Editorial: JRCRS. 2023; 11(02): e1-e2
1- Prevailing practices and advancements of speech and language pathology in Pakistan
Humaira Shamim Kiyani
Associate Professor/HOD Speech and Language Pathology Department, Riphah College of Rehabilitation & Allied Health Sciences, Riphah International University Islamabad, Pakistan
Correspondence:
Dr. Humaira Shamim Kiyani
Email: [email protected]
Speech and Language Pathology (SLP) is an emerging yet rapidly growing Rehabilitation and Allied Health discipline in Pakistan. Considering the welfare of patients, over the last few decades, it has been realized that there is an increased demand of SLP services. SLP practices are diverse and mostly provide services with communication disorders depending upon the needs of individuals. It is estimated that 23 million people in Pakistan suffer from communication difficulties such as articulation, phonation, fluency, voice, language disorders, and adult neurogenic disorders including aphasia and dysarthria, thus highlighting the significance and need for speech and language pathology services.1
Human society is organized and sustained by incorporating their own semiotic resources, such as speech, gesture, facial expression, and body posture in interpersonal communication. Speech is the most effective resource for shaping communicative encounters. Currently there is limited information available about the nature and scope of SLP in Pakistan. Furthermore, the speech therapy services market is expected to flourish at a compound annual growth rate (CAGR) of 5.9%.2
Cultural sensitivity in SLP is becoming increasingly important, particularly in diverse countries like Pakistan. Individuals’ cultural and linguistic backgrounds must be taken into consideration while evaluating and treating communication difficulties. According to the American Speech-Language-Hearing Association (ASHA), cultural competence is an essential aspect of speech and language therapy services.3 In Pakistan, the field of speech therapy was established considerably later than it was elsewhere around the globe. Despite the fact that research has been initiated from SLP department of Riphah International University to create culturally valid and linguistically relevant methods for evaluation. Numerous tools have been adapted and developed like action picture test, aphasia naming test, Test of articulation and phonology, Urdu speech perception test, Aphasia quality of life etc. but still there is dearth of standardized assessments.
There has been an increasing emphasis on evidence-based practice in SLP, which involves using the best available research and clinical expertise for decision-making. SLP services are tailored to treat and manage each individual’s requirements of all ages keeping in view the current evidence. Advances in technology have also created new opportunities and challenges for speech and language pathology. In Pakistan, the availability of technology and resources related to SLP is scarce, compelling them to work with limited resources.
Addressing these concerns there are now many tools and techniques available for assessment and intervention, such as tele-practice, virtual reality, and applications. App-based speech therapy is a growing trend in Pakistan and around the world. These apps are designed to provide speech therapy activities that can be accessed through a mobile device or tablet. Riphah Speech and Language Department has developed certain culturally relevant apps such as Izhar, Verbal Expressive Skills Management Programme (VESMP), and Dysarthria Urdu Management (DUM) etc. among others, as well as protocols of life participation approach for aphasia in Urdu to improve quality of life for individuals by focusing on their social support, participation and empowerment for the Pakistani population.
The use of Augmentative and Alternative Communication (AAC) in Pakistan is becoming more extensive, although it is relatively novel and still there is a need for awareness program regarding this topic. It refers to any method of communication that augment speech, such as sign language, picture communication boards, or electronic devices.4 SLP department of Riphah is the pioneer in developing culturally and linguistically appropriate symbols for Augmentative Alternative Communication like ADAM symbols, adapted Test of Aided-Communication Symbol Performance (TASP) and various customized communication books are developed. Moreover, communication board, eye gaze board, BIG Mack and GO talk have been utilized for patient care in clinical practices.
The COVID-19 pandemic has caused a paradigm shift in many areas of healthcare including speech and language pathology. The use of tele-practice has become more prevalent around the world keeping in view the social distancing and restrictions on face to face sessions. The pandemic has accelerated the adoption of tele-practice in Pakistan, with many SLPs now conducting virtual consultations and therapy sessions.
Community-based intervention is a common practice in Pakistan which involves SLPs reaching out into the community to provide services, such as conducting home visits, collaborating with local organizations, and commencing community workshops. Overall, speech and language pathology is a dynamic field that requires continuing education, training, and cultural adaptability to meet the evolving needs of clients and communities. There is a need for greater investment in research, infrastructure, and multidisciplinary collaboration to improve the practice of speech and language pathology in Pakistan.
References
- Noor H, Iqbal MZ, Rasheed F. A Survey of Linguistic Considerations of Assessment of Communication Disorders by Speech Language Therapists/Pathologists in Pakistan. International Journal of Innovation, Creativity and Change.15(06):912-33..
- Biologics Market–Growth, Trends, COVID-19 Impact, and Forecasts. (2022–2027). Mordor Intelligence. Available online: https://www.mordorintelligence.com/industry-reports/biologics-market#:~:text=The%20biologics%20market%20was%20valued,forecast%20period%2C%202021%2D2026 (accessed on 3 May 2023)..
- Meeks JC. Native American speech-language pathology assistants: Expanding culturally responsive services in reservation schools. Language, Speech, and Hearing Services in Schools. 2023;54(2):395-408.
- Biggs EE, Therrien MC, Douglas SN, Snodgrass MR. Augmentative and alternative communication telepractice during the COVID-19 pandemic: A national survey of speech-language pathologists. American Journal of Speech-Language Pathology. 2022 Jan 18;31(1):303-21