Hi again...still Sunday mid-day and we've already been awake for 8 hours. We started our Sunday morning at 420a, so we could jump on a flat-bottomed boat on the Mekong River to travel to the floating market. There were 9 of us who opened our eyes way too early this morning, but in the end it was worth the early start-time.
Let me catch-up on yesterday (Saturday) and then I'll give you the scoop on the floating market. :)
So, we were expected at the Children's Hospital yesterday, as because of New Year's they were working on Saturday, so we arrived at 830a. There were, as is typical, the 4-5 therapists sitting and waiting for us, but no patients for us to see. After sitting for about 10 minutes, Dr. Phuong arrived and explained to us that we would have 1 patient to see this morning, at 930a, and that she would like us to do some lecture/answer some questions in the mean-time. We were more than happy to do this, so after about 5 minutes of silence (everyone was shy to ask a question), a question was asked.
 |
| Amy teaching how to engage children in play for development of communication |
Then Amy was asked a common question, which was 'how do you get children to talk who have autism?' Amy then went on to discuss, in really clear and simple ways, about the 1st step is to get children with autism engaging with another person through play and that this is the start of communication. Play is a difficult concept here in Vietnam, as it is in many places, as they don't typically play with children, rather there is a lot of rote education/learning (numbers, letters, colors, etc.) and little engagement in silly play and 2 person (dyadic) play. So, Amy walked through with them how this type of play can be constructed and that to engage with a child with autism, the child with will have to 'need' the adult with whom they are engaging. Basically, we want the child with autism to see the adult playing with them as the toy (i.e. a necessary part of the game). I will put in a little video to let you know what this actually looks like.
So, after about an hour or so, a little girl walked in with her mother. Amy and I both looked at her and instantly recognized her as a patient we had seen in 2007 initially. She was 2 years old then and is now 7 years old and is just as cute as she was before. I actually have a photo of this little girl and me in my office at home. It was so lovely to see her again.
She is now walking, although seems to need mom to steady her a little bit. She is a very hypotonic (meaning 'floppy') little girl and as a result, gravity is not her friend. When she sits on the floor, she looks like she is sinking into the floor, so we got her sitting on a little stool to make it a little more challenging for her. She was VERY shy with us, as it expected and just fine, so Amy slowly began engaging with her with a vibrating toy, called a jiggler. She really liked it and you can see she became more engaged as they played.
Here she is in all of her cuteness. She has gotten very tall and is very thin. I love her pig-tails.
This is her walking in with mom. She needs a little bit of help, but can walk independently now. She has previously had physical therapy here in Can Tho, but stopped some time ago. I recommended to her mom, if possible, that they start PT again to help her get stronger.
After much encouragement, she began engaging with Amy. She nearly figured out how to turn on the jiggler (you have to turn it), but wasn't quite strong enough to make this happen. She was trying over and over and did not want to share this shaky toy with Amy.
When we finished with her, it was apparently time to eat lunch...but it was only 11a. So...lunch was had and then we were allowed to take our 'nap.' Yep...I said nap!!! At the 2 children's hospitals, from (usually) 12 - 130p it is 'rest' and/or nap time...for the adults! Nice, right?!?! Day 1 we both slept for a little while and day 2 we both mostly read books on our Kindles. In any case, we followed directions and took our rest.
Dr. Phuong finalizing our lunch of vegetables with snake fish (Ca loc, in Vietnamese). The vegetables and fish were wrapped in rice paper with noodles and eaten in that form with a tamarind sauce,
All ready to roll it up for eating. Delicious!
So around 1230p, after rest time, Dr. Quyen, the pediatrician that has a large caseload of children with autism, came to collect us to travel to her clinic in Can Tho. This is another funny uniqueness in Vietnam...folks are always very concerned we might get lost if traveling around on our own or when we express an interest or plan in walking to our next destination, this creates high levels of concern. It is a very hospitable culture and everyone is so kind, but we are so used to walking from here to there, it always is a little funny.
So, we all traveled via taxi to Dr. Quyen's medical clinic. It is a lovely building and we think her father may also be a physician, but are not completely sure. Her clinic is on the 2nd floor. When we arrived she had completed a schedule for our time on Saturday afternoon, Monday afternoon and all-day Tuesday. Amy is mostly taking this project on, as this is her specialty and her love, and I am primarily going to be offering some motor perspective, as appropriate, and taking videos/pictures during her work and to anything/everything I can do to help her. :)
 |
| Dr. Quyen's office. She set it up like this for today. So great! |
 |
| Amy and Dr. Quyen talking about the plan for the day |
Amy did a fantastic job of working with these children and with their families, teaching them good, simple strategies that will allow them to start engaging with their children. This 'project' will be an ongoing venture for Amy with Dr. Quyen, as there is just simply not enough time for us to answer all of her and her family's questions during this trip, but that is the beauty of email and we will be able to continue this work during future trips.
Here we go...
The 1st child Amy saw was an 11 year old boy, called Bao (pronounced 'Bauw'). He has a diagnosis of autism, but as we spent time with him he presented with abilities consistent with those children with Asperger's Syndrome. Let's just say Amy and I totally adored this kiddo! His family's main concern is that Bao has taught himself to speak English strictly from watching television and as a result, he is reluctant to speak in Vietnamese and when he does speak in Vietnamese, he has more of an American accent vs. Vietnamese accent. He is incredibly intelligent and as we discovered is fully bilingual at this point. His Vietnamese is intact, but per our translators, is not as clear in its pronunciations and use of words typical for an 11 year old. His family only speaks Vietnamese, so you can see this creates a bit of a challenge. Watch his videos and they will make you smile...
