Progress at Camino!

Today our work continued at Camino. With only two days left of therapy, we have to think about how to make our work meaningful and long lasting. In just two weeks, we have seen a lot of progress with these kids! Several parents have been able to attend their child’s session daily. This is incredibly important in transferring both knowledge and skills to them so that therapy can continue when we are gone. Here are some highlights of the gains the students at Camino have made in such a short time!

Noelia began with Michael in the spring through the Telepractice at the TC clinic. Michael attends the integrated school in the afternoon and is one of the most verbal students at Camino. He has made a ton of progress in the past two weeks. Currently, he is worked on producing words that contain m, b, d, and f with all vowels!

Valentina is another student who has made incredible progress. During the evaluation last week, Valentina did not even spontaneously vocalize. Now, we hear her vocalizing  all the time on the playground and in circle time. Christine has been working hard with Valentina and her mother, who attends every session. Valentina’s mother has then been practicing what she learns in the session with her at home! It is great when parents are able to sit in on the sessions since they will be able to apply the techniques learned in therapy everyday.

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Valentina and Christine

Since receiving a new hearing aid last week, Eduardo has made amazing progress with Elanna! Like Michael, Eduardo is able to produce many sounds and is currently working on producing words beginning with p, b, m, and f. Both of Eduardo’s parents have also been attending every session, which is awesome! Today, Silvia trained them in how to work the new hearing aid and check the battery.

Adriana also received her hearing aid last week and has made a ton of progress while working with Nia! Adriana attends the integrated school and is another one of the most verbal students at Camino. She is currently working on auditory discrimination between words, production of words beginning with several phonemes, and Nia has been incorporating incidental language into the sessions. Adriana’s mom has also been attending the sessions, which is great!

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Nia working with Adriana

I have been working with Liz and she has made significant improvement since we started! Liz is 8 years old and first received her hearing aid at age 6 when she came to Camino. Prior to therapy, she barely vocalized and relied entirely on signing to communicate. During the evaluation last week, she was only able to produce a few vowels and consonants. We have been working on producing words beginning with the vowel and consonant combinations that she can produce. She has been working really hard and has made some real improvement. On the playground, she is eager to use her voice with all of the TC students.

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Working with Liz

For the past two weeks, we have been developing “circle time” with the younger classroom with the goal of having the classroom teacher take over when we leave. Our aim for circle time is to provide the students with a time everyday where only Spanish is spoken and the students are unable to rely on using sign. In addition, we hope to increase the language input by using repetitive language. Circle time starts out with a song. Then, the teacher presents each student’s name and they are called up to put their name under the school, indicating that they came to school today. For those students who did not come to school, their name is put under la casa. Scripted and repetitive language is used during this activity. Finally, a book is read to the students and they are encouraged to use their voices to repeat syllables, words, or even phrases related to the story. Circle time has been going smoother and smoother everyday. The classroom teacher, Mariela, has been gradually taking over more and more responsibility, so that it will be an easy transition once we are gone.

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Circle time

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Theresa reading a story at circle time.

It is amazing to see such progress in such a short time. If only we could stay longer…

 

Christie Clarke

 

Another Day

The second group of students had the opportunity to watch a cleft palate/lip surgery on an eleven-month-old girl today. The two-hour surgery served as a great learning experience, as Dr. Rosa was very explicit in explaining what he was doing and why.

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Afterwards, Dr. Rosa consulted with the mother of a boy at Camino because of her cleft palate and difficulty speaking. It turns out that Dr. Rosa was actually the physician that operated on her cleft palate back in 1992 when she was 15 years old. She was supposed to return for follow-up and a second procedure, but never did due to financial difficulties. Because the mother is not considered a pediatric patient, the surgery can cost up to 2,000 dollars; however, Cate Crowley and Dr. Rosa are making the argument that fixing the mother’s cleft palate will be a better speech model for her deaf son and help facilitate better communication between the two. They are hoping to work with the accounts department to lower the price.

The most touching moment was watching the mother look at Cate and then at the doctor, with tears in her eyes as she said “Por favor doctor ayúdeme. Muchas veces ni hablo con otra gente por que es muy díficil que me entiendan. Yo quiero ayudar a mi hijo. Yo quiero esta operación. Translation: “Please doctor, help me. Many times I don’t even speak to people because it’s hard for them to understand me. I want to help my son. I want this operation.” Cate spoke to the students at the hospital today about the possibility of donating some of the fundraising money from selling Bolivia scarves to help pay for the mother’s operation.

