The Early Stimulation Programme (ESP) for children 0-6 years with various types of developmental disabilities has been without a speech therapist for some three years.

This even as director of the ESP Antonica Gunter-Gayle says the entity has been seeing more children with disabilities (CWD) calling on its services since the COVID-19 pandemic years.

“Our numbers have increased. I don’t know if because the children were home [for the prolonged period] and they were inside. I don’t know if this is because there wasn’t the exposure, the socialisation, the interaction. I don’t know if any of this has to do with it, but we find that a number of children especially the two, three-year-olds with speech delays, behavioural challenges, slow learners, cognitive problems, autism,” Gunter-Gayle told the Jamaica Observer on Monday.

The entity is one of two which the United Nations Children’s Fund (UNICEF) says is “unable to effectively carry out” its mandate due to insufficient resources. UNICEF Jamaica in a recently conducted study released last week said, “the ESP needs physiotherapists, speech therapists and behavioural therapists as well as more resources to increase service provision to CWDs in the parishes outside the Kingston Metropolitan Area (KMA)”.

The ESP is the main organisation providing services to children with disabilities in the 0-6 age bracket making it so that at some point each child affected in this manner will have accessed the ESP’s service, UNICEF said.

Gunter-Gayle on Monday said, while the entity has a regular physiotherapist and is now conducting interviews to hire another, it has been unable to source a speech therapist.

“The ministry is aware of the lack; we have no speech therapists. The speech therapy is really our great need especially for children with cognitive impairment and speech and language delay, and so forth. The curriculum that the ESP uses has a component for language development or language enrichment but the service of a speech therapist, it would complete what we do; the need is there, the need exists for a speech therapist,” Gunter-Gayle, who has led the entity for 34 years, told the Observer.

She said the void has been there since the Ministry of Labour some years ago, through collaboration with other entities including the World Bank, was able to procure the services of a speech therapist.

“But that expired about two to three years ago and since that time we have not been able to offer that, and so we use the curriculum,” she said.

Gunter-Gayle, who said she was unable to say offhand how many children who are served by the ESP needed speech therapy, added, “It is quite a number.” She said the issue was exacerbated by the fact that speech therapists are “few and far apart”.

“It’s about five [speech therapists] in all of Jamaica; they are few and far apart. That is a service that I don’t know how the Government could look at it, in terms of training and so on, because most of those who are here were trained abroad,” the ESP director said.

To fill that gap, she said, “There was a programme some time ago where some amount of audiology, speech therapy, some amount of child development [was done]; it was a mix of developmental areas and we had quite a number of persons that were trained. Something like that could be looked at again.”

Commenting on the dangers of this type of intervention being delivered when the children are past a certain age, she said, “That’s why we say the sooner the better. As soon as we suspect that the child may have a certain type of disabling condition, it is best to start the intervention as early as possible to prevent worsening of the disability.”

“Early intervention is key for any type of disabling condition. The sooner we start it is better for the child because we don’t want later on the problem exists, you know they say it is better to be safe than sorry, you do what you can do about it,” Gunter-Gayle added.

In the meantime, she said the ESP has had to be “referring out” children who need behavioural therapy as there is no one at the entity to provide this kind of assistance.

UNICEF, in batting for “increased budgetary allocations” for the ESP and the Jamaica Council for Persons with Disabilities, said, “Even though Jamaica’s high debt-servicing burden limits, to an extent, the monies it has to spend on social protection, there is room to significantly increase [from .02 per cent of GDP] the monies allocated to these two organisations.”

It said policies and programmes are needed to address the attitudes and norms surrounding disability, changes to legislation, allocation of financial resources, restructuring of administration processes and databases, management changes and reforms to the sector. According to UNICEF, it will take a concerted effort and commitment of all stakeholders to implement the recommendations to better serve the communities of persons with disabilities.

Different institutions refer children to the ESP which organises tailored interventions for children after a complete diagnostic and medical examination. The ESP has centres across the island with its ESP in Portland serving St Thomas and St Mary, while the ESP in St James serves Trelawny and Hanover. It also has a school in Kingston, the Stimulation Plus Child Development Centre, one of the largest such with over 100 young children attending.