Día Seis

It’s our last day in Querétaro, and some of us started the morning with yoga. Mark was our yoga instructor and has lived in Querétaro for six years. He taught the class in Spanish, and we learned new Spanish words like, “perro abajo” (downward dog).

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We visited our final site, Ándale para Oír, Padres de Niños Sordos A.C. This is a clinic that serves 70 deaf and hard of hearing children and adults. This clinic receives referrals through word of mouth, networks with specialists, and relations with the hospitals. Ándale offers many programs including individual therapy, group therapy, and several specific programs. For example, they have a program to prepare children for kindergarten and a group therapy program for teenagers. Many professionals collaborate at this site including audiologists, teachers, speech-language pathologists, and psychologists.

One way clinic raises funds is through generating campaigns to alleviate the stigma around people with hearing loss. Ándale has also begun a campaign to increase awareness of newborn hearing screenings. Within the U.S., it is federally mandated that all newborns receive a hearing screening. This is a federal mandate in Mexico as well however, many hospitals in the areas do not follow this protocol or do not have adequate equipment for the screenings. Ándale offers hearing screenings at their clinic to help mitigate this issue.

In addition to the funds made from campaigns, the clinic receives funding from the government and donations from various businesses. Due to this, patients pay for services on a sliding scale based on their financial situation. This model was used in previous sites we visited this week in Mexico as well and in some clinics in the U.S.

Maestra (teacher) Ofelia Gonzales, who is a speech-language pathologist, showed us around the clinic. All children that come to the clinic for therapy are taught sign language along with oral language. This includes children that are implanted with cochlear implants and children that use hearing aids. Maestra Gonzales expressed some of the barriers she faces as an SLP and obstacles that the clients experience. For example, issues arise while coordinating with doctors, audiologists, and teachers which she expressed are likely due to our recommendations and field being less valued or understood. Communication issues like this occur in our field in the United States as well.

Additionally, Maestra Ofelia Gonzales explained difficulties for cochlear implant clients in the clinic. Oftentimes candidates have to wait several months from the time they are identified as a candidate until they can be implanted. Furthermore, some of the clients do not have the funds to obtain new parts for their device or new devices if they are not functioning correctly. Lastly, candidates must go to the hospital, which is hours away from Querétaro, to have their hearing devices programmed. To make programming more accessible for clients, some of the therapists at Ándale are currently taking classes to learn how to program hearing aid devices within their clinic.

Regardless of some of the barriers Maestra Gonzales expressed, we were impressed by this facility. Each professional we talked to showed passion for our field and a drive to provide the best care for these clients. They measure progress utilizing assessments like the PLS-5, MacArthur Bates, and an auditory perception test. The auditory perception test assesses the child’s auditory discrimination at varying levels, uses a parent questionnaire, and evaluates auditory memory. These assessments are given every six months to monitor client progress. She explained how they create therapy plans and develop therapy goals for clients, which we found is not common in most facilities in Mexico.

Finally, we observed a class of children preparing for kindergarten. This class consisted of six students, aged 3 to 6. The students come to the clinic daily, 8:30 am to 12:30 pm to learn concepts within math, language, art, gym. They also receive individual therapy. We talked extensively with Maestra Daniela. She achieved a degree in education and works as a teacher and a therapist here. In contrast, Maestra Gonzales expressed that her training as an SLP included a bachelor’s degree and then becoming specialized through training. We learned other SLPs in Mexico have trained in this manner also, which is different than our model in the US.

After the site visit, we took a tour through the city with Señora Norma. We visited the pyramid, El Cerrito (little hill), which was once covered by a hill. Within the 19th century,  a private builder built a home on top of the hill and was unaware that the pyramid was below! Since then, the pyramid has been restored on two of the four sides, to what we see today.  She also spoke about the monuments and history of Querétaro. Señora Norma shared the legend of the aqueducts that coincided with the legends tour we experienced last night! She then took us to a market called Mercado Josefa Ortiz De Dominguez “La Cruz,” where we ate gorditas and viewed the many vendor stalls selling fresh fruit, seafood, piñatas, and toys. Finally, we stopped in the Plaza de Armas where we visited the governor’s office. The building is filled with murals that depicted the history of Querétaro.

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Following the tour, we attended our final Spanish class. All three classes had the opportunity to talk to university students who pretended to be parents seeking help from a speech pathologist. We were able to ask case history questions using vocabulary that we practiced during the week. We gave a diagnosis to the parent and explained our recommendations for the child. The possible diagnoses were: autismo, afasia, síndrome de downs, TEL (transtorno específico de lenguaje) and sordera. Finally, all three classes came together and split into three different teams, with team members from each class. We played games that tested our learning from the week. Games included vocabulary related to speech-language pathology and culture of Mexico. Team tiburones won the most games!

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As we prepare to return to the United States, we want to thank all of the sites for hosting us and allowing us to further our education within the field of speech-language pathology as well as expanding our cultural competence. Furthermore, we want to thank our extraordinary driver throughout this entire trip, Señor Antonio, for going above and beyond and sharing so much more of Querétaro with us. A special thank you to our two professors that organized this trip and facilitated our learning of culture, Professor Comer and Dr. Core.

AntonioGracías for following us along our journey. We hope to return to Mexico soon!

Hasta pronto,

Lindsay & Taylor

Día Cinco

Hola!!

Boy do we have a lot to write about today- we accomplished and learned so much during all of the activities we participated in.

After a yummy breakfast at our hotel, we got picked up by our faithful driver Antonio and went to our first site visit of the day- Centro de Rehabilitación Integral de Querétaro, or CRIQ.

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This is a rehabilitation hospital in Queretaro that serves children and adults with motor and communication disabilities. CRIQ is a government funded medical institution where patients meet with a social worker to determine a feasible and appropriate amount to pay for services based on their income. We were given a tour of the facility by Lic. Ibañez, who is the director of communication rehabilitation here at CRIQ. In an introductory presentation, we learned that they use a multidisciplinary team model where doctors evaluate and assess patients and then send them to get the necessary therapy, whether that is physical, occupational, or speech therapy.

Both pediatric and adult patients usually have sessions at the center once a week, and they offer both individual and group therapy sessions. Therapists who see groups can see anywhere from 20-40 patients in one day! The pediatric groups typically include between 4-6 children. Caregivers of younger children typically accompany them to therapy so they can observe the techniques and activities that are being implemented by the therapist. Older children often attend therapy alone while caregivers have the option of receiving parent training courses during their child’s session, usually once a month. Then at the end of the session the therapist will update them on the child’s progress, and offer suggestions for supporting their child’s growth and development at home. Similarly, in the US caregivers also have the option of observing their child’s session. We thought that the provision of caregiver training which occurred simultaneously with the child’s therapy session was an effective and time efficient way to maximize therapeutic outcomes.

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We were also given a tour of the hydrotherapy room, the physical therapy rooms, the occupational therapy rooms, and even a large comprehensive sensory room used to stimulate the visual, hearing, touch, and olfactory senses. One of the OT’s who explained the different aspects of the sensory room taught us that they use sensory stimulation in therapy because it can help drive neuroplasticity. We then went to the speech-language therapy rooms. We met 4 of the 8 therapists that provide speech services. One therapist specializes in adult communication disorders such as aphasia, dysarthria, as well as voice disorders, another specializes in feeding, swallowing/dysphasia and cleft palate, one specializes in pediatric speech, articulation, and neurologically-based communication disorders (like intellectual disability), and the last one we met specializes in pediatric language delay and language impairment not neurologically based.

