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.
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.”
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!
Kerry and Yawrely