Cultivating Cross-Cultural Learning and Collaboration Among Special Educators Engaged in International Service-Learning

Abstract

The purpose of this project was to explore the influence of international service-learning on the personal and professional development of future special educators and speech-language pathologists. The service-learning students engaged in educational site visits, presentation of workshops, cultural activities, and interprofessional exchange in Botswana. Students completed surveys at the end of the trip and then participated in a focus group interview nine months after the study abroad course was completed. Findings from a qualitative content analysis revealed five emerging themes: open-mindedness, boundary spanning, cultural humility, skill development, and confidence. Implications for cross-cultural collaboration are discussed along with consideration for predeparture activities, high-impact educational practices, and student confidence in achieving professional skills standards.

Full text

Volume 9 | Issue 1 Article 10
Cultivating Cross-Cultural Learning and
Collaboration Among Special Educators
Engaged in International Service-Learning
Amy Rose
Western Carolina University, USA
Melissa Snyder
Western Carolina University, USA
Amy Murphy-Nugen
Western Carolina University, USA
Gayle Maddox
Western Carolina University, USA
Carol Isaac MacKusick
Western Carolina University, USA
Bontle Molefe
Botswana Society for the Deaf, USA
Recommended Citation
Rose, A., Snyder, M., Murphy-Nugen, A., Maddox, G., MacKusick, C. I., & Molefe, B. (2021). Cultivating
cross-cultural learning and collaboration among special educators engaged in international service-
learning. International Journal of Research on Service-Learning and Community Engagement, 9(1). Article
10. https://doi.org/10.37333/001c.31307

International Journal of Research on Service-Learning and Community Engagement
Volume 9, Issue 1, Article 10 | 2021 | ISSN: 2374-9466 | https://ijrslce.scholasticahq.com/
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Cultivating Cross-Cultural Learning
and Collaboration Among Special
Educators Engaged in International
Service-Learning
Amy Rose, Melissa Snyder, Amy Murphy-
Nugen, Gayle Maddox, Carol Isaac
MacKusick, and Bontle Molefe
The purpose of this project was to explore the
influence of international service-learning on the
personal and professional development of future
special educators and speech-language
pathologists. The service-learning students
engaged in educational site visits, presentation of
workshops, cultural activities, and
interprofessional exchange in Botswana. Students
completed surveys at the end of the trip and then
participated in a focus group interview nine
months after the study abroad course was
completed. Findings from a qualitative content
analysis revealed five emerging themes: open-
mindedness, boundary spanning, cultural
humility, skill development, and confidence.
Implications for cross-cultural collaboration are
discussed along with consideration for
predeparture activities, high-impact educational
practices, and student confidence in achieving
professional skills standards.
Keywords: Botswana, special education,
communication disorders, speech-language
pathology, international service-learning,
study abroad
Cultivando el aprendizaje
intercultural y la colaboración entre
los educadores de la educación
especial participando en el
aprendizaje de servicio internacional
Amy Rose, Melissa Snyder, Amy Murphy-
Nugen, Gayle Maddox, Carol Isaac
MacKusick, y Bontle Molefe
El objetivo de este proyecto fue explorar la
influencia del aprendizaje de servicio
internacional en el desarrollo personal y
profesional de los educadores de la educación
especial y los patólogos del habla y lenguaje. Los
estudiantes del aprendizaje de servicio
participaron en visitas al lugar educacionales,
presentaciones de talleres, actividades culturales,
e intercambios interprofesionales en Botswana.
Los estudiantes completaron encuestas al final del
viaje y luego participaron en una entrevista de
grupo focal nueve meses después de la
terminación del curso de aprendizaje de servicio.
Los resultados de un análisis cualitativo del
contenido revelaron cinco temas emergentes: la
apertura mental, la expansión de fronteras, la
humildad cultural, el desarrollo de habilidades, y
la confianza. Se discuten las implicaciones para
las colaboraciones interculturales y se consideran
las actividades anteriores a la partida, las prácticas
educativas de alto impacto, y la confianza
estudiantil con respecto al logro de las habilidades
profesionales.
Palabras clave: la educación especial, los
trastornos comunicativos, la patología del habla y
lenguaje, el aprendizaje de servicio internacional,
estudiar en el extranjero
Editors’ Note: English-to-Spanish translation by Megan J. Myers
Department of World Languages and Cultures
Iowa State University, USA

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For future and current professionals in special education (SPED) and speech-language pathology,
developing the interpersonal skills necessary to serve children and families of diverse cultural and linguistic
backgrounds is a critical priority. As the diversity of U.S. student populations increases, special educators
need to find ways to serve individuals who are at risk for disabilities (Taylor, 2010). Infusing “culturally
responsive pedagogical training and practices” is a necessity for all students to reach their full potential
(Kea & Utley, 1998; Taylor, 2010, p. 28). Additionally, professionals need to understand differences in
interpersonal and social behaviors, and how disability may be interpreted (Rogers-Adkinson et al., 2003).
Engaging in service-learning experiences that focus on intercultural awareness, knowledge, sensitivity, and
cultural humility may help address this need (Baecher, 2019; Morley et al., 2019). Baecher (2019) noted
that engaging in these experiences intensifies the students’ ability to “understand, respect, engage with, and
ultimately teach diverse cultural groups” (p. 1). The purpose of this project was to explore the influence of
international service-learning on the personal and professional development of future special educators and
speech-language pathologists (SLPs).
Although some teacher education programs have begun to incorporate service-learning experiences and
activities into their pedagogy (Byker & Putnam, 2019; Gay, 2010; Olmedo & Harbon, 2010), there remains
limited research on the impact of international service-learning (ISL) programs for special educators and
SLPs. SLPs receive their education in communication sciences and disorders (CSD) programs and upon
graduation regularly work side by side with SPED teachers in school settings. The SLPs’ role is to prevent,
assess, diagnose, and treat speech, language, social communication, cognitive-communication, and
swallowing disorders in children and adults. Byker and Putnam (2019) noted that study abroad coupled
with international teaching experiences have an impact on the development of global competencies,
intercultural awareness, culturally responsive pedagogies, and the fostering of empathy. These are all skills
needed by special educators and SLPs to create an atmosphere of academic success for the culturally and
linguistically diverse students that they serve.
The High-Impact Educational Practices of International Service-Learning
The current project bridges aspects of cultural immersion and service-learning for the purposes of
deepening learning among SPED and CSD students. Cultural immersion is defined as an experiential reality
that provides opportunities for participants to directly engage with individuals from cultures different from
their own (Ridley et al., 1994; Tomlinson-Clarke & Clarke, 2010). Cultural engagement is one of the
reasons Bringle and Hatcher (2011) suggested that ISL is a pedagogy uniquely designed to prepare higher
education students to become engaged “global citizens” (p. 3). They conceptualized ISL as the educational
intersection of (a) service-learning, (b) study abroad, and (c) international education (Bringle et al., 2011).
Although there are various definitions of service-learning, Bringle and his collaborators are most frequently
cited (Felten & Clayton, 2011). Consequently, their definition guided this project:
A course-based, credit-bearing educational experience in which students (a) participate in an
organized service activity that meets identified community needs, and (b) reflect on the service
activity in such a way as to gain further understanding of course content, a broader appreciation of
the discipline, and an enhanced sense of personal values and civic responsibility. (Bringle &
Hatcher, 2009, p. 38)
ISL deepens learning by exposing students to experiences that may heighten understanding of social
problems and inequities they may not otherwise encounter domestically while simultaneously placing
students in a cocreated and collaborative learning environment where shared power among all participants
is valued (Mitchell, 2008). The consideration of power and privilege is one way that ISL cultivates critical
thinking beyond traditional classroom instruction (Hartman & Kiely, 2014). Reflecting on power dynamics
at the personal and structural levels during service-learning activities provides an opportunity for students
to develop a more informed and critical consciousness (Hart & Akhurst, 2017; Sakomoto & Pitner, 2005).
Faculty frequently integrate service-learning and cultural immersion elements into study abroad courses
that are available to students enrolled in higher education institutions. Further, service-learning,

