The NDBI Navigator
The NDBI Navigator podcast features engaging interviews with leading experts, researchers, and community practitioners who share real-world strategies and insights on using Naturalistic Developmental Behavioral Interventions (NDBIs) with young autistic children. Hosted by Dr. Jamie Hughes-Lika, each episode offers practical, actionable ideas to inspire and support professionals in making a meaningful impact.
The NDBI Navigator
Episode 31 Bridging Cultures and Science: Expanding NDBI in Latin America
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
In this episode of the NDBI Navigator Podcast, Dr. Jamie sits down with Dr. Ana Maria Hernandez Villalobos, a medical doctor, psychologist, pediatric neuropsychologist, and certified ESDM and JASPER therapist and trainer based in Monterrey, Mexico. Dr. Ana Maria shares her inspiring journey into NDBI and her passion for bridging science, culture, and family connection to ensure that high-quality early intervention is accessible to Spanish-speaking families across Latin America. Together, they explore the challenges and opportunities of implementing NDBI within different cultural contexts, shifting from a traditional medical model to a collaborative, family-centered approach, and empowering both therapists and caregivers in the process.
Welcome back, everyone. I am super incredibly excited to have you joining us again for another NDBI Navigator Narratives podcast, where we get to talk to professionals and researchers in the field who are doing NDBI in the community, in research settings, in school-based settings. And today we have Dr. Ana Maria Hernandez Villa Lobos joining us from Monterey, Mexico. And Anna is very busy. She is a medical doctor, a psychologist with a specialty in pediatric neuropsychology, an ESDM certified therapist and trainer, and most recently a Jasper certified therapist. Welcome. We are so glad to have you here, Anna Maria.
SPEAKER_01Thank you so much, Jamie. It's a pleasure to be here with you and talk about our patients, uh, NDBIs and another, I mean, don't autistic children and their families, because we are very patient about it. And thank you so much for having me here.
SPEAKER_00Yes, give us a little background from how you got from Venezuela to Mexico and to your journey for supporting families, from where you started out and how you got into NDBI.
SPEAKER_01Yeah, yes, I'm originally from Venezuela. Um, but I live in Mexico since 2002. And I am very happy here. I work here, I live here, my family is here. Um I am a medical doctor and a psychologist with a specialization in paediatric neuropsychologies. How do I begin my journey? It wasn't casual because I have um I had a uh teacher in my faculty. I mean uh he was very, very smart and very clever about everything, but also very warm with the um with us. And he approached to me and said, Oh, what about you? Do you like that? I mean, we we were talking about neurology, and I said, Yeah, very good, and it was okay. