When four University of Texas at Austin
students traveled to El Salvador to train clinicians to better
serve people with communications disorders, they had no idea how
much they’d learn. The College of Communication students
arrived at Centro de Audición y Lenguaje clinic in San Salvador
for PowerPoint presentations and a slew of classroom knowledge.
They left 10 days later with lessons and stories that will shape
Kolanko, Caroline Spelman and Scott Prath pose in the patio
of the clinic where they spent a week in May training Salvadoran
“It was an amazing exchange,” says graduate student
Scott Prath of his time at the clinic. “I think both groups
started out timid. They thought, ‘Here are all these young
kids coming in with book knowledge,’ and we thought, ‘Here
are all these self-made experts.’ And the exchange couldn’t
have been better. Toward the end, we fought over who got the education,
whether it was us or them.”
This is the fourth year graduate
students in the bilingual program in the Department of Communication
Sciences and Disorders have
journeyed to El Salvador. As always, they came home with experiences
that “blew our minds wide open,” as one student put
it. They watched 10-year-old Katy, whose family couldn’t
afford cab fare to the clinic, hear bird song for the first time
through donated hearing aids. They created a therapy strategy for
a boy who couldn’t verbalize the word “no” nor
any negation. And their Salvadoran colleagues cranked up salsa
music during the breaks and taught them to dance.
In El Salvador,
a developing country with a population of 5.5 million, only 40
to 50 clinicians serve about 150,000 citizens who have
communicative impairments. (By comparison, North Carolina, with
a similar population, has more than 3,200 speech/language pathologists
and audiologists.) Moreover, clinicians receive no formal training.
They graduate with degrees in special education and learn on the
job to work with clients with often very complex disorders.
Arias Mejia was able to hear for the first time through hearing
aids donated by a patient at Austin’s Audiology Diagnostic
“They are very committed and very hungry for information,
but they are poorly trained,” explains Professor Rodger Dalston,
who heads the El Salvador initiative.
Dalston first traveled to
El Salvador in 1998, at the urging of
Kendyl Richards, director of Austin Smiles. Austin Smiles provides
corrective surgeries to cleft lip and palate clients in Austin
and in El Salvador, as well as other countries. While cleft lip
and palate, both congenital defects, can often be corrected with
surgery, the client needs rehabilitation to relearn how to speak.
Austin Smiles is not able to provide that rehabilitation, and was
seeking ways to make that available to its clients. Richards drafted
Dalston to help her.
In 1998, Dalston and graduate student Kim McCollum
met with government officials in El Salvador and did an assessment.
training in El Salvador with that of his students in Communication
Sciences and Disorders, where the bilingual program is considered
the best in the country, Dalston saw an opportunity. His students
could benefit from immersing themselves in a different culture
and training colleagues with the knowledge they were mastering
in classes. Salvadoran clinicians could receive for free the clinical
education they hadn’t received.
It was a perfect match. Each
year that students travel to El Salvador they are greeted by lines
of clinicians waiting for them outside
the clinic at 8 a.m. Many travel long distances to attend the presentations.
Attendance averages between 40 and 50 participants, which accounts
for nearly every clinician in the country. And they keep coming
back year after year.
A recent attendee wrote on her evaluation
form: “Cada vez
que vienen me ensañan algo nuevo, lo cual pongo en práctica,” or “Every
time that you come, you teach me something new which I put into
practice.” Another wrote, “Me gustaría que vinieran
seguidos para capacitarnos más,”or “I would
like it if you could come again to teach us more.”
from all over El Salvador attend the presentations and create
a lively, informal environment.
who are selected for the project for their ability to speak Spanish
and their clinical skills, it offers an opportunity
they couldn’t receive anyplace else. And their enthusiasm
“When Dr. Dalston introduced the program at orientation
at the beginning of the year, I said, ‘Whoa, sign me up now!’” says
Holly Kolanko, who participated in the project this year.
chose the university based on the strength of its bilingual program,
and the El Salvador initiative gave her the opportunity
to combine her career goals with her love of Latin America.
“Even though it was such hard work doing all those presentations,” she
says, “I felt so lucky to be there and realize what an effect
we were having, and in such a culturally relevant way. We weren’t
going down and saying, ‘This is what you should do.’ We
were saying, ‘This is how we look at things, what do you
think of this? What could be valuable to you?’ It makes people
a lot more receptive, but it also makes sure that what they’re
doing will still be culturally relevant to the people they’re
The students devoted a semester to preparing
materials for use in their presentations. This year, they presented
two broad modules:
one on speech and articulation and one on preschool language. The
information was not simple, but it was basic, a foundation for
other learning. Much of the information was familiar to the clinicians,
but its organization and application were new.
“They learned a structure,” explains Prath. “They
know how to work with kids, but we shared how we structure therapy,
lining up goals and taking all this brand new information that
comes out every year and making yourself a better speech pathologist
to improve your kids and accelerate their growth.”
member Gail Goodrich Totten teaches articulation to four
deaf children in a clinic classroom.
in mind, the presentations took the form of an exchange. Clinicians
engaged in discussions with the students, participated
in game show format exercises and worked with case studies. There
were also tamale breaks, a two-cake birthday celebration for Prath
and shared stories about the challenges each group faces.
also had the opportunity to work directly with Salvadoran children
in the clinic. In these interactions they felt the measure
of the success of the project and the relevance of their training.
their last day at the clinic, they were asked to evaluate four
boys, aged 4 to 5, who were nearly completely deaf and had
no language skills. The Salvadoran clinicians posed the question, “How
do you do speech therapy on these kids?”
Gail Goodrich Totten, a clinical
faculty member in Communication Sciences and Disorders who accompanied
the students on the trip, took the
lead. The group got stuffed animals out and engaged the boys in
a competition to get the toy they wanted. Each animal was represented
by the sound in its name. The boys lay on the floor, playing and
competing, and by the end of an hour, the group was able to chart
which ones had which sounds, which ones were missing which sounds
and what type of plan could be used to help them.
“It was the first time we were forced to apply everything
we were learning,” says Prath, “and it came across
cleanly. It kind of gave you the shivers.”
exchange that the El Salvador project offers students provides
incomparable training for the realities of being
a bilingual speech and language therapist. Melissa Poole made the
journey to El Salvador in 1999, when she was a graduate student.
She now works as a bilingual speech language pathologist in Tuscon,
Ariz., at a clinic that serves mainly Spanish-speaking families,
and she volunteers at a clinic serving indigenous children from
poses with children in a San Salvador market. The students
were delighted to discover a Longhorn in the crowd.
“My experience in El Salvador not only helped me with my
clinical skills, including learning Spanish jargon for my profession,
but also allowed me to
have an understanding of the cultural aspects and its relationship to disability,” she
says. “The latter has been of immeasurable value in my professional career
and has allowed me to be a more effective and compassionate clinician.”
says the ultimate goal of those involved in the El Salvador initiative is
to work themselves out of a job. The Minister of Special Education
Salvador has expressed interest in establishing more formal programs in speech
pathology at two universities in the country, with University of Texas at
Austin students and faculty teaching modules to future Salvadoran
Until then, however, the College of Communication will
endeavor to send students down to work with their Salvadoran counterparts.
The clinicians will go back
to their jobs armed with better information and skills. And students will
come back with more than just stories to tell their friends and family. They
have irreplaceable lessons to take to their careers.
“I learned that there is never a situation in which you
cannot help a kid,” says
Prath. “I saw the worst cases I’ve seen in my life yet, and
they were nothing compared to what this clinic sees. And there was always
It doesn’t matter—you can do something, and it’s going
Photos courtesy Holly Kolanko