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Meanwhile, the other group of students continued their great work at Camino. As usual, the teachers were great in providing mid-day snacks and tea. They even went out of their way to buy some of the best salteñas in town!! After Camino, all of the students met at the integrated schools to take over the classrooms, while teachers sat in a capacitación (in-service training) with all of the Gran Bretaña teachers about the role of the Gran Bretaña teachers and Camino teachers/interpreters and how they could collaborate with one another to best serve the hearing and deaf children. Melissa (our audiologist) presented and talked to them about optimal seating arrangements for the deaf children to make better use of their audition.

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Finally, the day ended in a good-bye dinner at Coca for Program Coordinator/Found and Supervisor Cate Crowley. Announcements were made that grant money would be given to the teachers to pay for their vacation days, considering the little they are already paid. Everyone shared their favorite moment and how grateful they were for the opportunity and for Cate. Neither the students, nor the supervisors, nor the Camino teachers who joined in expected it to be emotional as it was. The truth is that Cate will be missed. The next three days won’t be the same without her, but they will still be wonderful and that is because of the vision that she had and followed through with. This trip has been and will continue to be, the opportunity of a lifetime.

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Keeping Busy!

Today was a great day!  In the morning we had a surprise.  We made a contact with Dr. Rosa, a pediatric surgeon at Hospital San Gabriel in La Paz.  This morning he agreed to let us come observe a cleft palate surgery.  We arrived early in the morning and changed into our surgical gear!

First group ready to go into surgery!

We took turns observing a 3 month old boy with a complete unilateral cleft of the primary and secondary palates.  This means that his bones did not fuse properly during embryonic development, leaving him with a completely open palate and lip, extending all the way up through one nostril.  Dr. Rosa was incredible and really wanted us to learn from observing the surgery.  He encouraged us to come right up to the operating table so we could really see what he was doing.  It was amazing watching Dr. Rosa work; he was incredibly precise and delicate.  After the surgery, a small group got to spend time with the doctor.  He let us visit with a patient who had their cleft palate surgery done 5 days ago to see the result.  The baby was feeding during the visit and recovering nicely!  After the visit with the patient, Dr. Rosa took the students into his office to discuss his preferred surgery techniques to prevent or fix insufficient velopharyngeal closure.  This is a term referring to the movement of the muscles at the back of the mouth that allows for accurate production of speech sounds.  As speech pathologists, this is of course a huge area of interest for us and it was great to hear his techniques and opinions.

After our time in the hospital we returned to Camino where we continued with our work there.  Our clients are making progress in therapy which is very exciting to see!  Today several of our clients worked with the computer program Audacity.  This is a free software that creates a soundwave from incoming speech signal.  The visual feedback helped many of our clients increase their intensity (loudness) and improve the quality of their speech!  The younger classroom also enjoyed another session of “circle time” today.  They are enjoying the songs, books, and routines and we hope it will become a sustainable activity for the teacher to continue once we leave. It’s hard to believe we only have 4 sessions left at Camino.  We’re all working hard to make sure our clients and all of the children at the school benefit as much as possible from the time that we’re there.

After we left Camino for the day, it was time for some more shopping!  Some of us got to visit “the scarf lady” as she has fondly been named.  We purchased 75 alpaca scarves to be sold at Teachers College in the Fall semester.  All of the money collected will be donated to Camino.  The students from the Bolivia trip last year brought back 50 scarves that sold in a few short hours! We’re looking forward to continuing this tradition and helping to support Camino.

Preview of scarves for sale!

In the evening we had class and discussed an article relating to racism and diversity in the schools.  We enjoyed sharing our individual experiences and learning from one another.

Buenas noches!

Elanna

Weekend at Lake Titicaca!

Viernes 25/05/2012

Friday morning at Camino was another wonderful day full of one on one therapy sessions and many different group activities. The children at Camino are responding very well to the popular game Zingo! which helps combine their math skills with their oral skills as they “use their beautiful voice” to say “yo tengo el numero..”. “Circle time” is also in full effect with the younger children as we as trying to develop sustainable activities that the teachers can continue on with long after we leave. The children seem to really like the “plin plin ” song as well as “los elefantes” to help get circle time going. The children are Camino are truly amazing to work with.

