LIFE IS NOT always smooth sailing, but it often happens that in coping with testing situations in our younger years we develop the passions and characteristics that guide our subsequent choice of career. Born to parents who had severely impaired hearing, Gladys Yan Ka-lee devoted herself to helping them overcome their difficulties in communicating and went on to make a career of caring for other people with similar problems. Ms Yan, who is now senior speech therapist at the head office of the Spastics Association of Hong Kong, realised early on how important it was to be able to express affection and exchange ideas within the family, and saw what a difference this could make. Before becoming a full-time speech therapist, she worked as a registered nurse in a ward for mentally handicapped patients. This experience also showed her that assisting people with different kinds of speech disorder could noticeably improve their lives. 'Whether in the case of my parents or patients I met in the ward, I saw how people with hearing impairment and speech problems suffer because the difficulty in expressing their feelings and opinions has such an impact on their social contacts,' Ms Yan said. So, after seven years in mainly nursing jobs, she dedicated herself to being a speech therapist. She began by taking the four-year BSc degree in speech and hearing science offered by the Faculty of Education at the University of Hong Kong (HKU). This full-time programme, which combines lectures and placements to gain practical experience, was challenging. 'It's not an easy programme and it certainly wasn't for me. Although I was a nurse, I had done very little science before and the course has a lot of compulsory science-related modules,' she said. These include anatomy, physiology, behavioural science and knowledge of phonetics. Placements start in the second year. Students must pass both the academic courses and their placements to graduate. 'The workload can be tough because a student might need to look after several clients at the same time,' she said. This entails regular interaction plus the need to come up with a session plan and complete assessment reports for each client. Just to be accepted for the BSc programme requires an above-average academic record because the annual intake is only about 40 students. After graduating, Ms Yan accepted an offer to join the Spastics Association as a speech therapist and initially focused on working with children. Different approaches are used depending on the age group and whether the children have special needs. Pre-schoolers would be trained in greetings, how to wash their hands, wear a uniform and eating. The therapist would also supervise assistants who were leading other sessions. Duties would extend to giving advice on the development of the children's cognitive and social skills. By 1997, Ms Yan realised there was more to learn and won a scholarship to take a master's degree in speech and hearing science. For the next three years she combined work and study. 'Luckily, I had some study leave so I was able to find time to finish the course requirements,' she said. With the extra qualification, she took on more administrative responsibilities and, this year, was promoted to senior speech therapist. A typical working day will now involve supervisory visits to pre-school centres, special schools and adult service centres. Ms Yan must also develop new resources to improve services and complete reports on all ongoing projects. She is collaborating with HKU on a project related to autism. She must also fit in recruitment, orientation, staff appraisals and discussions with other professionals such as occupational therapists about programme development. In the evenings she immerses herself in professional journals so she can keep up to date with all the latest thinking in her field. 'The longer I am a speech therapist, the more I understand it is not about learning certain techniques. The key is to be able to integrate the different tools that best serve individual clients,' she said. This applies especially when integrating visual tools to help autistic clients to comprehend information. 'Autistic people have problems understanding what you say but can understand visuals with relative ease. To recognise such things, a speech therapist needs to keep on learning and create synergy between the available tools.' While a degree and continuous learning are important, Ms Yan said good grades were not enough in a job which was all about helping others. 'I have often seen people who are well qualified academically but do not have the necessary interpersonal skills to do well. It is no surprise when they drop out of the programme or the profession,' she said. To test their interest and ability in serving others, students should do volunteer work before applying for a course or making a decision about going into speech therapy, she said. In doing this, they could assess their own communication skills, enthusiasm in motivating people and ability to observe. Speech therapists also need analytical skills. 'These are important because after the assessment of a client, we must define tailor-made treatment programmes. Usually, these are a result of observations in group settings and unaccompanied situations,' she said. Patience is also a very necessary quality. For example, some parents have preconceived notions about what their children should learn. They might also have unrealistic expectations about rates of progress. While this is done with the best of intentions, it might not tie in with what the professionals think. 'We deal with children every day, but must not forget their parents. We must understand why they have certain ideas and consider their point of view when coming up with a programme for their kids,' Ms Yan said. She said the most rewarding aspect of the profession was seeing children who had improved their cognitive and social skills thanks to an enhanced language ability. To become a speech therapist, you must ... Possess an undergraduate degree in speech and hearing science; Be committed to lifelong learning; Have excellent interpersonal and communication skills; Be enthusiastic and able to motivate people; Possess a high level of sensitivity to the needs of others; Show the ability to plan, analyse and organise. Salaries Senior speech therapist* $45,295 to $69,700 Speech therapist $17,190 to $44,045 *According to the Hong Kong Hospital Authority, it is up to the discretion of the employer to introduce the rank of senior speech therapist.