|About the presenter: Susan Felsenfeld, Ph.D. is an Associate Professor of Communication Disorders at Southern Connecticut State University. Her research interests include using behavioral genetic methods to explore the etiology of complex developmental disorders of speech, primarily stuttering. She has published and presented numerous papers addressing these topics. Dr. Felsenfeld was a member of a recent NIDCD task force charged with developing strategies to stimulate epidemiological research in communication and related disorders. Sheserved as an inaugural representative of the American Speech-Language-Hearing Association to the National Coalition for Health Professional Education in Genetics meeting. Dr. Felsenfeld is a member of the Division #4 Fluency and Fluency Disorders and the International Fluency Association.|
|About the presenter: Judy Kuster, M.S. in speech-language pathology and M.S. in counseling, is a professor of Communication Disorders at Minnesota State University, Mankato. She is well-published in Internet resources and has presented at state, national and international conferences. She is the webmaster for Net Connections for Communication Disorders and Sciences and the Stuttering Home Page as well as the coordinator of this online conference. She holds Specialty Recognition in Stuttering and is a member of the Division #4 Fluency and Fluency Disorders. She is a member of the National Stuttering Association, the International Fluency Association and the International Stuttering Association.|
This presentation consists of information about the Senior Specialist Fulbright program and reports from individuals who participated recently in this special program that connected them with professionals and consumers interested in stuttering in unique and exciting ways. It is shared in hopes that others will take advantage of this program.
The goals of the Fulbright Senior Specialist program are
Applications are accepted 8 times/year on a rolling basis and are peer reviewed. If approved, the candidate's name and expertise are listed on a roster which is published. Organizations in other countries with a Fulbright program or a U.S. Embassy can request someone with the candidate's qualifications and interests. If you are "matched," you are notified of an "invitation" and given the opportunity to accept.
Reimbursement for the Fulbright includes round trip airfare (a U.S. carrier is required), reimbursement for transportation expense to a U.S. airport and a $200/day stipend. The host country is also responsible for in-country travel expenses, housing, and money for food.
The above information and additional details are online at http://www.cies.org/specialists/. Both of the authors below, strongly encourage professionals interested in stuttering to apply for a Senioir Specialist Fulbright and professionals and consumers around the world to invite and host Senior Specialist Fulbright recipients!
I don't consider myself to be a terribly courageous person when it comes to international travel. However, when I read an email from Mr. Moussa Dao about four years ago describing his desire to have a stuttering specialist come to his West African country--Burkina Faso--I was certainly intrigued. Dr. Dao is a person who stutters and is the founder and current President of Burkina Faso's National Stuttering Organization (Action Contre le Begaiement, or "ACB"). His email described a place where stuttering appeared to be very prevalent and where people were eager to learn about the disorder and how to manage it. My next thought, of course, was how I was going to find resources to support such a trip. I had been aware of the Fulbright program for some time, but had not heard specifically of the Senior Specialist program. While browsing the main website of the Fulbright organization, I stumbled across a description of the Senior Specialists award mechanism and concluded that this was my best hope for funding. Once I decided to apply, I was pleasantly surprised at how straightforward and user friendly the application process turned out to be. After keeping my fingers crossed for about three months, I learned that I had been accepted as a roster member and, shortly thereafter, that I had been "matched" to the project Dr. Dao and I had proposed. The support I received allowed me to spend 14 days in Burkina Faso (June 1-15, 2007), with local host responsibilities shared by ACB and the University of Ouagadougou.
Burkina Faso isn't a place that is familiar to most Americans, including myself. It's a land-locked country in Western Africa about the size of Colorado that was formally called Upper Volta. The words Burkina Faso translate loosely into "Land of People of Integrity," which is both charming and descriptive. Over 60 ethic groups populate the country, most of whom belong to the Mossi tribe. While French is the national language, three native dialects (More, Dioula, and Fulfede) are the languages that are spoken outside of the capital city. Burkina Faso is considered one of the three poorest countries in the world, with a per capita gross domestic product of $424. More than 80% of the population relies on subsistence agriculture for survival. Recent State Department estimates place average life expectancy there at 48.5 years, and infant mortality rates in 2005 were listed as 96 deaths per 1000 births.