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While meeting the speech-language therapists, we had the pleasure of having an extended conversation with Señora Monica Sanchez, a highly skilled human communication therapist who currently works in pediatric feeding, swallowing/dysphasia and cleft palate treatment at CRIQ. Señora Sanchez is a highly skilled clinician who has worked in both adult and pediatric hospitals in a variety of medical settings. Prior to working at CIRQ she worked at a national cancer rehabilitation hospital where she treated adults with communication and swallowing disorders resulting from procedures such laryngectomy and palatal and mandibular resection secondary to oral and pharyngeal cancer. She has also worked in the ICU and NICU units of private hospitals.

In talking to Señora Sanchez we became aware of a variety of similarities and differences in the training and administration of therapeutic services that exist between clinicians in Mexico and those in the United States. Rather than completing a masters degree program in speech pathology, after completing her 5 year bachelors degree in human communication, she designed a comprehensive, self-directed program of study that prepared her treat adult and pediatric populations with a variety of diagnoses by acquiring a variety of professional certifications such as VitalStim, PROMPT, and certification in the administration of electromyography (this therapy consists of using electrodes to strengthen and stimulate muscles used for swallowing). We thought that this is similar to what SLP’s in the US do to fulfill the “continuing education” requirements mandated by ASHA after our general masters program. We were intrigued by how similar and yet how different our educational paths are. We also noticed a similarity in how physicians may not be fully aware of our scope of practice as SLP’s both here in Mexico and back home in the United States.

We then loaded back on the bus and after a quick debrief and nieve (ice cream) stop, we were off to our second site visit- Centro de Atención Multiple Helen Keller. Before we write more about what we learned here, we’ll provide some background: in the United States, there are some dedicated schools for children with special needs but most children attend their local public school and receive special education services as part of an IEP, or individualized education plan. A federal law known as IDEA (the Individuals with Disabilities Education Act) mandates that all children receive a “free and appropriate education (FAPE) in the least restrictive environment (LRE).” This means that when possible, children with special needs are educated along side their peers and are encouraged to function at the highest level possible while still being successful in their academic and social endeavors. In Mexico, children with special needs of many different varieties attend a school called a CAM, or Centro de Atención Multiple. This “center for multiple attention” serves children with a variety of special needs. Some are specialized and serve only children who, for example, are deaf or who are blind and some serve children with many different types of disabilities.

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CAM Hellen Keller serves children who are deaf, visually impaired, have intellectual disabilities, and other impairments. We first met Directora Garfias, director of the school who sent us into classrooms in pairs to observe. Several of the classes we observed were classes of deaf students that were taught in Mexican Sign Language. This school uses a bilingual approach to deaf education, and students learn Spanish as a second language. A great deal of emphasis is put on literacy (reading, writing, handwriting skills, vocabulary). The strong focus on written literacy skills in Spanish will support students when interacting with the hearing community and enable them to communicate effectively even when others don’t use Mexican Sign Language.

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Classes were comprised of a verity of ages and mixed ability levels. For example, one class that we were able to observe was for deaf students, and a small portion of the students had also been diagnosed with an intellectual disability. The students in this particular class ranged in age from 14 to 16 years of age. We were informed that the curriculum for this age group consists of Spanish, math, science, art, PE, history, and civics.

Through the class we learned so much from both Maestra Dalia and her students. They taught us to sign “thank you” and “Washington” in Lengua de Señas Mexicana, (LSM), or Mexican Sign Language, and honored us by assigning us a name sign. In Deaf culture, you sign your name with the manual alphabet until someone Deaf gives you a name sign. We enjoyed observing the students learn new information in the context of a rigorous, collaborative, and supportive classroom environment. As we thought about special education, and even general education in America, it was interesting to compare the two systems. In other classes that we observed, there were some differences in both content and how the teacher interacted with the students when compared to the United States that was eye-opening.

