Communication therapy in Malta - November 17, 2002

Speech therapy in Malta started in the 1970s, when expatriates were commissioned to provide a speech therapy service. This service was offered sporadically. In 1981 the Department of Health absorbed the first cohort of seven locally qualified Maltese practitioners who commenced a community-based service.

The second group of qualified speech-language pathologists started employment in 1995 following their successful completion of a four-year full-time degree course, run by the University of Malta.

To date we have had two other cohorts qualifying and two other groups are currently in training. Thirty-seven full-time practitioners are currently providing the speech therapy service. The number of qualified speech-language pathologists increased again this year and a further increase is expected by the end of 2004. This is a clear example of the collaboration that exists between the University and Practice and of the direct contribution that the University gives to health care.

In the 1980s the Maltese who benefited from the local speech therapy service were few, mainly because of the scarcity of staff and lack of awareness of the service. The range of communication disorders that comprised the caseload of the generic therapists was also narrow. The types of communication difficulties managed were limited mainly to developmental language and speech difficulties, voice disorders in adults, dysfluency and a limited number of acquired neurogenic disorders.

The increase in recruited personnel brought about an expansion in the type and number of caseloads managed by speech-language pathologists. There has been a significant increase in the number of adult clients receiving therapy.

The service has also opened up for client groups such as adults with mental handicap and those encountering specific difficulties with understanding or producing written language, as well as other forms of non-vocal communication. Individuals with drinking, eating and swallowing difficulties also form a significant proportion of the speech-language pathologist's caseload today.

Speech-language pathologists provided the service in community health centres initially. Nowadays, the service is offered in a range of settings that includes community-based clinics (health centres), acute hospitals (in-patients and out-patients), institutional settings, rehabilitation centres, day centres, school settings (special and mainstream) and the clients' homes. Intervention goals are based on assessment and the identified needs of the individual.

Therapy may take various forms, such as individual or group therapy, direct or indirect intervention and may include early intervention, rehabilitation, counselling, consultations and participation through a multidisciplinary team.

The speech therapy course at the Institute of Health Care is co-ordinated by Dr Helen Grech.