The primary objectives of my stay were to provide teaching and clinical consultation services. I did quite a bit of "teaching" while there, some of it quite formal and some very practical and applied. On June 7th, I presented a three-hour public talk about the disorder of stuttering at the US Embassy's Cultural Center located in the capital city of Ouagadougou (pronounced "wah-guh-doo-goo"). About 45 people were in attendance, including persons who stuttered, family members of PWS, classroom teachers, nurses, and students in various health-related disciplines. Because my high-school French is rusty at best, my talk was ably translated by a student who is majoring in English at the University. (It was quite a trial-by-fire for him.) The audience was very participatory, and we spent nearly an hour afterwards engaging in a wide-ranging general discussion about etiology and clinical management.
On June 12th and 13th, I gave a workshop from 9:00 to noon specifically for medical students at the University. These 35 students (and a few nurses who asked to attend) had volunteered to give up valuable time to learn about ways to identify and manage stuttering in the field. Because Burkina Faso currently has no speech-language pathologists, any treatment or advice that is offered comes from other sources. Right now, those affected by stuttering seek assistance primarily from doctors and nurses, teachers, or adult persons who stutter. In fact, although Dr. Dao is a pharmacist by training, he has become the de facto national expert on the disorder by virtue of his efforts at self-education and advocacy. The medical students I spoke to over these two days recognize that they will be on the front line in terms of managing this disorder, at least at the present time. Perhaps because of this, I found them to be an exceptionally engaged group. They were also good sports. At one point, I had this mostly male audience paired up into "therapist and child" dyads, practicing models of smooth and bumpy speech and using appropriate phrases to reinforce speech that was produced "with no bumps." This event was covered by the local media. Both Dr. Dao and I appeared on the local news that evening, and the print media ran a story about the disorder of stuttering and my presence in the country. Even better, the nation's (only) television station has decided to do a follow-up story featuring Dr. Dao. This will be excellent exposure for the ACB organization, and will also serve to educate a wide range of viewers about the disorder.
My first two full days in Burkina Faso were spent in three contiguous villages (Boromo, Wahabu, and Vy) located approximately 90 miles from Ouagadougou. These villages were selected by Dr. Dao because he knew they contained several large families with many stuttering members. (Boromo is the village of his birth, and many of his family memebers still reside there.) Because my area of research is genetics of speech disorders, meeting these "stuttering-dense" families was of particular interest to me. During my two-day stay, I met and informally examined approximately 60 children and adults who stuttered in these three villages. During these meetings, I communicated (with Dr. Dao's excellent translation assistance) with each person to verify that they stuttered. In addition, I spoke with parents of children about stuttering and provided some models of simple therapy techniques appropriate for both children and adults.
In order to approach persons in the village, it was necessary that I first be formally received by the village chief. Without his blessing, I would not be welcome to interact with the village populace. Dr. Dao had prepared the way for my visit prior to my arrival, so all of the chiefs were welcoming and supportive. The village chief in Wahabu took a special interest in my activities and sat with me for nearly an hour while I spoke with persons who came to see me. My experience in these villages was quite overwhelming. In some regards, it felt as though I was traveling back in time. The villages did not have electricity or running water. It soon felt almost normal to look up from the blanket on which I was sitting to see a sheep or a few chickens wander by and to hear goats bleating in the background. In Boromo, the crowd waiting to see the 'speech doctor' grew quite large, and there were still a number of people waiting their turn when the sun went down. Two women hastily disappeared and then came back with kerosene lamps which they quietly placed around my blanket so I could continue.