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community-based learning, and study abroad are identified as high-impact educational practices, which
may increase positive education results for students from widely varying backgrounds (Kuh, 2008).
Evidence to support the initial 10 high-impact practices (HIPs) came from data collected through the
National Survey of Student Engagement (NSSE), which suggested that purposeful, systematic, and active
learning processes increase rates of student retention and engagement. There are currently 11 HIPs (Kuh,
2008; Watson et al., 2016). For the purposes of this project, the HIPs of collaborative assignments and
projects (which promote self-understanding and appreciation of alternative views), diversity/global learning
(which increases understanding and appreciation of human differences), service-learning/community based
learning (which allows for structured reflection about how classroom learning informs community practice
and vice versa), and internships/field experiences (which provide direct experience in a setting typically
related to current career interests) are addressed (Kuh et al., 2017).
Although some researchers question whether ISL is distinguished from domestic service-learning in
general learning outcomes (Niehaus & Garcia, 2017), students participating in ISL are more likely to sustain
their international engagement and extend their experience as global citizens. Further, in general, service-
learning demonstrates high-impact learning experiences and personal and professional outcomes, including
higher-order academic performance, civic engagement, reciprocal collaboration, and personal development
(Felten & Clayton, 2011). Although research indicates that students participating in service-learning
performed similarly to nonparticipating students when assessing standard discipline knowledge, students
engaged in service-learning activities exceed their peers’ performance concerning higher-order, complex
tasks (Ash et al., 2005; Felten & Clayton, 2011). It may be that this deepened learning—the ability to think
critically about complex social issues—also lends itself to the sustained civic engagement that service-
learning cultivates. Service-learning participation is credited with enhancing students sustained civic and
political engagement, which demonstrates itself through civic efficacy, political interest, community
connectedness, and strengthened social solidarity as well as individual life skills (Astin et al., 2000; Eyler,
2011; Felten & Clayton, 2011). Personal enrichment related to service-learning is connected to various
positive attributes, including development in leadership, self-agency and confidence, psychological well-
being, and self-identity (Astin et al., 2000; Pless et al., 2011). Due to the exposure to diverse situations,
peoples, and environments that a student experiences through service-learning, particularly in ISL, a
personal appreciation for open-mindedness and deepened empathy may also be developed (Felten &
Clayton, 2011; Stanlick & Hammond, 2016). Through intersecting cognitive and affective processes,
another positive outcome of service-learning is an appreciation for reciprocal collaboration. As Felten and
Clayton (2011) succinctly explained, “service-learning encourages students to consider perspectives other
than their own and helps them cultivate capacities for making informed judgments” (p. 79). Transformation
and social change may occur in the community when students reflect reciprocal collaboration and
subordinate their judgment by valuing the contributions of other students, faculty, and community members
(Bringle & Clayton, 2012).
International Service-Learning and Special Education
Goals, competencies, and outcomes of ISL and cultural immersion study abroad courses in African
countries have been documented in several higher education programs, including programs in health
sciences and education (Coker & Majuta, 2015; Nickols et al., 2013; Tomlinson-Clarke & Clarke, 2010).
Yet, the literature is sparse when documenting specific learning experiences in Botswana—and with
students studying SPED/CSD, in particular (Heine, 2018). Since service-learning is identified as a high-
impact educational practice, it was instructive to explore any nuanced learning or community outcomes
associated with students studying SPED/CSD. At the time of the course, Botswana was experiencing an
overwhelming number of learners with special educational needs (SEN) in the public schools. Therefore,
the teachers needed knowledge and pedagogical skills for teaching learners with special educational needs
and exposure to positive practices of inclusion. Even more important, these learners needed prompt
screening, identification, diagnosis, and intervention because, with appropriate early detection,
intervention, and simple accommodations, they probably would not be deemed special needs. The lack of

