Family Fun Day

The Inspiration Center celebrated its 5th Annual Family Fun Day on August 18th and Therapy Abroad was excited to be a part of the action! A group of around 50 kiddos joined in on the fun day as they traveled through different stations including the photo booth, sensory play and the water station (my personal favorite)! The group of attendees included the speech and physical therapy clients who are seen at The Inspiration Center along with their siblings and caregivers. It was eye-opening to realize that the clients we saw at Family Fun Day were only a fraction of those who receive services from the sole SLP and PT at The Inspiration Center.

The ladies of group 3 had the best time playing with the kids all day– some of our campers from the current and previous Communication Camp groups were there too!

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Classic Photo Booth pic with the ladies of Group 3 before our day of FUNNNN got started ❤

The best part about Family Fun Day was seeing the children take part in and enjoy every activity no matter what physical challenges or communication needs they presented with. It just goes to show that every child has the ability to embrace the same experiences in life and that disability is only reflected in the obstacles we allow to get in the way of success for every child. When we open our eyes and find ways to overcome these barriers is when we realize the potential of every child and their ability to grow and learn.

Your SLP Overseas,
-Kristin AmRhein

Cambodia Project—Week 8: 2nd-6th November

This past week brought some exciting new developments!

Monday was no ordinary admin day. In search for a video on feeding babies with cleft lip and palate to add to our Friday presentation, we found a great animated video created by Smile Train, an NGO we later found out supports funding for cleft surgeries at some of our hospital settings. We are keen to make a feeding video as well but in Khmer. So we emailed Smile Train for permission to create a Khmer voice-over for the original copy and they agreed! Even more exciting– Today (Monday, 9th November), we have a meeting with Smile Train as they are interested in supporting funding for SLT in Cambodia! We are eager to hear what they have to say and how we can work together to continue raising awareness for SLT while we are here. Follow this link to watch the video we hope to create a Khmer version of!

On Tuesday, we saw Samnang at Children’s Surgical Centre. The twins weren’t able to make it to the therapy session again, but we saw two new cleft kiddies for a speech assessment. This gave us an opportunity to focus on Samnang’s clinical skills for carrying out assessments. He’s already great at asking the right questions for a case history and has quite good instincts in terms of appropriate decision-making, but we wanted to teach him the importance of introducing the session and informing clients of exactly why they are at the clinic and what will occur. A lot of people don’t understand the purpose of speech and language therapy here so it’s our goal to emphasize the importance of what we are doing for their children. We also built up his skills in assessing speech sounds by teaching him the importance of testing for stimulability of a sound on its own if the child is not able to produce it in a word during assessment as this informs the approach we will take in therapy. He proved to be a very receptive and quick learner, and by the time the second child came in for assessment, he was independently introducing the session and feeding back to us the specific difficulties the child had with production of the sounds. Overall, he has been a great guy to work with—though we still struggle to get him to use his email!!

On Wednesday, we went into Military Hospital to see the 5-year-old boy we first met when we arrived in Cambodia. Mom travelled far from Kampot province to have his hearing checked at All Ears followed by a second therapy session with us. We were happy to see good results from his audiology appointment reporting normal hearing. We were concerned he may have hearing difficulties because in our last session he was having difficulty distinguishing sounds. These good results meant that we could continue on with therapy that day. This time around, he did much better receptively discriminating the difference in sounds so we could move on to working on his production of them! In this session, a big focus was to train mom up in the facilitation of both the listening and production activities of his target sounds. Mom was an excellent student and we all had a lot of fun watching the boy crash toy cars towards the sound he heard when getting it correct. By the end of the session, mom felt confident enough to use the advice and skills she had learned in order to apply them independently to work with her son at home and said she wouldn’t need to come for another session. We were glad that she was happy with the tools we gave her to help her son at home as it was difficult for her to make the trip out to Phnom Penh so often.

Lauren and I with mom and the 5-year-old boy we have been working with at Military Hospital.

Lauren and I with mom and the 5-year-old boy we have been working with at Military Hospital.

The Friday clinic at National Pediatric Hospital was quite a whirlwind this past week! We saw many more children with language difficulties and had a few extra people in the room than usual. Alin, who is a doctor but has worked as a speech adviser with our project in past years, had returned from her 3-month SLT course in Taiwan and was back at the clinic seeing patients that day as well as Dr. Vanna, our speech adviser Chanthy, and Lauren and I. So needless to say, it was a full house with lots of kiddies running around. Our supervisors from City University who oversee the project came near the end of clinic and we all had a chance to properly meet Alin and discuss her experience in Taiwan. She was very enthusiastic about the wealth of information she had gained in the 3 months and expressed interest in being a fully certified SLT in Cambodia—Very exciting considering the role of SLT is virtually non-existent out here! Chanthy also expressed how much she has loved learning about SLT and how she would very much like to carry-on working as a speech adviser when we leave—so we have two very keen people who will hopefully build on their SLT skills together and continue providing services after we go!

