There is an increasing demand for Speech Therapists (STs) in Singapore due to our rapidly ageing population, increasing trend of chronic diseases, as well as increased awareness of children diagnosed with developmental issues. This is why the launch of Singapore’s first undergraduate programme in Speech and Language Therapy by the Singapore Institute of Technology (SIT) is extremely welcome news!

We approached the Programme Director, Dr Valerie Lim, to find out about her journey in speech and language therapy as well as what it takes to join this field. Warm and articulate, she was patient in answering the many questions we had. If you’ve been curious about the life of a speech therapist like us, do read on!

1. Hello Dr Lim! Could you introduce yourself to our readers?

Hi, I’m Valerie and I have been a speech therapist for over 25 years. I studied at La Trobe University in Australia and worked in the social sector when I came back, working with children with multiple disabilities, with teachers in mainstream schools as well as therapists in hospitals. In essence, I was sort of like a go-between for the two. Of course, I worked with parents as well.

Eventually, I joined SGH, and stayed there for about 17 years, helping to build up the speech therapy team and department. In 2016, I thought I needed another change so I came out into private practice. I still felt a connection with the public sector. So even though I was a private practitioner, I still did locum/consultancy work for the hospitals.

When this opening at SIT came up, I thought that okay, well, this would be another platform for me to contribute a little bit more. If I can be part of a team that trains students to be Speech Therapists, and also help them embody the right values of a speech therapist, I could make a greater impact to the profession and the patients overall.

2. We’re curious. With speech therapy being a niche field, does everyone know each other?

It still is a niche but I think it’s less so now than when I first started out. Back then, everybody knew everybody because we were such a small community. I would say that people still do know each other even though we’re about 600 strong now, which is still modest compared to other medical fields. Now at least I’m starting to hear names where I’d go, oh, I haven’t met this person. In the past, with every name mentioned we’d be like I know them; I know them, I know them (laughs). So, it’s different now, which is a good thing!

3. How did you come to be interested in the field of speech therapy?

I did some voluntary work with MINDS Singapore after my A-levels, and I got involved working with children with a range of communication difficulties, some who were able to communicate but weren’t clear with the way they were articulating. Some were not able to communicate verbally. I found non-verbal communication to be really interesting, because it allowed the children to still bring across what they wanted to communicate, such as emotions. Thereafter, my sister introduced me to speech therapy. I read up more about it and decided that was what I wanted to do.

I did my basic degree in Speech Therapy overseas. Being the only Asian in a sea of Australian students was tough because I had to familiarize myself with the culture. I also had to make sure that I was able to put into practice the things I learnt over there when I came back to Singapore for my clinical placements. Thankfully, I had good mentors!

4. What does a day in your job look like?

When I first started working as a junior therapist, I worked on honing my clinical skills. I saw children and adults and had to make sure that I was able to assess them accurately, interpret data and put my findings into context, then decide what kind of therapy a patient needed.

I also had to, as part of my role, work with teachers because the children I was supporting were in (mainstream) schools. We had a team of allied educators to help support them and be advocates for the students. I also had to work with physiotherapists, occupational therapists and social workers.

I also had to work with doctors as well as some of the respiratory therapists in the hospital. Some of the children I saw had tracheostomies, where they had to breathe through a hole in the throat, so they had to go for medical appointments. I would attend those appointments with them to explain to their doctors/other therapists what the child’s status was, so that we could come up with a care plan for the child. So, in our daily work, speech therapists have to participate in quite a bit of multidisciplinary collaboration.

As I progressed in my career, I also had to do things like train nurses or caregivers, take part in case conferences, teach students/junior therapists in clinical skills, do research etc.

5. What other settings would you find a speech therapist in?

Speech therapists work in special schools, nursing homes, and eldercare centres. They can also be employed in the hospitals, where they’d probably be working across the board, with children, adults and elderly with varying conditions. For example, a speech therapist in the hospital might work with patients who have had strokes, progressive neurological diseases such as Parkinson’s and dementia, and also geriatric patients. For such patients, we would have to assess their speech, language and swallowing function.

They’d also work with people with brain injuries from car accidents or falls as well as cancer patients, who’re unable to speak or swallow properly having lost part of the anatomy in their mouths. They’d also work with patients who have voice or stuttering disorders as well as children with delayed language or behavioural issues.

6. Do you have any memorable experiences to share?

There are so many! I remember a patient who couldn’t even order a chocolate ice-cream cone because chocolate was a word they would stutter on all the time. She would order strawberry instead and I remember her saying to me, “I don’t even like strawberry.” Imagine not being able to order something you like or even say your name! The consequences of that, emotionally and psychologically, are quite devastating, on a level that none of us can really understand. That’s what my patients will go through on a day-to-day basis. My job is to help them be able to communicate more effectively and efficiently.

7. What keeps you going/what do you love about your profession?

 I think it’s about making a difference. Most, if not all, speech therapists will tell you that the minute we go into a session and do therapy, we lose ourselves in a bubble. It takes our mind off the day-to-day stuff because we’re fully thinking about the patient and just working with them at that point in time. It’s almost like a little escape for us and being able to help someone improve their life. I think it’s what charges us up the most. It’s why we’re here and why we do what we do.

Speech therapy is a vocation to a very large extent. You must be passionate about wanting to help somebody. It’s about helping people to communicate, helping to rehabilitate them to be able to eat safely so that they can maintain a certain quality of life.

8. What is a common misconception people have about what speech therapists do?

 People tend to think of speech therapists as elocutionists. They think that it’s all about just minding your ‘p’s and q’s. A lot of people think we just focus on articulation only. Some of ­­­­­us get mistaken for being English tuition teachers.

I think awareness of the profession is better now as compared to last time!

 9. Do you have to deal with challenging clients?

Yes, of course, there’ll be many challenging clients that you’ll have to work with throughout your career. Not every case is an easy case; you really have to spend a lot of time thinking about the underlying issues that the person is actually facing. Is their presentation compounded by social, financial or behavioural issues?

Sometimes the cases come to me for specific reasons. A school might refer a child because he’s not articulating clearly or because he’s stuttering, but we’d soon realise that maybe the articulation or stuttering isn’t the main issue that the child or the family is dealing with, or the main priority for the child. Oftentimes, we are the ones to discover the true issues at hand because we interact with the patients for a longer time. Discussing the cases with other allied health professionals or medical professionals also help us come up with a holistic care plan for the individual as a team.

10. Lastly, do you have any advice for those interested in this field? What education should they pursue?

Going to do observations with speech therapists will be really helpful. The number of people who are interested in internships is increasing, and so places in hospitals get booked up quite quickly.

If you’ve finished your A-levels, IB, NUS or polytechnic diploma, and are passionate about working with individuals who have communication and swallowing difficulties, then the SIT Speech and Language Therapy Programme is the one you should apply for. If you have already completed a degree, and you’re thinking about Speech Therapy as a career, I’d recommend that you look up the NUS Graduate Entry local masters. Currently, there’re two entry points to becoming a speech therapist in Singapore.

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Before parting ways, I asked Dr Lim how she copes with such a busy schedule—apart from serving as the Programme Director of SIT’s Speech and Language Therapy Programme, she continues to help patients through her speech therapy practice Planting Speech.

Pausing to reflect on my question, she tells me that it’s about the patients and how fulfilling it is to be able to make a difference. The smile on her face says it all.

We thank Dr Lim for providing us insights into this fascinating career and wish her all the best in her pursuits. We’re sure that future students will learn a lot under her tutelage!

This article first appeared on Digital Senior. Image credits: Associate Professor Valerie Lim.