Bringing the Gift of Hearing and Speech to Nicaragua

Since 2012, a team of faculty and students from Missouri State University’s (MSU) Department of Communication Sciences and Disorders (CSD) have been impacting the lives of hundreds of Nicaraguans with hearing and speech disabilities.

Through the study away service learning program, faculty and students travel to Nicaragua and spend a week in the country providing hearing aids and screenings, speech and language assessments, and follow-up services to adults and children.

Dr. DiSarno fits a patient with new hearing aids.
Dr. DiSarno fits a patient with new hearing aids.

The program came to birth in fall 2011 when Dr. Michael Steer, then an audiology doctoral student, approached Dr. Neil DiSarno, the department chair at the time, with a proposal for a service-oriented study away program that would provide hearing aids to individuals in Nicaragua. With help from Barry and Chris Lydon, Dr. Steer’s in-laws, who are missionaries in Nicaragua, the first trip came to fruition in March 2012 with Dr. DiSarno and Dr. Letitia White, the current department chair, as co-directors.

Following the success of the initial trip, there have been four other trips led by Dr. White and CSD Professor Dr. Lisa Proctor, with another one scheduled for May 2015. More than 40 CSD students have participated in the trips thus far, serving more than 200 Nicaraguans in need.

While the first three trips focused primarily on conducting screenings and providing hearing aids and follow-up services, the two trips last year not only offered follow-up services, but also included visits to three special schools to help children with severe disabilities, as well as workshops to teach the staff about understanding hearing loss and augmentative and alternative communication and treatment of autism spectrum disorders.

According to Dr. White, the upcoming May trip will continue the work in the three schools. There will be several special education staff joining the trip specifically to work with non-verbal and autistic children. In addition, audiology graduate students will engage in a project to determine how those who have been fitted with hearing aids are benefiting from them.

Hearing Screening
Students conduct a hearing screening.

“Our goal is to develop and maintain relationships with the individuals with communication disorders and their families, as well as the staff of the special schools in order to provide sustainable services. We’ve found that these long-term relationships are critical in ensuring we provide services that are truly valued by the communities rather than what we think they need,” Dr. White explained. “We want to be culturally sensitive and make sure whatever clinical services we’re offering the Nicaraguan people are valuable for them.”

Dr. White and Dr. Proctor point out that the needs of those struggling with communication disorders in Nicaragua are different than in the U.S. because of several key factors—lack of access to technology, delay in early intervention, economic disadvantages and poor referral process as there are not enough professionals like speech pathologists and audiologists in the country who can help. As such, sustainability is a huge challenge and that is why the department has made a long-term commitment to this program.

Besides the opportunity for MSU’s CSD students to grow professionally and help deserving people in another country, the program’s benefits are many. For one, they get a crash course in cultural awareness as they work in a different environment and with a diverse group of people.

“The exposure enables them to better deal with individuals who are different than themselves when they come home and build confidence in working with a lot of people in unfamiliar situations,” Dr. Proctor said.

“They also see for themselves that happiness comes in different shapes and forms—not necessarily a new car or big house. While many of the Nicaraguans are poor, they’re happy and gracious,” Dr. White added.

Dr. Proctor and a student evaluate a child's communication ability.
Dr. Proctor and a student evaluate a child’s communication ability.

Another key benefit is the interprofessional collaboration between audiology and speech students and staff. They get to work hands-on alongside each other and experience for themselves what the other discipline does.

One good example of this occurred on one of the recent trips. Dr. White recalled how the audiology team had issues trying to test the hearing of a young boy with cerebral palsy so they referred him to the speech team to assess his communication ability. They used a simple communication board with pictures to engage him and he was able to pick up the pictures and put them in order. Seeing this happen, the audiology team were able to administer the hearing test successfully.

“It was an aha moment on how two disciplines can work together and go outside of the box to accomplish a goal despite the lack of resources,” Dr. White shared.

“I definitely enjoyed the collaboration with the audiology students,” said Jessie Goben, a CSD speech graduate student, who joined the January 2014 trip when she was an undergraduate and is part of the team going in May. “The experience taught me the importance of teamwork and how to build rapport with clients. After coming back, I had more confidence in putting my skills into practice.”

After five inspiring trips, there have been many memorable and rewarding moments. One in particular that stands out for both Dr. White and Dr. Proctor involved a mother and her daughter who was about 8-years-old. The team had just completed a screening at a church and were all packed up to head to the next location, which was an orphanage, when the pair showed up. So the team put them on the bus and when they reached the orphanage, the girl was screened and fitted with a hearing aid as she had hearing loss. Her mom was so thrilled and cried because her daughter was very shy and reserved, had been teased and picked on, and did not have many friends.

“We’ve seen this girl grow on subsequent visits and her mom has told us that she is much more communicative,” Dr. Proctor shared.

“Standing alone, both service-learning and study away are great teaching tools, but combined together, they’re even more impactful,” Dr. White said. “I wish every student could have this experience.”

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