Thursday, August 13, 2009

Looking back

With all the excitement of our final day, the rush to fit everything in - the meetings, the celebrations, the packing and the (extremely necessary) sleep - the final post had to wait until my feet were back on Canadian soil and my eyes were ready to open after a well-deserved day of rest.

The main goal of this trip was a clinical experience. An experience none of us would ever have gotten in Canada. Though few of us in the program had been lucky enough to observe for a half day at a cleft lip/palate or VPI clinic in London, the observations could never provide us with practical, hands-on experience in the area of cleft lip and palate. In Ontario, there are specialized teams at particular hospitals in only a few cities that even treat these children. There are a few very specialized speech-language pathologists working on these teams that get to be there from the beginning and intervene from birth. Afterall, in Canada these children are caught so early - intervention is at hand at the earliest moment and is accessible to any family that needs it.

A traditional placement might afford you some experience with a variety of clients - children of all shapes and sizes with all sorts of histories. But there is no traditional placement available to us that would allow us to intervene with this special population to work on resonance, compensatory articulation, nasality - not in such a direct, specialized, tangible way. We were right there, doing the therapy, assessing these children with feeding, speech and language difficulties - babies a few months old, babies with syndromes, teenagers with unrepaired clefts. We would be lucky to have even observed such intervention in Canada.

As a clinician in Canada, I am taking this experience and carrying it with me through every child I treat. I have truly learned what it means to collaborate with clients and families within a specific culture and to adapt my approach to fit the structural and functional abilities of each individual client. These very specific and special cases challenge us to think outside our box of "typical intervention" - out of our norms, out of our textbooks and out of our comfort zone. While traditional placements challenge us to put our studies into practice, this placement challenged what we know about typical (English!) development and what we take for granted about the typical children we see for intervention. It truly opened my eyes to special cases and our role as professionals in their development.

How do you do speech therapy with a teenager with a gaping hole in the roof of her mouth? I would never have had to ask myself that question in a typical placement, but I asked it Peru - and we answered it. We worked it out. We faced this huge challenge and I learned more about what it means to make a sound than I ever could have at home. I learned how difficult it can be, and I learned how valuable those skills are.

Placements always challenge us. Placements always aim to have us apply what we know how to do. We know how to do these things for children with cleft lip/palate - we are taught how to do these things; but when would we ever have the opportunity to use it without this placement in Peru? Likely never. I wish that everyone could have this opportunity to grow and experience this professional development. It is enlightening as a clinician to put your expertise into practice and to know that you have dipped your feet in to every area of your field, so that you know where you want to practice and you can find your nishe. Afterall, we all have the brains but we each have special gifts that lead us in different directions. How would you know where to go if you didn't know what your options were?

Thank you, Western, for the experience. For the opportunity to integrate my profession with social justice, participate in an interdisciplinary approach, gain critical knowledge about how SLPs practice in other countries, and bring our knowledge to a group of professionals and families alike that were eager to learn from us. It was an honour to bring them everything we could, but it was a greater pleasure to learn everything we did from each of them. I am a better professional - and a better person - for it.

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