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).
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.
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!
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.
Gracías for following us along our journey. We hope to return to Mexico soon!
Lindsay & Taylor