Ukraine – August 3 2018 Ukraine: Addressing a side-effect of conflict SOS Children’s Villages helps children with speech problems, but the need is growing When conflict broke out in eastern Ukraine in 2014, three-year-old Yuriy would hide in fear during the fighting that engulfed his town.* The boy became less and less talkative at a crucial time in the development of a child’s communication skills. His parents grew increasingly worried by his lack of verbal expression. “At the time, the schools and public services were closed and there was nowhere to go for help,” recalls Yuriy’s mother. One day in 2016, she met social workers from an SOS Children’s Villages mobile team who visited her son’s kindergarten in Stanytsia Luhanska and offered specialised help. Yuriy is not alone. Doctors, psychologists, and other specialists working in the conflict-affected communities of eastern Ukraine say there has been a significant increase in the number of children over the age of four who are experiencing speech difficulties along with other problems linked to traumatising events. Examples include children not expressing themselves at all, a lack of social interaction, and delays in the development of speech patterns that come with everyday communication. “Speech skills can be closely related to the psychological health of the child and how the child develops,” says Oksana Bozova, a speech therapist at the SOS Children’s Villages social centre in Stanytsia Luhanska, a Luhansk region town that is under Ukrainian government control. With 15 years of experience as a therapist, she estimates that up to 80% of children of the 150 children who attend the centre have speech difficulties. “During the diagnosis, my first question to the parents is where the child was in 2014,” Ms Bozova says. “What we see is that many of the speech difficulties are closely connected to the conditions during the fighting and growing up under these difficult circumstances.” Before the conflict, speech problems amongst children in the area were known to be higher than in other regions of Ukraine and often related to genetics, illness and disabilities. But fighting in 2014 and 2015 forced mass dislocations and many doctors, therapists and other specialists fled the region. “We don’t have enough qualified professionals and if a family needs very specialised care, there is no one available,” says Ms Bozova. Traumatising events Tatiana Fedotova, a psychologist at the SOS Children’s Villages social centre in the eastern town of Starobilsk, also sees a close link between traumatising events and the rise in children with speech difficulties. Ms Fedotova cites the case of a 13-year-old boy who appeared to be developing normally before the conflict but stopped communicating with his parents during the fighting. He was also having trouble getting along with other children. “There is stress in situations like this that influences the mind and can affect a child’s ability to express themselves,” Ms Fedotova says. After more than a year of regular meetings with the boy and his parents, he is beginning to show signs of confidence and is expressing himself. “These are very difficult and complicated situations,” the SOS Children’s Villages psychologist explains. “What is important about what we do at SOS Children’s Villages is that we address not only the child’s basic needs, but their emotional needs.” Long-term commitment Stanytsia Luhanska suffered heavy damage during the height of the conflict. Its only hospital was bombed twice and some of its most important diagnostic and treatment equipment was damaged. Many of the specialists have left, according to its chief physician. Ms Bozova is the only known speech therapist left in the town and she divides her time between the SOS Children’s Villages social centre and the local hospital. Working with children with speech difficulties takes time and long-term commitment. Ms Bozova herself will soon go on maternity leave, leaving a gap in the specialised care. “You start by developing a relationship with the child”, she explains, adding that diagnosis includes exercises to determine if the child may have physical impairments that could be affecting the movement of the mouth. Developing a relationship with the parents is also important to understand their situation and background. “It is very individualised care with every child and it takes time – months or sometimes a year.” Getting parents involved Ms Bozova encourages parents to be involved in activities at home that can help the child. She credits Yuriy’s mother for her participation in activities at the SOS Children’s Villages social centre and in working closely with her son at home to encourage verbal expression. The efforts are beginning to pay off, the mother says. “In our situation we don’t have any other opportunities for help. And it is very difficult for children when they start to go to school if they have speech problems”, Yuriy’s mother says. But with the help of SOS Children’s Villages, her son “has made real progress. And now we are starting to work on his pronunciation.” * The child’s name has been changed to protect his identity.