Biola Ladies take Belize!

Week 1 with our second group of Therapy Abroad students from Biola University featured a new group of campers and fresh ideas for Communication Camp at The Inspiration Center, a trip to a local school to carry-out speech and language screenings, and some fun team outings!

Communication Camp

We spent the first half of the week getting to know our new kiddos attending Communication Camp! For more info about the therapy program we run at The Inspiration Center, check out this previous blog post. Here are some highlights from our stations: Fine motor, story time, basic concepts, behavior regulation, gross motor, snack and pretend play!

School Visit

At the end of the week, we switched things up and made a visit to a local school in Cayo District where we screened several kids with an array of speech and language needs including cleft palate and language delay. Some kids just stopped by to say hi and hang out with us as we finished our screenings 🙂

Team Fun Days and a trip to the Blue Hole

The crew had a competitive few days at our home base, Monkey Bay, with a field day complete with bucket baseball (where ya get a refreshing bucket of water on your head following a strike out or caught fly ball) and a social media scavenger hunt consisting of 10 challenges around the campsite that had to be completed with photo/video evidence posted to instagram before time ran out! After all our hard working days and competitive nights, we ended the week with a cool down in the emerald green water of Blue Hole National Park!

Your SLP Overseas,

Kristin AmRhein
Team Leader
Therapy Abroad

And we’re back!

Therapy Abroad– Group 2, Day 1 (Sunday, 7/30)

After a mini hiatus, Therapy Abroad is back to work in Belize with a new group of students, all from Biola university, and some new staff too! I am thrilled to be the Team Leader for this crew and looking forward to meeting all the new kiddos we will work with for the next two weeks!

We kicked off our first day with a trek through the pine savannah of Monkey Bay Wildlife Sanctuary where we will stay for the next 2 weeks. After a rather toasty and humid walk, we took a refreshing dip in the river (something we didn’t get to do with the last group due to inclement weather conditions). Luckily no one fell asleep on us and floated away out of exhaustion from their red-eye flight 😉

Tuesday is day one of Communication Camp and the girls have been hard at work building resources for our new group of Pirate Campers! Stay tuned for updates on all our clinical and cultural adventures in Belize!

Your SLP Overseas,

Kristin
Team Leader
Therapy Abroad

Island Vibes

Days 11&12

After a week and a half of meaningful hard work, the Therapy Abroad team hopped on a boat and cruised to Caye Caulker. The emerald green waters of the island were all too inviting as we made our way to our hotel, La Isla Resort.

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View from the La Isla’s beach front

Before diving into the island fun, we made a visit to a local elementary school that is unique in every way imaginable when compared to the typical Belizean schools. Founded by Dr. Alberto Luis August, La Isla Cariñosa Academy was developed out of a need to change the standards of education in Belize. Born and raised in Caye Caulker, Dr. August obtained his PhD in Education from the University of North Florida. Following his worldly travels, he was inspired to incorporate the educational values found in schools of developed countries into schools of Belize. Principal August and his wife, Valerie August, Vice Principal of the private school, shared with us the typical conditions of schools in Belize—no AC in a stuffy classroom despite humid 90* heat, teachers lacking higher education and managing a class of 30 students independently, corporal punishment inflicted on children who misbehave, and no alternative teaching strategies integrated into the curriculum for a child with learning difficulties or special needs. Worried for their own daughter’s education, they created a school with an environment that is conducive to learning and caters to the needs of individual students.

 

La Isla Cariñosa Academy is the only inclusion school in Belize which supports the needs of students with Autism, language impairments and learning difficulties. Each classroom is limited to 15 students and is equipped with AC and windows for natural sunlight. Positive reinforcement is emphasized and corporal punishment is non-existent. You can find educational artwork painted on the walls of the school and a recreational yard used for recess. Principal August plans to further develop the school’s campus and construction for a rooftop playground is underway. Therapy Abroad is excited to build their relationship with the innovative couple and work as a team to support Dr. and Mrs. August in identifying students with speech and language needs and providing training and support within the classroom environment.

