Trip to Merida, Mexico

Group shot at Uxmal, Mayan Ruins

Whew! Back in the chilly Midwest after a service learning trip to Merida, (Yucatan) Mexico. An amazing trip to an amazing city; I don't even know how to start to recap. I'll start with a brief background about the trip.

Beginning in 2007, physical therapy students from The Ohio State University began what we hope will be annual trips to Merida to consult with physical therapists and staff at outpatient clinics, schools for children with disabilities, shelters and nursing homes. The trip originally was developed by Wheeling Jesuit University and 2007 was the first year that OSU participated.

My classmates fixing wheelchairs

In 2008, ten physical therapy students and five physical therapists along with two graduate engineering students and a teacher with special education experience made the ten day trip. We worked at many facilities; I spent most of my time at a privately funded school for children with developmental disabilities who were not permitted to attend public school. The children worked with a physical therapist and a language teacher in addition to their academic curriculum. Although the non-inclusive setting may seem to be behind the times, the program was very progressive in terms of intensity and the expectations they held for the children. Interestingly, the school also provided physical therapy to children with developmental disabilities who attended public school following an outpatient clinic model.

Dancing at Grand Opening of school's new location

As an aside, in preparation for the trip, I read some articles about the health care and political systems in Mexico. However, 11 days in Mexico, was not enough time to fully understand the idiosyncrasies of either system. I found myself asking many questions: What are the criteria for a child to be accepted or denied admission to a public school? Who funds physical therapy for the children who attend the public school but receive services at the private school? Surely, I have become so accustomed to the laws and funding sources available in the USA that I had long neglected these fundamental qualms that affect services provision. The timing of the trip came shortly after I had completed a presentation detailing early intervention services so Help Me Grow, IDEA, and even Medicaid were still on my mind. Although the systems in our country leave much to be desired, my experience in Mexico made me more appreciative of the services and systems we do have. The PT who served as my mentor for most of the trip put all my thoughts into words, describing our days as "a history lesson." Being of the generation that I am, I never experienced pre-IDEA schools. I never knew institutionalization. I have always valued linking knowledge learning from text books, lectures, or research to personal experiences. My experiences in Mexico helped me do just that.

Me standing in the chapel window at Hacienda Teya

The other component of the trip that resonated with my LEND training was our immersion in the culture of the city. Cultural competence is a buzzword that has come about as America continues to diversify. It's a core competency of our LEND program at OSU, but this trip has made me reflect upon its meaning. Surely, every city, state or region, every school, hospital or clinic has a distinct culture. But they are all a part of a broader culture which is American. How can I achieve true cultural competence when I only practice in cultures of the same main branch? Perhaps living and working within a different culture, one outside my comfort zone, is a step. It is unrealistic to think I could ever practice in every culture so as to become competent in all cultures. But I'd like to think I learned a few things that can help me practice in a more culturally competent manner. First, never underestimate the value of non-verbal communication. I was fortunate to spend much of my work day with people who spoke excellent English. At other times, however, I had to communicate with the rusty Spanish I learned about 5 years ago! Also, in Mexico I began to understand home programming in the context of their culture. It is easy to get into the habit of recommending the same set of ideas (in PT, exercises or activities) to patients or clients. It is easy to take conveniences and customs for granted and make assumptions. I learned this one the hard way, recommending that a patient try an exercise at home lying on her back on a bed. She gave me an interesting look and responded that she slept in a hammock. Talk about feeling sheepish! From this, I learned not to assume to know a patient's home environment without asking. In class, I can remember reading about a home health therapist who made a very poor first impression by not removing her shoes at her patient's door. Again, linking the knowledge to my personal experience is what really made me think.

If could write for days about this trip and everything I did, saw, and learned. It was a very unique opportunity and I would encourage anyone who has the chance to practice in another county to take advantage it! It is an experience you simply cannot replicate practicing in our country.

Last day at AUCD

Last day at AUCD

Today may have been the last day of the conference, but AUCD knows how to end with a hit! The awards breakfast was not only delicious, but also encouraging as many AUCD members and even trainees were bestowed with prestigious awards. A link to the video of the poster session awards is available.

Michael Strautmanis, a transition specialist for the Obama Administration and father of a son with autism, was a last minute addition to the plenary session with a focus on outcomes of the election. He spoke of the three issues of primary focus for the new administration including:
· Full funding of IDEA/Improvement of EI programming
· Choices for independent living for person with disabilities
· Employment options for persons with disabilities

Boy did his speech ignite a fire! (be sure to watch the video in two parts using these links http://www.youtube.com/watch?v=UY1wczjoNC4 and http://www.youtube.com/watch?v=HT5SmDduA_s My camera skills are poor but the audio is the interesting contenta anyways) He challenged his audience to actively support this agenda. At the board meeting which followed the plenary session, the AUCD board of directors spent more than an hour discussing the best course of action to support these issues and actions to take in response to Michael’s speech.

Other speakers at this plenary session included Marty Ford, chair of the Consortium for Citizens with Disabilities, Nathan Gonzalez, political editor for the Rothenberg Political Report (video link coming soon! ), and Julio Abreu, Senior Director Of Government Affairs: Mental Health America. These speakers helped us understand the results and implications of the 2008 election at the executive and legislative levels.

These are exciting times for persons in our field and all the political talk was a great segue into the next big AUCD event, the disability policy conference in April (27th-29th). Hope to see many many trainees at this next big event! Put this event on your calendar and talk to your training director NOW about this amazing opportunity!

