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Giving Voice to the World

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Giving Voice to the World

Catherine Crowley and Karen Froud with Bayon dancers in Siem Reap, Cambodia

Giving Voice to the World

Boys looking out their classroom window in Kumasi, Ghana.

Giving Voice to the World

Catherine Crowley and TC student Melissa Inniss at TC working with children in Bolivia via Skype.

Giving Voice to the World

Scene from Lake Ton Le Sap from a site visit in Cambodia.

Giving Voice to the World

Catherine Crowley, at the Unit School of The University of Education at Winneba, Ghana, says, "There's maybe less than a handful of speech/language pathologists who are bilingual in any of the African languages. When these kids come to the United States, they need services.”

Giving Voice to the World

John Saxman, TC's Professor of Speech Pathology on location in Bolivia, says, "We've made a commitment to the multilingual and multicultural aspects of communications and its disorders.”

In Ghana, a country roughly the size of Oregon, there is exactly one certified speech therapist for a population of some 20 million people. Partly that’s because of the nation’s poverty, but it also reflects some cultural biases—for example, a belief that children afflicted with language disabilities are cursed.
“One of the special education teachers we worked with there this past February was pregnant, and people were saying to her and her husband, ‘You should keep away from those children,’” says Catherine Crowley, Distinguished Lecturer and Coordinator of the Bilingual/Bicultural Program focus in TC’s Speech and Language Pathology (SLP) program. “So when her baby was born, people filed into her home to see if she was normal, and they couldn’t believe it when she was.”

Crowley and the bilingual/bicultural staff and students have faced many similar cultural challenges during the past several years as they have sought to work with speech-impaired children in developing nations around the world. The aim of their efforts, which have included work in Ghana, Bolivia and Cambodia, is threefold: to seed their profession in countries where it is either almost wholly lacking or its practitioners are inaccessible to average people; to build up existing structures or leave sustainable gains wherever they can; and, longer term, to increase the number of bilingual speech/language pathologists in the United States, particularly to serve the country’s booming Latino population.
 
“Communication obviously is essential to the whole learning process, whether in a classroom or for a single human being, and we’ve made a commitment to the multilingual and multicultural aspects of communications and its disorders,” says John Saxman, Professor of Speech Pathology and Chair of TC’s Department of Biobehavioral Sciences. “If children have disorders of speech and language, then they need someone working with them who has an understanding of what the bilingual situation is and can separate out those problems that may simply be a function of learning two languages and using them simultaneously, from something that may be an actual disorder of speech and language.”
 
Until recently, much of that work was conducted in New York City at Teachers College’s Edward D. Mysak Speech, Language and Hearing Center on the first floor of Macy Hall. Then a few years ago, Crowley began taking groups of students down to Bolivia for a month each summer to provide free speech and language services at established facilities there, supplementing and in many cases working to build up existing services. Under the direction of Crowley, clinical coordinator Miriam Baigorri and others, the students work at the Hospital Del Niños, which is Bolivia’s national pediatric hospital; at Camino de Sordos, a school for the deaf; and at Fundacion CEREFE (Center for Physical Rehabilitation and Special Education), a school for students with developmental disabilities and autism. For those TC students not fully fluent in Spanish, intensive Spanish instruction is provided.
 
At Hospital Del Niños, the TC students work with children in the acute care wards and with parents of babies and toddlers who are failing to thrive, showing them feeding therapy and early intervention stimulation techniques such as cooing, eye contact and touching. At Fundacion CEREFE in El Alto, they work with children and teenagers with disabilities ranging from Down’s syndrome to swallowing disorders. And at Camino De Sordos, the TC students provide children with hearing aids secured by TC alumna Melissa Inniss, a Panamanian audiologist and speech/language pathologist, and apply a multisensory approach to help children identify and use phonemes, the smallest sound units that differentiate meaning, as they learn to read.
 
Before the TC team arrived, the school was focusing on non-academic exercises. “We were able to bring in the idea that people with disabilities have the right to learn and the ability to learn,” Crowley says. “We didn’t know that’s what we had to give.”
 
The group has left other lasting impressions, as well. As part of their work in Bolivia, students and supervisors give regular interactive talks, called Charlas, to parents and teachers on such subjects as feeding and swallowing, Down’s syndrome, autism, hearing loss and deafness. The Charlas begin with 20 minute presentations and continue with hands-on demonstrations of techniques and approaches conducted on each child in attendance. According to Crowley, a Charla for parents of children with Down’s syndrome at CEREFE drew more than 90 parents and teachers and 30 children.
 
