Turning lives around word by wordBan Jun-seong has stuttered since kindergarten, but since entering therapy he has shown marked improvement in his speech. During a recent session at Shin’s Speech Language Clinic in Seocho-dong, the 6-year-old’s assertiveness attests to his newfound confidence.
“I want to arrange the pictures by myself. Can I make this a long story?” he asks his therapist, Park Jee-hyun. “Yes, you can arrange this as you like,” she answers.
Jun-seong arranges the small pictures in sequence, pasting them on a sheet of paper to come up with a storyline. He explains to Ms. Park how the story evolves from a dog wagging its tail to people greeting their new canine friend. Jun-seong speaks rapidly and excitedly, stuttering only slightly as he ends each sentence. For the most part, however, Jun-seong speaks normally for a child of his age, although he does have some trouble getting the intonation correct.
“His treatment is nearing its end and he has regained much of his language fluency,” says Ms. Park, who assists children and adults who are receiving treatment for stuttering, aphasia, dyslexia, delayed language development, articulation problems and other speech difficulties.
As Jun-seong prepared for his show-and-tell, Ms. Park turned on a portable recorder and began taping his speech patterns. Looking at the pieces on the board, Jun-seong described the flow of events, speaking quickly, then slowly, for about three minutes.
Ms. Park then rewinds the tape and hits the play button, which elicits a whine from Jun-seong: “I don’t want to hear myself.” As the tape ends, Ms. Park asks, “What do you think?” to which Jun-seong replies, “I think I did a little better.”
“A little?” Ms. Park exclaims. “You did much, much better.”
Jun-seong’s mother, Lee Seon-gyeong, is called into the room and the boy repeats the exercise for her. But this time he loses his composure and speaks hurriedly, and begins stuttering.
Later, after Jun-seong leaves the room, Ms. Park tells his mother, “Jun-seong’s fluency has improved but he hesitates when trying to prove himself in front of others. He needs to be made to feel comfortable when talking to others.” Ms. Lee nods and says she is happy to learn about her son’s progress.
“It’s been almost ten months since Jun-seong started speech therapy; his stuttering has lessened and his peer relations have greatly improved,” Ms. Lee says.
Speech therapy was introduced to Korea in the late 1960s by American Peace Corps volunteers. Later the Korean Red Cross took up oversight of these services. Speech therapy first became an academic field for undergraduate study in 1988, at Daegu University. In 1995, Ewha Womans University and Yonsei University also established graduate schools of speech pathology.
After completing an undergraduate degree program, speech therapists must pass an examination that certifies their clinical competence as speech pathologists.
Despite gains made in the field in Korea over the past decade, Shin Moon-ja, a veteran speech pathologist and founder and director of the Speech Language Clinic, says, “In Korea, speech and language pathology is still underdeveloped. We do not have enough faculty members supporting the growing number of students enrolled in graduate schools. In the United States, therapists are required to complete 350 hours of field experience, compared with 45 hours in Korea.”
In the United States and Europe, speech therapy involves an interdisciplinary approach, combining anatomical sciences, sociology and psychology. In the West, treatment is provided by a team, comprising physicians, experts in special education and sociologists.
“These days,” Ms. Shin says, “most Koreans go abroad to receive treatment for speech disorders. The reason is that our welfare system does not support children who need this type of help, so they turn to the United States or Canada, where treatment by speech pathologists is much more affordable and accessible than here.”
Opened in 1992, Shin’s Speech Language Clinic was one of the pioneer private institutes of its type in Korea. Ms. Shin spent seven years at Seoul National University Hospital’s pediatrics division, helping children with speech and language disorders, after which she pursued further studies at Michigan State University.
In another treatment room at the Shin Clinic, Gyeong-won, age 4, is joined by his mother and a speech therapist in the reading of “Peter Pan.” Gyeong-won, who also stutters, repeats what the teacher says as his mother listens closely, occasionally responding to his questions. The therapist tapes the session and later discusses with Gyeong-won’s mother some approaches that would help her son improve his speech.
The parent-child session, in which the parent participates in the speech exercises, is one of the techniques employed at the clinic. Group sessions, with a number of children taking part in conversation exercises, parent-child interaction and one-on-one sessions with a therapist are also used extensively, depending on the diagnosis. Each of these sessions takes from 40 minutes to an hour. Depending on a speech problem’s severity, therapy can take from two weeks to five years.
“In most cases in the United States, both the father and mother participate in the child’s therapy, but in Korea, the mother is usually the sole supporter,” Ms. Shin says. “One of the worst cases I’ve seen is a mother who stutters a little, and her child stutters as well. So she does not talk to the child, fearing his speech disorder will get worse. Cutting off communication can be detrimental to the parent-child relationship. In such cases, providing adequate therapy is crucial.”
According to Ms. Shin, there are three main speech disorders: articulation (mispronunciation or wrong pronunciation); voice (usually caused by an anatomical defect) and fluency, or stuttering. The symptoms usually appear before age four, experts say, and if not dealt with early on, treatment can be long and arduous.
Boys are four times more vulnerable to stuttering than girls, but there are no gender-specific social or emotional defects involved.
“Problems with speech and language are part of the process of growing up,” Ms. Shin says. “One can be a slow learner or a child with a speech disorder, and it is our job to discern one from the other.”
Dyslexia, Ms. Shin notes, is much more complicated to treat because the problem may lie in a learning disorder rooted in visual or emotional problems.
Ms. Shin explains that speech disorders can be inherited ― the child of a parent that stutters has about a 50 percent chance of being a stutterer; caused by the environment, such as a stressful family atmosphere, or linked to personality. For example, introverts are more likely to have a speech disorder than extroverts.
The biggest concern of parents whose child is diagnosed with a speech disorder is the diminishment of job opportunities available to them, therapists say.
“In the West, there are social workers to help people who have speech disorders find a job, and the welfare system is admirable. No wonder Koreans are sending their children abroad,” Ms. Shin says. “Speech and language therapy are part of private education in Korea, whereas in the West, speech therapists are on the staff of many public school systems.”
Jun-seong’s mother says she sees a better future for her son, not only from the improvement in his speech, but, more importantly, from the healthier friendships he will develop.
“It gives children a sense of confidence to be able to speak well. That, perhaps, is the biggest result. One patient said it was akin to living a new life,” Ms. Shin says.
by Choi Jie-ho