Two of NI's 10 male speech and language therapists on rewards of the job
Of the speech and language therapists working in Northern Ireland, only 10 are male — equivalent to just over 1%. Una Brankin meets two of the men and finds out why the job is so rewarding
In the riveting film adaptation of The Diving Bell and the Butterfly, the internationally bestselling 1997 memoir by former Elle editor Jean-Dominique Bauby, the author describes the endless hours of learning to communicate by blinking with one eye with the help of a spelling frame, after suffering a massive stroke that left him with locked-in syndrome.
He was left with an almost totally paralysed body - only his left eye was able to move.
For the speech and language therapist Paddy Moriarty, the film is compulsory viewing for anyone who comes to him for training.
"It's a very powerful movie. A lecturer recommended it to me and now I set it as homework," says Paddy. "If they can't get it, I will lend it to them. It captures perfectly how good speech and language therapy can change lives.
"Five years ago, I worked with a man who had locked-in syndrome after a stroke, who could only move his eyes. It was many painstaking hours with the Alpha frame, starting with blinking once for yes and twice for no, then building up to letters and words using the colours and lines on the board.
"We made progress quite quickly; the entire team at the hospital embraced the process and the nurses learned to use it."
From Lurgan, Paddy (38) is one of the small group of 10 male speech and language therapists in a pool of 777 in Northern Ireland. It wasn't his first choice of career - his father is a solicitor and he has a degree in law and accountancy from Queen's University Belfast. After graduation, he decided law wasn't for him and went on to manage a supermarket for four years before enrolling at the University of Ulster, at 25, to study speech and language therapy.
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"As a child I attended a speech therapist - who described me as a 'particularly unintelligible little boy'," he laughs. "But it wasn't on the radar at school when it came to careers. I took a circuitous route, but I was always interested in how people communicate with each other, and how effectively. It's the key to all human connection; life can be very hard for people if they can't communicate properly.
"On the shop floor, I could see how hard it was for some people with a communication impairment to get their message across, even just to ask for a refund, and how that affected them emotionally. It was very satisfying if I could help and, after four years, I knew retail wasn't for me. So, I made the leap and headed to Jordanstown [campus]."
Paddy now works with the Southern Trust's Acquired Brain Injury team. Back in college, during his one-year work placement, he met up with the therapist who had helped him as a child.
"My mother's a primary school teacher and she noticed I was mispronouncing words," he recalls. "She sent me to this lady and she made the therapy fun. She used farm sets for naming tasks and letter sounds, for example.
"My fiancee, Seana, also works as a speech and language therapist, in paediatrics, but I specialise in acquired brain injury, which is incredibly varied. I work with people impaired through strokes, accidents, dementia, Parkinson's, and so on, as part of a rehabilitation team.
"It can be a matter of introducing a whole new communication system based on symbols and explaining effective communication skills to hospital staff, family and carers. With acquired brain injury, the swallow reflex is often affected, and a lot gets lost in translation."
Stammering is one of the better-known issues that can be addressed by speech and language therapists, including an impediment resulting from acquired brain injury.
"After brain injury, stammering can be symptomatic of how quickly it is taking to process words, or it can be a symptom of anxiety," Paddy explains. "It is very rewarding to see someone's confidence improving when their communication difficulties are repaired, through various strategies and relaxation techniques. It is all about the process.
"Self-confidence can be very low after a brain injury - but no one is beyond help, even if they may not communicate in the same way. There are some whose whole focus is to want to go back and hit the re-set button; that's their motivation. They may not get there but just because someone cannot talk in the same way they used to, doesn't mean they have nothing to say.
"What I do is help people accept their circumstances. People need time and we can give people time. We often start our intervention - I hate that word - after people leave hospital. That's when the reality really sets in."
Paddy is getting married in August. He met his fiancee at a wedding, unaware she was one of the 767 female speech and language therapists working in Northern Ireland. He sees his job as a vocation and puts the shortage of males in the profession down to a lack of awareness of the job.
"In hospitals, some have presumed I'm a physiotherapist. Otherwise, people automatically assume speech and language therapy is elocution," he concludes.
"There are so many varied roles within it, from paediatric clinics to acute hospital wards, to core community work.
"A doctor once suggested we should be called communication and swallow therapists.
"For what I do, that would be more appropriate."
Daniel Browne's speech and therapy work with children diverges radically from the roles of his brother, a surf instructor, and his father, a carpenter.
"Dad and I both did our fair share of baby-sitting though," he laughs. "Mum teaches business and I've two younger brothers. I've always got on well with children and I love working with them."
Daniel (25) has recently returned home to Limavady from Bangladesh, where his wife, Lydia, was based temporarily for her job with the United Nations, monitoring the population's health.
Daniel worked with Rohingya refugees from Myanmar living in Bangladesh camps to escape ethnic and religious persecution within Myanmar's borders.
