Day 6-día final en Mexico! (Our final day)

Spanish class

Today we began with a sunrise yoga session. After a long week of educational tours, town adventures, and continued education, this morning was a perfect opportunity to renew and refresh for our final day in Mexico.
Our site visit today was to Ándale Para Oir, an auditory rehabilitation center that offered multiple services for both children and adults. The youngest client seen so far in the clinic was 5-6 months old through adult age patients. The clinic offers different types of programs with a family centered focus on prevention, intervention and education for individuals with varying degrees of hearing loss. Additionally, Andale Para Oir, has a daily preschool program which we had the privilege of observing during our site visit. The speech therapy offered is play based and includes a heavy amount of parental involvement during sessions. It has been a trend throughout our site visits for the parents to be very involved in their child’s therapy along with services being targeted to those of a low income status. This clinic is a non-profit organization which receives money from the government, grants, and creates scholarships in order to service those families who otherwise could not afford these services.
Impressively, Andale Para Oir not only conducts education at their clinic, but additionally send staff to go to schools to speak to teachers and administrators. The clinic also is able to sell hearing equipment (hearing aids and accessories, batteries, etc) at a lower cost.
Overall, we were very impressed with how motivated and passionate the clinicians were to assist their clients with their communication needs. The ability to super-serve their clients, meant so much more than any monetary compensation. Many long hours are spent helping their clients with speech and hearing. We were humbled by their enthusiasm and dedication.
Our afternoon was spent in our final Spanish immersion class. The level 1 class continued to work on medical terms and verb conjugations which we would use working with clients. The level 2 class discussed detecting SLI (speech language impairments) and otoacoustic emissions detection with infants. For the last hour, both classes were merged and participated in speech language versions of Bingo and Jeopardy. Congratulations to los Enchiladas for the win!
This evening we regroup to have a traditional Mexican meal. We have learned so much during this trip, not only academically but culturally as well. It has been an eye opening experience.

We want to thank our host, Doctora Donna Jackson-Maldonado, a Researcher and Professor of the Center for Linguistic and Literary Studies at the Universidad Autónoma de Querétaro en Mexico. We also want to thank our wonderful profesoras (professors), Dr. Core and Professor Comer for the opportunity to truly have a multicultural and interdisciplinary experience in this incredible country.

Adios Amigos de Mexico! Gracias por leyendo esta blog (Good bye out Mexican friends. Thank you for reading our blog)

Until we meet again Mexico,
Emma and Claire

Day 5!

 

Today we began the day at 7:30am! After an early breakfast, we spent 2 hours in Spanish class. In the advanced class, we are learning about autism. Our teacher, Liz, taught us terms relating to autism symptoms. We also practiced interviewing and discussing diagnostics results with family members. In the beginner class, we learned how to ask questions related to speech language pathology at our site visits and practiced conjugating verbs.

Then we traveled to the Unidad de Investigacion en Neurodesarrollo (center for neurodevelopmental research), a part of UNAM (Universidad National Autónoma de México). Our goal was to learn about the infant research conducted and treatment of premature infants. Monica Carlier, a speech therapist, gave us a tour of the facility to show the variety of services that exist (and to look at cute babies). The center receives referrals from local hospitals for premature infants and after enrollment, follows the premies through 8 years of age. The center provides EEGs to each premie to determine risk for seizures and other brain abnormalities. They use a prevention model, a therapy they called “catona”, where babies are assessed monthly for motor development and bi-yearly to yearly for speech and language development by PTs and SLPs. We saw a physical therapy evaluation conducted by a therapist and doctor. They were evaluating the babies physical development by looking at his reflexes. This was part of a research study and this baby was a control (meaning he was a full term baby and will be part of a group for comparison of premature development).

When speaking with Monica and several other speech therapists, we learned more about the speech and language services offered. We learned that babies are given language evaluations every 6 months to determine the need for therapeutic intervention and specific deficits. The evaluations include the CELF, PLS, MacArthur Checklist, and Bayley Assessment which are standardized tools used to evaluate language development compared to typically developing peers. These are also measures we commonly use in the US. Here, the role of the speech therapist is to provide extensive education to the parents on how to aide their child’s language development and improve areas that may be delayed. The parents implement these techniques at home. The speech therapist stated how it is difficult to know whether a child is delayed or has a disorder between birth to 3 years of age because language development is so variable. As students studying language development, we totally understand the difficulty in diagnosing babies!

We learned that the center also provides attention therapy. They use a measure created at UNAM to assess development of visual and auditory attention. The checklist helps determine a need for therapy. This was a great example of the research coming out of this institution! The therapists were encouraging of our questions and allowed us to see what their assessment looks like.

Throughout the tour, we saw parents standing close by to their infant or working hands on with their baby. The center also focused on child-led interactions, meaning the children are not forced to engage in activities but are given opportunity to make choices. The role of the parents is to provide intensive and repetitive training at home to promote generalization of skills to the home. The parent role is more intense here than we have seen in the US, however the children do not come in for speech therapy as frequently as they may in the US. Overall, Monica and the therapists at the center provided an in-depth look at the programs that are offered at no cost for premature children, from day 2 to 8 years of age.