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Dr. and Mrs. August, founders of this exemplary private school

After the visit to the exemplary school, it was time for our vacation to officially begin! We took to the sea where we snorkeled alongside the 2nd largest barrier reef in the world and even swam with sharks!

 

Day 13—Our Last Night Together

After 2 relaxing nights on the island of Caye Caulker, we headed back for one last evening at Monkey Bay. After dinner, we danced around the campfire to traditional Creole drumming and learned some new moves!

 

And just like that, group 1’s time in Belize has come to an end. Crazy to think that in just two weeks, a group of students and staff who knew nothing about each other could form such strong bonds and lasting relationships by the end of the trip! We worked together–we lived together–we played together–we killed bugs together. But most importantly, as a team, we raised awareness of speech, language and feeding therapy in a country where special needs and disability is stigmatized and poorly understood. Together we collaborated with local professionals to expand the current services provided to support our clients and their families and in the process we grew as individuals and clinicians.

To all those students and staff who were part of Therapy Abroad’s first group, well done! I am proud to have been your Team Leader and already miss everyone! Same time next year?!

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That’s a wrap with Therapy Abroad’s first group in Belize!

I am looking forward to working with the next two groups and seeing the new ideas they bring to Communication Camp and the entire experience in Belize this August!

Until then, it’s back to NYC for the next 2 weeks for a little summer fun and R&R!

Stay tuned for our Belizean adventures in August!

Your SLP Overseas,

Kristin AmRhein, M.S. CCC-SLP
Team Leader
Therapy Abroad

Therapy Abroad–Week 2 at the Inspiration Center

Days 9-11

Therapy Abroad kicked off week 2 in Belize at the Inspiration Center. Our last week of Communication Camp was even better than the first. The blossoming student SLPs took charge and found ways to improve the activities from week 1 in order to elicit more language from the Pirate Campers while managing behavior and having fun!

The students also had another opportunity to make home visits through the Inspiration Center’s Community Based Rehab program. They played with the kiddos and observed Therapy Abroad’s SLP, Mollie Mindel, in the field as she worked one-on-one with caregivers and Inga, social worker at the Inspiration Center.

Our last day at the Inspiration Center was a fun one…but also pretty emotional for some of our Pirate Campers when they realized camp was ending 😦

After a week and a half of hard and meaningful work in Belize, it’s time for some well-deserved island time! Next stop– Caye Caulker!

Kristin AmRhein, M.S. CCC-SLP
Team Leader
Therapy Abroad

Belizean Weekend Adventures

This weekend the Therapy Abroad crew took a break from work the great outdoors of Belize! I will let the pictures tell the story…

Saturday, 7/8

Saturday was spent ziplining through the jungle and tubing through caves filled with stalagmites and stalactites. We had some interesting encounters along the way….

Ziplining

Cave Tubing

Sunday, 7/9

On Sunday, we explored the ancient Mayan ruins of Xunantunich! Though the temples are over 3000 years old, the site was only discovered in the 1800s and unearthed in the 1920s. It continues to be excavated today. From the top of the temple we could see the gorgeous landscape of not only Belize, but Guatemala too!

With an action packed first weekend in the books, it’s time to get back into work mode and prepare for group 1’s last week of Communication Camp at the Inspiration Center before heading out to the islands for some rest and relaxation!

Until next time,

Kristin AmRhein, M.S. CCC-SLP
Team Leader
Therapy Abroad

Belmopan and the Jungle (Day 6)

Today, the Therapy Abroad team made a trip into Belmopan, the capital of Belize. Our first stop was a visit to Helping Hands, an educational resource center created by Miss Emily to support the learning needs of Belizean students. During the visit, she told us about the challenges students of all ages face to receive a good education in Belize. She shared with us that many students in Belize do not continue on to high school and some even discontinue their education after elementary school. Several cultural and economic factors influence this decision and Miss Emily’s mission is to provide free educational support at Helping Hands. Furthermore, she aims to unlock the learning potential of all students she works with by improving their literacy skills and encouraging them to think about their future selves and what they aspire to be when they grow up in the hopes that they will continue to seek out a good education as they get older.