The next child was Thu, Dr. Quyen's 5 year old daughter. Thuy's father also came to meet with Amy and like Dr. Quyen had some important questions to ask of Amy. They also have a 9 year old son who does not have autism. Thuy has demonstrated signs of autism since she was young. She is a beautiful little girl, with long pig-tails, and was quite tall for her age. She came in with her bag of toys, but throughout the course of the time with Amy, especially toward the end, she realized her toys...the toys from her home...were in her mother's office and so she started packing them all away in her bag to take them back. It was quite sweet. She exhibited signs of what many folks call 'classic autism.' She has some good potential, if her parents can work with her a lot.
The 3rd little boy Amy saw on Saturday was also autistic and he was 6 years old, called Bi (pronounced 'Bee'). Initially, he wouldn't come into the room in which we were sitting, but eventually he did. He, at the start, made no eye contact or exhibited very limited engagement, but after about 45 minutes of working with Amy and Amy teaching his mom how to best engage with him, he began talking a little bit (saying 'Ok,' and saying '3' (as in 1-2-3)) in the 2nd video...so exciting. With some good practice/intervention at home with mom, we hope to see him progress.
We were, as is typical and so lovely, offered a snack during the afternoon between patients. As always it was delicious fruit...
Dragon fruit. Quite delicious! You eat the white (the black are seeds that are edible) and the pink rind just peels away once it is cut.
A lovely assortment of bananas, oranges, pomelo (grapefruit) and pears (with dragon fruit in the background).
The final little boy we saw was a 5 year old with more severe autism, called Danh (pronounced 'Dahn'). He was very 'in his own world and was very self-directed, showing no interest or awareness we were in the room with him.
His mother had a little more difficulty learning how to try to engage with him, but she was open to trying and will have Dr. Quyen teach this little boy's babysitter how to engage with him as well, as mom is at work throughout the day. His is a tougher situation due to the level of his impairment, so we will see.
Needless to say, Amy was really exhausted after the conclusion of our day. I was just tired watching her work. She offered each family good ideas for where to start with their children and hopefully they will, along with Dr. Quyen, try to integrate these ideas into their daily lives with these kiddos.
Last night was a fairly quiet night...some Pho (noodle soup) at the Cam Chay (vegetarian) restaurant and then a stroll back to our hotel for an early night to bed, because...
we went to the floating market at 5a this morning. Here's a few photos and a little video of what it's like. It really showed the 'water' culture that is the Mekong Delta. It was a little chilly ~ shocking, I know ~ so I was happy to have worn a long-sleeved t-shirt...a first for me in Can Tho.
Our driver and our boat...heading down the Mekong River. It's early...
Petrol station on the river. There were a few of these along our journey. The Mekong River sees a steady amount of boat traffic.
Amy...happy she brought her rain coat to help her stay warm. It was also raining a little bit throughout the morning.
Getting Ca Phe Sua (sweetened hot coffee) from a vendor who pulled up to our port-side and tied to our boat and delivered hot Ca Phe Sua to those who wanted some...for about $0.35.
Sun is just starting to rise...time to wake up!
There are 4 boats in this picture. Our boat (railing in the bottom, left-hand corner), 2nd boat (with man in black shirt standing), 3rd boat (woman with blue top + hat), and 4th boat (with tire on its side). There wasn't much space...very tricky driving.
This is a traditional boat, propelled by 2 oars that cross in-front of the person in the back of the boat. Often times it is the women who are in charge of the boat.
This is a house boat...with some bright, sparkly lights. We thought it might be the party boat of the floating market?!?!?
The bow of a boat with lots of live plants and flowers perched upon it. Lovely!
There were several dogs on boats. Not sure my sister's dog, Olivia, would like to exist on a boat??? She'd keep watch though.
Another puppy...watching things go by.
Baby bananas for sale.
Little boy counting his money, as he was the seller of the bananas and pineapple on a stick. His mom was driving the boat.
This is a little video of us motoring around the market...
This is an old ferry boat that is no longer in use. During my first 2 trips to Can Tho (in 2004 and 2007), we had to cross the Mekong River on a ferry, as there were no bridges connecting the Mekong Delta to the mainland of Vietnam. There is now a bridge, so these ferries are no longer required. Amy and I believe this might have been one of the ferries that were in use in those early trips. We both kind of miss traveling to Can Tho via the ferry.
Lumber yard. These long poles are primarily used as scaffolding and to hold-up levels of buildings until the cement dries. You see them everywhere in construction here.
Sugar cane traveling down the river on a huge barge. It is pressed and the juice is enjoyed here in Vietnam. You can buy this on the street.
We returned at 730a (felt like 1030a), had breakfast and then went to the co-op...a large market to look around and get a couple of items. Then back to our room to rest/relax and take it a little easy. Might even take a little nap now. :) All-in-all, a good Sunday!!
Two more days of work here in Can Tho and then on Wednesday we travel back to HCMC (Saigon). As usual, the trip is moving along quickly, but has been lots of fun so far. More to come...
xoxo
Stacy
P.S. ~ This is primarily for my family, but all can take a peek. Amy and I were at the co-op market and they have anything and everything there. We were walking down an aisle and what did I see...
xoxo
SLL
Stacy and all,
ReplyDeleteJust an amazing trip, and your blog is fabulous!