Following the tour, we hopped on our bus for lunch and shopping in Tequisaquipan, known as the wine district and largest opal distributor in the world!

Throughout the week we have met various UAQ students with the promise to see them again at happy hour on Thursday! Today, the students organized 3 locations for us. Heading out now to continue immersing ourselves in Mexican culture.

Adios amigos!
Alyssa and Nicole

 

Wednesday: Mexico Day 4!

¡Buenas tardes! We began our day at the Universidad Autónoma de Querétaro. Today’s focus was on intellectual disabilities. During our lesson we reviewed terms relative to the following syndromes: Fragile X, Williams, and Down Syndrome. The class emphasis was on the impact Down syndrome has on the development of expressive & receptive language, articulation and cognition. This laid the perfect foundation for our afternoon site visit to a private equine therapy center (also known as hippotherapy) named “Fundación Angeles al Galope A.C.”

We were welcomed by the lead physical therapist and founder, Isabel Diaz Alvarez. She opened the center 15 years ago after working with UNICEF and explained how she wanted to merge her two passions: helping children and her love for horses. She now offers 24 sessions per week and will soon be opening up 10 more sessions on Saturdays.

This facility offers therapy to children with intellectual and physical disabilities, both congenital and acquired, with a focus on Down syndrome and autism. There are two therapy horses in rotation that are desensitized to the overwhelming stimuli they encounter on a daily basis. Therapy begins as young as one years old and incorporates physical therapy as well as language. The physical therapists work on motor movements, posture, and muscle tone while targeting comprehension and expression via songs and narration. The sessions occur twice a week for thirty minutes each and are extremely individualized, with language targets selected through a specialized consult with an off-site speech-language pathologist.

The children who attend therapy at this facility come from a variety of socioeconomic backgrounds and are fortunate enough to receive services for free. This is all made possible by incredible fundraising efforts and donations, as well as dedicated staff and volunteers. It is undeniable the passion and pride that the staff and volunteers take in the work that they do, and that is felt as soon as you set foot on the track. Please follow along with their journey at https://m.facebook.com/angelesalgalope/ and experience the joy we all felt today.

We hope you check in with us again tomorrow to read about our visit to the Neurodevelopmental Research Unit (UNAM) and afternoon stop in Tequisquiapan

– Emily & Alexandra

Tuesday: Mexico Day 3

Today, we visited the Centro de Rehabilitación Integral de Querétaro (CRIQ), a health and human services outpatient center funded by a government program called Desarrollo Integral de la Familia (DIF). When we arrived, we were greeted by Leonora Ibañez Mariel, the coordinator of speech-language therapy services at CRIQ, who explained the mission of the center with an in depth presentation. The vision of CRIQ is multifaceted. Their aim is to provide high quality rehabilitation services from experienced health professionals to people of all ages and a wide range of disabilities in the community. One incredible aspect of CRIQ is they provide services to families of all SES backgrounds, including the “very poor people in the community,” at little to no cost, since billing is dependent on income. Another dimension of their mission is to promote the inclusion of people with disabilities in society, integrating families into the therapy session, providing caregiver education coaching, and preventing disabilities through early intervention. In addition, the importance of treating patients with compassion was illustrated through a list of center values. The center provides services from a variety of disciplines, including speech-language therapy, occupational therapy, and physical therapy. The center works with professionals to integrate services across specialties, and also provides job training for people with disabilities. Finally, we found out CRIQ also acts as a training hospital for physical therapists.

After the presentation, Leonora also took time to clarify many of the outstanding questions we still had about the field of speech-language pathology in Mexico such as professional education, healthcare cost, patient privacy, and how patients accessed services. We learned that many SLPs typically complete a five-year degree equivalent to a bachelor’s, and later specialize through certificate programs in different areas in speech and language therapy. The majority of the therapists at CRIQ attended the Instituto Nacional de Rehabilitación, in Mexico City.

We then got a tour of the entire center from Leonora. As soon as we arrived we saw that the center was beautiful, organized, and equipped with all types of high quality technology and resources. Each wing was specialized for different types of therapy. We first toured the physical therapy wing, which was equipped with a pool for hydrotherapy (which we observed) and a massive space dedicated to physical therapy with patients with neurogenic disorders. After that we saw occupational therapists working with groups of children and groups of adults. Finally, we received a full tour of the speech and language therapy wing. We were able to observe a therapist giving a group speech therapy session to parents and their children with cleft palate. The speech-language wing included multiple therapy rooms well equipped with materials and technology. AAC

There was a lot that surprised us about CRIQ. We were amazed at the quality and variety of resources available at the center, the standard of care and implementation of evidenced-based practice, and the similarities between services offered at CRIQ and equivalent centers in the United States. For instance, CIs are now being provided to children as young as 2 years old, and we noticed much of the therapy was similar to what we see in the US, including large teams of professionals working within and communicating across disciplines. Leonora also mentioned they used PECs with children with autism, and implement both low-tech AAC communication boards and high-tech AAC devices, such as iPads. We were also surprised at how much parent involvement and training is provided by the center, which is best practice in our field. We were also intrigued by the differences in allied healthcare and professional expertise at CRIQ compared to practice stateside. In the speech-language wing, we learned about a type of therapy the SLP’s do that integrated cognitive and receptive skills with motor-spatial awareness and balance, something we don’t see in the U.S. Leonora also explained that some of the physical therapists specialized in neurogenic disorders, and provided services in a separate wing of the center.

