The present project aims to bring accessible assessment and treatment for speech and voice disorders and autism, to children at the Sele Enat Mahiber Orphanage, through telepractice. Children at the Orphanage are not presently diagnosed for communication disorders, and some conditions might go unnoticed, for which early therapy would be extremely beneficial. The Hofstra Speech-Language Hearing Sciences Department will collaborate with Sele Enat Mahiber, to make speech pathology care available: we will provide assessment and intervention by telematic devices. Collaborating with NEPAD, we will work to make telepractice a viable solution to receive speech pathology care in Ethiopia.

April 2019 – June 2019 - Work with the orphanage to determine which children need assessment and therapy. - Staff training: we will work with the Director of the orphanage, to identify local personnel who can assist during the screening and therapy. - Select and prepare computer resources and software needed to provide speech pathology care: this stage includes providing to the orphanage telematics resources they need; assuring encryption of data, to be collected and transmitted during the therapies, to protect confidentiality and privacy of the patients. - Organize the communication settings for teletherapy. We will set up the video conference environment we will use to give the tests and then the treatments. Assistants from the orphanage will be present on site to help. Paris Huizinga, our collaborator from NJ, speaker of Amharic, will be present to translate in the interaction between the students from our Department, administering the therapies, and the patients. - Fundraising initiatives: we will fundraise for the duration of the project. A donor was found, willing to sponsor a sustainable funding for the project: buying small crafts (change purses, necklaces, bracelets, etc.) handmade by women-owned local businesses in Addis Ababa, and sell them here through local sales in the US. - Dr. Patrizia Bonaventura will work with Dr. Roberts and Prof. Silverman, to identify students who can administer tests and treatments in a new situation of telepractice. - Once the possible disorders of the children are identified, we will discuss with Prof. Silverman, on how to adapt existing tools for assessment and therapy techniques, to this new condition of therapy at a distance July 2019 - February 2020: - Therapies will be administered for the identified disorders. - Outcome data on improvements of the children after the therapies will be collected and analyzed, to evaluate the effectiveness of the therapies and of the process of delivery of services at a distance. - Outcome data will be discussed together, by the Hofstra Speech-Language Hearing Clinic, the Sele Enat Mahiber Orphanage collaborators and the NEPAD representative. - Possibility of applying teletherapy at the Sele Enat Mahiber for other disorders, and to try telepractice in other countries or settings will be also considered.

Following recommendations by the American Speech and Hearing Association and the WHO, we could start a pilot training program for local health providers, teachers, parents and other personnel, who could be administering speech pathology care in the future. Possible interactions with hospitals and other health care facilities could be established, to improve local teletherapy techniques and to transfer the know-how that can be used to reach rural areas where access to speech pathology care is more difficult. Finally, the NEPAD representative can bring the results of the project to the Ethiopian Government, to evaluate the creation of future health care policies, including speech pathology telepractice as a regular standard of practice.

Dr. Patrizia Bonaventura, Assistant Professor of Speech Pathology in the Department of Speech-Language and Hearing Sciences at Hofstra University and UN-DPI representative, will lead the project, coordinating the activities; maintaining the contacts with the Ethiopian sites and collaborators; selecting, together with Prof. Roberts and Prof. Silverman, the services to be provided and the staff to perform the therapies; and coordinating the interaction with the NEPAD collaborator, Mrs. Chimwemwe Chamdimba. Dr. Jenny Roberts, Professor and Chairman of the Department of Speech-Language and Hearing Sciences at Hofstra University, will determine the contribution of the members of the Department to the project (students, professors, clinicians and supervisors); also she will contribute to the selection of assessments and therapies more effective for the children in the Orphanage. Prof. - Wendy Silverman, M.S.C.C.C./S.L.P., Director of Speech-Language Hearing Clinic at Hofstra University, will contribute to the selection of assessments and therapies more effective for the children in the Orphanage; will select and coordinate supervision of some speech pathology students who would administer the assessment tests and the therapies. Mr. Zelalem Etefa, Vice Director of the Sele Enat Mahiber Orphanage, Addis Ababa, will determine the contribution of the personnel of the Orphanage to the project; identify the children to be interviewed and supervise the telepractice process. Mrs. Chimwemwe Chamdimba, NEPAD Principal Programme Officer, and Policy Specialist, will contribute by creating liaisons with the Ethiopian Government, to assure that local regulations in terms of health care provision, are complied with; and will oversee the project, from the perspective of feasibility of use of the telepractices, to assure access to quality essential health-care services to people in Ethiopia and Africa. Mrs. Noura Huizinga, previous volunteer at the Sele Enat Mahiber, and native speaker of Amharic (language spoken in Addis Ababa), will be in contact with the personnel of the Orphanage, will explain the tasks and participate in the process of identification of children needing screening for speech disorders; she will also contribute to translation of the speech therapy materials, from English to Amharic. Ms. Paris Huizinga, daughter of Mrs. Noura Huizinga, and native speaker of Amharic, was volunteer for two years at the Orphanage, and will be the liaison with the personnel of the Institution, translating and making possible the administration of the teletherapy.

- Hofstra University, Department of Speech-Language and Hearing Sciences and Saltzman Center's Speech-Language-Hearing Clinic - New Partnership for Africa's Development Agency (NEPAD) - Sele Enat Mahiber Orphanage