Our supervisors gave us some great tips as to how Lauren and I should continue training Chanthy and Alin and what our next steps should be in promoting the development of SLT. They also attended our training later that day at One-to-One. We were happy to see that everyone from last week was back to learn more and even more pleased to see a few new faces. For last week’s training, we taught about feeding in CLP and syndromes associated with CLP. Training is a brand new experience for Lauren and I, and it was a bit intimidating but also encouraging to have a supervisor there who had taught us in uni lectures and was now watching us teach!

Well a new week has begun and we are looking forward to what’s to come. Hoping to have more exciting news to report next week!

Learn more about past adventures from the City Cambodia team and more about cleft lip and palate on the Cleft Lip and Palate Association’s (CLAPA) web site!

Your Cleft team,

Kristin and Lauren

Cambodia Project– Week 7: 26th-30th October

So it has been a different but exciting week this week.

On Monday we went to Khmer Soviet Friendship hospital for Day 3 of the Smile Cambodia mission. Our first job was to get a document translated into Khmer about how to care for children after cleft lip and palate operations and how to feed them. We thought this was very important as sometimes cleft repairs can get infected and break down if they aren’t looked after properly, leading to poor speech and feeding outcomes and the need for further surgery. We also were able to have a quick look at some surgery going on for a cleft lip in the operating theatres. They managed to get over 50 operations done during the mission over 3 days, so as you can imagine it was very busy! Another way we helped was by playing with children waiting to go in for operations and provide a speech development video in Khmer for their parents to watch. Although this isn’t an ideal time to give out information to parents, some of the families have travelled a long way to Phnom Penh for the mission and we would not be able to reach them otherwise.

On Tuesday we visited Samnang at CSC again and while we waited for the twins to arrive, Kristin and I talked Samnang through the planned activities and the rationale behind them. The twins didn’t turn up in the end but it is just one of those things! Their mother was ill and couldn’t bring them in but hopefully we will continue therapy with them next week. While we had some spare time, we thought it would be a good idea to do some training with Samnang about different speech activities and help him to plan a presentation he will hopefully give to an MDT meeting about ADHD.

We didn’t go to Military hospital on Wednesday as Dr Nous Sarom was working with the Smile Cambodia mission so we used this as our admin day instead of Monday. In the evening we went to the closing ceremony for the Smile Cambodia mission and the son of the Prime Minister made a speech. This is the closest we have come to meeting a Cambodian celebrity! All volunteers received certificates thanking them for their support with the mission. It was really nice to see some of the volunteers we met on Saturday and Monday and thank them again for their help with translating for us.

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Kristin and I with some volunteers at the Smile Cambodia Closing Ceremony

Friday was a very busy day at National Paediatric Hospital and One-2-One. We took another UK Speech and Language Therapist with us, Sam, who normally works in schools but wanted to find out more about cleft. We saw around 15 children from 8.30 until 12 and the time flew past! As well as the cleft cases we saw one child with possible hearing difficulties or language delay and another child with possible learning difficulties and referred them to either All Ears Audiology service, CCAMH (Child and Adolescent Mental Health Services) or both. I think we both really enjoy Fridays because it is so fast-paced and also involves on-the-job training for Chanthy our speech adviser, so there is lots to think about! In the afternoon, we went with Chanthy to One-2-One, an NGO which trains medical professionals from Cambodia to work in the communities and slums. Here we are planning to do some training on four Friday afternoons, all about the importance of Speech and Language Therapy in cleft lip and palate and other related conditions.

The first of our four sessions was about introducing Speech and Language Therapy and why it is important and providing information about the anatomy of speech and particularly the types of speech difficulties people with cleft lip and palate have. It was very rewarding and everyone really got involved in our silly activities! We hope that raising awareness of speech, language, communication and swallowing difficulties among Khmer health professionals such as doctors and nurses, will raise the profile of Speech and Language Therapy in Cambodia.

So that was Week 7 and it has been a whirlwind! We hope you have enjoyed reading about our work with the City-Cambodia Project so far.

You can also follow our adventures and learn more about cleft lip and palate on the Cleft Lip and Palate Association’s (CLAPA) web site.

Your cleft team,

Lauren and Kristin

Cambodia Project: Week 4- 4th October

Written by the lovely Lauren Cooper:

On Tuesday we went back to the Children’s Surgical Centre and saw Samnang our speech advisor carry out a session with twin 11 year old boys, both with cleft lip and palate. One had bilateral cleft lip and palate and one had unilateral cleft lip and palate and they were both very co-operative during assessment. We used the KASS (Khmer Assessment of Speech Sounds) to assess the boys’ speech sounds in Khmer (the language used in Cambodia). This was interesting as it helped us to see the difficulties each boy was having and helped us to plan therapy for when we next see them. Samnang identified target sounds for the boys to work on as homework appropriately. One of our goals is that with support and training, Samnang will feel confident in using session plans to help him plan therapy. We ended the day providing training for Samnang in ADHD, which he requested at the start of our visit. He will then hopefully feel more confident in giving a presentation on this subject at the doctor’s morning meeting in 2 weeks time. Good luck Samnang!

