Interview with one of TAASC's newest members: Ms Michelle Mifsud

Despite only graduating from University of Malta 2 years ago, Ms Mifsud is already helping children around the country both as a Speech and Language Therapist within TAASC, and by contributing her skills to the education sector’s Early Intervention Service. Her passion for assisting those facing adversity early in life is clear; as a student she focused her undergraduate final-year research on the reasons some children fly under the radar for Autism Spectrum Disorder diagnoses, and as a young professional she plays a vital role in making sure children with Autism or other difficulties are properly recognised and effectively helped early on. Read on for the insights she’s gained from University and her first years on the job…

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You graduated from UOM as recently as 2016, has a career as a speech and language therapist (SLT) been different to what you expected / experienced as a trainee?

As a student I covered over 450 hours in clinics with clients, so that offered a realistic taste of the working world. I consider myself lucky to have met some very inspiring educators along the way who helped mould me into the professional I am today. The reality is when you're no longer a student you'll never have the luxury, or not, of being up until 3 am preparing materials - so time management Is key.

I joined TAASC's family In February 2017 which offered me a different perspective of working as a speech-therapist. With so many in-house experts from different areas of health care, my SLT services are part of an interdisciplinary service, aiming to offer therapy which is more holistic.

 

As a specialist within the Early Intervention Service, what in your opinion is the biggest hurdle the children with difficulties you meet face in early education? 

Like our lifestyle, our education system is rushed and on steroids. We're expecting children to lift weights before they can walk. Children are expected to sit and listen - as early as 3 years old in Kindergarten. Currently the early years at school are highly academics based - it is hard enough for children to transition to a school environment, let alone for them to become 'students' so early on - they should be allowed to be children; children need play, children need to be little explorers. This is true for all our tiny humans in Kindergarten, let alone for those facing developmental struggles. It is just as overwhelming for the parents/caregivers as it is for the children - nobody wants their child 'lagging behind' at age 3. If a child has not yet developed basic communication skills, how then can a child cope with comprehending academic material?

Thankfully, this situation is likely to change in the near future. Changes to the Maltese education system are in the pipeline which aim to make learning more child-led and explorative. This should lead to schools becoming a happier place for all children, especially those experiencing developmental difficulties.

 

Your UG Dissertation was titled ‘Girls with autism spectrum disorder: missed diagnosis or misdiagnosis?’. Could you summarise why young females are at a higher risk for mis/missed diagnosis, and what the general symptoms for Autism Spectrum Disorder are in young children?

Two of the main diagnostic criteria of Autism are impairments in social communication and social interaction.

Females, in general, are more socially inclined than males - this does not change with the presence of autism. Girls often 'pass through the net' as due to this natural need to be social-beings, girls with autism may learn to imitate social behaviours, and to mimic females in order to act appropriately in different situations. So, although it does not come naturally to them, many females with Autism who do not have a cognitive impairment may appear to present with 'typical' social behaviours during the early years of life. Then there comes a point, particularly during teen years, when dynamics of social relationships change, and often become more complex and less superficial. It Is here that very often females with so-called 'high functioning' autism start to struggle building social relationships. It is very often here when such girls start to question why they feel different - in fact, often times a diagnosis comes as a relief to them.

In addition, females with autism who are on the higher functioning end of the spectrum have a higher incidence of co-morbid mental disorders than males. Such mental disorders may mask the autism. Differently, these girls are sometimes misdiagnosed with mental disorders rather than autism.

It Is noteworthy that most diagnostic tools for autism were standardised on symptoms of males since there Is a higher prevalence of males with autism - one may then question, is the higher prevalence of males due to girls 'flying under the radar'? - A vicious cycle.

 

What is the role of a Speech and Language Pathologist in the context of TAASC’s holistic approach to the diagnoses and treatment of children and young persons?  

 

Within TAASC SLPs collaborate with other professionals through assessment pathways and multi-disciplinary team meetings. Assessing Communication is a vital factor when assessing for the presence or otherwise of Autism; Attention Deficit Hyperactivity Disorder; and Behaviour difficulties. TAASC's SLPs offer individual and group therapy - for speech, language and feeding. I also co-plan and co-deliver social language groups.

For more information on social language groups please check out: https://www.taascmalta.com/group-sessions/

And finally, what are your suggestions for any parent / care-givers concerned about the communicative development of a young child?

Nobody knows a child better than their parents/main caregivers. When concerned about their child's communicative development they should seek a professional opinion by setting an appointment with a SLT for an assessment.  An assessment may serve to put a parent/caregiver's mind at rest, or to guide them in the right direction. Early identification of difficulties allows for early intervention, and this in turn will offer a more positive prognosis for the child.