Their ultimate destination? The largest craniofacial treatment center in the world, Centrinho — The Hospital for the Rehabilitation of Craniofacial Anomalies of the University of São Paulo (part of the Bauru School of Dentistry).

From March 13-17, the students were immersed in treatment and therapies for children and adults with cleft lip and palate and hearing impairment. At this renowned center, they learned firsthand how these congenital anomalies and deafness not only affect physical appearance, but often lead to complications in the ability to hear, speak, eat and even breathe effectively.

Each morning, Centrinho’s waiting room was filled with children and their families who came from all over Brazil, a country about as large as the continental United States, for surgeries to close cleft palates or cleft lips, installation and adjustment of cochlear implants for hearing loss, therapy to restore the ability to speak intelligibly, and other specialized therapies and treatments. The Â鶹ӳ»­´«Ã½ team stayed in student housing and studied with USP students, accruing clinical hours in assessment and treatment of children with communication disorders.

As part of their preparation to become speech-language pathologists, the students participated in family-centered interventions, learned how to make ear molds, were involved in an intensive speech therapy program, observed inter- and transdisciplinary team interactions, and discussed evidenced-based research and its’ application in treatment. They worked together with Brazilian speech-language pathologists, audiologists, plastic surgeons, ENTs, dentists, psychologists, art educators, occupational therapists and social workers, and they had daily discussions to reflect on what they had learned.

“Every day that I participated in the USP study abroad, I became more enamored and passionate about the field of speech-language pathology,” said Â鶹ӳ»­´«Ã½ graduate student Kaira Clapper. “The students at USP in the Fonioaudiologia [speech therapy] program shared their knowledge and clinical strategies as we worked alongside them … and as communications disorders professionals, we shared common goals.”

Linda I. Rosa-Lugo, associate professor and director of the Â鶹ӳ»­´«Ã½ Listening Center, was the faculty leader and inspiration behind the trip. She partnered with Jeniffer Dutka, a faculty member with the speech therapy department and the craniofacial center at USP, who had been a colleague in Florida before returning to her native Brazil. She also partnered with Michelle Bourgeois from the University of South Florida, who brought seven undergraduate students on the adventure.

This study abroad experience was the culmination of years of work to finalize an affiliation agreement between the Bauru College of Dentistry at USP and Â鶹ӳ»­´«Ã½’s College of Health and Public Affairs to foster research collaboration and student exchange in communication sciences and disorders. Faculty members and students from both institutions are focusing their efforts on aphasia, craniofacial anomalies, and deafness and cochlear implants.

In recent years, USP sent two groups from Brazil to visit the college. The March 2017 program was the first time Â鶹ӳ»­´«Ã½ reciprocated, in part because the complexity and costs of the program were intensified since it was a clinical experience, which required supervision in accordance with the American Speech-Language-Hearing Association.

“This program happened because a lot of people felt a commitment to student preparation, including the Â鶹ӳ»­´«Ã½ Global office” Rosa Lugo said. “Logistically, study abroad programs can be very challenging, and that commitment keeps you going.”

She noted that the program also contributed to two of Â鶹ӳ»­´«Ã½ President John Hitt’s key goals: provide international focus to our curricula and research programs, and be America’s leading partnership university.

Rosa-Lugo encourages all students to participate in a study abroad program, which can provide new insight and open their eyes to the potential of practicing their profession outside the United States.

“Students need to see the strengths of other countries,” she said. “They need to get out of their comfort zone, be open to new experiences and reflect on how those experiences are going to mold them not just professionally, but personally.”

Inspired by the success of this trip, Rosa-Lugo plans to bring more students to Brazil in the future so they, too, can expand their horizons.

Some 140 researchers and practitioners from across the United States and Canada came to discuss ways to serve individuals who have aphasia, a condition caused by a stroke or brain injury that affects two million Americans. Their focus was the “life-participation approach to aphasia� to help clients regain their speech and meet their personal needs and goals.

AphasiaAccess, a Moorestown, N.J.-based nonprofit that promotes the approach, sponsored the 2017 Leadership Summit March 17-18 at FAIRWINDS Alumni Center.

“The life-participation approach is a paradigm shift in how we think about the kind of life a person with aphasia can have,� said AphasiaAccess President Kathryn Shelley. She learned of the approach after her father had a stroke and she was desperate to find a way to help him.