As a proud Garifuna woman, Miss Emily shared about the origins of her people and their presence in Belize then sang a song in the Garifuna language. After bringing tears to our eyes with her passion for education and her culture, she took us to meet the children who were attending the summer tutoring program she set up for those who were identified as falling behind in school. The Therapy Abroad students and staff broke into small groups with the kids based on their age and academic levels. We spent the next hour or so getting to know our kiddos and eliciting language opportunities through the interests of each individual child. We met kids who love singing, pretending, writing and drawing. We met young students who aspire to become teachers and the older students shared their dreams of becoming a lawyer in the future to support their families. Two things all of these children had in common—enthusiasm to learn and lots of love to give!

In the afternoon, we took a trip to a local market where we explored the fruits and goods, ate some local grub, and took a much needed coffee break!

Dinner at Jungle Creek

After some afternoon R&R, we headed to Jungle Creek for a dinner with Pathlight, an organization who’s mission is to ensure that secondary education is made accessible to all children in Belize. As previously mentioned, many children do not go on to continue their high school education because unlike elementary years, high school is not free and many families cannot afford to send their children to school. As a result, Pathlight setup a program called Sponsorship+ which allows individuals to sponsor a child by providing monthly financial support to cover fees such as tuition, transportation, school supplies, tutoring and so on. To fully sponsor a child costs $200/month.

Pathlight also provides teacher training to local teachers to build on their own education and teaching strategies. This July, Pathlight will hold their annual Teacher Training Conference and Therapy Abroad’s SLPs and Behavior Therapist will attend to provide education and training in these specialties.

During our dinner we had the opportunity to meet 3 Pathlight students who are being sponsored by the Therapy Abroad team!

That wraps up week 1! Time for some weekend fun exploring Mayan ruins, cave tubing and ziplining!

Kristin AmRhein, M.S. CCC-SLP
Team Leader
Therapy Abroad

Therapy Abroad–Welcome to Belize (Week 1: 7/1-7/7)

The students and staff of Therapy Abroad, a program designed to provide students and professionals with opportunities to develop speech and language therapy overseas, launched its first student program in Belize this week! As an avid blogger and the Team Leader of the undergraduate students participating in the program, I am thrilled to share about our experiences thus far and those to come this summer!

DAY 1
We arrived early Sunday morning after our red eye flight from Los Angeles. Despite the exhaustion (and unBelizable heat), the students and staff were eager to explore our home for the next two weeks, Monkey Bay. We kicked off our trip with a trek through the Pine Savannah!

DAY 2
Our first real day of work began at the Inspiration Center, the only clinic in all of Belize to provide speech and language therapy. The students and staff of Therapy Abroad will support the Inspiration Center throughout the summer by carrying out evaluations and a group therapy program we have dubbed ‘Communication Camp’.

The students spent the day planning all the activities that will be carried out during Communication Camp and prepped LOTS of resources for our pirate themed camp which will run for 6 days over the 2-week period!

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On our way to the Inspiration Center

DAY 3-5
Time to play with our Pirate Campers!

Communication Camp is based on Titan Tykes, a group therapy program developed by Dr. Kris Brock from CSU, Fullerton who is also working with Therapy Abroad in Belize to provide a well-rounded experience for the SLP students and campers. The language enrichment program consists of 7 stations—Fine Motor, Storytime, Basic Concepts, Behavior Regulation, Gross Motor, Snack (a station added to support those picky eaters!) and Pretend Play. With the support of licensed SLPs, the undergrads have had an unique opportunity to plan activities for the stations and lead the campers in each as they grow to become more confident communicators!

In addition to providing therapy, we supported the head SLP at Inspiration Center (and only therapist in all of Belize) with her backlog of evaluations. While some students and SLPs stayed at the clinic to carry-out these evals, a small group of students went with myself and Chad, the Program Director of Therapy Abroad, on home visits to both evaluate the children being seen and support the caregivers with communication and feeding strategies. We worked alongside the Inspiration Center’s social worker who regularly sees clients in the community to support their needs; however, as her educational background is not in speech and language pathology, this gave us an opportunity to provide training and model strategies that can be implemented during her visits following the departure of Therapy Abroad’s students and staff.