After our site visits we came to campus and had a delicious lunch at the cafeteria that consisted of enchiladas and agua fresca. Satisfied, we then walked across campus to our classroom and attended Spanish class. The advanced class had a discussion about out site visits, as well as children and adults with intellectual disability and what we as speech-language pathologists can do to help them reach their communicative potential. We also talked about swallowing disorders and learned related vocabulary. In the beginning class we learned adjectives related to frequency (todos los dias means every day), practiced generating simple sentences, verb conjugation, reviewed basic syntax, and learned that when a speaker raised his or her intonation at the end of an utterance it transforms a statement into a question. This is consistent across English and Spanish. We also learned functional phrases that we can use to introduce ourselves to parents and describe the profession of speech language pathology. The intermediate class discussed the past tense and how to talk about things that have happened.

After class, our wonderful teachers got on the bus with us and we all went to Parilla Leonesa, where we ate many delicious tacos, drank delicious horchata (a rice water drink with cinnamon and sugar) and jamaica (hibiscus juice) and had great conversation. It was so fun to spend time with our maestras outside of class and we were glad to be able to thank them for all of the hard work that they have put into preparing this curriculum for us.

 

Now we are back at our hotel and a group of us is going to do a city center tour where we will learn about the local “leyendas” or legends. The rest of us will do the leyendas tour tomorrow night after our final group dinner.

 

Hasta mañana!!

Whitney and Leah

Día Cuatro

Saludos, amigos!

Today we didn’t have a site visit, so we started the day with a morning trip to Peña de Bernal. This was the third “pueblo mágico” (magic town) that we’ve visited on this trip, including San Miguel de Allende and Mineral de Pozos. The Magic Towns program was a government initiative to increase tourism that was launched to highlight towns that are significant in terms of natural beauty and historical significance. This initiative was launched in 2001 and there are now over 100 “magic towns” throughout the country.

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San Sebastián de Bernal is the city that houses the 3rd largest monolith (massive geologic rock formation) in the world! In the morning, we climbed as far as we could to the base of the monolith. On our hike, we crossed paths with an American woman who explained that her husband was helping to set new repel lines on the monolith, and that his was causing dangerous rock fall below. Because of this, we were forced to turn back early, but we still were in awe of the size and significance of this massive geological feature!

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During the rest of our morning in the city, we continued to implement what we’ve learned in our Spanish courses as we interacted with the locals. We sampled a new Queretano dish — Huitlacoche (corn fungus!). It tasted like mushrooms and we ate it on gorditas (stuffed tortillas) and/or on sopes (thick tortillas with beans and meat toppings). We were excited at this opportunity to try a regional food that we had never been exposed to before. We are learning that food is yet another way we can appreciate Mexican culture.

In our spare moments, we have taken the time to dissect our experiences in terms of what we can bring back to practice as speech-language pathologists. During our site visits, we have been impressed by the flexibility and compassion demonstrated by the individuals who provide speech and language services. While the field of speech-language pathology is not well-known in Mexico, all the providers with whom we’ve interacted have been passionate in their efforts to provide the best services possible. Many parents travel long distances to access services and are not able to come to clinics frequently or regularly. Because of this, therapists have to be extremely flexible in how they administer treatment. Some therapists film therapeutic exercises, provide parent training, create manuals, and otherwise arrive at create solutions to accommodate a variety of family situations. This flexibility is something that we hope to bring back and apply in our practice as clinicians.

In the afternoon we attended Spanish class. The beginners learned names of basic colors, how to give directions, and how to give descriptions of themselves and patients. The intermediate class talked about the stages of child development and practiced giving narratives of experiences in the field and with patients. The advanced class brainstormed questions for future site visits, learned words to describe aphasia, discussed language impairment in children, and analyzed a language sample.

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The beginner and intermediate Spanish speakers in our group have noticed an increase in confidence while asking questions, ordering a meal, buying items, and more! Our interactions have become more fluid and we have noticed a reduction in communication breakdowns. In addition, our participation in our Spanish classes has increased as we have felt more comfortable asking questions and taking notes in Spanish.

