Crossing barriers to speech Guatemala project highlights the critical need for bilingual speech-language therapy in non-English, high-poverty communities here and abroad

With one in 10 students in the Philadelphia School District identifying as English language learners, demand for bilingual speech therapy services is high. And the speech-language-hearing graduate program at Temple's College of Public Health is one of a growing number of speech-language pathology (SLP) programs offering a bilingual emphasis.

Sources: National Institute on Deafness and Other Communication Disorders (NIDCD)

“There is a tremendous need for speech-language pathologists who are proficient in other languages,” says Beth Levine, director of clinical education and clinical services at Temple’s Department of Communication Sciences and Disorders.

One group of graduate students have taken their bilingual specialization to another level with a service trip to Guatemala – the first of its kind in the speech-language pathology program.

Melissa Wooten and three other students proposed the trip and, in January 2016, traveled to Zacapa, Guatemala, with the NGO Hearts in Motion and two supervising faculty members. They provided services to children and adults, educated the community about communication disorders as well as their assessment and treatment, and taught caregivers techniques to continue speech-language services after the students left.

Melissa Wooten

In November, Wooten and her team gave a presentation on the project at the 2016 American Speech-Language Hearing Assocation (ASHA) annual convention in Philadelphia. We talked with her about what she learned in Guatemala and how she can apply it to her work here and abroad.

How did you discover speech-language pathology – and bilingual SLP?

I was working in a community action program for lower-income families, and a lot of the kids there were being identified with some sort of communication impairment. I originally thought I would teach special education, but then I realized I could bring a lot of my other interests in to work as a speech-language pathologist. I’d taken Spanish in high school and was fascinated with linguistics and the structure of language. Speech-language pathology combined all my passions. I graduated from West Chester University with a bachelor’s degree in communicative disorders with minors in Spanish and linguistics. One reason I chose Temple for graduate school was the bilingual emphasis.

Sources: National Institute on Deafness and Other Communication Disorders (NIDCD)

How did you and your classmates decide on Guatemala?

We wanted the bilingual practice, but we also wanted to provide services abroad and explore the idea of how to provide sustainable services in impoverished communities. We knew that Guatemala has very limited access to speech-language services—there are no speech language pathologists there. So we knew there was a need. We connected with the NGO Hearts in Motion, and they let us accompany them on a trip to Guatemala that they already had planned. The Physical Therapy Department at Temple already has a relationship with them, so we knew it was a reliable nonprofit.

Clockwise from top left: Melissa Wooten works with a student at Paz y Bien, a residential center for children with developmental disabilities in Quezaltepeque-Chiquimula, Guatemala. Temple students and faculty (from left) Zoe Hunter, Victoria Diedrichs, Melissa Wooten, Liora Segal, Emily Elias, and Ann Addis outside the mobile clinic at Escuela Oficial de Párvulo in San Cristobal, Guatemala. An Escuela Oficial patient and her grandmother with Addis, Elias, and Wooten. Segal (left) and Diedrichs work on articulation and language skills with two students. Wooten works with a student at Hearts in Motion Orphanage and Nutrition Center in Gualán, Guatemala.

How did cultural differences help you improve your clinical skills?

I really grew my competency and learned how the people in Guatemala view speech-language therapy, medical services, and clinicians. There’s a belief that the parents didn’t think they were qualified or capable to provide language services themselves once we left, so a big part of our work was to educate caregivers about their loved ones’ impairments, set goals for the person receiving services, and teach caregivers how to provide those services after we’d left.

Making these services sustainable was one of your primary goals for this – say more about that.

To me, sustainable service is providing services that are continuous and accessible to the people using them. On a project like this, where you’re there for nine days and then you leave, sustainability becomes about empowering community members to provide services after you’re gone. Poverty brings its own barriers to sustainable service, like trouble with transportation or not being able to get off work. We saw that from day to day in Guatemala.

Poverty brings its own barriers to sustainable service, like trouble with transportation or not being able to get off work. We saw that from day to day in Guatemala.

How do you bring that principle back into local communities?

I think education and empowering caregivers to provide services at home is huge. Guatemala taught me a lot about working with limited resources and using a person’s environment and everyday routines to provide services. In Guatemala we didn’t bring a lot with us because we didn’t want to bring things they wouldn’t have after we left. So we got creative. My course work and training gave me a strong foundation, so that I was comfortable branching out.

Now that I’m back, I think a lot about how to use everyday opportunities and natural environments to provide services. It’s also given me a new perspective on the kind of world some immigrants to the U.S. are coming from.

What’s next for you?

Right now I’m finishing my master’s degree in speech-language-hearing science. This is my last semester, so I’m applying for jobs, which is exciting.

Final thoughts?

I am very grateful to Temple University and to the department for letting us go on a trip like this. It’s helped me grow personally and feel more confident when treating individuals in Spanish. I’m so glad to have had the opportunity to do this with supervision, while in school, and I’m excited to provide better services to Spanish speakers in our local communities.

Learn more about what's happening at the Department of Communications Sciences and Disorders at Temple's College of Public Health here.

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