Fun Times
Therapy Abroad isn’t all about work. We like to have some fun too!

It’s only Day 5 and already so much has happened! It is the end of our first big work week and the students and staff worked so hard to make the first ever Communication Camp in Belize come to life! I feel like a proud mama as the Team Leader of these intelligent and creative women who surpass the expectations of undergraduates in our field. I look forward to seeing what ideas they bring to the table for next week’s camp. But until then, it’s time to see some more of Belize and embrace the culture!

Next up— A visit to local schools and Pathlight (more on them later) on Friday followed by an adventurous weekend of Cave Tubing and Ziplining! Stay tuned….

And follow us on instagram @therapyabroad

Kristin AmRhein, M.S. CCC-SLP
Team Leader
Therapy Abroad

Cambodia Project- The FINAL Week

So we’ve done it! We’ve worked out in Phnom Penh for 12 weeks now (3 months!) and this week was our last. The final hurrah.

Monday and Thursday, our admin days this week were spent report-writing for each of the settings and drawing our work to a close. It is really difficult to summarise our work into a few pages of a report but we tried! Although we both love the hands on Speech and Language Therapy work, we know that it is important to keep good records so that these can be passed on to the next cohort of Speech and Language Therapists who go to Cambodia. Hopefully our work can continue where we left off.

On Tuesday we went to say goodbye to our Speech Advisor Samnang and our Speech Advisor in-training Srey Lak at Children’s Surgical Centre. It is great that Samnang has someone to pass on his skills too – the further we spread the word about Speech and Language Therapy, the better. Srey Lak will shadow and learn from Samnang on Tuesday afternoons until she feels confident enough to work on her own at Khmer Soviet Friendship Hospital. She is a trained midwife and full of enthusiasm for her new role. It is such good news as well that these two hospitals are willing to learn from each other and communicate as this was unheard of a few years ago. We had a second session with a boy we saw a few weeks ago with lots of sound substitutions in his speech making it difficult for him to be understood. We did some further assessment and with Samnang we decided on sounds to target with him in therapy. He has agreed to come regularly for therapy which is another success story! The twins were ill today but we also saw Samnang give advice to the parents of several young patients in the wards about post-op care and feeding. Samnang is using his leaflets wisely and we gave him more copies to start giving out. We ate lunch with Samnang as a special goodbye and also said goodbye to other staff we know at the hospital.

On Wednesday we saw Dr Alin at the National Paediatric Hospital (NPH) to help with her non-cleft caseload. Inevitably there were some cleft cases but this always tends to be the case. There were a few cases we referred to CCAMH (Centre for Child and Adolescent Mental Health) and a few that Dr Alin would like to see for therapy in her clinic. This week we saw the new clinic room being decorated along the corridor. This is exciting and the future at NPH for cleft and non-cleft patients alike looks very bright!

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A little girl who loved playing to the crowd at NPH clinic

Friday brought us back to NPH for the final time and with it, so many babies! We saw Chanthy again, our Speech Advisor who works with Dr Alin now at the Friday clinics. She is hoping to stay working on Fridays until she has her baby next year and she is so confident now at giving advice for feeding and speech difficulties. This week we worked with Chanthy to train her in using the KASS (Khmer Assessment of Speech Sounds) which helps us to decide which speech sounds a child struggles with and which to target in therapy. She found it difficult to listen for the sounds at first but it takes practice. We found this one of the most difficult things to learn when we didn’t really know the language! The assessment involves asking the child to name pictures and writing down how they say them. As we have used this assessment a lot, we now know lots of weird and wonderful Khmer words such as ‘grapes’ (‘dom-be-an-buy-chew’) and ‘hammer’ (‘nya-new-ah’). It was great working with Dr Alin as well and she saw the young lady we brought in for a second opinion about her secondary palate surgery from another hospital. She now has to decide whether to have the surgery or not. A whirlwind day as always.

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Chanthy, our Speech Advisor, giving early speech advice to a mum of a baby with cleft lip and palate.

It is so sad to write this final blog post and even sadder to leave everyone in Phnom Penh who continue to work tirelessly for children with Cleft Lip and Palate. We look forward to returning to Cambodia in the future and using our new found skills in jobs in the UK or USA.

