PEACHY SAT beside her mother on a bench at Benavides Park. Her hair was neatly tied back in a ponytail, and her hands were busy playing with the fallen leaves she had gathered from the grassy edge of the path.
It was early December, and the ornaments for the year’s Paskuhan had just been installed on the poles and trees around them. They were waiting patiently; in a few minutes, they would walk to the UST Central Laboratory for Peachy’s weekly therapy session.
Her mother, Angela, only had one wish: to hear her daughter’s sweet voice clearly.
Peachy has a speech disorder called alalia, which is characterized by a delay in the development of mechanisms needed to produce sounds and form words. While kids her age are starting to string sentences together to express their desires and observations, Peachy finds herself in a different situation. The words she longs to say and the needs she wishes to express often get tangled, sometimes lost, on their way from her mind to her mouth.
For Peachy’s mom, the typical milestones of language development weigh heavier. Each mispronounced word and each fragmented sentence is a reminder of the gap between Peachy’s vibrant inner world and her ability to share it with others.
“Noong mga nakaraang Pasko, talagang kahit ‘Merry Christmas’ ‘di niya masabi. Kahit nga ‘Merry’ lang, hindi talaga,” Angela told The Flame.
(In previous Christmases, she could not even say ‘Merry Christmas.’ Not even ‘Merry.’)
Initially unsure of the specific nature of Peachy’s challenges, Angela, concerned by her daughter’s delayed speech, decided to arrange a playdate in 2022. She hoped that by observing Peachy interact with other children, particularly those with autism, she would get insights from fellow mothers who have experience dealing with similar conditions. When her playmates would try to talk to her, she would freeze.
“Para siyang nawawala sa sarili niyang mundo (It is as if she is lost in her own world),” Angela said.
The thought of her daughter growing up and being subjected to ridicule or social isolation due to her manner of speaking is a heavy burden that Angela bears daily.
“Bilang nanay, number one na pumasok sa isip ko nu’ng na-realize namin na hirap nga siya ay baka ma-bully siya,” she said. “Masakit ‘yun para sa aming magulang niya eh. Isipin pa lang namin masakit na.”
(Of course, as a mother, the first thing that came to mind when we realized she was struggling was that she might get bullied. It is painful for us, her parents. Just thinking about it is already painful.)
Angela revealed that while she and her family initially thought of enrolling Peachy in a special education (SpEd) school after her time in daycare, Peachy showed a complete aversion to the idea, crying inconsolably every time it was mentioned. Witnessing their daughter’s distress, Angela and her husband decided to prioritize speech therapy, with the hope that addressing Peachy’s communication challenges would ease her anxieties and pave the way for a smoother transition into a non-SpEd kindergarten by the following year.
“Maaga ko kasi siya nilabas, kaya sinisi ko rin sarili ko for a while (Because she was born prematurely, I blamed myself for a while),” she continued.
“Iniisip ko, baka kung mas matagal ko siyang dinala, baka kung may iba akong ginawa noong buntis ako… (I thought, maybe if I had carried her longer, maybe if I had done things differently while I was pregnant…)” she paused, composing herself.
According to a literature review published by the National Library of Medicine in 2018, babies born prematurely may have a higher chance of experiencing developmental delays, including difficulties with language acquisition during their toddler and preschool years. Angela has yet to confirm with a developmental pediatrician if such a correlation applies to her case.
“Pero alam ko naman na wala na doong magagawa. Ang importante, matulungan namin siya ngayon.”
(But I know that there’s nothing I can do about that now. The important thing is that we help her now.)
Inaccessible care?
The challenges faced by children like Peachy and their families are exacerbated by the limited access to specialized care in the country.
According to Fernando Alejandro Ligot, chairman of the Philippine Association of Speech-Language Pathologists (PASP), speech therapy is a relatively small field compared to other rehabilitation professions, like physical and occupational therapy. This stems from its recent emergence as a profession in the country.
The University of the Philippines (UP) Speech Pathology degree program started in 1978, and it took decades before other institutions followed suit. UST offered the course 31 years later, in 2009.
For Ligot, who is also an associate professor at UP Manila and a faculty member of the Department of Speech Pathology, this limited training capacity has resulted in a shortage of qualified speech-language pathologists (SLPs).
“We still have not produced enough to provide the services that the country needs in terms of speech therapy,” Ligot told The Flame.
As of this year, only four schools in the Philippines offer degree programs in Speech-Language Pathology (SLP), namely, the UP, UST, De La Salle Medical and Health Sciences Institute and Cebu Doctors’ University.
Nationwide, there are only roughly a thousand licensed SLPs, a surprisingly small number considering the size of the population and the prevalence of communication disorders. Yet, some still elect to practice abroad.
“There is also a considerable number of Filipino speech therapists who are outside of the country already,” Ligot said.
“There could be several reasons — seeking opportunities is one. Secondly, the economic benefits of having to work overseas. Third, some personal reasons for growth, professional growth,” he said.
Ligot added that the concentration of professionals in urban centers creates unequal access to healthcare for Filipinos in rural areas.