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allied professionals to identify and intervene was a major obstacle because the National Central Resource
Centre for special education was critically understaffed to meet the needs of all SEN learners in the country.
When examining ISL for preservice educators, Holliday and Brennan (2020) proposed using a
transformative learning theoretical perspective and noted that reflection and hands-on tasks during learning
can be used to expand an individual’s worldview. Areas of exploration may fall under the general categories
of student outcomes, partnership outcomes, and program/system outcomes (Blosser & Means, 2018).
Regarding student outcomes, students in education-related disciplines learn the importance of describing
and measuring a child’s progress in high- and low-demand classroom situations. Partnership outcomes
involve creating effective, collaborative partnerships with parents, teachers, and other professionals to
develop effective individualized plans and strategies for helping children with communication challenges.
Program and system outcomes include making changes and/or improvements within the classroom, school
and/or community setting, resulting in more efficient and effective services for students with special needs
(Blosser & Means, 2018).
Another critical area of emphasis for students in education-related service-learning is the ethical
standards outlined by SPED and CSD national associations and programs of study—specifically the need
for increased cultural humility and linguistic competence. Yomantas (2020) has emphasized the need for
culturally responsive teaching in American classrooms and has recommended intensive field experiences
where future educators develop a critical consciousness through cyclical action and reflection. Students
engaged in service-learning find that their stereotypes are challenged and their cultural awareness is
enhanced; discipline-related problem solving and competency are strengthened; and appreciation for, as
well as response to, the community experience is increased (Crawford et al., 2017; Hoppes et al., 2005;
Knecht & Fischer, 2015; Kohlbry, 2016; Scott et al., 2005). The development of these personal and
professional attributes is relevant to SPED/CSD students as they cultivate clinical skills, learn how to
respond empathetically to students/clients, and develop critical-thinking and problem-solving abilities to
use in complex educational settings (Heine, 2018).
Being able to practice and cultivate clinical skills in environments where complex social issues exist is
highly beneficial to emerging SPED/CSD practitioners (Heine, 2018; Nickols et al., 2013). Although the
practical, real-time experience is noted as beneficial, client situations and needs in speech pathology ISL
environments are often described as unpredictable and chaotic (Heine, 2018; Pechak et al., 2013).
Consequently, preservice training—including role-playing and experiential opportunities—are critical.
Adding further complexity and significant learning to ISL experiences for students studying SPED/CSD
are cultural considerations (Johnson & Battalio, 2008). It is not surprising to find that students are initially
overwhelmed in ISL learning situations, given the complexity of social issues and cultural immersion.
However, it is also documented that students quickly acclimate to these challenges and deepen not only
their confidence and self-efficacy but also their clinical practice skills (Heine, 2018; Pechak et al., 2013).
Further, in being exposed to challenging situations, students studying SPED/CSD become engaged global
citizens—confronting access and quality issues in their future practice (Heine, 2018; Pechak et al., 2013).
Although these findings are overwhelmingly positive, given the considerations of using ISL as a
pedagogical approach with students studying SPED/CSD (i.e., ethical clinical practice, cultural
responsiveness, instructional expense), additional research is needed. The current study aims to generate
understanding of the impact of a cross-cultural and collaborative learning experience in Botswana for
undergraduate and graduate students representing the field of SPED/CSD. This study provides insight into
participants’ intercultural awareness, sensitivity, and cultural humility along with participants’
understanding of how children with special needs may be served in international settings. Several strategies
to increase cultural competency were embedded within the course to reflect on challenges and successes,
including debriefing sessions, reflective journals, and surveys. This analysis will focus on participant
surveys completed during the course and a focus group conducted several months after the course, which
was used to expand individual learning and reflection.

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Description of the Service-Learning Project
Considering the minimal research regarding students studying SPED/CSD with ISL experiences, and the
importance of providing opportunities to more effectively serve an increasingly diverse population, the
purpose of this study was to explore whether ISL influences the personal and professional development of
SPED/CSD learners. The significance of evaluating this high-impact learning experience is to assist
students in fulfilling the SPED/CSD professional standards that guide the ethical care of patients/clients.
Methods
A sequential explanatory mixed methods design was used for this research because the authors wanted the
participants’ experiences to guide the focus group questions. Both qualitative and descriptive quantitative
data were gathered, with a priority given to the qualitative data (Ivankova et al., 2006). To explore the depth
and meaning of the ISL experience and relevance of ISL to students’ global competency and cultural
responsivity, a case study approach was utilized (Creswell & Poth, 2018; Padgett, 2008). Surveys were
completed at the end of the experience and a focus group nine months post experience. The results of the
surveys were analyzed prior to conducting the focus group and the results guided the development of the
focus group questions. Surveys and the focus group interview at different time points provided a more
accurate representation of individual and group impact. Completing the surveys while engaged with
activities and experiences in Botswana captured the immediate impact of in-country interactions on
participants while the focus group completed nine months post trip captured a broader reflection on the
impact of the experiences on participants’ personal, academic, and professional lives.
The project was approved by the university’s Institutional Review Board (1042248-1), and informed
consent was obtained from all participants. The purpose and procedures of the study, benefits and risks,
right to refuse, privacy, and contact information were explained as part of the informed consent
documentation. This study presented no more than minimal risk, participation was voluntary, and names
were not published with the results of this study. Completed surveys and focus group transcripts were kept
locked at all times and destroyed after three years.
Participants
Participants in the study consisted of students from a single mid-sized public institution in a rural county in
the southern United States. Any undergraduate or graduate student majoring in SPED/CSD could
participate in the ISL study abroad course. The students were recruited through presentations in classes and
a flyer distributed through e-mail. The course was a joint undergraduate/graduate class titled “International
Service-Learning Project – Botswana.” The three-credit course was an elective and the graduate students’
participation counted as clinical hours. A total of 10 students enrolled in the course and went on the study
abroad trip to Botswana. Nine of the students were CSD majors and one was a SPED major.
All 10 participants completed surveys immediately post-trip and were invited to participate in the focus
group. Six participants attended the focus group session. Demographics can be found in Table 1. Four
participants were current graduate students, one senior undergraduate, and one student who graduated the
previous semester; all students were in the CSD program.
Case Context
Botswana, officially the Republic of Botswana, is a landlocked country in Southern Africa (see
Figure 1), with a population of just over 2.3 million. It is rich in both culture and language, with
10 percent of the population living in the capital and largest city, Gaborone. The official language
of Botswana is English, although Setswana is widely spoken across the country. The service-learning
students stayed at a lodge in Tlokweng, a village located directly adjacent to Gaborone, in the South-East
District.

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Table 1
Participant Demographics
Participant
Age
Education
Race
Gender
Previous
International Travel
Previous Intercultural
Experiences
1*
23
M.S., 2nd
year
White
Female
Personal Travel –
Jamaica, Bahamas,
Dominican Republic
Service-learning –
Nicaragua two times
Participated in a volunteer
service project, formal course
in a language
2*
32
M.S., 2nd
year
White
Female
Personal Travel –
Mexico, Canada, St.
Lucia, France, Spain,
Turks & Caicos
Hosted a foreign language
guest, participated in
volunteer service, personal
interaction in the community
or through social media,
formal course in a language
3*
23
M.S., 2nd
year
White
Female
Personal Travel –
British Isles, Mexico,
Canada
Formal course in a language
(Spanish)
4*
23
M.S., 2nd
year
White
Female
Personal Travel –
Mexico, Caribbean
Formal course in a language
5*
21
B.A.,
Senior
African-
American
Female
Volunteer Trip –
Costa Rica
Study Abroad – Spain
Formal course in a language
(Spanish)
6*
27
M.S.
White
Female
Teach English –
Chile, Spain
Study Abroad –
Mexico
Participated in a home-stay
exchange, a volunteer service
project, personal interaction
in community and through
social media, formal course
in a language
7
36
M.S.
White
Male
Military Service –
Kyrgyzstan, England
Language learning for time in
Kyrgyzstan; formal course in
a language
8
26
MAEd.
White
Female
Volunteer Trip –
Chile, South America
Participated on a farm,
learned and communicated in
Spanish
9
20
B.A.,
Senior
White
Female
Personal Travel –
Europe
Formal course in a language
10
23
M.S., 2nd
year
White
Female
No Previous
International Travel
Formal course in a language