“A lot of people who have had strokes and have aphasia are sitting at home,â€� said Janet Whiteside, director and founder of Â鶹ӳ»­´«Ã½’s in the Communication Disorders Clinic and an inaugural member of AphasiaAccess. “We believe it’s possible for people with aphasia to fully participate in life.â€�

Aphasia House was a perfect setting for the summit’s welcome reception March 16. The Central Florida Research Park facility offers therapy for clients with aphasia in a setting that simulates a home. Clients participate in therapy sessions in a comfortable living room, a spacious kitchen and thematically decorated rooms that evoke times in their lives and encourage communication.

For many of the summit participants it was the first opportunity to see Aphasia House in person.

“From the moment I walked in the front door, I was greeted with warmth and immediately recognized that the ‘house’ was welcoming, comfortable and perfectly appropriate for people with aphasia,� said Abbe Simon, a speech-language pathologist with Triangle Aphasia Project, a nonprofit in Cary, N.C.

“It’s thrilling to see it in living color,� said Elizabeth Hoover, clinical associate professor and clinical director of Aphasia Resource Center at Boston University. “Janet’s vision has been inspirational. You can’t exaggerate the influence she and this program have had on the aphasia therapy community.�

The summit participants also had an opportunity to meet Mark McEwen, a well-known CBS reporter who had a stroke and acquired aphasia in 2005. McEwen went through extensive speech, physical and occupational therapy to regain his speech and life. In recent years he’s spoken to clients at Aphasia House.

“You have to have someone say it’s going to be okay, that there’s hope,� McEwen said. “I want them to come away thinking, ‘If he can do it, I can do it.’ But you have to be stubborn and you have to stay focused.�

The reception launched two days of keynote presentations, breakout gatherings and poster sessions. Among the keynote topics were service operations and evaluation, client motivation in therapy, and using the media to influence communities. Seventeen roundtable discussions, 16 “share and care� sessions, and 39 poster presentations offered forums for the participants to present and learn about the latest strategies and activities that support life-participation therapy.

The schedule was effectively packed with content, but it also provided space for participants to build friendships and just be together, Shelley said.

Whiteside said she thought the summit was “synergistic.�

“It allowed researcher and practitioner to share collective thoughts to spawn new ideas,� she said. “It both energized and applauded the work of those who care for people with aphasia.�

Top two photos by Tim Berry/AphasiaAccess

Kent-Walsh studies the use of augmentative and alternative communication (AAC) by individuals with severe speech problems to express their thoughts, needs, wants and ideas. More than 4 million Americans, including many young children with developmental disabilities, rely on AAC aids and devices to supplement their natural speech.

In her new project, Kent-Walsh will evaluate the impact of an AAC intervention program for preschool children with severe speech disabilities that combines tablet technology with language-learning techniques.

The tablet technology is an iPad with an AAC application that displays an array of single-meaning graphic symbols on the screen that a child can select. Mass marketing of tablet technology has prompted an increasing number of families and clinicians to turn to tablets with AAC apps for young children with significant speech disorders.

However, simply providing a young child with an iPad with an AAC app will not lead to functional communication skills, according to Kent-Walsh, who directs the in Â鶹ӳ»­´«Ã½â€™s Communication Disorders Clinic.

Earlier AAC research suggested it may be very difficult for children to learn to combine graphic symbols to communicate grammatically correct sentences. But more recent studies, including a pilot project led by Kent-Walsh and funded by the American Speech-Language-Hearing Foundation, have revealed more encouraging results.

“We’ve found that even very young children with significant speech disabilities have the potential to learn to produce grammatically correct sentences using AAC when we implement short targeted interventions,� said Kent-Walsh.

In particular, interventions focused on early language and literacy can effect dramatic changes in children’s sentence production using AAC, she said.

The new project will enable Kent-Walsh and her team to conduct a larger investigation of an AAC intervention program with techniques informed by studies of child language disorders. They will teach young children the rules governing language structure and grammar so the children can generate multi-symbol phrases and sentences. Learning the rules will teach the children that each word in a sentence is important ― and that the word order is equally important ― to clearly convey a message.

Kent-Walsh and her collaborators believe these findings on language-focused interventions have the potential to impact AAC clinical practice in the years ahead.

“Without intervention services, the educational, social and employment outcomes for these children are not nearly as favorable,� she said.

In addition to advancing scientific knowledge of how children can use AAC to communicate, the study will help prepare a new generation of speech-language pathologists with expertise in the field. Undergraduate and graduate students studying communication sciences and disorders at Â鶹ӳ»­´«Ã½ will participate in all aspects of the study, including working with Kent-Walsh and her colleagues Nancy Harrington, instructor of communication sciences and disorders at Â鶹ӳ»­´«Ã½; Cathy Binger, associate professor of speech and hearing services at the University of New Mexico; and Lesley Olswang, professor emeritus of speech and hearing services at the University of Washington.

