Views on Disability Around the World Traveling abroad can offer many opportunities. As a speech-language pathologist, foreign travel can develop or sharpen your linguistic and cultural competencies through language immersion or volunteer work. I chose this path while conducting a self-directed Texas Speech-Language Hearing Association (TSHA) independent study. From May through August in 2004, I traveled, ... World Beat
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World Beat  |   January 01, 2008
Views on Disability Around the World
Author Notes
  • Katandria Love Johnson, is a trilingual (English, Spanish, Portuguese) speech-language pathologist, linguist, clinical and field researcher, and second-year public health graduate student at the University of North Texas Health Science Center at Fort Worth. Contact her at katjohn@hsuunt.edu.
    Katandria Love Johnson, is a trilingual (English, Spanish, Portuguese) speech-language pathologist, linguist, clinical and field researcher, and second-year public health graduate student at the University of North Texas Health Science Center at Fort Worth. Contact her at katjohn@hsuunt.edu.×
Article Information
Speech, Voice & Prosodic Disorders / Special Populations / Cultural & Linguistic Diversity / Genetic & Congenital Disorders / School-Based Settings / Professional Issues & Training / Attention, Memory & Executive Functions / World Beat
World Beat   |   January 01, 2008
Views on Disability Around the World
The ASHA Leader, January 2008, Vol. 13, 24. doi:10.1044/leader.WB.13012008.24
The ASHA Leader, January 2008, Vol. 13, 24. doi:10.1044/leader.WB.13012008.24
Traveling abroad can offer many opportunities. As a speech-language pathologist, foreign travel can develop or sharpen your linguistic and cultural competencies through language immersion or volunteer work. I chose this path while conducting a self-directed Texas Speech-Language Hearing Association (TSHA) independent study.
From May through August in 2004, I traveled, studied abroad, conducted research, and completed volunteer work, spending one to two weeks in 12 countries including Italy, France, Spain, Portugal, Canada, the Dominican Republic, Puerto Rico, Costa Rica, Mexico, Brazil, Argentina, and Chile.
I interviewed and observed 21 service professionals and seven families in Western Europe, Canada, and Central and South America in a variety of disciplines: speech-language pathology, otolaryngology, occupational therapy, education (language professor), psychology, and psychometry. Each professional responded to an interview or answered a 10-parameter questionnaire examining sociocultural, economic, and environmental factors that influenced his or her views of disability as well as the client’s.
Afterward I submitted the log to the TSHA independent study coordinator to approve the number of direct contact hours for a certificate of completion. My research paper, “Cross-Cultural Perspectives of Disability Views Among Culturally and Linguistically Diverse Populations,” focused on my work in Mexico.
Study Goals and Observations
The TSHA study examined the sociolinguistic, economic, and sociocultural influences on views of disability, specifically related to disorders of speech, language, and hearing among culturally and linguistically diverse (CLD) populations. At the conclusion of the work in Mexico, I was invited to continue volunteering at a private clinic in Puebla, where I served as an evaluating and treating SLP, consultant, and workshop presenter.
All service professionals I interviewed agreed that environmental, socioeconomic, and sociocultural factors strongly influence attitudes toward disability in their country. European service professionals appeared satisfied with government-provided services. In all other countries, however, professionals sought additional public services and recommended increased budgets for health programs.
All South American countries reported that disability was generally well-accepted, while all Central American families reported emotional difficulties accepting their child’s disability. Families interviewed in Europe indicated a lack of support from medical professionals in obtaining referrals to an SLP. The Central American and Canadian families reported appropriate services were provided upon referral or if an SLP was needed; however, waiting lists were problematic for families seeking public services. In addition, all interviewed health care professionals and families concurred on the need for medical service professionals to collaborate with SLPs on early detection of speech and hearing difficulties and appropriate referrals.
International Directions
The current ASHA database of SLPs who practice internationally contains listings from only a few countries. However, contact with these professionals by e-mail can create opportunities to receive mentoring and otherwise communicate regarding speech-language and hearing issues among CLD populations.
Specialized credits or continuing education units (CEUs) may be obtained through your local university and/or national or state organization, depending on your academic or professional status. A database of professional contacts, however, is not readily available and inquiries may be required upon arrival in a foreign country. Planning in this manner is not recommended, but in some countries it may be inevitable.
A working proficiency in the language and culture of the CLD populations we serve is necessary to have an effect on long-term treatment outcomes. More importantly, understanding critical cultural differences will give health care professionals insight on how to meet the needs of different populations. I hope that international opportunities, clinical practica, and continuing education can provide another avenue by which such challenges can be addressed.
Mexico: Working Across the Border

In Mexico, my work included consultation on therapeutic assessment and treatment procedures. I obtained information detailing these areas through interviews (which included a questionnaire) and observation of various speech-language pathologists and families who consented to video- and/or audio-taped visits for a minimum of one hour. Analysis of the results was based on the following criteria: a) affective; b) behavioral; or c) cognitive views of the cause of a disability and intervention style.

In addition, I completed an immersion program that allows students to gain clinical assessment, treatment, and observation hours, and to participate in service delivery workshops and on-site personnel training. The first international clinical externship and Texas Speech-Language Hearing Association-approved workshop took place in 2005 at the Center of Integrated Development clinic in Puebla.

The clinic’s clientele consists mostly of children, from infancy through high school. Referrals come from pediatricians and other health care professionals. The socioeconomic level of the clients’ parents ranges from low to middle class; the educational level is some high school. The clinic offers pediatric and adult services in: educational psychology, qualitative and quantitative psychometry and learning intervention, and clinical treatment. Payment is arranged on an individual basis.

In the area of educational psychology, early childhood intervention offers assessment “in utero” to age 3 for conditions such as hypoxia, macrocephalia, cerebral palsy, Down’s syndrome, selective mutism, and autism with schizophrenia. Intervention entails early orientation to speech, language, and behavioral learning activities.

Intervention is offered for university students who have learning disabilities. Students receive a written evaluation that examines their ability to construct visual images and verbally describe them based on auditory-verbal stimuli. Evaluations also include neuropsychology of oral language.

In the area of learning intervention, a well-established elementary education project utilizes neuropsychology, physical education, and development of cognitive skills through:

  • Expositions and theater

  • Mimickery of the SLP’s language-based activities of socialization, e.g., painting, cooking and dancing

  • “Neurotheatre,” in which theatrical plays are designed to stimulate cognitive functioning, educational activities, and clinical treatment through short scripts

  • Personality tests, play-based therapy for those who present no psychological issues, and family-based therapy

  • A state-funded program that addresses the needs of families with violent backgrounds

Katandria Love Johnson

Resources

Many agencies provide varied services requisite to travel abroad (language courses, internships, volunteerships, international health insurance, housing, and airport pick-up) for a one-time fee. You may choose to go through your university or a local travel agency.

For additional information, review BusinessWeek’s September 2005 online article, “Schools with a View,” which highlights my international travels and those of several other professionals.

References
Johnson, K. L. (2004). Cross-cultural perspectives of disability views among culturally and linguistically diverse populations. TSHA Independent Study.
Johnson, K. L. (2004). Cross-cultural perspectives of disability views among culturally and linguistically diverse populations. TSHA Independent Study.×
Tomoeda, C., & Bayles, K. (2002). Cultivating cultural competence in the workplace, classroom, and clinic. The ASHA Leader, 7(6), 4–5, 17.
Tomoeda, C., & Bayles, K. (2002). Cultivating cultural competence in the workplace, classroom, and clinic. The ASHA Leader, 7(6), 4–5, 17.×
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January 2008
Volume 13, Issue 1