On June 9th (which happens to be my birthday), I met with children who stutter and their parents at a local elementary school in Ouagadougou. To make the consultation process manageable for me, Dr. Dao had invited about 12 families to this event, selected from a list of 150 families. (This, by itself, was a hear-breaking statistic). For parents of younger children, I provided a brief overview of the Lidcombe program and we practiced having parents provide reinforcement for smooth speech. For older children, we focused a bit more on fluency enhancing techinques, primarily Barry Guitar's flexible rate approach. My final group consultation occurred at a meeting of ACB members. About 20 adult PWS attended and we discussed their experiences as children and adults who stutter in this culture. Afterwards, I collected emails from everyone, all of whom expressed a desire to keep in contact.
In addition to these meetings, Dr. Dao and I met with two professors from the University of Ouagadougou who had expressed particular interest in the disorder of stuttering. The first very pleasant meeting was with Dr. Arouna Oudraogo, who is Head of Psychiatry. The second meeting occurred on the day prior to my departure and was a particulalry fruitful one. We met Dr. Lassana Sangare, a Professor of Microbiology who has a keen interest in Human Genetics. Dr. Sangare received his doctorate in Canada and completed post-doctoral training at Harvard's School of Public Health, so his English is excellent. At this time, I'm not sure whether we'll be able to put together a logisitically feasible follow-up project, but this is a possibility we will continue to pursue.
My trip to Burkina was not all work and no play. Moussa managed to squeeze in some wonderful side trips along the way. Along with his beautiful wife and two adorable sons (one of whom now apparently refers to me as Auntie Susan), we visited an arts and crafts cooperative just outside of Ouagadougou. It was filled with stall after stall of amazing local art. I bought ten exquisite carved animals from one vendor to give as gifts. From a transporting perspective, not necessarily the best choice, but it did allow me to make good use of my to-be-laundered clothes and undergarments. (Apologies to those who received one of these gifts.) One Sunday afternoon, Moussa and his family took me to visit the crocodiles. That was an experience I won't soon forget. I was literally surrounded by a group of adult crocs who had been trained to stay put when approached by humans. On my birthday we went to an outdoor cafe and listened to a band of African drummers while sipping cold drinks. I'm quite certain that will be a birthday experience that will be hard to beat.
When I wrote my final report for the Fulbright organization, I was asked what I had learned from this experience. I found this to a very tough question. In the end, here's what I wrote (with some post hoc polishing). It's woefully inadequate, but hopefully it will capture some of the powerful feelings of those days:
I first learned about the Senior Specialist Fulbright (SSF) program from Dr. Kenneth St. Louis, who went to Bulgaria in October 2005. Ken introduced me to Dr. Dobrinka Georgieva, the deputy director of South West University, Neofit Rilski in Blagoevgrad, Bulgaria. At the ASHA convention in Philadelphia, Doby and I shared a room. Several months later, when I received an email from Doby asking if I were interested in coming to Bulgaria through the SSF, after catching my breath, I responded with an excited "yes" and emailed Ken who was very supportive of the experience and process and encouraged me to apply. Funding provided by my Senior Specialist Fulbright was for 15 days (May 15-30, 2007) in Blagoevgrad in conjunction with South West University.
I lectured several hours at the university, through the translating expertise of three professors, to approximately 50-60 people -- students just beginning their studies, seniors soon graduating, department faculty, and speech therapists (logopeds). The lecture hall was large and comfortable.The technology was perfect.
My choice of topics combined my expertise in counseling, stuttering, and Internet informatics. Information about stuttering among logopeds in Bulgaria has been greatly informed in the past by training in Russia which focused heavily on outward behaviors associated with stuttering . Another approach often used in the U.S. focuses not only on outward behaviors, but also addresses important cognitive aspects (learning about stuttering) and affective aspects (feelings related to stuttering). After reviewing current thinking about the etiology and treatment of stuttering in the U.S., I chose to focus on the affective aspects in dealing with stuttering and the important counseling needs often seen in treating people communication disorders.