“AAC technologies and services can supplement or completely replace natural speech in individuals with severe communication disabilities,� Kent-Walsh said. “We are eager to develop new interventions so speech-language pathologists can take full advantage of AAC to help these individuals express themselves as early in life as possible.�

Kent-Walsh is the lead author of one of just eight invited papers recently published in the 30th anniversary issues of Augmentative and Alternative Communication, a highly ranked rehabilitation publication and the official journal of the International Society for Augmentative and Alternative Communication. Her article, “Effects of Communication Partner Instruction on the Communication of Individuals using AAC: A Meta-Analysis,� appears in the journal’s most recent issue.

She treasures the freedom she’s found in America, including freedom of speech. For Mello, that carries greater meaning than it does for many others. A paralyzing stroke at age 27 robbed her of the ability to speak, something she’s finally regained with help from Â鶹ӳ»­´«Ã½â€™s Communication Disorders Clinic.

“It was so frustrating,â€� Mello said about the stroke, which left her partially paralyzed and unable to speak. “I was so angry. I could hear and understand everything the doctors were saying. But they couldn’t understand me. My brain was scrambled. Thank God for Â鶹ӳ»­´«Ã½. They helped me get my life back.â€�

While non-Â鶹ӳ»­´«Ã½ doctors and physical therapists helped Mello learn to walk again, Â鶹ӳ»­´«Ã½â€™s instructors and graduate students at the clinic helped her with her speech. Mello progressed so well that she was able to pass her U.S. citizenship exam in May. She said this Fourth of July has special meaning to her because she now has the freedom to speak again.

To see a video about this story produced by the Orlando Sentinel click here.

“I always wanted to become a citizen,� she said. “This country is wonderful, so many opportunities. Then with the stroke, I had to fight. It was so hard. Now people can understand me again. I have freedom to be understood. It’s so wonderful. I promise you I make my voice heard at every election until I die.�

Jane Hostetler, the clinical instructor who oversaw Mello’s treatment at Â鶹ӳ»­´«Ã½, said she is in awe of the Orlando resident.

“With aphasia patients, all the information is in their head,� Hostetler said. “But they just can’t access it. They have to relearn how to think and communicate. We worked with her by coming up with strategies to help her speak, read and write. She really is an American hero to me.�

The Â鶹ӳ»­´«Ã½ clinic provides cutting-edge diagnostics and services to people of all ages in the community with communication and hearing challenges. Clients range from preschoolers to seniors and from those learning speech for the first time to those challenged by a loss of speech from disease. Graduate students of the Â鶹ӳ»­´«Ã½ Department of Communication Sciences and Disorders work under the supervision of faculty and staff experts to help clients. More than 1,800 patients were helped at the clinic last year.

The clinic staff and those who attend the clinic’s social Friday Club threw Mello a recent surprise Fourth of July party to celebrate her earning her citizenship. Staffers played the song “Hail to the Chief� when Mello walked in, presented her with flowers and led her to an all-American-themed picnic they had prepared.

Mello beamed as staffers and fellow patients showered her with red, white and blue balloons, flowers and streamers. She mouthed a thank you to Hostetler and Michelle Condemarin, the graduate student who modified the therapy sessions to include studying for the citizenship test last semester. Condemarin, who is scheduled to graduate next spring, hopes to work with geriatric patients with degenerative diseases when she graduates.

“She was nervous about the [citizenship] interview portion,� Condemarin said about Mello. “She knew all the answers, but it is stressful. But she did very well. It’s so nice to see someone do so well. It really makes all the work worth it.�

Mello said the team at the clinic changed her life. It was one thing to learn English when she was 15. It was another to relearn to read, write and speak again after her stroke. She plans to go back to school. She’s decided nursing is a bit ambitious at her age, but still wants to help others. So she’s looking at enrolling in a program that will lead her to become a physical therapist assistant.

“They did so much for me,â€� Mello said. “I love talking and to be understood again; that is freedom. I will always thank the people at Â鶹ӳ»­´«Ã½ for that.â€�

Individuals with acquired neurological damage, which may result in aphasia, may receive therapy at Aphasia House in the Communication Disorders Clinic. Aphasia House offers a full range of services for individuals with aphasia, from intensive treatment to traditional delivery (both group and individual therapy), as well as community support groups. Learn more at