After a quick lunch we headed off for Lake Titicaca! We had been talking about this trip for a while so the anticipation was mounting. We arrived to Hotel Gloria in Copacobana in about 4 hours. We were all looking forward to a nice relaxing dinner. We found a restaurant near the hotel and settled down for some delicious  trucha (trout)! During dinner some local musicians played us some traditional music to start the weekend off right.

             

Dinnertime entertainment from “Los Choclitos”               Sunset on Lake Titicaca, view from Hotel Gloria, Copacabana

Sábado, 26/05/2012

Saturday morning started off with a delicious breakfast at Hotel Gloria, followed by a walk down to the water to meet Ismael, who would take us on his private boat from Copacabana to Isla de la Luna and Isla del Sol. The ride to Isla de la Luna was about 90 minutes, and we got some beautiful views of the mountains and the Andes peaks as we watched from on top of the boat!

At Isla de la Luna we were greeted by some cholitas selling necklaces, belts, and figurines of typical Aymara symbols. As we walked up the island with these women, we asked them about some of the things we have learned about the Aymara culture, such as child rearing and education. We also got to look at the Templo de las Vírgenes, where beautiful Inca women were once sent to maintain an eternal sacred fire.

After departing from Isla de la Luna, we made our way back on Ismael’s boat toward Isla del Sol, where a hefty hike up a steep mountain awaited us.  Our bags were sent up ahead of us on Ismael’s donkeys as we all made the journey uphill. As we got higher and higher, we were able to see more and more of Lake Titicaca below us. We passed by donkeys, sheep, and llamas, as well as Aymara men and women, and other tourists. Note: if you see an adorable llama and decide to take a picture, be sure there are no small children around who will try to charge you for it – otherwise, they will follow you up the mountain until you erase your photo! Along the way, we stopped for lunch at the Luna Restaurant – I think the large group of us may have surprised the woman working there! After eating, we took to the mountain once again.

By late afternoon, we reached the Puerta del Sol, the hotel run by Ismael and his family. After we settled into our rooms (which were absolutely lovely, despite having no heat), we decided to go for yet another hike, because one trek up a mountain a day is never enough!

Views from the top

            

After a delicious dinner of trucha (trout), habas (beans), and potatoes, the group met with Agapo, a yatiri (Aymara shaman) who prepared a special misa for the whole group, complete with tinsel, llama fat, sugar, and coca leaves. We then went outside (it was quite chilly by this point) and watched as Agapo burned the ingredients as an offering to the Pachamama to bring us good luck and success in our futures. Then we bundled up to go to bed so we could get up early for a sunrise misa the next morning!

Domingo, 27/05/2012

VERY early Sunday morning we arose to meet Agapo to do a traditional Shah-man blessing while the sun rose. It was an example of what is typically done on winter solstice. At 6:10 we followed Agapo to where he usually does some of his traditional rituals. It was a beautiful ceremony filled with many blessings of good fortune, travel, good luck with our studies, and any future encounters. The sun rising was also an amazing way to start the day. Then after a quick breakfast we made our way back down Isla del Sol to meet our boat back to Copacobana.

Shah-man sun rise ritual, Agapo

In Copacobana we had some time to wander, shop, and explore. Copacabana is a destination for tourism in Bolivia. Our Lady of Copacobana is the Patron Saint of Bolivia and this is truly felt when visiting the Church.  On Sunday’s many people travel to Copacobana for the blessing of the cars ceremony. There were many cars, one even from Peru, gathered in front of the church waiting to receive their Blessings.  Time was well spent at Copacobana taking in the sites and looking around in the local shops.

Then we made our way back to La Paz. On the way back we encountered a local city celebrating their community.

We arrived safe and sound back at Hotel Rey Palace to begin work on another busy week. We are excited to see the children at Camino tomorrow and enjoy our week with them!

Theresa and Carla

6:30am waiting for the sunrise :)

One of the joyous moments ever!

