S'pore speech therapist on helping children speak clearly

Dr Selena Young, head of craniofacial speech pathology at the department of plastic, reconstructive & aesthetic surgery at KK Women's and Children's Hospital, during a speech therapy session with a child.
PHOTO: S'pore speech therapist on helping children speak clearly

SINGAPORE - When Dr Selena Young, 37, first began her career as a speech therapist at Singapore General Hospital, she received a few referrals, in just one month, of primary school pupils who spoke as if they had a lot of air coming out of their noses. But they did not have any obvious anatomical deficits.

Later, she realised that these children had abnormally positioned muscles of the palate that were hidden under the mucosal skin of their palates of the mouth, as well as physical features which were subtly out of the ordinary, such as ears which were slightly lower or larger than normal.

But in 2000, doctors were not familiar with the velocardiofacial syndrome.

This is caused by the mutation of a small piece of chromosome 22 and is characterised by a combination of medical problems such as a cleft palate, heart defects and learning difficulties.

Dr Young was keen to raise awareness among her colleagues and her patients' caregivers, as well as help the children regain optimal speech function.

She won a fellowship in 2003 to gain specialist skills in craniofacial and velopharyngeal anomalies at Great Ormond Street Hospital for Children in Britain.

Upon her return in the same year, she was the only Singaporean specialist speech therapist who was formally and fully trained in this area.

She was later awarded a scholarship to do her PhD in craniofacial speech therapy at the University of Sydney in Australia, which she completed in 2011.

She is also a lecturer and research supervisor for the National University of Singapore's Master of Speech-Language Pathology Programme.

The Head of craniofacial speech pathology at the department of plastic, reconstructive & aesthetic surgery at KK Women's and Children's Hospital is single and lives with her parents in the eastern part of Singapore.

I specialise in treating children born with deformities in the face, head and facial bones (craniofacial) or in the muscles of the palate (velopharyngeal) because...

They have the best opportunities to normalise their speech, language and eating abilities with early intervention and regular monitoring.

This would enhance their confidence to face society and improve their prospects in spite of their facial differences.

The tongue, hard and soft palates, teeth, lips, jaw and nose are fascinating because...

Their complex interaction bridges art and science. They work together to allow us to speak and have a unique tone and voice.

Many of us take speaking and eating for granted, but children born with deformities of the head and faceneed to be actively taught these skills through speech therapy. They also need to be monitored until they are young adults.

One little known fact about patients with craniofacial and velopharyngeal anomalies is...

They have the ability to achieve excellent speech and language abilities, talk and be understood by people after surgery and speech therapy, even though they may look slightly different, such as having ears that are slightly lower.

If I were to give an analogy for what I do, I would be...

A detective intent on finding the missing parts - medical or social - of a child's puzzle to enhance his holistic care.

I gather information from other professionals who have seen the child, as well as caregivers who know the child best.

I also evaluate and refer the child to other specialists, such as geneticists and developmental paediatricians, to understand their condition better.

A typical day for me starts...

With waking up at 6.15am to have breakfast with my parents and flip through the newspapers before I get to the hospital at 7.45am.

I clear my e-mail messages and look through my files before clinic starts at 8.30am.

I also have weekly research and multidisciplinary team meetings during lunch time. I see an average of 10 patients a day and finish by 6pm.

Every fortnight, I run a clinic with the dietitian for children who have feeding difficulties, as well as a speech evaluation clinic for patients with velopharyngeal dysfunction, or the inability to adequately close off the nose during speech.

In the evenings, I have dinner with my family or friends, watch plays or musicals and jog or do yoga.

I have come across all types of cases...

From babies born with feeding issues such as nasal regurgitation of milk and children with air rushing out of their noses while speaking, to adults who have had corrective jaw surgery.

The most common cases are those with a cleft lip or palate. I also see children who have oral tumours and require tube feeding and an artificial breathing tube.

I love patients who...

Enjoy their therapy sessions and do not realise they are in fact "working".

Patients who get my goat are...

Those who do not comply with intervention, advice and therapy schedule, yet expect immediate results.

Things that put a smile on my face are...

When caregivers thank us for believing in their children's communication potential.

Also, when I am able to help patients get an accurate diagnosis of their underlying medical condition so that preventive management can be started early.

I am often humbled by how strong some young children are, though they are often teased because of their looks.

It breaks my heart when...

Children do not turn up for speech therapy because their caregivers choose to adopt a wait-and-see approach, or have challenging life circumstances such that therapy is not a priority.

I would not trade places for the world because...

I have a rewarding and balanced career which juxtaposes clinical work, research and teaching to invigorate my mind.

My best tip is...

Caregivers should know that no two people with craniofacial anomalies have their speech affected in exactly the same way.

They should therefore be open and trust that we will individualise their children's speech therapy, from birth to adulthood, to optimise their potential.

joanchew@sph.com.sg

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