On Wednesday we spent the morning in Military hospital and had a session with a 3 year old boy who has not been seen for therapy before. He was quite stubborn and wouldn’t let us look in his mouth, despite Kristin’s crocodile puppet demonstrating what to do! We did however gain a detailed case history from his mother, which is what we often do with younger children and often we can get an idea of how a child communicates just from observing them during the appointment. We also had a session with a 5 year old boy who really needs more surgery for a fistula to help his speech. Fistulas (holes) in the roof of the mouth mean that air can escape through the nose, even when you are trying to make air come through the mouth. This means that Speech and Language Therapy is not appropriate for him until after he has had this operation. We organised for his operation to happen in 3 weeks time, but still we have to wait around 3 months after the operation before we can see him for therapy. We will be back in England but hopefully there will be a trained speech advisor around by then who can see him.

Thursday was spent in talks with Dr Theavy about possibly hiring a speech advisor! Making a paid position for a speech advisor would really encourage the Speech and Language Therapy profession in Cambodia. At the moment there are no Khmer Speech and Language Therapists and speech advisors are generally volunteers. However we are not getting too excited as he still has to talk to the board of directors at Khmer Soviet Friendship Hospital about it and persuade them that it is a good idea!

Lip taping is commonly used in Cambodia as a way of encouraging the tissue either side of a cleft lip closer together before surgery.

Lip taping is commonly used in Cambodia as a way of encouraging the tissue either side of a cleft lip closer together before surgery.

On Friday we attended the Cleft Clinic at National Paediatric Hospital with Chanthy, our speech advisor and Dr Vanna. After the clinic today Chanthy, Kristin and I all agreed that we were feeling more confident in giving the advice for children with cleft in terms of speech and feeding. This is really great and we hope that Chanthy will be giving advice independently in the coming weeks. We saw a 15 year old boy today with cleft lip and alveolus and we are pleased to say no concerns with his speech. This is often the case with this type of cleft because it doesn’t affect the hard and soft palate. Children with cleft palate often have nasal speech and other speech errors as there is no separation between their mouth and nose. Again we had training after lunch with Chanthy and Dr Sophen, this time on the anatomy of speech and the types of cleft. This was a slightly harder presentation than the last one as it involves a lot of terminology but they coped really well! Possible Speech and Language Therapists of the future!

Kristin’s crocodile puppet named Cambi proved very popular at the clinic!

Kristin’s crocodile puppet named Cambi proved very popular at the clinic!

Kristin and I had a really positive experience this week and we are looking forward to a week off next week for Pchumben (a festival celebrating ancestors) where we hopefully delve into some more Cambodian culture.

Your Cleft team,

Lauren and Kristin

Welcome to SLP Overseas

Welcome to SLP Overseas, a site dedicated to linking the world of speech, language, and swallowing therapy.

As a current international Master’s student in the field, I aim to bring awareness to prospective and current students as well as professionals on the opportunities available in the field on a global scale.

This site will allow students to discover Bachelor’s and Master’s programs around the world that will provide them with an opportunity to learn from international educators and build a network overseas. Additional opportunities available to students also include overseas clinical placements and volunteer work which will allow students to develop their skills alongside professionals in developing countries.

The site also provides information on how to work abroad as a professional. Both paid positions and volunteer opportunities are provided for qualified clinicians to take advantage of around the world in both developed and developing countries.

As an American studying in the UK, I have had the unique opportunity to learn from professionals with different views and approaches to intervention. This has allowed me to open my  mind to the different possibilities within the field and has encouraged my desire to expand my career within the international community. The experience has also helped me to realize the need to bring awareness of the field to areas of the world that would benefit greatly from speech, language, and swallowing services, but do not have the knowledge nor the means to implement intervention.

I hope that this site will encourage individuals to take the time to understand the importance of international speech and language therapy. I hope it will encourage students and professionals from around the world to learn from each other and work together to improve the effectiveness of therapy and the quality of our client’s lives on a global scale.

This site is far from finished but it is the beginning of something positive and it is full of potential. Check back regularly as I plan to post new pages focused on international conferences, research in developing countries, stories from inspirational students and professionals, and much more! I also plan to keep up to date on blog posts featuring my experience as an international Master’s student and the undertaking of my Master’s research project soon to commence this winter!

To learn more about me and my academic and professional pursuits, read My Story. Please contact me with any questions, feedback, or information you would like displayed on my site.

Speechie Love,

Kristin AmRhein
MSc Speech and Language Therapy
City University London