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All ISL activities occurred in and around Gaborone. The main aim of the collaboration was to visit schools
that had been identified by the Ministry of Basic Education to share ideas with peer special education
teachers in those schools and learn from different practices. The collaboration would enable both the
participants and teachers to share expertise through discussions and recommendations on a
multidisciplinary approach through practice intervention. It would help to guide implementation of
intervention, support, strategy, assistive devices, and access arrangements. The collaboration would also
provide opportunities for both participants and special education teachers to gather information from one
another and to apply it beneficially to both their situations so as to improve delivery.
Figure 1
Map Showing Location of Botswana
Source: WorldAtlas.com
Partnership
A partnership effort to address special education along with other areas of need in Botswana has been
established between a State located in the southern United States and the Ministry of Education in Botswana
through the National Guard State Partnership Program and, more recently, through the State’s Department
of Military and Veterans Affairs. Principles and procedures of a Memorandum of Understanding signed
between the State and the Republic of Botswana include efforts to increase cultural awareness,
understanding of shared values, and promotion of common interests through cooperation between various

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agencies, along with sharing of human resources and expertise and providing the opportunity for
professional, scholarly, and governmental staff exchanges.
The partnership between the State and the Republic of Botswana is further supported by the State Board
of Education. Included in this partnership is a collaboration between the public university involved in this
project and the Department of Special Support Services (DSSS, 2013) of the Ministry of Education and
Skills Development in Botswana. This collaboration has included reciprocal visits by representatives from
each country.
Itinerary
Ten ISL students and two faculty members participated in the two-week service-learning/study abroad
course. The DSSS in Botswana played an integral role in planning details of the itinerary. There were three
key features of the project: educational site visits, presentation of workshops, and cultural activities. The
participants and teachers collaborated on the curriculum as well as the identification and discussions of
curricular activities. Participants observed classes in progress and interacted with the learners, special
education teachers, and staff. Also, participants were taught the culture, language, and history of Botswana
they learned about the education system of the country and specifically special education.
Educational Site Visits
Participants visited communities in the urban, peri-urban, and rural areas of the country. They visited
public schools and met with nongovernmental organizations that provide education to learners with special
educational needs. The educational sites served learners with hearing impairment, autism spectrum
disorder, and intellectual disabilities. See Table 2 for descriptions of sites and activities completed.
Workshop Presentations
Participants planned and presented a full day of workshops at a local public college in Tlokweng. The
college offers a three-year diploma in primary education, including special education. Participants
presented three 2-hour workshops to 40 attendees, including special educators, faculty, and Tlokweng
students. The “Early Intervention” workshop shared developmental milestones for speech and language
skills and stressed the importance of early intervention for children with developmental disabilities. The
“Augmentative and Alternative Communication” workshop addressed low- and high-tech communication
options for children with moderate/severe disabilities and provided examples of communication systems.
The “Developing Materials for the Classroom” workshop centered around autism spectrum disorder and
structured teaching methodology. Activities included approaches for engineering the classroom
environment, use of visual schedules, and creation of shoebox tasks. Due to the desire for activities to be
easily incorporated into special needs classrooms, a variety of hands-on learning activities (i.e., visual
representation of concepts, demonstrations of teaching strategies, and make and take products) were used
in all workshops.
Cultural Activities
Participants stayed at a game lodge in Madikwe, South Africa, and observed more than 27 species of
animals, including the big five game animals (lion, leopard, rhinoceros, elephant, and Cape buffalo). Other
outings during the experience included shopping, dining, and a half-day drive through the Gaborone Game
Reserve, a small national reserve inside the city of Gaborone. Participants learned Botswana traditions,
history, and language through interactions with children, teachers, and administrators and a visit to
Matsieng footprints, engraved petroglyphs dating back between 3,000 and 10,000 years. Traditional food
was provided; it included seswaa (traditional meat dish), mopane worms, and pap or porridge. The group
attended a farewell dinner at a popular craft store courtyard with local fare, song, and dance. Special
educators and administrators accompanied participants to meals and cultural activities for further sharing
of information related to language, traditions, history, and the educational system.

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Table 2
Educational Site Visits
Educational
Site
Location
Site Description
Activities Completed
Central
Resource
Center (CRC)
Tlokweng
Established in 1990 to assess
children with disabilities for
placement in special needs
classrooms and to provide
counsel to parents on their
child’s disability and resulting
placement decisions.
Formal introductions, overview of
work assignments; assisted SLP in
completing assessments with four
children and their families; participated
in producing written reports
Center for
Deaf
Education
Ramotswa
One of two residential
facilities serving children with
hearing impairment in the
country, with 100 children
residing at the school plus 18
academic staff.
Formal introductions, tour of facility,
speech and language assessments of 12
children; feedback session at the end of
the day with classroom teachers and
administration.
Ithuteng
Primary
School
Gaborone
A governmental primary
school with a Special
Education unit. Approximately
20 children attended the unit
with 3 classrooms and 3
teachers. Ages ranged from
early primary to adult, with a
variety of disabilities.
Formal introductions, tour of school; 5
speech and language assessments and
teacher feedback session. Results of
assessments were written by students
with recommendations including a
variety of learning and communication
strategies.
Camphill
Community
Trust
Otse
A nongovernmental (NGO)
residential facility established
in Botswana 40 years ago to
serve children with special
needs; currently serving
people from primary school
through adulthood.
Students toured the site and engaged in
a formal meeting with administration.
Princess
Marina
Hospital
Gaborone
The largest referral hospital in
Botswana, with 530 inpatient
beds and facilities for speech
language therapy, physical
therapy, and occupational
therapy.
Completion of 6 speech and language
treatment sessions. Students toured the
hospital, observed the newborn unit,
and walked through the children and
adult wards.
Measures and Data Collection
Sensitivity to Context
There are many methods to demonstrate sensitivity to context, including familiarity with relevant
theoretical and practice literature, empirical data, sociocultural setting, participants’ perspectives, and