A 2019 study by the Philippine Association of Speech-Language Pathologists revealed a significant disparity in the availability of professionals, with almost 60% of speech therapists practicing in the National Capital Region (NCR), while the remaining 40% are scattered thinly across all other regions.
“Accessibility is definitely a major problem or a major issue confronting our fellow Filipinos,” Ligot said.
“Very few of our colleagues are working in the provinces, in the far-flung areas. Very few centers have been set up in other provinces. We all know that individuals with communication problems do not just reside in the major cities.”
Peachy’s family is originally from Pasuquin, Ilocos Norte, but because Angela works in Makati, accessing UST for Peach’s therapy sessions became more feasible. Yet, Angela has observed that some children within their town also struggle with speech and other health concerns.
“Siyempre, iba talaga ‘yung magpunta ka sa Maynila, kasi dito kumpleto — pero ‘yun nga, hindi lahat kaya nila” (Of course, it’s really different if you go to Manila, because everything is here, but as I said, not everyone can afford it),” Angela said.
Peachy’s parents sought out speech therapy services in 2022, but they encountered a disheartening reality: excruciatingly long waitlists. An academic staff member of the UST Department of Speech Pathology said that the waitlist at the UST-SLP Communication Sciences Center (UST-CSC) currently has around 800 people. According to the member, the center prioritizes patients without access to such services in local therapy centers and those who are unable to afford sessions from private clinics.
This year, Peachy was able to have her first session at the center.
“Sabi ng mga kapitbahay namin, ‘too late’ na raw. Sabi ko, wala namang ‘late’ kahit malapit na siya mag-nine. Ang mahalaga, nakukuha na namin ‘yung help na kailangan,” she said.
(Our neighbors said it was “too late” already. I said there’s no such thing as “late” even though she is almost nine. What’s important is that we’re getting the help she needs.)
The commitment of Peachy’s parents to her therapy journey extends beyond simply finding a suitable center; it also involves making adjustments to their daily lives.
Angela works as a software development officer. She said that her boss has been incredibly understanding of Peachy’s needs and even offered to adjust her work schedule as needed. Now, she works remotely on therapy days, allowing her to learn from the center and possibly apply the techniques at home.
More than a defect
Despite the challenges, Angela chose to focus on her daughter’s strengths and unique qualities. For her, Peachy’s speech is not a defining trait.
“Mas lamang pa rin ‘yung mga bagay na alam naming magaling siya. ‘Di lang ‘yan makapagsalita nang maayos pero magaling ‘yan mag-drawing. Malambing. Mahilig mag-alaga sa pets namin,” Angela said.
(The things we know she is good at still outweigh her speech defect. She just cannot speak properly, but she is good at drawing. She is affectionate. She loves taking care of our pets.)
Angela emphasized the need to recognize and celebrate children’s talents and abilities. She vividly recalled one such milestone as she recounted Peachy’s very first almost-clear sentence: “Gutom ko (I’m hungry).”
“Yes, we laughed, but we were more happy because we know she struggles with vowel sounds, and that sentence has a lot of vowels, right? Gu-tom-ko, so that’s three,” she said.
For Angela, the fact that Peachy’s first clear sentence revolved around a basic need highlighted one fundamental role of communication: to express oneself and be understood.
“Of course, I also want her to be able to tell us how she feels. Happy, sad, hungry, everything,” she said.
More recently, one milestone that Peachy reached is learning to say “ayaw (no)” and “oo (yes)”.
Waiting with hope
“My advice to parents is to learn about your child’s condition, seek the right professional and do not lose hope,” Ligot said.
“Have a positive mindset towards your child’s condition — kasi meron at merong pwedeng gawin. Merong puwedeng mangyari sa anak ninyo.”
(There is always something that can be done. There can be a good outcome for your children.)
While Angela finds solace in patience and celebrates each small victory, Peachy’s father feels a more pressing sense of urgency.
” ‘Yung papa niya, naiinip na. Gusto niya makakuwentuhan agad-agad si Peachy. Sabi ko, huwag natin siya madaliin — basta in God’s perfect time,” she said.
(Her father is getting impatient. He wants to be able to chat with Peachy right away, but I told him not to rush her, and that it will happen in God’s perfect time.)
Yet, Peachy’s mother harbors the same wish, albeit in whispered prayers.
“Kung ako tatanungin, wish ko ‘yan palagi kada birthday ko ‘tsaka Pasko ‘tsaka ‘pag nagsisimba — na sana makausap na namin siya (If you ask me, it is always my wish every birthday and every Christmas and whenever we go to church — that we will finally be able to talk to her),” Angela said.
“Kahit ilang Pasko pa abutin, basta sure ako darating ‘yung araw na ‘yun (No matter how many Christmases it takes, I’m sure that day will come),” she added.
“Hihintayin namin ‘yun (We will wait for it).” F — Lorraine Belle Baguio, with reports from Arabella Peñaranda
Editor’s note: The names of the subjects, Peachy and Angela, have been changed at their request to protect their privacy.
