It Began with the Letter R…

“My speech therapy career literally came from the tip of my tongue.” – Christella Antoni

I wanted to be a speech and language therapist since I was about 5 years old. The seed was planted in infant school. My first teacher had noticed I couldn’t say my ‘R’ sound properly, and referred me for speech therapy. I had no idea that the tip of my tongue was not tensioning and curling back sufficiently to produce the /R/ sound, so, happily and unknowingly, I glided effortlessly into a light /W/ sound instead.

I LOVED having speech therapy. It got me out of class and the speech therapist was lovely . She put down endless picture cards which I diligently identified:  ‘rake, robin, rock, river,  rainbow, red …. and then sentences heavily loaded with words beginning with /R/. My reluctant tongue tip had me skipping off across the infants playground several times to meet the speech therapist. I met her in a little lofty library that was accessed by carefully climbing a spiral staircase. There, in that elevated place in the school,  I felt lifted up from the routine confines of my classroom.

One day, the speech therapist said she wouldn’t be coming the next week and I remember my heart sinking. She was so much nicer than my form teacher, Miss B——– who had a pet pupil – Peter – and even then as a 5 year old, I had a strong sense of social justice. I knew it wasn’t right to favour one child over the others. Miss B only ever sat Peter on her knee and always smiled when she said his name, sometimes saying ‘my Peter’ (odd I thought). Yes, she could not hide her favouritism but at least her ears detected my phonological shortcoming which introduced me to speech therapy.

I needn’t  have worried when the speech therapist said she wouldn’t be there the following  week . Her next words were: ” but another therapist will come to see you”. She did. And she was lovely too. I thought wow! These speech therapists are all lovely …. And they speak the truth and they’re fair. I progressed to reading phrases like ‘running around , ruby robe, red Robin  eventually making it to ” The rugged rascal ran around the rugged rock ‘. I achieved the tongue tip curl back required so that I could produce the ‘R’ sound consistently. My speech therapy career literally came from the tip of my tongue.

Nowadays, after my MSc training in Speech & Language Therapy and Pathology, I still treat some phonological  (sound  production)  difficulties. I enjoy speech and voice work with a wide range of clients. I do this almost exclusively at my private treatment rooms in Marylebone. I still have an NHS link running a fortnightly Joint Voice Clinic with my eminent ENT colleague Mr Guri Sandhu at Charing Cross Hospital but private practice allows me more flexibility with appointment times and caseload. It also means I can bring together  a supportive and supported team of associates and admin staff.  I have a varied practice, working from a lovely room in the heart of Marylebone village . It’s a long way from Leopold Road school in Leighton Buzzard.

From qualification to honing my craft

Very soon after qualification, I was bowled over by a six day intensive VoiceCraft voice run by one of my main mentors in Voice, Alison Bagnall. It was the start of many VoiceCraft courses for me. I already had an inkling towards voice work during my training and an ability to manipulate my own vocal tract. I became increasingly more able when working with other people’s voices too. In my early career, I developed my general SLT skills whilst working in a community post working with adults with diagnoses as varied as dementia, stroke, Motor Neurone disease (MND) and Parkinson’s disease. As geographically lost as I was in the beginning, trying to navigate my way around North London, the orientation I learned regarding medical conditions have always stayed with me. There is sometimes the most grace and kindness in people during their hardest times. I remember Mary who had MND in her seventies and her sprightly husband, about the same age who were so welcoming when I visited them at home. Mary had the type of MND that affected her speech and swallowing but not her movement below the neck. By the time of my involvement, she was no longer able to eat or drink and had a PEG feeding tube in her stomach. She would insist on making me tea and giving me a Kit-kat – I could never bring myself to eat the Kit-kat in front of her but I said I would take it and eat it later which always seemed to please her so much.

After 6 months in the community job, I was based at the North Middlesex hospital itself, working with stroke and the elderly inpatients . One day I noticed Mary with MND lying in a bed on one of the wards. I sat by her bed and she wrote something for me “How are you?” Of course I wanted to know why she was there and how her husband was. She wrote back that he had died, just suddenly, one day, whilst picking up something from the chemist. It was a lesson for me that day on the arbitrary nature of life. The fact that people with progressive illnesses can sometimes far exceed life expectations and seemingly healthy people can die in an instant.

It was in that job that I learned the value of a boss who would give you opportunities. My boss was Judith Langley. She was my first boss and the best I ever had. An amazing compassionate clinician and someone who cared about the therapists who worked in her team. I never forgot her decency to students – I had my long-term clinical placement there and when a part-time job came up to cover a 6 month maternity leave I took it, knowing that I was going to a place where the manager was first and foremost a clinician and a brilliant person. It was in that job that I first had the opportunity to see voice and stammering patients because Judith recognised my interest. I was vocally ignited.

Eating,  Living &  Breathing ‘Voice’

In 1997, filling in the referral book in the dept at North Middlesex Hospital, I decided to take up  Alison Bagnall’s offer to accompany her on some training courses in New Zealand.  At the end of that trip she had selected me as her associate. A few months later, I was working intensively in her practice in Adelaide Australia and then dissecting cases with Alison over dinner most evenings, I literally lived, breathed and ate voice. Chewing over and digesting cases was never difficult, however challenging the case was. Digesting Kangaroo meat proved more of an obstacle- I just didn’t have the right gastro-enterological enzymes to comfortably hold down meat which emanated from creatures who repeatedly bounce up and down….

As for all clinicians who progress, I developed my own additional exercises and approaches, continually honing my practice to produce efficient and achievable systems of voice change and development. Nowadays, I see a wider variety of voice and speech clients than ever before. Pre and post treatment voice recordings provide evidence and information about the effects and outcomes of speech and voice therapy.  I love the moments when clients gain the awarenesses of how to achieve their voice improvement . Right in front of me, I both see and hear people’s lives change. There are moments when, peoples voices are written all over their faces.