For children in developing countries, corrective surgery for cleft lip and cleft palate is usually only the beginning.
The situation is especially difficult when surgery is delayed and speech has already been established. Speech sound errors learned before surgery often continue after surgery and children then need help to correct them.
That’s where RSF EARTHSPEAK comes in. Using a collaborative, community-centred approach, EARTHSPEAK trains parents and other lay people to become the speech teachers for children in need.
Established by Andi Jobe and her husband Richard Jobe from California, EARTHSPEAK has projects in Bogota, Colombia; Hyderabad, India and San Pedro Sula, Honduras, among others. Speech-language pathologists with the Nova Scotia Hearing and Speech Centres and professors at Dalhousie’s School of Human Communication Disorders have been involved with the project in Portoviejo, Ecuador for the past seven years.
Cindy Dobbelsteyn, Elizabeth Kay-Raining Bird, Raylene Delorey and various grad students have been traveling to the South American country once or twice a year for two weeks at a time and maintaining contact by email and phone the rest of the year. In Portoviejo, a city of 250,000 people and a large commercial centre for Manabi province, they work with volunteers of the local Rotary Club in developing a community development model. The Rotary is now coordinating a whole suite of services for children born with cleft palate, from surgery, dentistry and orthodontia to audiology and speech therapy.
Without intervention, these children often grow up unable to talk properly. Speech problems further impede education and employment, and can be a social stigma lasting a lifetime.
“It’s very hard to correct habits once they become well established,” says Professor Dobbelsteyn. “The children can be isolated, bullied or even rejected. It’s very distressing and highlights the need for education.”
EARTHSPEAK uses a unique speech teaching method coined “corrective babbling.” The technique involves parents teaching their children to correctly produce sounds. Parents and other caregivers are taught how to elicit and stimulate sound production during week-long “speech camps” or by trained teachers. Afterwards, the parent-mentors and their children are directed to practice as taught, once or twice a day for 10 minutes each time.
“It involves teaching one sound at a time, one syllable at a time,” explains Prof. Dobbelsteyn.
Establishing local expertise
Using the “train the trainer model,” the Dalhousie speech therapists would like to work themselves out of their current job with EARTHSPEAK. Before that happens, they’d like to see the expansion of the program throughout Ecuador and other Latin American countries. That goal came one step closer with a meeting with Lenin Moreno, the Vice President of Ecuador, on a recent trip.
“Every year we go, we feel a little more gets accomplished or solidified with this interdisciplinary approach and the Rotary Club is really the link,” says Dr. Kay-Raining Bird. “We feel this meeting was a turning point and we’re very optimistic and excited.”
Adds Prof. Dobbelsteyn: “Our hope is that the program can be sustained through those who have been trained in Portoviejo. If we can draw national support and expand this model across the country, the program will develop its own experts to keep it going.”
LINK: School of Human Communication Disorders
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