Thanks to technology, the program has even developed a way to work from afar with the students in La Paz during the fall and winter months. Using computers and Web cams in La Paz that were donated through arrangements made by Ray Diaz, a technology expert whose wife works with Crowley, the TC team has provided remote, over-the-internet aural therapy from New York City to help children ages four to 17 learn to use their new hearing aids.
 
The half-hour sessions, conducted via Skype technology in what Crowley believes is the first such opportunity provided to graduate students in the United States by an academic speech and language program, allow the children to continue to make progress.
 
“One teenager told us how he had had hearing aids when he was a young boy but did not use them because he could not make sense out of the sounds,” Crowley says. “Since receiving a new hearing aid in August, he has made great progress because he already knew a language—sign language. As a result, he has acquired spoken Spanish quickly and now understands his family when they speak Spanish, which was not possible for him before.”
 
Each year when they return from Bolivia, Crowley’s group gives a presentation on their experience to the American Speech Language Hearing Association’s annual conference, which is attended by 14,000 people. “A lot of people come and hear us,” she says. “The idea is to kind of let people understand how valuable the international experience is in terms of training speech/language pathologists to know what they’re doing from a multicultural perspective or from a world citizen perspective.”

Crowley’s team first established its Ghana connection in February 2008 and went back again this past winter. Again, the work is as relevant to the Ghanaians in the United States as it is to their mother country.
 
“There’s a huge influx of people from Africa, and there’s maybe less than a handful of speech/language pathologists who are bilingual in any of the African languages,” she says. “When these kids come, they need services.”
 
During their 2009 stay in Ghana, Crowley and the students she brought with her worked in a cleft palate clinic with babies just 24 hours old. They also worked with the head of cranio-facial surgery and the Provost of the university teaching hospital at the Kwame Nkrumah University of Science and Technology in Kumasi. And they also promised the Ear, Eye, Nose and Throat Department Chair of the University of Ghana in Accra, the country’s capital, that they would work with him and his Dean of Allied Health Sciences to establish the country’s (and West Africa’s) first speech/language pathology program.
 
“He told us, ‘I have people with cancer, and I remove their larynx and there’s no speech, and I leave them without a voice,’” Crowley recalls. “And then he said, ‘You are the answer to my dreams.’”
 
In fact, Crowley says, those dreams are not far from becoming reality. A building to house the new program is under construction, and Crowley says she is nearly done writing the program’s curriculum. 
 
And then there is Cambodia, where Crowley and Karen Froud, a neuroscientist and professor in the SLP program, toured during summer 2008 to take stock of speech-language needs in a country left nearly bereft of medical and educational infrastructure by the brutal reign of the Khmer Rouge.
 
The two worked with young patients and their parents at the National Pediatric Hospital in Phnom Penh, where, among other encounters, Froud—who has a long-standing association with Cambodia—discovered that doctors there did not have sufficient expertise to make good use of a 36-channel electroencephalogram (EEG) machine donated from Korea. She has since returned to provide system repair and instruction. Working with Etoile LeBlanc, a TC doctoral student and clinical director in speech/language pathology, Froud will be taking a group of students and clinicians to Angkor Hospital for Children in Siem Reap this August. This venture constitutes the first formal provision of speech/language services in Cambodia.
 
In Siem Reap City, where Handicap International provides prostheses and rehabilitation for people who have lost limbs in land mine incidents, Froud and Crowley met a two-year-old boy with cerebral palsy, who sat hunched over, with his gaze permanently fixed on the floor due to poor muscle tone. By showing his mother how to hold his head, change his posture, and use some stimulating materials, they were very quickly able to engage his attention so that he was reaching out to turn the pages by himself. To provide the boy’s mother the means to help him learn obviously was a huge benefit to the child; to witness the sharing of medical expertise across cultures would, Froud and Crowley believe, be of almost equal benefit to a student seeking to work with multicultural populations.
 
“If you want to really know how to work in a culturally sensitive way, you’ve got to go outside your own culture,” says Crowley, who traces her interest in international work to a college semester spent in Mexico. “You’ve got to go to a place where you don’t know the language, and you don’t know the culture, and you’re trying to negotiate that. It’s a very deep and profound experience.”
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