Updates

speech therapy singapore

Our Online Speech Therapy or Telepractice Experience in Singapore during Covid-19

According to ASHA definition: https://www.asha.org/Evidence-Maps/
‘Telepractice is the application of telecommunications technology to the delivery of speech language pathology and audiology professional services at a distance by linking clinician to client or clinician to clinician for assessment, intervention, and/or consultation.’

Telepractice for Speech Therapy has been proven to be effective and has been practiced in countries like the United States, Canada and Australia.

Our experience:
Since Covid-19 outbreak started, the acceptance of telepractice for speech therapy in Singapore has increased significantly especially during the circuit breaker period.

Our experience shows that it benefits most of our clients who require speech and language therapy, and to some of our clients who require swallowing therapy. We prefer to use Zoom Meetings for our telepractice. We find it easy to be used for 1-to-1 session as well as for group therapy sessions. Therapy tasks can to be shared and be viewed easily by our client(s). Clients are able to respond easily by indicating their answers on the screen by using the writing/drawing function. The Zoom file sharing function has allowed us to still customize and personalize each therapy sessions for our clients.

However, we need to take into consideration client’s proficiency level in technology. For clients who are less tech proficient, our experience shows that simple apps such as Facetime and Whatapp video call can work as well.

LATEST: On 24/4/2020, Facebook has just announced their videoconferencing function that allows video meeting up to 50 people without downloading any apps. That will open up another platform for telepractice.

For Speech-Language Therapists who would like to adopt Telepractice, you may refer to the following links for resources:

Singapore swallowing therapy

Happy New Year 2019 from Speech Therapy Works and Singapore Swallowing Specialists

2018 has been a great year for Speech Therapy Works and Singapore Swallowing Specialists in both business expansion and mentoring program. As we come to the end of 2018, the team would like to take this opportunity to thank all the Singapore and overseas clients, doctors, partners, and healthcare professionals for all their support and trust in us. We will continue to improve to ensure better service satisfaction and treatment outcomes for all our clients.

As part of the effort to reach out to even more people who requires speech and swallowing therapy, we will continue to work with our regional partners to conduct more training and workshops in the coming years.

Wish Everyone a Happy and Healthy New Year 2019!!!

Lecture on “The Importance of Anatomy & Physiology Knowledge in Dysphagia Management & Treatment” to Year 2 – 4 students at the National University of Malaysia (UKM), Kuala Lumpur, Malaysia. 18 December 2018

Continue reading “Happy New Year 2019 from Speech Therapy Works and Singapore Swallowing Specialists”
dysphagia research

Swallow with CTAR (S-CTAR) Poster presented at DRS 2017 @ Portland, Oregon

S-CTAR Poster

Life has been so busy since I came back from DRS 2017. Finally, I have some time to put up this blog.

I was honored to be invited to present a research poster at DRS this year.

This is probably one of the best year for dysphagia research representation from Singapore as we have 2 oral presentations from Singapore General Hospital and 1 poster presentation (presented by me) from National University of Singapore.

My poster presentation was on Swallow with Chin Tuck Against Resistance (S-CTAR). 

Some of the happy moments at DRS:

  • Portland, Oregon is really beautiful and … cold. 
  • Finally get a chance to meet my Facebook pal, Nabil from Canada in person. We share a common interest in dysphagia. Lots of interesting discussion on dysphagia via WhatsApp and Facebook messenger. 
  • Get to meet some old friends and made more new friends from all around the world. 
  • managed to take a selfie with Dr Reza Shaker!
  • Happy to know that CTAR or Chin Tuck Against Resistance is a well known and well like exercise in USA and Brazil. Brazil Speech Pathologists informed me that they have started research on CTAR! I really hope that clinical study on CTAR will be out soon. 
  • Most Speech-Language Pathologists were excited to know that S-CTAR can be used as a task specific exercise and foresee that they will use it in their dysphagia therapy or management. 
Portland Oregon
Portland, Oregon
Portland
Portland, Oregon
  • With Dr Shaker
    with Dr Reza Shaker
    Nabil = my FB Pal
    My FB Pal, SLP from Canada – Nabil
    Kotomi - SLP from Japan
    Kotomi Sakai – SLP from Japan
    Brazil SLP
    SLP from Brazil
    Poster presentation
    Demonstrating CTAR to a dentist from Japan
    Demonstrating CTAR & S-CTAR
    Demonstrating CTAR and S-CTAR
    I am a new DRS Member
    I am a new DRS member.
    Ironing sandwich
    This is new to me… Ironing sandwiches?!!!

    I was asked a few interesting questions on CTAR. One of the few interesting question is: are there any devices in the market that you think is good to be used to perform CTAR? I think this is an interesting question as we have seen quite a number of devices (different type of balls, hand held devices etc) being introduced to the market since the first paper on CTAR was published in 2014.

    Click  S-CTAR Poster to download the poster that I presented at DRS 2017.

    I will list out all those questions and answers in separate post soon. 

    To end this post, I would like to congratulate and express my appreciation to all the DRS committees for this successful and enlightening meeting. 

    Dysphagia Training, Teaching

    Lecture on Pharyngeal High-Resolution Manometry – Clinical Applications in Dysphagia Management

    NUH will be organizing the following lecture:

    Pharyngeal High-Resolution Manometry: Clinical Applications in Dysphagia Management.

    Speaker: Dr Timothy McCulloch.

