice disorder occurs when voice quality, pitch and/or loudness are inappropriate and prevent the speaker from communicating with others effectively. 

We address voice disorders related to:

  • Occupational voice demands
  • Age-related voice changes
  • Laryngitis
  • Vocal nodules, polyps or cysts
  • Vocal fold paralysis or paresisTremor
  • Spasmodic dysphonia
  • Chronic cough
  • Laryngeal dysfunction 

We also provide gender-affirming voice and communication training for transgender individuals.

Voice Assessment 

During an assessment, our speech therapists will: 

  • Obtain a detailed case history concerning the voice problem you are seeking help for
  • Ask questions to understand the nature and extent of your voice use in daily life
  • Listen to your voice through various tasks to evaluate your voice quality, pitch and loudness 

In addition, we partner with doctors in Ear, Nose and Throat (ENT) to conduct a specialist voice clinic. In this clinic, patients are seen jointly by a voice-specialised ENT surgeon and speech therapist. We provide consultation, videostroboscopic examination of the larynx (using a flexible scope with strobe lighting to take clear, detailed images of the voice box), and advanced diagnosis of all voice problems. Together with patients, we will develop a plan of care that may involve a combination of medical, surgical and/or therapeutic treatment.

Voice Therapy

If therapy is recommended, our speech therapists will: 

  • Design a treatment plan to reduce hoarseness and improve your voice condition
  • Guide you towards healthy vocal and lifestyle behaviours to assist in vocal fold recovery
  • Prescribe voice techniques and exercises to rehabilitate and optimise your voice quality

Voice therapy is the first line of treatment for many voice conditions and can be highly effective in treating hoarseness in patients of all ages. Generally, voice therapy consists of one therapy session each week for 4-8 weeks. The duration of therapy depends on the severity of hoarseness, nature of the underlying voice disorder, co-occurring medical treatment, and patient commitment to the treatment outside therapy sessions. With close adherence to therapy, patients are often able to restore their voices and meet their daily speaking needs successfully.    

Fluency 

What is stuttering?
Stuttering is speech disorder in which the normal flow of speech is disrupted. People who stutter may experience repetitions (c-c-c-cat), prolongations (Fffffffish) or blocks (no sound).

Fluency Clinic*

Fluency Assessment

During an assessment, our Speech Therapists will:

  • Obtain a detailed case history to understand the impact of dysfluency on your activities of daily living
  • Obtain speech samples through various tasks to evaluate your dysfluency
  • Share information about stuttering and treatment options

Fluency Therapy

For therapy, our Speech Therapists will:

  • Conduct the Camperdown Program, an evidence-based speech restructuring programme to reduce stuttering in everyday speech. This is also available as a four-day programme
  • Provide regular outpatient follow up to help you maintain positive therapeutic change

Hearing impairment

What is aural rehabilitation?

Aural rehabilitation is the assessment and management of hearing loss and its impact on communication.

Aural Rehabilitation Clinic*

Aural Rehabilitation (AR) is often used as an integral component in the overall management of individuals with hearing loss by a team of Audiologists, ENTs and Speech Language Therapists.


Aural rehabilitation is conducted by our Speech Therapists, with the aim of reducing the impact of hearing loss on our patients’ communication and quality of life. For individuals who have undergone a cochlear implantation, rehabilitation includes auditory training, speech therapy, training on communication repair strategies and telephone training.

Additional Services

Community Therapy Services

In addition to the outpatient clinical services provided at Sengkang General Hospital (SKH), our Speech Therapists have been actively involved in multiple projects in the wider community of the Northeast region. They include:

  •  H2H Programme - a transitional hospital to home care programme to ensure smooth transition of care for patients who are bedbound, and/or may have difficulties attending outpatient follow up appointments. 
  • Project ASPIRE - a community care clinical service to manage frailty among seniors living in the community, in which participants will receive medical, nursing, physiotherapy, occupational therapy, speech therapy  and dietetics services as needed. It is a collaboration with St Luke’s Eldercare (SLEC), SATA CommHealth, selected Senior Activity Centres (SACs) in the Northeast, and AIC’s Community Network for Seniors (CNS).
  • Provision of Speech Therapy services to Nursing Homes. 
  • Talks and workshops for family, caregivers, and colleagues in care facilities (such as eldercare centres and nursing homes) to raise awareness of swallowing and communication disorders and the role of speech therapy, and to support them in caring for loved ones and patients who have these disorders. 

Video-Consultation Services

In addition to in-clinic consultation services, our Speech Therapists offer speech therapy via online video consultation. Our therapists will be able to interact with patients, perform diagnostic assessments, and provide intervention in real-time during remote sessions. Our video-consultation sessions are largely similar to face-to-face consultation with some modification of therapy methods and materials to better suit the online environment.

Patients managed via video-consultation will require a personal computer, tablet or smartphone with a webcam and internet connection. Speak with your Speech Therapist to find out whether receiving therapy via video-consultation may be suitable for you. 

1. How can I obtain an outpatient appointment to see a speech therapist?

A referral letter to Sengkang General Hospital’s speech therapy department is needed. You may request for a referral from your GP. A doctor’s referral from Singhealth institutions such as polyclinics is encouraged as suitable patients may then receive our services at a subsidised rate.

2. What can I expect in a speech therapy session?

Our Speech Therapists will assess and evaluate your communication and/ or swallowing difficulties and prescribe the appropriate interventions for you. We may speak to your family members to have a better understanding of your difficulties.

3. How long will the treatment progress take?

An initial speech therapy assessment session will usually run for 45 to 60 minutes. A typical therapy session will last approximately 30 to 60 minutes, depending on the nature of your concern (e.g. swallowing or communication concerns).
Your speech therapist will discuss the frequency of therapy that is suitable for you, depending on your needs and progress.

4. Do you conduct therapy in other languages?

Yes we currently offer speech therapy sessions in English and Mandarin. We may also require the presence of a caregiver to assist in translation for your loved ones during the sessions.


Contact Us

You may contact us at speechtherapy@skh.com.sg for any queries. To make any changes to your existing appointment, please call 6930 6000. Alternatively, you can fill up this form: 

Location

We are located at Sengkang General Hospital, Outpatient Rehabilitation Centre, Blk 8, Level 2 (via Lobby C).



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