Later in the afternoon we went back to continue with our Spanish classes. In the advanced class we learned about deaf culture in Mexico and learned a lot of useful terminology about audiology, the ear and deaf educational models. The beginner class practiced conjugating verbs used in the field of speech-language language in exercises describing developmental milestones.

Tomorrow, we’re off to learn about hippotherapy! (No hippos, just horses.)

Monday: Day 2

This morning we attended intensive Spanish language courses at the Universidad Autonoma de Queretaro. We were divided into two groups: Beginner and Advanced. Our “profesoras” emphasized specific terminology related to our profession of Speech Language Pathology, otherwise known in Mexico as logopedia or terapia del lenguaje. We also discussed in-depth the differences in educational systems between the U.S. and Mexico and differences in incidence rates and prevalence of disorders between the two countries. This prepared us to visit the two local sites in Queretaro that we were seeing this afternoon.

We attended two facilities; A private clinic, which offers speech therapy services and a Gigi’s Playhouse, an educational and therapeutic center for Down syndrome designed for infants as young as 5 days old and adults up to 42 years or older. At the private clinic, Blanca Arreguin is a speech therapist who is PROMPT certified and offers speech and language therapy sessions to children. We had the opportunity to observe two sessions, both of which focused on expressive and receptive language skills. She also mentioned other methods that she employs such as the Ventura multisensory approach.

Gigi’s Playhouse is directed by Eva Barba with one assistant director and a voIunteer coordinator. These coordinators help organize 16 programs: Therapeutic, educational, and specials. The therapeutic program includes speech and language services, physical/occupational therapy, and orofacial services. The educational program involves reading/writing and math. And specials include painting, dancing, cooking, taekwando, and rhythmic gymnastics to name a few. Aside from the therapeutic programs all of the instructors are volunteers. There are 5 speech therapists, 1 physical/occupational therapist, and approximately 200 volunteers comprised of students, parents and community members. Up until 2 years of age therapeutic services are provided in small groups and then transition to individual sessions. All services provided at Gigi’s Playhouse are free. In efforts to support services at Gigi’s, they host fundraisers. Children and adults at the center create handcrafted ceramics and sell them to fundraise money. They will also request donations and submit grant proposals. The center is invested in involving family members to help teach children and adults skills and strategies they need to facilitate development and functional independence. While some families only travel 40 minutes others will travel up to 2 hours away to receive services from Gigi’s Playhouse in the afternoons between4-7pm. Gigi’s Playhouse originally began with 10 mothers and 10 children 4 years ago and today has 100 children at the center.

Upon reflecting on our experiences today, we found that both the similarities and differences between the educational and therapeutic systems of our two countries were eye opening and gave us perspective on how to move forward as culturally competent professionals. While access to services for individuals with disabilities vary, service providers are dedicated and passionate about giving the utmost support beginning in early childhood. Today we learned that professionals in the community of Santiago de Queretaro can have various backgrounds when treating individuals with speech and language disorders. We still would like to gain an understanding of how these professionals come to learn about and be involved in this profession.

Hasta pronto,

Nadda and Datie

 

Sunday: Mexico Day 1

Today our group went on a day trip to two cities outside of Querétaro: Guanajuato and San Miguel de Allende. We heard rumors of the shopping opportunities so we were very excited! After a wonderful first breakfast at the hotel buffet (we may have each had two or three plates…) we headed out to Guanajuato in our van. Guanajuato is a beautiful hillside town with colorful homes and grandiose basilicas. We set out on an adventure to travel up to the “Pipila” which is a statue at the top of the city. Some chose to walk, while others took the tram. Either way, we all arrived to the same beautiful panoramic view of the city. We all set out to shop and eat before heading out on our second journey of the day.

In San Miguel de Allende, we continued to satisfy our shopping and eating desires. Some of us bought bags, blankets, jewelry, while others snacked on churros and helado, “ice cream”. By the end of the day our feet were hurting but our tummies were happy. Our wallets were a little sad. But that’s okay! Overall we experienced Mexican culture, practiced our Spanish, and enjoyed a great welcome to kickoff our trip! We are excited to begin the rest of this week’s journey and take our first Spanish class tomorrow!

Tomorrow after our Spanish classes at the Universidad Autónoma de Querétaro, half of our group will visit a local center for Down’s Syndrome, Gigi’s Playhouse, and the other half will visit a private practice that primarily uses the PROMPT therapy technique. We are looking forward to getting down to business, and immersing ourselves to learn about speech language pathology services here in Mexico!

Here are some pictures from our adventures today!

Hasta Luego,

Caroline and Abby

The Journey Begins

Bienvenidos todos (welcome everyone). Follow us as we explore Speech-Language Pathology in and around Queretaro, Mexico! Vamonos (let’s go)

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