Tomorrow will be busy as we have two site visits!

Hasta luego!

Maria & Gina

 

Día Tres

Hola!

Today we visited Gigi’s Playhouse, a center for children and adults with Down’s Syndrome that started in Chicago and has expanded to Querétaro. There are 41 centers in the United States, while this is the first center of this kind to open in Mexico. They work with children from 5 days old up to adults who are 40 years old. The center began its venture working with only 10 children and has now blossomed to provide services for 100 families, free of cost. This growth has been largely accomplished through word of mouth. The focus of the center is to provide a comprehensive experience through about 20 therapeutic and recreational programs. Specifically, the center offers physical therapy, speech therapy, occupational therapy, oral facial therapy, literacy and math instruction. Some of the recreational programs include Tae Kwon Do, cooking, gymnastics, crafts and painting.

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One program that we found particularly interesting was Gigi Prep. This program is geared to adolescent 18 years an older as a means to prepare this population to enter the workforce. They focus on providing guidance for successful interactions in a work environment such as turn-taking and working with others. Specifically, we were amazed that the adults chose a profession they were interested in and the professionals structured individual programs towards enhancing those particular skills. In one instance, a student who had a passion for doing physical therapy with babies, was taught to give massages and is now an intern at Gigi’s Playhouse and also works at another institution giving massages. Another component of the work the center does is  an awareness initiative called “I Have A Voice”. It is a gallery of pictures of people who attend Gigi’s Playhouse displayed in the center of Querétaro. The program has grown immensely, and as such this gallery and a calendar featuring their students aid in fundraising to keep the cost of services at zero. Another effort put forth by Gigi’s Playhouse in the context of awareness is Generation G, which has a focus of making the conscious decision to “be accepting, be generous, and be kind.”

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Yearly calendar for Gigi’s Playhouse

We also discussed speech language pathology services at the center with Eva Barba Reynoso, the director (la directora) of the center. We were interested in how the speech-language program is administered. La directora Eva, shared with us that the 5 speech therapists were employed while the remaining 2 therapists were volunteers with backgrounds in other disciplines. One of the challenges that La directora Eva found most difficult to overcome is the cost of retaining speech-language pathologist due to the mission of the program with a cost-free initiative. Students are evaluated in order to determine appropriate areas of focus within the speech program and they are reevaluated each quarter to assess progress and new areas of need. We had the opportunity to speak with one of the volunteers providing speech therapy who was an undergraduate student studying psychology. We found that her explanations of expanding utterances and her cueing  hierarchy were very similar to what we have learned. The focus of her sessions were similar as well, including functional tasks, and encouraging vocalization attempts before providing models and asking for imitation. An important difference we noted was that parents are required to participate in the session until the child is 6 years old. This allows for better parent education to facilitate home practice and carryover. Moreover, after the age of 6, debriefing the parents consists of having the child demonstrate what they learned during the session. We found that in our clinical practices that debriefing the parent consists of the therapist discussing the highlights of the session, rather than the child showing what they worked on in the session.  While discussing parent involvement as a group, we surmised that there might be a connection between the frequency of services and parent involvement. Parent buy-in might be greater because services are less frequent due to transportation issues, cost and reduced access speech and language services. We discussed the consumption mentality in the United States, in which some parents may believe that increasing therapeutic services is more beneficial than focusing intervention on home programs.

Literacy is also within our scope of practice as speech-language pathology, and is addressed at Gigi’s Playhouse. The center utilizes a program called Troncoso which was developed for people with intellectual disabilities to develop pre-writing and writing skills. La directora Eva expressed much success with this method and we look forward to learning more about this program. Gigi’s Playhouse also implemented “habla complementaria”, which we recognize as cued speech. The primary goal is to make a connection between the mouth and the eyes. For example if the child says “able” for “table,” the therapists can use a cue to remind the child to include the omitted sound. This method is used to individualized treatment for children with Down’s Syndrome because visual learning is a common strength for this population.