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ethical issues (Yardley, 2000). The primary researcher was familiar with the theoretical and practice
literature related to discipline-specific clinical skills in SPED/CSD. Further, the primary researcher was
intimately connected with the sociocultural context related to SPED/CSD. All researchers adhered to the
highest ethical conduct throughout the research process. In addition to fulfilling requirements of human
subjects review, the researchers regularly communicated with their collaborators in Botswana, and one
collaborator is a coauthor of this article. Researchers were also sensitive to power differentials among
researchers, community collaborators, and student participants.
Student Survey
All 10 participants completed surveys upon their return to the United States. The first and second author
developed the survey, and the other authors and an additional expert researcher validated the survey. The
questions were chosen to gather information about participant interactions and skill learning and to provide
recommendations for future projects. The question format was similar for each group and contained three
Likert Scale questions (5 = strongly agree; 4 = agree; 3 = neither agree nor disagree; 2 = disagree; 1 =
strongly disagree) and three open-ended questions.
Focus Group Interview
The focus group interview took place approximately nine months after the study abroad course was
completed in a conference room on the university campus. Five of the participants attended in person and
one participant used Skype. The instructor/primary author and facilitator/secondary author were present.
The focus group session included an overview and purpose of the session, informed consent, introductions,
and ground rules.
The interview guide consisted of four open-ended questions and allowed for follow-up and probing
questions (Table 3). Each question for the focus group was chosen through group discussion among all five
researchers after a review of the survey results. The first question led to self-reflection and reflection on
how the experience impacted each student, either personally or professionally, or both. The second question
was a compare-and-contrast question that required respondents to engage in critical thinking about their
learning experiences in two different countries. It also related to an academic paper required for the course.
The third question encouraged respondents to identify their most impactful experience and its personal
significance. The fourth question related specifically to the university’s common read, The Bright
Continent: Breaking Rules and Making Change in Modern Africa by Dayo (Olopade, 2015). Specifically,
the researchers were informed by Olopade’s (2015) critical discussion of the outside-in approach that too
frequently accompanies Western-influenced aid and development activities in African nations. More
directly, Olopade (2015) referred to such white-savior interventions by a locally known acronym,
SWEDOW—or “stuff we don’t want” (p. 53). SWEDOW is the physical manifestation of outside helpers
who think they best understand community needs and opportunities in the absence of considering the
knowledge and expertise of local people. In essence, African communities become the recipients of
SWEDOW, instead of having Westerners partnering with the communities to build on existing assets and
resources. This question also came up during the site visit at the Center for Deaf Education when one of the
teachers stated, “When the white man comes, it rains.” The students were uncomfortable with this question;
more discussion surrounding the comment and the content of the book ensued, and this question was added
to the focus group as a follow-up. The session lasted approximately one hour, was audio-recorded, and was
transcribed verbatim.
Five researchers independently coded the surveys and transcripts using conventional qualitative content
analysis (Hsieh & Shannon, 2005). Conventional content analysis helps to identify, analyze, and report
patterns or themes within data and is an appropriate method to describe emotional reactions without the
researchers’ use of preconceived categories (Kondracki et al., 2002). As Braun and Clarke (2006) noted,
this type of analysis is widely used and offers an accessible and flexible approach to analyzing qualitative
data.

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Table 3
Focus Group Questions
1. Can you tell me how studying abroad impacted you?
2. What is the largest cultural difference you have seen between the two countries?
3. Tell me a story about one of your experiences in Africa. Why is this important to you?
4. Tell me what this phrase means to you: “When the white man comes, it rains.”
Data analysis started with each researcher reading the data several times to understand the data as a
whole, with no a priori assumptions (Manimozhi & Srinivasan, 2018). Researchers read the data, looking
for repeated phrases and concepts, then summarized first impressions and initial analysis. Impressions
became initial codes, which were then grouped into relevant clusters (Manimozhi & Srinivasan, 2018).
Researchers discussed codes and clusters found independently and reached consensus on five main themes
that emerged.
To demonstrate transparency and coherence, the researchers established a fit between theory and
method and addressed reflexivity (Yardley, 2000). The primary researcher maintained field notes to
illustrate the research process and provide transparency of subjectivity and bias. The field notes were used
to establish any bias and remove the bias from the data interpretation. In addition, the researchers included
extensive excerpts of transcribed text in tandem with their interpretations for the audience to follow the
interpretative process of articulating the ISL experience. Trustworthiness was ensured through independent
coding by all researchers, member checks, and peer review (Creswell & Creswell, 2018; Gibbs, 2007).
Member checks involved the researchers sharing the initial results with participants and asking them to
examine the findings relative to their own experiences to ensure that the findings were accurate and
plausible (Pitney, 2001).
Findings
Student Survey
A student survey assessed overall program success for the participants. In Table 4, mean scores ranged
from 4.6 to 4.9 on the Likert Scale. Participants indicated that they enjoyed the opportunity to interact with
SLPs and special educators from another country (M = 4.9), that the experience provided them with new
skills and strategies that may impact their work with special needs children in the future (M = 4.9), and that
they recommend this experience to other students (M = 4.6). Comments focused on educational site visits,
challenges, and recommendations for future trips.

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Table 4
Botswana: Student Survey
Survey Question
Mean Score (N = 10)
1. I enjoyed having the opportunity to interact with speech-
language pathologist and special educators from another country
4.9 (9 Strongly Agree, 1 Agree)
2. This international service-learning opportunity provided me
with some new skills and strategies that will directly impact how
I work with special needs students in the future
4.9 (9 Strongly Agree, 1 Agree)
3. I would recommend this experience to other students studying
communication disorders and special education
4.6 (6 Strongly Agree, 4 Agree)
!
Comments
4. What did you feel was the best
part of this experience?
• Going to the different locations to get a feel for many
different settings
• Being able to be hands on with treatment and assessments
• Being able to experience the safari
• Experiencing another culture/country
• Learning to be flexible
• Seeing new disorders I hadn’t seen during my clinical
placements
• Being able to learn and think on your feet in a place you are
not familiar with
• I feel the best part of this experience was having to be
flexible and having to use what few materials we had when
doing assessments and treatment. I think both of those
aspects will make me a better clinician
5. What would you change about this
experience?
• Spending more time at the CRC
• Break up the workshops into different days
• Having a day to catch up and rest
• Adding a little more history or culture of Botswana into the
trip
• More cultural activities need to be included
• Timing of activities; use time more wisely
6. What additional areas related to
communication disorders and special
education do you think should be
addressed in future works for
Botswana special educators?
• Have a workshop focused on Autism
• Full workshop on parent training
• Literacy, strategies for parents
• Social stories
• Classroom arrangements

