speech-language pathology

Leader in Taiwan’s Speech-Language Field Joins LIH Healthcare Consultant Advisory Board

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Wang Nan Mai, Speech-Language Pathologist, LIH Healthcare Consultant Advisory Board

Wang Nan Mai, Speech-Language Pathologist, LIH Healthcare Consultant Advisory Board

Wang Nan Mai, SLP (Dept. of Speech Language Pathology and Audiology, Chung Shan Medical University, Taiwan) became a member of the LIH Healthcare Consultant Advisory Board in October. She will routinely consult with speech-language teams throughout LIH Healthcare.

As a speech-language consultant on the Consultant Advisory Board, Wang Nan Mai will support development of clinical training programs and best practice service models for inpatient and outpatient settings. In addition, she will support LIH Healthcare’s efforts to identify and recruit highly-qualified speech-language therapists to provide leadership in this field.

Wang Nan Mai’s expertise makes her an excellent fit to facilitate teaching and research activities throughout LIH Healthcare, as well as to support collaborative research projects with strategic partners.

Nan Mai’s unique background in speech-language therapy combines professional degrees from Soochow University in Taiwan, Minnesota State University in the United States, and 30 years of extensive clinical and teaching experience as one of the few researchers in the early development of speech development assessment models in Taiwan. In the early years, she led the initiative to construct teaching curriculum and labs for the Department of Speech Language Pathology and Audiology.

Nan Mai has served in many leadership roles. Aside from being the director of the Department of Audiology and Speech at Chung Shan Medical University for 6 years, she is the Chairman of the Asia Pacific Society of Speech, Language and Hearing (APSSLH), and a committee member of the International Society for Augmentative and Alternative Communication.

AAC Bridges Communication Gaps

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by Cristina Sakthivel, Speech Language Pathologist, LIH Olivia's Place Shanghai

by Cristina Sakthivel, Speech Language Pathologist, LIH Olivia’s Place Shanghai

I first arrived in China linguistically unprepared, possessing little aside from xie xie and ni hao. I relied on all the visual cues and signage available to me; in the metro alone, the symbols depicting the ticket gate, entrances and exits were lifesavers! These visual supports increased my comprehension of the world around me while my handy Chinese translation app helped to bridge the communication gap I was experiencing. For children with communication impairments, augmentative and alternative communication (AAC) functions in the same way, enabling individuals to increase comprehension and providing a means to communicate expressively.

AAC refers to text-based or symbol based communication systems. This can take the form of symbols printed on paper, at the low tech end of spectrum, to dedicated speech generating devices/iPads with communication applications at the high tech end of the spectrum. The communication systems are customized and tailored to the needs of the individual by a speech-language pathologist and the child’s educational team.

It is never too early to introduce AAC to a child with communication impairments. Communication impairments can impact cognitive and social/emotional development; provision of alternative and augmentative means of communication allows the brain to develop and practice linguistic concepts in a functional manner until “natural” speech is possible. Additionally, increased ability to communicate leads to decreased frustration and increased social participation and engagement. AAC is essential for people who are non-verbal, but also benefits those with severe articulation (speech intelligibility) deficits and speaking individuals who need extra support structuring their language output.

There is a misconception that the use of alternative and augmentative communication will prevent children from speaking. This could not be farther from the truth! Studies have illustrated that the introduction of an alternative communication system promotes speech development- the use of visuals acts as an extra cue to scaffold oral language. As soon as a child develops the necessary fine motor skills and coordination to approximate and produce words, they will, as speech is the fastest and most efficient way to communicate. AAC acts as a means to an end, and not the end, allowing for functional communication until speech is possible.

Important Things to Know about Feeding Therapy

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Authored by Edna Elisabeth Nyang, Lead Speech-Language Pathologist, Beijing

Authored by Edna Elisabeth Nyang, Lead Speech-Language Pathologist, Beijing

Many families know to consult with a speech pathologist if their child is delayed with their articulation or language skills, but they do not know who to turn to if their child has trouble tolerating certain food textures. As a result, some of these symptoms remain untreated and turn into a more serious issue. According to the Kennedy Krieger Institute, approximately 50% of children experience a form of feeding difficulty, of which 10% develop a severe feeding disorder. If a child has difficulty eating properly, this can result in weight loss for a developing child. For all families, regardless of the issue, the main goal for children who present with feeding difficulties is for them to eat a variety of foods with their family in a fun, nurturing environment.


You should consider seeking out a speech pathologist, if your child is experiencing a couple of the following symptoms: coughing and/or choking during or after swallowing, crying during mealtimes;, decreased responsiveness during feeding, dehydration, difficulty chewing foods that are texturally appropriate for age (may spit out partially chewed food), difficulty managing saliva, disengagement cues, (e.g., facial grimacing, finger splaying, or head turning away from food source), frequent congestion after meals, frequent respiratory illnesses, gagging, loss of food/liquid from the mouth when eating, noisy or wet vocal quality noted during and after feeding, extremely long feeding times, refusing foods of certain textures or types, taking only small volumes or over-packing the mouth, and vomiting (more than typical “spit up” for infants).