After visiting Gigi’s Playhouse, we spoke to an undergraduate linguistics class taught by la Dra. Donna Jackson- Maldonado about the academic and clinical requirements for obtaining a degree and license in speech-language pathology. The students were interested in understanding the differences between clinical practice in the United States and Mexico and ethical considerations for the field. We also had the opportunity to ask la Dra. Jackson-Maldonado about her experience becoming a speech-language pathologist and the challenges faced as a speech-language pathologist in Mexico. We had previously learned that speech-language pathology programs were reducing in number in Mexico but we were surprised to learn that this is due to the belief that physical therapists are competent in delivering speech pathology services. We were grateful for the opportunity to discuss our field with these students and felt that many of them were interested in becoming speech-language pathologist.

Taco Tuesday came next! We enjoyed a variety of tacos which satisfied both vegetarians and omnivores alike. Following our lovely lunch, we went to our Spanish classes where the beginner class learned how to gather basic information about a person (e.g. name, nationality, phone number). The intermediate class defined many terms associated with speech-language pathology like theory of mind and babbling. The advanced class engaged in a discussion about an article and video concerning hearing loss in Mexico. We utilized our new Spanish vocabulary in restaurants and in our salsa class!

And now off to dinner!

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Gigi’s Playhouse with la directora Eva Barba Reynoso

Hablamos mañana!

Kerry and Yawrely

Día Dos

Buenas tardes, readers!

After a hearty breakfast at our hotel, we made our way to Universidad National Autonoma de México (UNAM) at Unidad de Investigacion en Neurodesarrollo. At UNAM, research is conducted through the evaluation and treatment of infants with motor, language, and cognitive deficits, but the main focus is on motor therapy.

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They utilize a therapy model called “Katona,” which focuses on developing motor reflexes and improving motor planning. Katona is an intensive program that requires infants to participate in therapy for three times a day and also requires parents to incorporate these practices at home. The researchers at UNAM believe that the improvement of motor patterns facilitates better language and attention development, which differs from what we have observed in the United States where we don’t place as strong of an emphasis on the link between motor movement and language. It was interesting for us to explore a different perspective and see how that translates into treatment for language.

During this time, we had the opportunity to observe several of the physical therapists working with infants using this Katona therapy model. In our first observation, a physical therapist targeted control of head and neck movement as well as core strength for sitting with a 6-month-old infant. The main goal was to increase her muscular tone to help with her other motor patterns. We then observed a 2-month-old infant born at 40 weeks. The physical therapist also targeted core strength through sitting, as well as targeting arm and leg movements through crawling and walking reflexes.

The focus on parental involvement in therapy at UNAM was one of the areas we admired the most. Parents are referred to UNAM by their pediatricians or gynecologists when certain risk factors are observed including low birth weight of the child, concerns with fMRI results, high levels of bilirubin, if the child was born via C-section, and evidence of sepsis. Due to the intensive nature of Katona, the families require a reliable form of transportation to UNAM every day. Dra. Carlier informed us that many of the families travel by bus, but that UNAM has a van that picks families up for those who can’t afford transportation or who live far from the center. The Unidad de Investiagacion en Neurodesarrollo is a public institution and UNAM functions as a non-profit organization within it. This means that UNAM raises funds each year to provide services for families. Since they are a non-profit organization and do not take insurance, UNAM pairs parents with a social worker to determine the cost of treatment based on their socioeconomic status.

