Arianna Azmi is four years old but, unlike the rest of her peers, she struggles to eat a McDonald's Happy Meal.
She has a rare disease called trisomy nine mosaics, so her facial muscles are less developed and she has chewing difficulties.
Just five months ago, Arianna was able to eat only porridge and soft vegetables.
Meat and leafy vegetables were a choking hazard.
"We can always blend the food and feed her, but this is not the long-term solution as she grows up," said her mother Sara Handayani, 38, a part-time pre-school teacher.
Madam Handayani used to take her daughter to speech therapists at KK Women's and Children's Hospital every three months.
But since the start of this year, she has been able to go to the Cerebral Palsy Alliance Singapore's (CPAS) feeding and swallowing clinic once a fortnight.
There, speech therapists taught her how to do a series of facial exercises, to stimulate growth in Arianna's oral muscles.
She practised these with Arianna at home. Madam Handayani also learnt how to use assistive tools that reminded her daughter to chew with her molars.
Arianna is now able to chew meat. She is even enjoying raisins and gummy bears.
"She is also able to pronounce more syllables because her oral muscles are stronger," said Madam Handayani.
The CPAS feeding and swallowing clinic used to be only for its own clients, including cerebral palsy and Down syndrome patients, but it is now open to the public.
Waiting lists in some hospitals can stretch to several months, so CPAS hopes to provide an alternative for parents, said its head of speech language therapy Sunitha Sendhil.
A recent survey of 120 speech and occupational therapists conducted by the group found that most saw a need for more frequent therapy services for feeding problems.
CPAS' feeding and swallowing clinic is open to the public every Wednesday. It can serve about 12 patients from the public each month, including the elderly who have swallowing difficulties due to stroke. Charges range from $50 to $90.
The voluntary welfare organisation is also opening its audiology clinic to the public daily. It can help about 25 patients with hearing problems each month.
Given the waiting list in public hospitals, some patients go to private speech therapists, who might charge higher rates. "It's definitely a bonus to have more affordable options," said Mr Kenneth Mah, president of the Rare Disorders Society Singapore.
This article was first published on May 1, 2015.
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