This summer, Scotia Bank sponsored me to support the Step-by-Step School for Autism in Guyana, South America. All of the children have an autism spectrum disorder diagnosis, and a majority are functionally non-speaking. The school officially opened in 2011. Ten children attend the program, most stay from 8:30-12, and a few stay in the afternoon. My talented colleague, Dr. Jim Ellis, PhD, BCBA-D, assesses the children as they come in, and writes up all of the ABA programs. As far as I know, he’s the only person in the city (more likely the country) that diagnoses children with ASD. He visits several times a year, brings supplies, and supports the staff through Skype sessions and video.
The school sits on the top floor of a car dealership. If you look closely, you can see a trampoline in the top right…which is their outdoor space.
I think I underestimated the cultural adjustment. While the primary language is English, the dialect is Guyanese Creole, a form of Creole influenced by African and East Indian languages. A couple of days new families came in to meet with me at the school; luckily one of the head tutors was there to gracefully interpret and mitigate any language difficulties. Everything was different from what I was used to–the roads, the livestock wandering the street, the weather, the sound of generators. Not an ATM in site. I did love the mangoes I got to eat every day, and the neighbor next to the school had three beautiful (and loud) McCaw Parrots for pets, which were amazing.
Most of the families do not have enough money to pay tuition. The cost per child is $4,800 per year, which pays for the tutors’ salaries. Assistance is also given for snacks and transportation costs if the families need help. That’s right, tutors make about $480 per month, which is considered relatively high for teachers. And don’t think the cost of things is much lower… I spent 300 Guyanese dollars on a bottle of soda, which was about $2.
In Guyana there are no speech-language pathologists per say, rather there are trained “rehab techs” that, after 18 months of training provide OT, PT and speech services to children and adults. The pay is so low, that qualified people simply leave, so there are simply no speech-language pathologists in the country.
Kudos to the tutoring staff there, aside from a few who have children with ASD, very few of the tutors have any teaching experience, let alone experience with autism, but they do remarkable work. They work around the power outages, flash floods getting to work, and that one morning where we didn’t have running water. The entire program is supported by donations from private citizens and businesses, so finding consistent financial support is a struggle. Despite these obstacles, the students are clearly benefiting.
I appreciated that the tutors welcomed me, a total stranger, into their school. In the mornings, I observed or worked with the students and tutors. In the afternoons, I conducted training and workshops. A few of the rehab techs from the hospital came to the school, observed the tutors working with the students, and then stayed for training. The majority of my time was spent modeling how to use each student’s communication system, evaluating language, and coming up with communication and language goals.
First, however, the tutors needed a foundation. While I evaluated the students, I assessed the most practical things that the tutors needed to learn. It’s important to know why you are doing what you are doing, so lecturing at them wouldn’t be helpful (let’s face it, none of us really learn that way). Every day, I divided the seven tutors into groups, one group per table. Each table had slightly different materials, whether it be games or books. Every day, the tutors made therapy materials, and then role-played with their partners using the materials to support the games or books on their tables. Then they swapped tables and partners. This was important so they could naturally provide feedback to one another. So, in 10 days, the tutors focused on:
- How to create communication books and use pictures to communicate (we made 10 in 10 days!)
- Preliteracy activities: How to modify and present books to enhance language
- How to use play to support language development
- How to use Boardmaker® software
- How to use an iPad to support language and social skills (iPads donated by the British High Commission)
- How to use pictures and language to support transitions
- How to use functional sign language to support language development
- Typical language development for grades K-1
Learning language through play
One statement that stuck with me, was one tutor who said she loved the sense of teamwork that she felt that week, every tutor pulling together to make materials for all students. Another commented how nice it was to play, and to see how the students responded. The students were amazing and so responsive to intervention.
So, I’m hooked. We will keep collaborating via Skype, and I’m sponsored for two more trips this year. And in August, I will go back to my public school with my newfound perspective of gratitude, and what can be possible.
For more information about the school, please visit the Step by Step Foundation, or feel free to contact me directly by posting to this blog.
Kerry Davis, Ed.D, CCC-SLP, is a city-wide speech-language pathologist west of Boston. Her areas of interest include working with children with multiple disabilities, inclusion in education and professional development. The views on this blog are my own and do not represent those of my employer. Dr. Davis can be followed on Twitter at @DrKDavisslp.