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Focus Group
The focus group revealed five emerging themes: (1) open-mindedness, (2) boundary spanning, (3) cultural
humility, (4) skill development, and (5) confidence (see Table 5). Identified themes provide important
insight into the impact of this ISL program for CSD/SPED students. The five themes and their definitions
are not to be considered in isolation as there is some overlap among them. They provide a roadmap to
analyze and document growth in participants’ preparedness for working in diverse professional settings.
Table 5
Themes and Definitions
Theme
Definition
Open-mindedness
Open-mindedness is generally defined as being willing to rethink an idea or
concept despite having a previously formed viewpoint. Being open-minded
requires autonomy and has been shown to contribute to the effectiveness of
diverse teams (Hare, 2003; Mitchell et al., 2012; Taylor, 2017).
Boundary-spanning
Boundary-spanning acknowledges the need for acceptance of differing
perspectives but further addresses the ability to cross over disciplinary lines,
to learn from one another through both self-awareness and awareness of
others in public or private employment sectors (Muñoz & Jeris, 2005;
Needham et al., 2017, Weerts & Sandmann, 2010; Williams, 2002).
Boundary-spanning also includes competencies such as building
interpersonal relationships, fostering trust, and managing power relationships
(Williams, 2002).
Cultural humility
Cultural humility is defined as having two main characteristics, intrapersonal
(an awareness of one’s own limitations in regard to one’s own cultural
worldview and one’s ability to understand others’ worldview) and
interpersonal (other-oriented in relation to the other person’s cultural
background and experiences, marked by respect and lack of superiority)
(Hook & Davis, 2019). Cultural humility is identified as a need for
preprofessional skill development in both CSD and SPED programs of study.
Skill Development
CSD programs follow the Knowledge and Skill Acquisition Standards, which
delineate specialized outcomes for learning skills in evaluating and treating
children and adults with communication disabilities. Additional skill areas
include interaction and personal qualities, and oral and written forms of
communication. SPED programs follow Initial Preparation Standards as
outlined by the Council for Exceptional Children, with program requirements
of providing sufficient opportunities to develop and demonstrate appropriate
pedagogical skills, including extensive field experiences and clinical practice.
Confidence
Confidence is an encompassing theme that takes into account the many
activities experienced by the participants. Results from previous higher
education studies engaging college students in diverse experiences have
shown increased academic self-confidence, social agency, and critical
thinking when engaged in positive interactions with diverse peers (Laird,
2005; Roksa et al., 2017).

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Open-Mindedness
Participants found that they needed to be open-minded and aware of their preconceived notions and
stereotypes. One participant provided an example of a workshop that she and another participant gave to
the SPED teachers at Tlokweng College. The participants had a script and thought they knew what the
teachers needed; however, when they started the workshop, they realized that the teachers would benefit
from something else. They had to get rid of the preconceived notions and listen to the Motswana teachers.
Another participant had a similar experience where she realized she had biases and needed to observe and
listen to understand how she could best serve the people in Botswana. Many participants self-reflected
during the experience and realized they were taught as much, if not more, than they taught. One participant
stated:
I think we’ve learned a lot more, like life lesson wise from them and being there. … It was more
collaboration, like when the teachers during our presentation were like okay, well, we had scenarios
for them but then they were like, okay, well, my student is going through this. So, it was I do this,
what do you suggest? It wasn’t like we’re American and we are telling you to do this.
Additionally, they felt that the Motswana people had culture-related preconceived notions about them. They
reflected on a time where they went to a remote school and the students were all signing to each other,
“They’re white, they’re white.” One participant made a link to what was happening in their own country
and concerns about what may be preconceived about them, given a U.S. president who espoused isolationist
policies and perspectives:
I was embarrassed just being a white American because I don’t want to be associated with Trump.
... Just because I’m white, I don’t want to be thought of like that.
Many of the other participants agreed with this comment. Furthermore, the participants felt that it helped
them realize that they had preconceived notions. One participant commented:
I think it’s [learning about different cultures] especially important now because the news and media
like to feed you certain things about different cultures so you experience it first-hand. Especially
like traveling to Africa for me, because you always see the commercials of starving kids; so, a lot
of people think that’s all of Africa and that’s only what’s in Africa. So, it was nice to actually be
there and experience it.
One of the participants was African American. Reflecting on the meaning of the learning experience for
her, she noted an ancestral connection to the community as well as being challenged by competing ideas
she held:
Like wow, my ancestors are from here, this is so crazy. And then I think seeing the elephant that
was the moment, because at first, I was like yeah, I’m in another country but I don’t really feel like
I’m in this other country because we are staying at this inn and a really nice hotel in South Africa
and then we were out there and I saw that and I was like, ya know, elephants don’t roam around in
the United States. And I was like, this is Africa.
The feelings relating to open-mindedness were very personal for each student, with expressed linkages to
family dynamics and/or previous experiences.
Boundary Spanning
Participants largely felt that the experience gave them perspective on the world and other cultures. They
had to learn how to interact with people who spoke a different language and who were from a different
culture. When discussing cultural differences, the participants all agreed that punctuality and perception of
time were different. But they did recognize that learning this was valuable. One participant stated that she
learned to be more flexible about being on time and changing a lesson plan when the Botswana educators
indicated that they preferred something different.

