Shortage of speech pathologists hurting special needs kids

The field of Speech-Language Pathology, and its treatment services, are in significant shortage, not only in Jamaica, but worldwide. Last year in the United States alone, statistics revealed that some 1.2 million children were diagnosed with a speech disorder. Compared with the rate of occurrence before the pandemic (570, 000 children diagnosed with speech disorders per year), the figure translates to an alarming rate of increase of approximately 110 per cent, in just one year.

This, for children in the age range of between 0-12 years who were diagnosed with speech disorders in 2022 according to a research brief published by Komodo Health Institute in 2023.

With global data showing a rapid increase in the number of children presenting with speech and language delays, the corresponding indication is the increasingly high demand for qualified speech-language pathologists. This is a global dilemma, more so in Jamaica, where there is a dearth of speech-language pathologists to provide treatment to children in need of related services.

This is detrimental to these children’s ability to learn and thrive, considering that effective communication is a daily survival skill that is needed to successfully navigate life.

This widening divide between supply and demand presents as a larger scale of conflict for the delivery of speech-language pathology services for children across the world.

In the Jamaican context, there are currently fewer than ten speech-language pathologists practising on the island, serving adults, as well as children. With this level of shortage of locally available specialists in this field, and with The Mico University College Child Assessment & Research in Education (CARE) Centre being the only public sector institution that offers speech-language pathology in Jamaica, the uncomfortable reality is that the majority of children with language delays living in Jamaica may never be able to access these services in their lifetime.

FORMAL DIAGNOSES

The Mico CARE Centre is where most of Jamaica’s children who present with learning challenges go for assessment. For the period April 2023 to August 2023, 98 per cent of the children who were referred to the Mico CARE Centre for speech and language related concerns have received formal diagnoses of some degree relating to speech and/or language delay(s). Twenty-eight per cent of the children seen over the same period were specified as having an articulation delay (delayed speech sound development), characterised by unclear speech. Forty-two per cent of these children were specified as having a language delay (difficulty in understanding and expressing their wants/needs/ thoughts), while twenty-four per cent were specified as having both articulation and language delays. Four per cent of these children were specified as having a fluency disorder, primarily characterised by stuttering, or selective mutism (a related anxiety disorder that hinders a person’s ability to speak and effectively communicate in certain environmental situations).

With the exception of fluency disorder and selective mutism, it must be noted that one of the leading factors accounting for these presentations was Autism Spectrum Disorder.

Taken as a whole, the burdensome and sometimes controversial question is: What is the next step for these children, considering the limited count of Speech-Language Pathologists available, excessively long waiting period for service, and the very expensive and prohibitive cost for private treatment?

In the coordinated quest for a solution to better serve the special needs children of Jamaica, the Mico CARE Centre has, recently, spearheaded several initiatives to provide relief to some of the affected families.

One of these major initiatives was a Speech Therapy Summer Camp which was conducted during the month of July 2023 by the Centre at its Kingston office. Over the course of the three-week-long summer camp, speech therapy services were provided twice per week, for thirty (30) minutes, to children who were enrolled in the programme, as well as coaching in speech/language development techniques for their families.

Data captured from a progress monitoring study conducted by the Centre on the cohort of students who participated in the Speech Therapy Camp revealed that by the end of the programme, a total of eighty-four per cent of the students demonstrated mild to moderate levels of improvement. This demonstrates that when specialised treatment is delivered even for a short period of time, notable progress and improvements can be realised.

It also underscores the fact that there is hope for these children as their conditions are evidently treatable, leading to the ultimate goal of enabling them to live wholesome, and productive lives once they can access the required treatment.

Another very important initiative undertaken by the Centre to extend services to more families is the forging of a partnership with Eastern Illinois University (EIU), Illinois, USA.

Launched in September of this year, this pilot programme will see a number of speech language specialists from EIU offering speech tele-therapy services to a select number of students. Speech tele-therapy service is when speech therapy treatment is administered virtually, for example, utilising Zoom video calling technology. Speech tele-therapy services became very popular during the pandemic. One positive feature of this delivery model, is that it allows therapists to treat persons in places that would usually not be easily reached.

This presents as a viable solution that could increase access to service on a larger scale for more children with special needs in Jamaica.

WIN-WIN SITUATIONThis novel approach to providing treatment in the area of speech-language pathology has never been tried before by the Mico CARE Centre, but is expected to open up new windows of opportunity to explore other partnerships in this realm. The mechanics of the current programme will see graduate students in the major of speech-language pathology delivering treatment services to a selected number of children, once per week for 40 minutes.

The assigned graduate students administering treatment to these children will be closely monitored by a team of highly-trained and well experienced, licensed Speech-Language Pathologists at Eastern Illinois University. The tele-therapy pilot programme also includes a

parent/caregiver coaching model that facilitates the involvement of family members in therapy sessions for the children. Parent-Coaching is a unique component that was added to allow parents/caregivers to receive training and insights from the therapists on how to

implement learning strategies that can benefit their children. This level of exposure can help to increase the parents’/caregivers’ confidence level in providing more hands-on assistance to their children in their home environments.

This tripartite partnership represents a win-win situation for all stakeholders, especially against the background that under the terms of the agreement with EIU, all speech language related services, including therapeutic sessions, are being provided at no cost to the families. It is also another tangible demonstration of the Mico CARE Centre’s commitment to continuously seek out new avenues and explore available technology to make specialised service and treatment accessible to the families who require these services.