Today, Dr. Melissa Innis, an audiologist who traveled with us with 8 donated hearing aids, decided on the first 4 kids whom she decided had the most high-necessity for hearing aids, and we watched the fitting. One of the kids is 16 and has been traveling by himself to school since he was 11. He told us that the hearing aids would really help him to hear noises on the street. The smile on all 4 kids’ faces when they were able to hear again for the first time was priceless. While Dr. Innis was programming the hearing aids, you could definitely see when the kids started hearing by the huge smile on their faces. A lot of people cried today. Everyone agreed that it was definitely one of the most joyous moments we had ever seen. It really means so much to the kids and their families to be able to receive a hearing aid that costs around 1500 dollars. The average Bolivian makes only 70 pesos a month, which is the equivalent about 10 US dollars. Just the batteries alone cost 10 Bolivian pesos a month, so Dr. Innis gave some to the children who received hearing aids.

The therapy sessions today were great, because in a few of the sessions a parent joined us. We really want the children to be able to keep up with their work after we leave, otherwise everything we do here is useless. If the teachers or parents do not decide to invest time in the therapies that we are working on now, our work is not sustainable. That is why it is so exciting to get so many parents involved. It is really amazing how dedicated and loving a lot of these parents are.

We’re definitely building a lot of rapport with the kids as we become closer and closer to them. A lot of us really got the kids motivated to vocalize through playing “Zingo” today, which is a game similar to bingo. We also read books to them, and did some language development work.They’re really motivated to learn, and they’re all actually very well behaved. We wish we had longer to work with them but we are trying to also develop sustainability through “circle time”, through working with the teachers to create some sustainable plans in the classroom as well.

Primer dia de terapia en Camino!!!

Dia 3, we started with circle time in the Mariel’s  class. The night before we had made name charts in the shapes of a house and a school. We had written the name of the students and we had drawn body parts. All  of this material was used today when circle time was implemented. Cate and five other clinicians engaged the students in circle time. “De las cabeza hasta los pies” was read to them and the students got so engage and participate acting out the story.  They loved circle time and want more!!!!!

Carla had her first session ever and it was such a success. Congratulations!!! Other students observed her client and he showed us great aural potential. He loved playing the memory game that Carla had prepared for him.  After “merienda” we went to Lais’s class and we engaged the students in play activities to stimulate language development, such dominoes, jenga, memory game. It was so much fun and we also learned a lot of signs from the kids.

Christine talked to Mireya and was really impressed by how smart she is. Mireya is so eager to learn and is so curious about everything. She was always asking more questions. Her level of written and reading Spanish is very high. They talked a lot about their families and they had a really interesting conversation.

The hearing tests also continued today. We interviewed the parents and they shared a lot of information about the children. Dr. Innis had a donation of 8 hearing aids, and we are trying to evaluate who would benefit the most. We wish we could aid every single child though…

After Camino, most of the students headed to the integrated school. Five students read “El Pez Arco Iris” out loud in one of the integrated classrooms and Dr. Crowley asked the class some follow up comprehension questions. Two other students did a joint reading of “De La Cabeza a Los Pies”, also followed by some comprehension questions. It was amazing to see some of the children from Camino in the integrated classrooms raising their hands to answer comprehension questions. Finally, the students led the classroom in some group songs such as “Mi Cuerpo”, “El Payaso Plim Plim”, “Los Elefantes” and “La Arana Pequenita”.

During the evening practicum, Jean ___,a freelance journalist that has frequently written articles about Bolivia for Time Magazine, facilitated a group discussion about Bolivian culture with our group of students. It was really eye-opening to learn about topics ranging from Bolivian politics and government to medicine and the intervention/knowledge that needs to be built around cleft palates and cerebral palsy.

Día 2 en Camino!!!!

Day 2 at Camino. Today we had several incredible experiences. The day started off with presenting Paola from Camino with funds raised by the TC students throughout the past year. We were then given an opportunity to observe the classrooms of the students that we are going to be working with. We observed their morning routines and determined the routines we can implement, such as circle time and scripted routines (e.g., interactive activities that involves calendars, attendance, weather, etc).

We were so excited about our donation that the money ended up on the floor!!!

The TC family with Paola giving her the donation the former TC students  raised for Camino!!!

We were able to observe and participate during the phonetic/phonologic evaluation and the clients were assigned to us. After the merienda (mid-morning snack) we also participated and observed audiological evaluations to determine the need for hearing aids.

After the school day was over in Camino, some of the TC students went to observe the integrated students from Camino in the regular education setting. They learned about their educational curriculum  as well as they learned beautiful songs that we will happily implement at Camino!!!!