We spoke to a psychologist at UNAM who is doing research on maternal mental health and bonding to see if these areas impact neuropsychological processes in infants. We were informed that parents are referred to the psychologist when their child has behavior/psycho-social concerns that inhibit them from doing language therapy at the center and at home. They are taught strategies on how to implement boundaries to facilitate successful therapy. We really enjoyed hearing how the fields of psychology and speech-language pathology work collaboratively at UNAM. This interdisciplinary approach is something we learn about in graduate school and are striving to implement in the United States. We found it incredibly beneficial to observe how this collaboration operates here in Querétaro. We witnessed great respect between all of the professionals and each other’s disciplines and willingness to refer to a practice outside of their scope. We’ve participated in interdisciplinary events with graduate students in other professions back at GW and we were excited to witness the same level of collaboration here at UNAM.

After speaking to the psychologist, Dra. Carlier talked to us about the language research, evaluation, and therapy done at UNAM. One of the studies she is focusing on includes documenting event related potentials (ERP) in 12 healthy, full-term infants and 12 pre-term infants where they are presented with syllable and tone discrimination tasks. It is hypothesized that children who are unable to discriminate between the syllables and/or tones during the tasks are more likely to present with learning disabilities and attention deficits. We’re eager to read about the results of this study once it is published!

When it comes to evaluation at UNAM, Dra. Carlier listed the assessments that they use including: CELF, PLS, MacArthur checklist, and Bayley Scales of Infant and Toddler Development. These are assessments that we’ve given in the GW clinic as well. Dra. Carlier introduced us to Licenciada Andrea Amaya, who is a part of the team that assess the children with language disorders. Children from 3 months to 36 months undergo a language evaluation every 6 months to track progression. Since transportation is limited, the goal at UNAM is for parents to come in at least twice a month for their children to receive language services. The language services mostly consist of parent training to facilitate language development in the hone. The researchers are currently developing a manual to help parents with language stimulation that includes all the protocol that is used at UNAM. We discussed how beneficial a similar protocol would be when working with families in the United States.

At the end of the tour, Dra. Carlier commented on how often parents do not understand the importance of language intervention at an early age and how it can affect school age language. To overcome this issue, the researchers at UNAM require parents to go to the psychologist, so they can explain the importance of early intervention. We told Dra. Carlier that we have similar obstacles in the United States when it comes to educating families on our roles as speech-language pathologists and the importance of early intervention. In graduate school, we are taught that the interdisciplinary collaboration between professionals should be the standard of care; however, in the United States we’ve observed that it often isn’t the case across settings. At UNAM, we were able to see the ideal standard of care which we hope to implement as future speech-language pathologists in the United States.

We want to formally thank Dra. Carlier for showing us around UNAM, discussing her research with us, and answering all of our questions about practice here in Querétaro. Some of the most importance pieces of advice she gave us were to always engage in evidence-based practice and to always critically think about the treatment we’re implementing. We’ll be sure to follow this advance as we pursue our careers as speech-language pathologists.

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After UNAM, we went to the university, had a lunch of tortas (sandwiches) which were muy deliciosas, and then headed to the first day of our language classes since arriving in Querétaro.We split into three groups: beginner, intermediate, and advanced.Both of us were in the intermediate class where we had introductions, delved into verb conjugation, and came up with case history questions we would ask a Spanish-speaking client. All of the classes focused on defining and discussing different concepts in the field of speech-language pathology. Our beginners learned different syndrome names in Spanish and the incidence of these syndromes in Mexico. The advanced class researched statistics of the incidence of speech and language disorders in the United States versus those in Mexico. We are all very excited to see what the classes during the rest of the week entail!

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Now we’re off to eat dinner and head to a salsa class!💃🏽

Hasta luego,
Shilpa and Erika

Día Uno

Hola from Querétaro!

Before we talk about our first 1.5 days in Mexico, let’s go back to January when we (twelve students and two professors) first met as a class at the Mexican Cultural Institute in Washington, D.C. The executive director of the institute, Señor Alberto Fierro, gave us a presentation on Mexican culture, economy, and history. We were so grateful for such a wonderful introduction to the class and it made us very excited to learn more before we embarked on our journey.

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The first class at the Mexican Cultural Institute in Washington, D.C.