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The participants bonded with one another. Most participants did not know one another before the
experience, and they learned how to build trust and interact with among themselves. Many thought that this
experience would help them as professionals, deepening their interpersonal skills when interacting with
patients and other professionals. For example, one participant stated:
I think that it kind of helped me with my patience. I’m a very impatient person; so, it helped me
just by having limited resources or schedules not lining up and helped me to kind of calm down
when it comes to being impatient.
Participants consistently noted the need for greater flexibility, especially with time management, and
learning to be patient with their peers and with those whom they met in the country.
Cultural Humility
Many participants had moving stories about developing cultural humility that helped them learn about
the culture of the people from Botswana. Participants stated that they had preconceived notions about the
culture. One shared that she recognized the need to keep an open mind and not go into the experience with
any biases and preconceived ideas about Botswana and Africa. Every participant nodded in agreement with
this and acknowledged the importance of listening to the people they were serving. For example, another
participant said:
We went in wanting to learn from them not so much you need do this, you need to do this.
Obviously, we came in with ideas of how we could help but it wasn’t our ideas were superior it
was wanting them to also teach us.
Not only did the students deepen their cultural humility, but they also had a greater sense of modesty
in general. A participant shared an experience that developed her introspection about significant life
challenges that may affect a client/patient. She shared that one of the patients was an 8-year-old boy
diagnosed with cerebral palsy and recently had his feeding tube removed. His mother had to carry him to
the hospital. Their challenges did not end there:
When we were done with the eval and sitting their chatting with her and asking if she was going to
go back to her village. Her mom had died the day before; so, she said no—that she had to travel to
that village. I don’t know, it was some long travel time, and I was like “wow, you came and got
your son therapy,” and I was just so shocked. I feel like I’ll always remember that when working
with patients.
Another humbling learning experience concerned possessions. One of the men working the night shift
at the inn was looking at the participant’s camera because he was also a photographer. She shared:
There was a picture of my old house on it, and they were blown away that I had a house, like,
myself. And that for me was pretty humbling and huge because I was like oh, I liked that house, I
didn’t love it but, and then I was like oh wow, that’s my house, I should be thankful for it.
As future SLPs and educators, participants expressed sensitivity for understanding differences in the
patients whom they worked with at the educational sites. They related their observations to previous clinical
or personal experiences with disability.
Skill Development
Most participants had a moderate amount of patient interaction; the second-year graduate students had
two years of supervised clinical experience in both child and adult settings with varying disabilities and the
undergraduates did not have any. The Botswana experience helped them realize how much they actually
knew and that they could be effective with minimal equipment. For example, one graduate student
participant reflected on an experience at a primary school where she and another participant were supposed
to assess children, and the only materials available were paper and pencils. The participants worked with a

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child with Down syndrome, and it was a notable skill development experience because they are used to
having games, materials, and fun toys that are interactive to get the patients engaged. They did not have
high technology, but they were still able to provide excellent care with paper, crayons, rocks, sticks, or
pencils. One participant stated that the most significant learning was that she did not need the most advanced
technology because she had the skills to do therapy with whatever was available.
A different participant had a similar experience while working with a 23-year-old male with cerebral
palsy. The Botswana teachers told her that the patient could not do many things. She created a
communication board and had the student point to things. She commented:
It shocked us with what he knew. So, it was amazing, and I felt good and proud that we were able
to come up with this board out of a piece of paper. We gave ideas to them, and they were super
receptive of it.
This went beyond developing hands-on skills. Participants shared an experience from an outpatient hospital
with a police officer who suffered from a traumatic brain injury. The participant stated:
He forgot his language, and I think both of us were about to cry because it was so neat to see him
come in with one of his police officer friends and see him try so hard. It made us realize that it’s
about making a connection with your patient. The more connection you have with a patient, the
more they will buy into the therapy. It was just a neat experience.
Participants used the skills they learned in Africa in their current education and practice. Two participants
discussed how they used what they did in Africa during their master’s project. They learned methods during
the experience, which gave them the foundation for exploring new ideas and increased their competence.
Similarly, another example of skill development came from a participant who did not initially think that her
experiences were going to be directly applicable to her job. She said:
I came back to North Carolina and thought I’m probably not going to be able to use a lot of this
stuff. But first thing, I got a referral for a little girl that had just gotten adopted from an orphanage
in China and she hadn’t been exposed to any English. … So, it was interesting using what I had
learned over there to transfer here.
Participants showed evidence of constructive learning as well. One participant stated that in classes
since the trip, she would think of how to apply to Botswana the material she was learning. During classes,
she would think of how she could use the skills in Botswana, how the particular class example would not
work within the settings in Botswana, and how she could have changed what she did with the students in
order to better help them. While participants were at different points in their educational careers, they each
expressed that skills or strategies that they learned in Botswana were continuing to influence new learning
and experiences.
Confidence
Participants felt that their confidence increased overall and would help them in the future. For example,
one participant shared that her confidence as a professional improved because she did speech therapy in a
different country with limited resources. She often thought to herself, “I can do this; I did it in Botswana.”
Participants also found that their confidence in dealing with people, working with limited resources,
and surmounting language barriers increased. The participants overwhelmingly felt that their ISL/study
abroad experience increased their confidence in their capabilities to be professionals and helped them
socialize to the profession.
Additionally, participants saw the confidence increase in each other. One of the participants, who was
an undergraduate, seemed less confident to the other participants. However, they had to complete a parent
interview near the end of the experience, and she led the interview and did a fantastic job. The others
commented on how she did not second-guess herself and it was a great interview. She herself stated:

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I am undergrad while everyone else is in grad school; so, I was really nervous. I’d say don’t second-
guess yourself because I was super nervous, and it wasn’t that bad actually, like being over there
applying stuff that I had learned in classes.
Participants consistently expressed their increased feeling of confidence after returning from the trip,
especially within academic or professional activities.
Discussion and Implications
Findings suggest it is beneficial for SPED/CSD students to engage in ISL. This is a contribution to the
current knowledge base as there is minimal research with this specific student population as participants in
ISL, in general, and in Botswana, in particular. Overall, participants expressed that their experience was
beneficial, both professionally and personally. Findings showed the participants felt that the ISL experience
provided them with new skills and strategies that would directly impact their future work in the field. The
focus group revealed additional insights into how the ISL experience affected participant growth in (1)
open-mindedness, (2) boundary spanning, (3) cultural humility, (4) skill development, and (5) confidence.
These findings support prior research on ISL (Crawford et al., 2017; Heine, 2018; Johnson & Battalio,
2008, Morley et al., 2019; & Pechak et al., 2013).
The high-impact practices associated with the project appear to contribute to both the personal and
professional development of the students (Kuh et al., 2017). This finding is a relevant contribution for other
instructors of SPED/CSD as they consider the most effective curriculum design to teach ethical clinical-
practice skills, empathetic and culturally humble relationship-building with clients/patients and the diverse
communities in which they reside, and strengthen their ability to be innovative and creative problem-solvers
in complex healthcare situations with diverse clients. Further, recent research has also indicated the ability
to deepen critical learning by scaffolding additional high-impact practices into ISL. Bringle (2017)
suggested complementing ISL with four other HIPs: (1) service-learning, (2) study abroad, (3) research,
and (4) internships. For the purposes of this and similar projects, it may be beneficial to integrate intentional
community-based participatory action research (Padgett, 2008), which may enhance reciprocal and
collaborative approaches with the local community and provide internship opportunities abroad.
One of the main purposes of this project was to expose SPED/CSD students to culturally diverse clients
and situations through an ISL experience. Some of the challenges noted in the student survey concerned
cultural issues. For example, participant feedback on Survey Question 5 (What would you change about
this experience?) indicated frustration with time management and timing of activities. In Botswana, the
arrival time for a meeting is more flexible than in the United States, and importance is placed on taking
time for personal interaction and communication. In the focus group, participants expressed that being
flexible and patient would help as future professionals.
Coker and Majuta (2015), who engaged in an international experience teaching a group counseling
course at an institution of higher learning in Botswana, found that respect is important to group dynamics,
with older group members providing mature feedback, social support, guidance, cultural value, and
credibility. Collectivism and giving advice also need to be appreciated because of their importance in
communities like those in Botswana. Some successful strategies to work through cross-cultural challenges
were identified. They include regular debriefing sessions to share concerns and highlight successes;
journaling; peer supervision; and learning as much as possible about the host country prior to travel,
especially its language and customs.
In addition, Coker and Majuta (2015) identified important elements of preparation activities, including
discussion of cultural content with students for their ISL participation. Yet other research indicates that
predeparture activities should expand beyond cultural content overviews to include role-playing and hands-
on experiential activities (Taylor et al., 2017). Team building during the predeparture phase of the course
may have helped to prepare participants more effectively to assign roles and develop strategies in working
together (Tuckman & Jensen, 1977). This expanded preparation seems particularly essential to SPED/CSD
students, who encountered challenging health- and/or education-related situations and needed to work
collaboratively with one another and with others to achieve their goals.