If you have concerns about your child and their feeding habits, I would like for you to consider the following:

  1. All therapy starts with an evaluation.

Typically conducted by a speech language pathologist or occupational therapist who specializes in feeding and swallowing difficulties in children, this evaluation can be done in the clinic and generally consists of replicating a mealtime that is similar to one that your child experiences at home. It should it be noted that prior to the evaluation, you may be asked to complete a questionnaire and/or keep a “food journal” over a period of time to provide the therapist with more information.

2. The therapy should focus on the whole child and not only the symptoms.

It’s extremely rare for a child to have a feeding or swallowing difficulty due to one issue.  For example, some children with cerebral palsy present with low tone and have difficulty eating and chewing tougher textures because it hurts. As a result, they may start to eat less or not at all. A pediatrician may prescribe medication to stop the pain, but the learned behavior is still there and needs to be addressed.

  1. Family dynamics and culture should be incorporated into the therapy.

Feeding your child is cultural and emotional as it’s about creating a bond with your child and your culture.  When feeding becomes challenging, it’s stressful and it impacts the entire family on a daily basis and potentially socially as the family may be less likely to socialize during mealtimes. It is extremely important for the therapist to recognize what is culturally important to you and incorporate those objectives into the therapy program.

  1. It will take time.

First, eating is a developmental process. When a child has difficulty eating, it means they have stalled in the midst of learning a new skill.  Regardless of their age, the therapist will begin to teach the step by step process wherever they are having trouble (e.g., chewing) as a means to reaching the long term goal of eating with less restrictions. Therapists also have the advantage of charting every detail of progress and going days without seeing your child. On the other hand, when you are immersed in trying to feed your child multiple meals a day, it’s not always easy to see progress. Your therapist will give you small goals to work on every session and together, we will celebrate every single accomplishment!

  1. Every child will have their own journey

You may meet other parents who describe different techniques and strategies that your therapist uses with their child. It’s important to keep in mind that every child is different and that each approach will be tailored toward your child.

Inner Mongolia Reflection

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by Joyce Fok, Speech-Language Pathologist, Olivia's Place

by Joyce Fok, Speech-Language Pathologist, Olivia’s Place

Inner Mongolia is a world away from the metropolises that I’ve lived in. This province gave me a sense of peace that I haven’t experienced since moving to Shanghai this winter. Within this province, we visited the special needs classroom at an orphanage. This was the first orphanage I’ve ever visited, as orphanages do not exist in Canada. The orphanage exuded a warmth and love in its brightly colored walls and rooms, and the ayis’ teachable attitudes, however the charm that this orphanage held lay within the bright smiles of each of its children.

After an 8 hour, overnight train ride, our team (2 speech-language pathologists  and an administrative staff member who is in training to be a speech therapy assistant) arrived in the city where the orphanage was located (specific details about this orphanage are not provided at the request of the orphanage). There we met up with our SLP lead from Shanghai and our contacts from the orphanage. Although we had no formal schedule for therapy or training for our visit to the orphanage, we were all eager to meet the children and the ayis… and to determine just how we could be of use to the orphanage.

Within the first 30 minutes of arriving at the orphanage, we had set up an observation and training schedule. The children’s ages ranged from a few months to 8 years old, presenting with cerebral palsy, Down Syndrome, cleft lip and palate, and global developmental delays.

Frangie Yan, a member of our administrative team, works with a child in Inner Mongolia

Frangie Yan, a member of our administrative team, works with a child in Inner Mongolia

We spent the first day observing how the ayis interacted with and taught the children in the two therapy rooms, and observing the foster families. The second day was spent providing specific feeding and early language stimulation strategies and training to the ayis and foster families. The evenings were spent debriefing and planning for the following day. It was a busy two days!

The highlight of my first trip to this orphanage was spending time playing and practicing my early language stimulation skills with the children. As a new speech therapist, I was amazed at how using early language stimulation strategies actually elicits more sounds and interaction from the children. Although all of the children were nonverbal, each of them found alternate ways to connect with me. The key was to find and to elicit the appropriate level of communication, be it a laugh, eye contact, or a sound. It was my greatest joy to see their eyes light up and their joyous laughter when they connected with me and with others.

I am looking forward to returning to Inner Mongolia and seeing the children’s bright smiles again!

Kunming Medical University Starts First Medical Bachelor’s Program in Speech-Language Pathology

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Kunming Medical University’s Rehabilitation Medicine Department, led by Dr. Ao Lijuan, who is also a member of the Olivia’s Place Technical Advisory Board, has just recruited the first cohort of freshman students in September for a four year degree program in Audiology and Speech and Language Pathology. It is the first-ever such program at a medical school in China. Through collaborative work with Olivia’s Place, Kunming Medical University began a partnership with the University of Hawaii’s John Burns Medical School.  The University of Hawaii has been providing technical support and faculty training to Kunming Medical University since summer 2013 to develop this groundbreaking new program.  Congratulations to Kunming Medical University, the faculty led by Dr. Ao who have worked to establish this program, and to the first freshman class of future speech-language pathologists!