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Kristin, Samnang, Dr Alin, Chanthy and Lauren meet at NPH for one final goodbye

 

Goodbye and Good Luck! (‘Nee-hi’ and ‘Samnang la-or’)

Your cleft team signing off,

Lauren and Kristin

You can find all of our blog posts on CLAPA’s new web site too!

 

Cambodia Project Weeks 10-12: 16th November-4th December

It’s been awhile since our last post! During week 10, many of the surgeons and speech advisers from our settings attended a cleft lip and palate conference in Thailand and during week 11, Cambodia celebrated Water Festival so our clinics were closed. Though these two weeks were quite slow with work, things picked up in week 12 and we were as busy as ever!

On Monday, we spent our admin day visiting the other settings where our other colleagues involved in the project work. First, we checked out the Rabbit School where Sam and Shona work. The Rabbit School is a school for children with special needs including Autism spectrum disorder, Down’s syndrome, and learning disability. Following this visit, we went to the Children’s Centre for Adolescent and Mental Health (CCAMH) where Kim works. This centre focuses largely on multi-disciplinary care for children with Autism. It was great to visit this setting as Lauren and I often refer non-cleft clients seen at the clinic for suspected Autism and learning disabilities to CCAMH. The opportunity to visit the other settings gave us the full picture of the positive impact we are making to spread support and awareness for several areas of SLT in Cambodia!

On Tuesday, we spent a full day at Children’s Surgical Centre with our speech adviser, Samnang. Samnang did a great job following through on his promise to book in a substantial amount of clients. The day was non-stop with the twin boys being seen for a therapy session in the morning and three assessment and advice sessions with cleft clients in the afternoon. Additionally, we invited a speech adviser in training from Khmer Soviet Friendship Hospital to begin her training that afternoon. As Samnang now has 8 years of experience as a speech adviser with our project, we thought this would give him the opportunity to share his knowledge and develop skills in others to become speech advisers. It worked out perfectly since we have just recently secured a speech adviser at Khmer Soviet but are near the end of our 3 months here. It was great to watch Samnang work with the clients and train the speech adviser at the same time. He seemed very confident and was excited to be the teacher rather than the student. We even got to watch him use his ENT skills when he carried out a nasendoscopy on one cleft client who expressed concerns of difficulty breathing. After watching Samnang in action, we are confident that he will be able to train the new speech adviser independently after we have left.

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Samnang in action taking a case history.

 

On Wednesday, we supported Alin in the morning clinic at National Paediatric Hospital. Now that Alin is back from Taiwan, she is providing SLT services to non-cleft clients on Wednesdays in addition to the Friday cleft clinics. As Alin is keen to become a qualified SLT, we think this is an excellent opportunity for her to broaden her skills in the field beyond cleft lip and palate. Though the clinic is meant to be primarily for non-cleft cases, we still saw quite a few cleft kiddies! But that’s OK because the important thing is that the clients are aware SLT services are available! Since the bulk of Alin’s experience is with speech and feeding advice for cleft clients, we have started developing her skills in assessment and advice for language delay and disorder. In doing so, we worked with Alin to create a basic language assessment known as the Derbyshire Language Scheme which assesses a child’s ability to understand directions at different levels of complexity.

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Alin training a cleft client on how to practice using oral sounds with the use of a tube. When producing oral sounds into the tube, the client should be able to feel the air reach ear. If the air doesn’t reach the ear, this is a sign that the client is using nasal sounds rather than oral sounds. This is an effective tool for providing feedback to the client.

 

As time was limited on Wednesday, we met with Alin again on Thursday morning and we completed the language assessment together. She offered great ideas and grasped the concept of the assessment quite quickly! We plan to do a role play this week with the assessment so that she can learn how to administer it and feel competent doing so. During our Thursday meeting, we also helped Alin to create a budget for her cleft services. The organisation which sponsored Alin to go to Taiwan has agreed to provide Alin with some funding in order to set-up a 5-day clinic at NPH for cleft clients. She will continue to provide SLT services on Wednesday and Friday, and on the other days she will take on her doctor role in providing care and management to the cleft clients. We are very excited that Alin will have some funding to build up the SLT services at NPH and look forward to seeing the developments of the clinic!