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The participants were initially challenged by complex issues and constrained resources encountered in
the ISL setting, which affirms prior research findings (Taylor et al., 2017). Kiely (2005) conceptualized
such service-learning situations as “disorientating dilemmas” (p. 7). Although these situations are described
as creating disruptions and dissonance for students, it is often where confidence builds and transformative
learning occurs in ISL settings (Hartman & Kiely, 2014; Taylor et al., 2017). The ISL experience provided
the learning environment to connect textbook knowledge with applied clinical practice. Further, it appeared
that this uncomfortable nexus underscored the overall purpose of this project: preparing SPED/CSD
students to respond more effectively to complex issues and diverse client populations.
The findings for the theme of confidence align with a finding from a study by Nickols et al. (2013)—
that students’ self-confidence increased as a result of ISL. It was noted that personal development related
to adaptability and maturity are frequently attributed to ISL experiences (Astin et al., 2000; Stanlick &
Hammond, 2016). For this course, student confidence appeared to increase over time and was frequently
expressed during the focus group discussion. Possessing confidence is critical for future educators and SLPs
as it will enhance planning abilities, increase resiliency and persistence, and help them be better models for
their students.
As the partnership between Botswana and the university has evolved, emphasis has been placed on
creating a reciprocal relationship with the sharing of ideas and strategies and learning from one another.
During the focus group session, students discussed that, while they were working with others and helping
their peer educators, they felt that they were being taught so much more. Being cognizant of who benefits
from service-learning experiences, as well as maintaining a balance, is critical to the success of the current
project and also to developing deeper relationships and creating opportunities for educators in both
countries (Hartman & Kiely, 2014; Meens, 2014). It is also worth reflecting on disorienting dilemmas here:
When students are properly prepared during their preservice experience, they can quickly acclimate to
disruptive environments, and respond with complex and innovative thinking, resulting in their being more
responsive and reciprocal collaborators (Bringle & Clayton, 2012; Felten & Clayton, 2011).
To summarize, the themes outlined above show that ISL experiences for students studying SPED/CSD
can have a direct impact on their future work as educators in American schools. While this ISL experience
was only two weeks in duration, the intensity of the hands-on activities with educators in the host country
and cyclical reflection appeared to be transformative. SPED/CSD students regularly engage in domestic
service-learning activities through clinical practicum and student teaching experiences; however, this ISL
experience added greater levels of interaction and collaboration with educators and children from a diverse
ethnic group, with the heightened tension of living and working in a cross-cultural and under-resourced
region.
Limitations
A limitation of this study was the small sample size and relative homogeneity of the participant group. This
is common for this type of qualitative study, however, where the aim is to provide rich and thick descriptions
of the students’ experiences rather than generalizing to other populations. Several of the students who took
part in the ISL experience were unavailable to participate in the focus group because of graduation from
their respective programs and because they live and work in other parts of the state.
It may have been helpful to engage in systematic gathering of student data prior to participation in the
ISL project—specifically, in areas related to content, skills, and attitudes. Having this pre-/post-
comparative data would have helped the researchers delve even deeper into what was gained and learned
by the participants. Another consideration for future research would be to incorporate in the research design
data collected through direct and indirect measures, which could better address questions related to student
learning and development

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Conclusion
ISL experiences with collaborative partners in other countries who share similar professional goals, such
as improving services for individuals with disabilities, can influence the personal and professional growth
of future special educators and SLPs. Specifically, ISL has an effect on the development of the interpersonal
skills necessary to serve children and families of diverse cultural and linguistic backgrounds. There could
be far-reaching benefits as participants apply what they learned during ISL, in their clinical preparation and
during interactions with students, families, and other professionals. High-impact practices like ISL help in
teaching broad skills such as problem solving, critical thinking, and cross-cultural communication.
Additionally, engaging in preservice preparation, which incorporates collaborative skill development,
knowledge and reflection of power dynamics, and strategies to deal with uncomfortable situations, should
be considered. Programs in CSD/SPED may benefit from including this content in course and/or program
objectives. This experience led to cross-cultural relationships, collaboration, and communication between
the participants and professionals in Botswana, which led to transformative educational experiences and is
positively impacting services for children with disabilities in both the United States and Botswana.
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______________________________________________________
About the Authors
Amy Rose is an associate professor in the Department of Communication Sciences and Disorders at
Western Carolina University.
Melissa Snyder is an associate professor at Western Carolina University.
Amy Murphy-Nugen is an associate professor and graduate program director in the Department of
Social Work, College of Health and Human Sciences, at Western Carolina University.
Gayle Maddox is a professor of health education at Western Carolina University.
Carol Isaac MacKusick is a former faculty member at Western Carolina University and is now working
as an adult nurse practitioner for HCA in a rural setting.
Bontle Molefe is the former director of the Special Support Services Department, Ministry of Basic
Education, Botswana; chairperson of the Botswana Society for the Deaf, and a member of SAALED.
Correspondence concerning this article should be addressed to Amy Rose at ajrose@wcu.edu.