Speech Therapy as a Career: Insights from Rachita Pandey (Part II)

Rachita Pandey: Speech therapy can be taken at any age. We even work with geriatric patients who lost their speech after accidents and aphasia. So age is not a problem. Now, talking about stuttering, I would share my experience with a 25-year-old boy. He had been stuttering for the past 6 years. His coping strategy was to avoid all social communications and being in IT, he didn’t need to do much as well. We took a complete history of how long it was. And we told him clearly that since it has existed for a long time, it would take time to improve. But we asked him to thoroughly follow whatever techniques we provided him. So within 8 to 9 months, he did improve. As we are talking about stuttering, Sachin Tendulkar was a classic case of stuttering in severe form. One of our professors treated him. Today, you can hardly notice anything in his interviews. One of our professors also treated Hrithik Roshan, who was another classic case.

Rachita Pandey: This is a very debatable topic that is going on. And there have been a lot of recent studies on this. Before, we used to say that you should focus on only one language if your child has a speech delay. They will be confused between the two languages. But now recent studies say that a child’s brain is diverse. So you can start with two languages, but first, let them be proficient in one language to which they commonly listen. We do not say to start with English. For example, if my mother tongue is Hindi, let them be proficient in that first, and then you can add on the other language.

Rachita Pandey: I leave for work at 6:30 a.m. My child wakes up at 8 a.m. I leave her with a nanny. In Dubai, we only have 45 days of maternity leave. So I had to leave my child at 45 days of age to rejoin work. As I told you before, I plan her schedule a day in advance. The schedule includes the timing of her meals and her activities. I make her listen to bhajans, which is calming for her. For language learning, I let her watch an educational show called Ms. Rachel Show, just for 10 minutes. I create play activities for her. And that was the main reason I started my channel. Because I encounter many parents who are working, they say that they don’t know what to do at home and their children are getting bored. So I thought that if I could share the basic day-to-day activities that we can make the child do, they could learn a lot of things. Then, by evening, when I come back at 6 p.m., I take her to the park and I spend my whole time with her.

Dr. Shanjitha Hussain: I had to restart my work at 8 months postpartum. So, in the initial days, I felt really guilty about leaving my son. I even thought it was impossible to manage between my career and my kid. But after some time, I realized that it is actually possible if you plan your time wisely. I aim to spend as much time as possible with my son. I try to be with him, as he needs me. Even now, I feel guilty at times. But it is more manageable now as I plan and prioritize my time.

Rachita Pandey: In my situation, I had to leave my baby in 45 days. My eyes were holding tears and I kept thinking about her all the time. I felt guilty for over a month. I even had a dilemma about whether I should continue my work, as my baby shouldn’t be affected. And the comments from society are never-ending, so I stopped listening to them. And eventually, over a period of time, it got better. My daughter, being small, adjusted soon. For me, it took some time to get adjusted. Luckily, in my place, I have three days off from work every week so we get our time together.

Rachita Pandey: As of my present situation, my daughter is 16 months old and I cannot explain such issues at this time. But I’ll tell you from my personal experience. I took the decision to hire a nanny because of the safety of the country in which I live now. Nannies are very common here. My house is equipped with audio-visual cameras. The nanny whom we hired is from a reliable agency and we have all her documents with us. And the law for such child abuse and harassment is very strict over here. Back in India, I’ve heard a lot of things. Many of my friends were very scared to leave for work. We’ve decided to teach our children about good and bad touch at two or two and a half years of age, when they start to comprehend things. We can start by teaching basic things like Mama kissing or Papa kissing good. Other people kiss wrong. Also, teach about the place, like kissing on the lips wrong. Who can touch the breast or the private part? Either Mama or Papa can change clothes. Other people can’t. If you are living in a joint family, then your grandmother can change clothes, not your grandfather. Such things can be taught only after two years of age. Till then, you need to be vigilant.

Dr. Shanjitha Hussain: My kid is 2 years old now and has just started talking. I have started with teaching the naming of his body and other private parts. Luckily, I have my parents living nearby and they take care of him when I’m away. And I’m planning to teach slowly about good and bad touch when he is able to understand me better. But I will definitely make sure that he learns everything before he goes out, like for playschool. 