Dat 3 at AUCD

Day 3 at AUCD

Another busy day at AUCD! I began my day with an early morning jog with a training director I met on day one. The first plenary sessions detailed the National Center for Birth Defects and Developmental Disabilities (NCBDD), a partnership between the Center for Disease Control (CDC) and AUCD. One of the first examples I think of when I hear the term “birth defect” is spina bifida/myelomengiocele. It was interesting to hear about the worldwide initiative for Folic Acid Fortification and see effect it has had in different countries. I also was intrigued by the term “Folic acid resistant spina bifida.” I think professionals and community persons can be guilty of assuming that in these times, the mother of a child with spina bifida must have not “taken care of herself” during her pregnancy. I think this term will be helpful in educating colleagues and others regarding the inaccuracy of this assumption.

At a concurrent session related to early intervention, the University of Connecticut presented data from OSEP (Office of Special education Programs) funded research project looking at gaps/area for improvement of training for Early Childhood/Early Intervention professionals. At their website one can find study reports and “two pagers” about each study. (www.uconnucedd.org/projects/early_childhood/publications.html)

One new and interesting fact for me was hearing the UCEDD in the US Virgin Islands describe their newly designed inclusive early intervention program and training for those professionals. If technology cooperates, I have a video of Yegin Habtes describing this program to the attendees. You may need to crank up the volume to hear it because there were no microphones at the session.

I decided to sit in on the autism SIG (special interest group) meeting during lunch. It was very informative and again got me thinking about the role of physical therapists in treatment for children with autism spectrum disorders. As a student, I have had mentors advocate for weekly PT treatment for these children and mentors who, in the absence of a true gross motor delay or deficit, allowing the parents and other professionals to focus on the child’s more significant needs. I am interested to hear other PT‘s and PT students philosophy on PT for children with ASD.

As it is Veterans Day and I am in the Nation’s Capital, I felt in appropriate to do some sightseeing. With the Patricias (from USC and Miami), I visited the White House, the Lincoln and Washington Memorials, and the Korean War and the World War II Memorials. Be sure to check out pictures from our afternoon a the trainee page on facebook or at shutterfly site: http://share.shutterfly.com/share/received/welcome.sfly?fid=82c142f639743e660031ecd658bfd733&sid=0AbMWrRyzcs2TiA

AUCD day 2

During the second day of the AUCD annual meeting, I was fortunate to be able to listen to Pat Morissey, AAD commissioner, address the LEND and UCEDD directors and later, the trainees. As part of both of her talks she reminded us that people "don't read" and in written communication, it can be important to get a point across succinctly. This is a concept we I am well aware of, scanning text-heavy emails myself. Pat recommended bullet points, so I am going to give it a try today.

Highlights of the day:

UCEDD/LEND directors meeting

**New administration in the White House means changes in personnel. If you know anyone suitable for a possible administrative job related to DD at this level, alert board at AUCD

• Talk of an Autism "Czar" to be hired as an expert in this area
  
• Policy areas of focus for AUCD:
  Employment,
  Higher Education,
  Transition services
  Health care
  Early Identification (Obama suggests newborn and 2 year old screenings for many conditions)
  Autism SERVICES- to complement research and training
  
• In this time of change we should all be prepared to offer new ideas, new solutions, and our reactions to change

Ideas for trainees

**Professional Training Resource Library (PTRL) is a collaboration with ISEI (international society on early intervention)

• many trainee resources (info about other disciplines, etc)
  
• training material related to DD and at risk populations 0-5 years can be submitted
  
• http://depts.washington.edu/isei/ptrl/PTRL_Purpose.ph

**Consortiums exist for post-secondary education and self-determination

**AUCD-AAID young professionals collaboration

• presents webinars of interest to early career professionals
  
• more info at http://aucd.org/template/page.cfm?id=608

Other highlights


**Research! America presentation by Mary Wooley

• researchers should aim to advocate for research funding and help the media and congress understand the importance of research. They understand their research best

**"Performance Measures" Song performance, video to come!
**Trainee Reception/meet and greet
**Outing with directors from Oregon: Art exhibit at Smithsonian Portrait Gallery/National Mall

And of course an early morning jog to the capitol building:)

Day one at AUCD

November 9, 2008

Day one at AUCD annual meeting!

My first day of the conference was packed with activities! I arrived before registration even began thanks to my early and uncomplicated flight from Columbus. At the National Training Director Council, I met trainee directors for LEND and UCEDD programs all over the United States. As part of the meeting, we shared ideas for facilitating networking amongst trainees. Imagine my excitement! There are some unique and interesting existing consortiums and collaborative efforts amongst trainees at LEND and UCEDD programs in the same states and/or region. One such effort is at UNC, Chapel Hill, where the LEND program collaborates with other “unidisciplinary” MCH funded programs on their campus. We all learned that MCH funds a variety of activities and trainees and faculty can find out what programs exist in their area by visiting MCH’s website. I gained some new ideas that will hopefully help me reach more trainees! You can contribute too by sending me your ideas for fostering relationships amongst trainees near and far!

I also sat in on a workshop on healthcare transitions from pediatric to adult systems of care. It was interesting to hear the challenges associated with transition of medical care and compare this to the transitions issues in the educational systems. (This comparison was not the topic of the session, but rather, a connection I made based on previous experience). I learned about a CDC disability and health initiative, free community clinics, and an institute for innovative transition. Talk about inspiration!

In the evening, a brief update on legislative issues throughout the past year was open to all conference attendees. The review was concise and informative and helped many attendees make sense of new legislation. I ended the evening with a walk downtown to a tapas bar with another trainee. There is certainly no shortage of dining options in DC, but I am still on a quest to find ice cream that can compare to J.P. Licks in Boston, MA.

I am looking forward to another full day tomorrow, particularly meeting more trainees tomorrow at the evening reception.

Remember to keep and eye on the facebook page during and after the conference for pictures and video from trainees!