On Friday, we went back to NPH for the morning clinic. It was a pretty crazy morning because our other speech adviser, Chanthy, and Dr. Vanna were absent leaving just Alin, Lauren and me to see over 20 clients in the space of 3 hours. But Alin handled it like a pro and we managed to see all of the clients! That afternoon, the three of us met with Betsy, a visiting Speech and Language Therapist from the USA. She comes to Phnom Penh for about 9 weeks at a time every few months to provide SLT input for the adult population. Betsy is one of the only SLTs providing support for adults with communication and swallowing disorders in Cambodia so her work is very important! She spends most of her time training physical therapists in communication strategies for stroke clients and trains surgeons and doctors in FEES, Fiberoptic Endoscopic Evaluation of Swallowing. This January, she will hold a 4-week training course in this procedure to advance the skills of surgeons and doctors here in order to become competent with the use of this assessment tool in order to evaluate swallowing difficulties in adult clients. Even more exciting, Susan Langmore, the inventor of FEES, will provide this training with Betsy and offer her expertise in the field to further support services in Cambodia! Very exciting stuff! We were glad Alin had the opportunity to meet with another SLT who works with a different population outside of cleft so that she could begin expanding her professional network!

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A very busy day in the cleft clinic with Alin!

 

Our second to last week in Cambodia sure was full-on and eventful! We are hoping our last week here will be as well. We can’t believe we will be leaving Cambodia in just a few days. It is crazy to think how fast time flew by! We are so thankful to have had the opportunity to develop our field in a country where it is essentially non-existent and hope to be back one day soon!

To read more about the adventures of past volunteer SLTs and learn more about cleft lip and palate, visit the Cleft Lip and Palate Association’s (CLAPA) web site!

Stay tuned for our final post coming soon!

Your cleft team,

Kristin and Lauren

 

SLT job posting in Cambodia and visa info!

Indigo International in Cambodia is currently looking for a speech therapist to join their team. Indigo is a multidisciplinary clinic based in Phnom Penh working with adults, children and families from a range of backgrounds, both expat and local, and with a wide range of difficulties.

You would join a team of psychologists, speech therapists and occupational therapists picking up an existing caseload from a therapist who is leaving. The work is paid sessionally so this would mean that you would be able to start with a good sized caseload and income. Sessional work also means that you are in charge of the hours you work and the size of caseload you would like to take on. The role can be very flexible and there is high demand so scope to develop any special interests as appropriate.

The start date is for January 2016 and applications will stay open for the next two weeks (until Sunday, November 29th). You will hear back soon after the application closing date.

To apply, please send a CV and cover letter to angela@indigo-international.organd paula@indigo-international.org. Please send further questions or informal inquiries to paula@indigo-international.org, though please note Paula will be out of town from 23rd-29th due to a national holiday.

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Some useful info for working in Cambodia:

Visa requirements and cost:

You are required to purchase a 30-day visa when entering Cambodia. There are two visas available–the tourist visa ($30) or the ordinary visa ($35) both good for 30 days, both single entry visas. If planning to work in Cambodia, get the ordinary visa as this one can be extended for as long as you like.

To renew your visa, go to a local travel agency (we went to the Air Asia office). There are several options for visa renewal and prices vary based on where you go:

1-month extension– $50

3-month extension-$80 (we went with this option for our extra 2 months in Cambodia as it worked out to be cheaper than getting two 1-month extensions.

6 and 12-month extensions also available (do not recall exact prices but was $100+). The 6 and 12-month visa extension options provide multiple entry into Cambodia whereas the 1 and 3-month extensions are single-entry visas. So if you plan to work in Cambodia for a long time and travel around Asia, go with the 6 or 1-month extension as it will be a cheaper and more relaxed option.

DON’T FORGET PASSPORT PHOTOS! You will need these for the arrival and renewal visas!

Useful site for living in Cambodia– http://www.movetocambodia.com/

Good luck!