Iowa LEND Trip to Puerto Rico

March 27, 2017

Last month six Iowa LEND trainees from Iowa's UCEDD flew to San Juan as part of a new collaborative partnership project with the University of Puerto Rico UCEDD to provide training and cultural exchange opportunities.

The project will focus on cultural and linguistic competency as well as a public health perspective on childhood disability in Puerto Rico and associated services, resources and supports. Research and policy projects may be developed beyond the exchange program. This reciprocal exchange experience promises to be of great value to LEND trainees in the Maternal and Child Health (MCH) network programs and the University of Puerto Rico UCEDD.

Yaniz Padilla Dalmau, PhD, BCBA-D, LBA, former Iowa LEND psychology trainee and native of Puerto Rico, will serve as a liaison between the two programs to identify student and faculty/staff interests and needs. She will also design a program to meet these needs.

While in San Juan, Dr. Dalmau and the trainees attended the Association for Behavior Analysis International's 2017 Autism Conference and toured the Puerto Rico UCED's facility. Trainees had the opportunity to observe an interdisciplinary evaluation and speak to the clinicians about services available in Puerto Rico.

The focus for the LEND trainees during this trip was to have a better understanding of the access to and delivery of health care services for children and individuals with developmental delays in Puerto Rico. Despite Puerto Rico's status as a U.S. Territory, federal regulations are not necessarily in place for residents of the territory. Through the ABAI conference and discussions with Dr. Dalmau, trainees have a better picture of the access and delivery issues in Puerto Rico including poor insurance coverage for ABA services, little local access to services in San Juan and beyond, high cost of living coupled with a low average salary, and no Spanish-based BCBA curriculum for students. These conversations were also geared toward the relationship-based culture in Puerto Rico and Latin America overall and how it affects the delivery of care for these patients.

The trainees' onsite visit to the local UCEDD clinic showed the delivery of these types of services in action. Due to lack of funds, the diagnostic clinicians were only able to do evaluations once a month, further eliminating access to these clinical evaluations. The evaluations were interdisciplinary based and showed the relationship-based care that Puerto Ricans value. While mainland United States value social relationships, time is not necessarily taken to develop those relationships. Social relationships are the cornerstone of earning patients' trust in Puerto Rico, and the UCEDD clinic visit showed the importance of forming these relationships.

This partnership will continue to grow over the next year with Iowa LEND providing continuing education opportunities through webinars and a trip for some Puerto Rico trainees to Iowa sometime next year.