I was happy I had read some Bulgarian history that I could incorporate. One example - an important part of stuttering therapy is teaching appropriate pause patterns. I was able to relate how important a pause can be by recalling the story of a Bulgarian town that was not destroyed by invaders because of the change in a comma (pause) between "destroy the town, not spare it" and "destroy the town not, spare it." One of the students was from that town!
I also presented about the use of creative expression when dealing with affective aspects of therapy. This was well-received since much of creative expression supersedes spoken language. One activity was asking students to draw a picture of stuttering. Among the guests that day was a 13 year old who stutters. It was interesting to discover that he and one of the university students had drawn nearly the same picture.
Besides the university lectures I also consulted a full-day with 12-15 speech therapists on finding reliable professional information and freely-available therapy materials on the Internet.
I spent several hours consulting on an article being submitted for publication and with a faculty member on her Ph.D.study answering questions and finding articles, references, and materials available online. Finally, I consulted with the program director on professional certification and licensure in the U.S., including program requirements, practicum supervision, continuing education, differences in US and Bulgarian training programs and provision of therapy services, etc. as she is preparing a report for the European Union of Logopedics about their current program and plans for development.
We were surprised about the price of food, Internet, and taxi service. Together we could get along on 20 LV a day for meals (about $14 US) if we were careful. Internet access was only 1 LV (70 cents/hour). Taxi service to the university cost about $1.25.
Our host provided opportunity to visit two important places on our rest days - the Rila Monastery, Melnik (an interesting town close to the Greek border) and the Blagoevgrad museum.
We felt very safe in Bulgaria. Many children were out playing, carefully watched by parents and grandparents. Young women dressed in jeans and t-shirts or blouses. Spike heels are worn with jeans. Old women dressed in more traditional darker clothes, especially in the smaller towns, sitting on benches visiting. The pace of life seemed calm and content.
So many things I didn't understand at first - more than just the language. I don't know how to use the telephone, how to find things in the grocery store (we can't read the signs above the aisles of larger markets), how much we are paying for everything (we always have to check our conversion tables. Some grocery stores and restaurants list prices/kg so you have to figure out what the price/item will be), and which is the men's and which is the women's bathroom! Most stores had steps, and some with an escalator required you to step on the escalator to make it start. All the elevators hold about 4 people with no luggage. There are solar heated water barrels on the roofs of several buildings in Blagoevgrad. There seems to be much more concern about saving energy than in the US.
Communication was difficult. We quickly learned the difference between a U.S. and a Bulgarian "yes" and "no" head nod. They are close to opposite. A smile when passing another person on the street is not typically returned unless the person knows you. An acquaintence who spent six months in Bulgaria apparently did not understand that this is actually a cultural difference between Bulgaria and Minnesota. He had told me, "All the people in Bulgaria are so sad. They never smile!" It was frustrating not to have the language to be polite. "Please," "thank you," and "good day" were the first words we wanted to learn. I know how it feels to be illiterate - seeing all the signs and words but not understanding what any of them mean! I search for words not printed in Cyrillic - Ford, vodka, casino, etc.
We saw evidence of the recent political changes. There are many older statues of Russian liberators who helped free Bulgaria from the Ottoman Empire years ago. We see buildings that were begun prior to the changes in the 1990's that are not yet finished because of loss of funding. We learn about the last Bulgarian Czar who died under suspicious circumstances when he refused to turn over the Bulgarian Jews to Hitler. There is a huge building boom in Bansko (a town about 80 KM from Blagoevgrad ), There seems to be a real estate office on every block! People from all over Europe are investing in ski vacation apartments, and perhaps a place to retire. We see extensive construction everywhere. Our guide book relates the problems associated with the rapid political changes and how often entrepreneurship is hurting the country's ecology, including the ski runs in Bansko which are changing the ecology of the forests in the mountains. The current government is developing new policies to protect the natural beauty of Bulgaria.
It was sad to say good-bye to people who are not only gracious hosts, but have become truly good friends. We have learned a great deal from this experience and have a lifetime of memories!
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