"My job was to train UN workers in the learning centres in the camps to communicate with the refugees, to ensure inclusiveness," he says. "It was quite a challenging process, working through eye contact and body language to different forms of communication. There is a humanitarian crisis going on; there are many women and elderly to be mentored in the camps, too. It's very rewarding to do something to help, however small."
Daniel left Limavady after school to study speech and language therapy in Scotland.
"My best subject at school was English and I had a very good teacher who saw that I had a real interest in the language development units," he recalls. "I did my own research into the career paths and went to all the university open days, where I stuck out like a sore thumb at the speech and language therapy stands.
"There were only two other guys among the 26 on the course I chose at the Queen Margaret in Edinburgh but that's okay. It was never an issue for me. I absolutely love the profession, especially for the variety it offers. It's not just about articulation. It's not elocution. It's about total communication - challenges and supporting people in being functional and independent when it comes to communicating."
While observing speech and language therapists in Coleraine using language-based play to work with a group of children, Daniel found himself fascinated.
He decided to focus on paediatrics and children with complex needs. "To make a bit of money during the course, I worked in a nursery school - I took a module in early years development and that was good experience for my work now, which takes place in an educational setting and can include profound and even challenging behaviour," he says.
"I support kids with language, communication or speech difficulties, and kids with special educational challenges.
"Achieving even a small amount of progress can have a massive impact."
Daniel has also worked at an international school in Brussels, mentoring speech and language therapists there. In contrast to his work in the Bangladeshi camps, he worked more structured days in Brussels, starting at 8am and finishing at 6pm.
"The kids were a delight to work with," he says. "One in the group was a very high functioning autistic child, attention-seeking, with no understanding of social boundaries. He could be anxious, aggressive or upset, and dramatic and over-the-top, for want of a better term.
"But he'd come to me with his communication difficulties and we developed a very good working relationship and friendship.
"I worked with six or eight kids a day and observed them in class.
"Again, it could be challenging but I love it. You're constantly empowering someone - communication is a very powerful thing. There are three or four core strategies and it's a case of trial and error.
"When the child begins to understand how to communicate, step by step, it's wonderful."
One of the children seared into Daniel's memory is a young girl with Down's Syndrome, whom he met in one of Bangladesh's two official refugee camps.
"The camp was the size of Leeds, full of people speaking two or three different languages, so communication was complex," he says.
"I'll never forget this particular little girl - she was very willing to interact. I saw her playing and making her own toys, as the children do there, and she came over and started lifting my hands and examining them.
"She took an interest in me and I was able to provide strategies to her mum and dad for communicating with her, starting with asking her a question and waiting for her answer. Children with learning difficulties must be given as much opportunity to communicate as possible. Part of that is asking her siblings to support her and to include her in their games. Play is so essential for communication."
Next stop for Daniel is London, for a teaching course. His wife, Lydia, is currently based in Yemen and the couple are planning to work internationally for the next few years.
"I really enjoy seeing progress in the children," he concludes. "In Bangladesh, 60% of the children were unaccompanied - there were five-year-olds holding babies. It was difficult at times, but it's not about you. It's about the children and if I can make a small but significant impact every time I see one, that's enough for me."
The profession that’s working to help speech conditions
Ceara Gallagher, head of the Northern Ireland office for the Royal College of Speech and Language Therapists, says:
"The Royal College of Speech and Language Therapists (RCSLT) is the professional body for speech and language therapists (SLTs) in the UK, representing over 17,000 members. Around 777 are based in Northern Ireland.
SLTs enable children and adults with speech, language, communication and swallowing difficulties to lead fulfilling and better lives.
Before becoming head of the RCSLT NI office, I worked as a clinician for over 24 years in the HSC.
Working as a speech and language therapist has greatly enriched my life, as well as that of the children and families that I had the honour of working with.
SLT offers many career choices and pathways and provides an opportunity to be part of widespread innovation that is urgently needed to help transform our health service.
A career in SLT is diverse and exciting, offering opportunities to work in health, education and justice and with a myriad of conditions ranging from stroke to hearing impairment to autism.
Traditionally, speech and language therapy has been a career path pursued by women, much like other caring professions such as nursing. It is wonderful that so many women work in our sector and at RCSLT we are very proud of our workforce.
Currently in NI however, only around 1% of our profession are male (RCSLT membership figures) and in 2017/2018 there were no male SLTs training at an undergraduate level. That is something we are keen to address, to ensure that our workforce becomes more diverse and is seen as a viable career for all types of people.
- RCSLT NI is hosting a stand at the Belfast Careers Fair at Ten Square Hotel, 10 Donegall Square South, on August 9 from 10am-2pm, and would love to talk to more men about pursuing a career in speech and language therapy, and ultimately help transform more lives