To continue our preparation, we created presentations in pairs for our second class meeting in February. We researched topics including the history of Querétaro, indigenous cultures, food, Spanish language, manners, education, and healthcare. One of us even made a guide of common phrases in Spanish for us to use while abroad.

During our February meetings, we also decided to research the field of speech-language pathology (SLP) in Mexico. After reading articles by our host, Dra. Donna Jackson-Maldonado, about language delays in Mexican children, effects of early intervention on language outcomes in pre-term infants, assessing the effectiveness of a short-form version of the MacArthur-Bates Communicative Development Inventory (a way for clinicians to use parents as informants about their child’s language). From there, we developed a list of questions that we still had regarding typical SLP practice in Mexico.

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A street in San Miguel de Allende

We also read articles pertaining to internal collaboration in the field of SLP. One article had developed a list of competencies for effective global engagement that we believed would apply well to our study abroad experience. The competencies were broken down into the framework of disposition, knowledge, skills, and attitudes. Some of the competencies we thought would impact our trip the most were: empathy, humility, inquisitiveness, self-awareness, ability to engage in critical and dialectical thinking. For one of our our learning outcomes for the course will be to describe instances throughout the trip that directly relate to the competencies discussed in the article.

After all our preparation, we were extremely excited to arrive Saturday afternoon in Querétaro. We were able to spend the evening in the city center, which is about a 25-minute walk from our hotel. We went over the itinerary for the week, including our site visits and Spanish classes. We had our first group dinner, where we ate gorditas (a pastry made with masa stuffed with fillings such as cheese and meats) at Las Deliciosas Gorditas Del Portal. We spent the rest of the night wandering around the city center, taking in the sights and sounds.

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Guacamole and Huevos y Chorizo (eggs and chorizo) gorditas

Sunday morning, we met for breakfast at the hotel and prepared for our day trip to Mineral de Pozos and San Miguel de Allende, which are both pueblos mágicos (magic towns). Our day mirrored chronological history of Mexico, beginning with a demonstration of pre-Hispanic instruments in Pozos. A local artist performed music on instruments he made using local plants and other materials. We were also lucky enough to have a tour of a historic mine that produced gold, copper, zinc, and mercury. We learned about the labor-intensive and scientific process of mining for gold and were able to descend into a former mine to see an underground cavern. Our guide even taught us a few words of his indigenous dialect, Chichimec. The area was home to over 500 mines until the 1970s, when it became a ghost town. The area is experiencing a rebirth, and we were happy to see all that it had to offer.

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Wearing protective gear before descending into the mine at Pozos
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Demonstration of pre-Hispanic instruments by the artisan and musician in Pozos

 

After a 45-minute drive, we arrived in San Miguel de Allende. This city is called El Corazón de México (the heart of Mexico) and has a reputation for attracting artists and tourists. We split up into groups and were able to explore the city all afternoon. We all toured the Parroquia de San Miguel Arcángel, a church that was built in the 17th century. Many of us also bought crafts and other artwork from local artisans. On our way home, we reflected on what we experienced and learned during our first full day in Mexico.

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Parroquia de San Miguel Arcángel in San Miguel de Allende

 

Tomorrow, we are excited for our first site visit and begin Spanish classes at the local university!

Hasta mañana,

Alison and Julia

The Journey Begins

Follow us as we learn the skills necessary to become a culturally rich speech therapist while participating in international collaborations in speech-language pathology. In addition to the rich cultural events and encounters, we will have the opportunity to meet with local professionals; visit numerous service delivery sites, observe and collaborate with health and education service providers and experience and evaluate the scope of practice in Speech Language Pathology in Queretaro, Mexico. We will also participate in one of three language courses (beginner, intermediate, or fluent) to learn Spanish terminology specific to SLP.

Travel makes one modest. You see what a tiny place you occupy in the world.   Gustav Flaubert

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