    Dr McCulloch is a world reknown Otolaryngologist specializes in treatment of head and neck cancer, voice and swallowing disorders, trauma, reconstruction, and skull base surgery.

    The lecture is opened to all healthcare professionals.

    high-resolution-manometry
    Pharyngeal High-Resolution Manometry
    Swallowing Problem

    How does dysphagia from mechanical obstruction sounds like?

    The following patient presents with dysphagia (swallowing difficulties) secondary to the presence of prominent anterior cervical osteophytes at the level of C3-C6, most prominent at C4.

    Dysphagia symptoms include:

    • Occasional coughing noted when eating solids as well as drinking fluids.
    • Multiple swallows per bolus

    I managed to record the patient’s usual swallowing sound using my IPhone 6s. Could this be the sound of mechanical obstruction?

    osteophytes
    MRI Cervical Spine shows cervical myelopathy. Prominent anterior cervical osteophytes from C3-C6.
    osteophytes label

    The sound of patient swallowing 10ml water recorded using an IPhone 6s. Note multiple swallows & loud squish sound.

    Cost effective treatment, dysphagia research, Dysphagia Therapy, Singapore, speech therapy singapore, speech-language therapy, Swallowing Problem, Teaching, Uncategorized

    Second Publication on Chin Tuck Against Resistance (CTAR)

    We are happy to announce that the follow up study on CTAR has been published online (online first version) in Dysphagia Journal.

    Original Paper

    Dysphagia

    pp 1-11

    First online: 02 February 2016

    Evaluating the Training Effects of Two Swallowing Rehabilitation Therapies Using Surface Electromyography—Chin Tuck Against Resistance (CTAR) Exercise and the Shaker Exercise

    • Wei Ping Sze 
    • , Wai Lam Yoon
    • , Nicolas Escoffier
    • , Susan J. Rickard Liow

    Abstract

    In this study, the efficacy of two dysphagia interventions, the Chin Tuck against Resistance (CTAR) and Shaker exercises, were evaluated based on two principles in exercise science—muscle-specificity and training intensity. Both exercises were developed to strengthen the suprahyoid muscles, whose contractions facilitate the opening of the upper esophageal sphincter, thereby improving bolus transfer. Thirty-nine healthy adults performed two trials of both exercises in counter-balanced order. Surface electromyography (sEMG) recordings were simultaneously collected from suprahyoid muscle group and sternocleidomastoid muscle during the exercises. Converging results using sEMG amplitude analyses suggested that the CTAR was more specific in targeting the suprahyoid muscles than the Shaker exercise. Fatigue analyses on sEMG signals further indicated that the suprahyoid muscle group were equally or significantly fatigued (depending on metric), when participants carried out CTAR compared to the Shaker exercise. Importantly, unlike during Shaker exercise, the sternocleidomastoid muscles were significantly less activated and fatigued during CTAR. Lowering the chin against resistance is therefore sufficiently specific and intense to fatigue the suprahyoid muscles.

    Details of the journal can be found at http://link.springer.com/article/10.1007%2Fs00455-015-9678-2

    We are happy to announce that we are starting our third CTAR research at the National University of Singapore.

    CTAR research 3
    CTAR research 3 in progress

    materials for CTAR 3
    Materials used in CTAR 3

    Dysphagia Therapy, Featured clinicians, Singapore, Swallowing Problem, Teaching, Uncategorized

    Workshop on ‘Best Practices in the Management of Oropharyngeal Dysphagia’

    Dear all,

    JurongHealth Speech Therapy department will be organising a 2 day workshop next year entitled ‘Best Practices in the Management of Oropharyngeal Dysphagia’. The workshop will be conducted by Dr. Catriona Steele and will be held on 20 – 21 May, 2016 at Ng Teng Fong General Hospital, Singapore.

    NTFGHJCHoverview
    NTFGH  

     

    About the speaker:

    Dr. Catriona M. Steele is a clinician scientist working in the area of swallowing and swallowing disorders. She has a background as a medical speech-language pathologist, and is Director of the Swallowing Rehabilitation Research Laboratory at the Toronto Rehabilitation Institute – University Health Network. Dr. Steele is a Professor in the Department of Speech-Language Pathology at the University of Toronto and is in demand as a teacher and workshop instructor around the world. Dr. Steele holds research funding from the National Institutes of Health (USA) and has more than 100 peer-reviewed publications.

     

    Brief outline of workshop

    > Best Practices in the Identification and Assessment of Oropharyngeal Dysphagia

    –   Sensitivity and specificity of different dysphagia screening tools

    –   Purpose, protocols and important technical considerations of videofluoroscopy

    – Using information from research to quantify observations during a clinical bedside swallowing assessment

    > Management and Rehabilitation of Oropharyngeal Dysphagia

    –  Evidence behind texture modification and postural approaches

    –  Direct and indirect swallowing/exercise approaches including the use of IOPI and sEMG biofeedback

    –  Other approaches in the literature: respiratory interventions, electrical stimulation, vibratory stimulation

     

    Estimated cost:  $400 – $500 per participant for the full workshop.

     

     

    Registration Correspondent: Ms Wong Wan Xin

    Wong Wan Xin| Speech Therapist, Rehabilitation | Ng Teng Fong General Hospital & Jurong Community Hospital | Jurong Health Services
    1 Jurong East Street 21, Singapore 609606 | T: (65) 67161674 | E: Wan_Xin_Wong@juronghealth.com.sg