Rachita Pandey: Yes, Himani. I was thinking about shedding light on this issue in this interview. Today, in many places, fake speech therapist practice is going on. The issue here is that these people learn about speech therapy on either Google or Youtube and start claiming themselves as speech therapists. They start treating the child in the wrong manner. They charge so much money. And they waste our child’s time as well. Because at the end, the child is not able to learn or improve what he could have done long before. So I want to share this message with everyone: Whenever you think that your child needs help, first consult a doctor. The doctor will refer you to the right person. Also, if you are searching on your own, when you find someone, please ask them for their educational background for your own awareness. If you feel that something is not right, please don’t waste time anymore and consult a doctor instead. They will refer you to the right person. Don’t put your money blindly on someone. I’ll tell you about a patient from India from my online consultations. They told me that they contacted a person in Delhi. That person told them that they would make the child talk nicely in four months and the child had autism. Firstly, none of the speech therapists will say that. Second, they asked the parents to transfer Rs. 40,000 into their bank accounts and then they would share the plans and medicines. This is another major red flag. Parents who just wanted their child to speak did it. But nothing was given. To make it clear, for speaking, there is no medicine. Children learn naturally, as we all do. There is medicine only for hyperactivity, cognition and nutritional needs, and your paediatrician will prescribe it to you. None of the speech therapists will write you medicine. And know that it is a trap when someone says that they will make the child talk in these many months, which is never possible. The child will learn to talk at their own pace. 

Rachita Pandey: In India, all speech therapists and audiologists are Rehabilitation Council of India (RCI) certified. You can practice only when you get this license. There is also another certification provided by the Indian Speech and Hearing Association (ISHA). You can tell them that you want to know which license they are holding. It is either RCI or ISHA. 

Rachita Pandey: Yeah, sure. Basically, I do it in my weekends. They can directly message me through my Instagram, Facebook or mail me through my email ID. I’ll connect with them and give them a home-training program. Or else I can refer them to the right professional in their area. We speech therapists are all connected via a WhatsApp group. 

Rachita Pandey: I would ask them to write the All India Institute of Speech and Hearing (AIISH) Entrance Exam. If they get in that, very good. If they don’t, they can get enrolled in colleges for this profession that are available in Bangalore or Delhi by attending a small test conducted by the respective colleges. But they should have a background in physics, chemistry, biology, or math. 

Rachita Pandey: First of all, this field requires your knowledge of anatomy and physiology, though they teach them in your bachelor's, these are our major subjects. The second thing is that you must be passionate about working as a doctor because you will serve your patients. The third and most important quality that you require is patience. You will face many problems in this field. Many parents will be pointing at you and asking you that, despite how many times they visit you or how much they pay you, their child can’t talk well. You need patience and counseling skills to deal with such patients. And the rest of the things your college will teach you well.

Dr. Shanjitha Hussain: So regarding my mental health, I need some time for myself everyday other than work or child care. I didn’t have any aha moment about this discovery. This is something that I learned through years of experience. It is that some amount of me-time, even 15-20 minutes, of doing what I love to do and nothing else. This is what I aim to achieve everyday. And if I had this alone time, I feel accomplished. Usually, I take advantage of the time when my kid naps, to relax and unwind. This is how I take care of my mental health. 

Rachita Pandey: Himani, I’m answering your first question about the scenario where your child doesn’t respond well to the therapy. We schedule a lot of meeting with the parents. In addition to parent observation, sitting with them and explaining the entire situation is very important. So, child not responding to therapy is another thing, but there is an entire list of things that the child must be mastering by that time. We will be showing the parents that checklist. If the child is not talking, we will be showing them the alternatives. We also use technology to help the child communicate. So we will showing them that way and eventually it goes well. And there are many parents who face this problem. 

Second, talking about mental health, as Dr. Shanjitha told, I also need my me-time. But personally I want to tell you that on weekdays I’m not able to get it, because I have a limited time span. On weekends I make sure I go our somewhere. I plan outing, with my baby or without my baby depends on the place. That’s how I maintain my mental health. Also, I had started working out in between. Though I’m unable to do it continuously, working out gives me relaxation. 

Rachita Pandey: Yes, I want to add on to your line. My first message is to choose the right professional; don't get into fake hands. And the second message is to be aware of social media scams because social media is nowhere less. Because today, every influencer has become a parenting expert, sharing advice. The main thing I’m talking about is the fake speech therapist whose reels are getting millions of views. And people are just asking for their clinics and their appointments. I recently saw a reel in which the person was asking parents of children with autism, ADHD or hearing problems to give 4 drops of almond oil mixed with milk, claiming that the child would start speaking. This is unsafe. So when you are following such people, either ask them directly or search in their bio for their credentials. Because certified professionals will add it there. I recently saw another video of a speech therapist who was giving prompts to the child. Speech therapists can give prompts, but there is a way to give them, and they need to know the anatomy and physiology. And to give prompts, you need a separate certification from Australia after your Masters. If you see that when prompting, if a child is in discomfort, pain or the child's mouth is being squeezed, then it is the wrong way. Certified professionals will never cause pain because there is a proper way to do it. In that video, the person was just pressing the child’s lip to make him say “ba.”. The child’s eyes were filled with tears and obviously, from the pain, he said "aah,” and the parents felt happy that their child was speaking. This can amount to physical abuse. So if you contact the right professional, you will be in safe hands.