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Telepractice to Bolivia

Telepractice from TC clinic to school in Bolivia

Teachers College Program in Speech-Language Pathology Establishes ongoing speech and language therapy via SKYPE for students at School for the Deaf--Camino de Sordos--in La Paz, Bolivia.

As part of a leading university located in New York City, the Teachers College program in speech language pathology (SLP) has a strong commitment to educating students to work effectively in a multilingual world. The program is dedicated to ensuring that its students acquire the knowledge and skills needed to provide culturally and linguistically appropriate services to multicultural populations. This content is infused into our courses and clinical experiences.  

In addition to coursework and clinical experience in New York, the SLP program offers its students several international experiences where they provide free speech and language services to children with disabilities. Cate Crowley is the coordinator of the bilingual/multicultural program focus which incorporates the Bolivia and Ghana projects. For the past three years Cate has brought 17 TC SLP students to La Paz, Bolivia for one month. Under Cate’s direction, and with  the supervision Miriam Baigorri as the clinical corrdinator, and two additional ASHA-certified and New York State licensed bilingual SLPs, these TC students work with the children and their families in the national hospital for children, a school for students with developmental disabilities and autism, and a school for the deaf. Elizabeth Ijalba, Lorena Diaz, and Jenyffer Ruiz have provided clinical supervision in the past. For those students who are not fully fluent in Spanish, intensive Spanish instruction is provided.

One of the sites in Bolivia—Camino de Sordos, a school for the deaf—has 46 students, ages 4 through 20. Less than a handful of the students at Camino have ever had hearing aids. We realized that if we were to be effective, we had to find a way for the students to get hearing aids and to learn how to use those hearing aids. An idea was born that the Teachers College SLP students could provide the needed therapy over SKYPE from New York City to La Paz, Bolivia in real time.  

Melissa Inniss is the audiologist who stepped forward to work on this project. Melissa is a Panamanian woman who graduated from TC with a masters in audiology. Melissa is also an SLP and was enrolled in the Teachers College Bilingual Extension Institute for SLPs where she heard a presentation by TC students on their work in Bolivia. Melissa approached Cate and offered to go to Bolivia to test the students’ hearing and to obtain donations of hearing aids and molds for the children at Camino. At about the same time, Ray Diaz, a technology expert and husband of Lorena, one of the Bolivia clinical supervisors, visited the group in La Paz. He was so taken by Camino and its students that as soon as he returned to the U.S., he found a financial company that was willing to donate computers to this project.

About this same time, the Downey Family Foundation contacted Cate to say that they wanted to provide funding for her work. Stephanie Downey is a recent graduate from the SLP program. This project was a perfect fit for the foundation with its focus on education. With that funding, Melissa and Ray went to La Paz in August 2008. Melissa tested the hearing of all the students and made ear mold impressions. She gave eight students hearing aids for the first time in their lives. Ray installed three computers at Camino so that we could provide aural habilitation and speech therapy via SKYPE to the students with hearing aids. In addition to the three computers he installed at Camino, Ray installed three additional computers in the Teachers College Mysak Speech and Hearing Clinic.  

Melissa received donations of hearing aids and mold impression materials and audiological equipment from several companies including the Hal-Hen Company, Microsonic, Inc., Northeastern Group, Inc., Widex Hearing Aid Company, and Williams Sound. Ray sought out a financial company that donated 14 computers to this project.  

With the technology in place, and the ten students with hearing aids, we began providing aural habilitation from the TC speech and hearing clinic to the school for the deaf in La Paz. Eight students in the speech language pathology program are participating this semester. All eight students have high level Spanish skills. Five of those students are Latinas—Ana de la Iglesia, Natalia Martinez, Ileana Perez, Diana Posadas, and Jen Rodriguez—and  the other three--Cate Brandford, Emily Sweet, and Courtney Van Buskirk --have acquired native-Spanish skills. La Paz is directly south of New York so there is no time change and therapy can be provided in “real time”. The students come to the Catalina Crespo Computer Room in Camino for 20 to 30 minute sessions. The younger children are always accompanied by an adult who can learn what to do in the school and at home. The adolescents can come on their own as long as sometimes a teacher or parent accompanies them. 

We have done pre-tests on the students and are keeping records. In addition to recording the progress the Camino students are making, we also are learning about the strengths and weaknesses of international telepractice for aural habilitation and speech and language therapy. Because parent training is a critical part of any aural habilitation program, mothers and fathers participate whenever possible. Cate is supervising the students this semester so she and they can learn together how to make it work. If this project benefits the students at Camino and the development of the TC students as quality speech language pathologists, we intend for it to become an ongoing opportunity for the Teachers College master’s students in speech language pathology. 

Melissa continues to work with the hearing aid manufactures to secure appropriate aids for the Camino students who do not yet have aids. Ray is always available to give us the technological support we need. The Downey Family Foundation funds pays for hearing aid batteries and hearing aid maintenance and assorted equipment we need.

In June 2009, another group of 17 TC SLP students will make their way to La Paz. For that month, they will provide aural habilitation to the children in person and training and support for the teachers and parents. By that time most of the Camino students will have hearing aids and when we return to New York City, we can continue to provide the services via SKYPE.

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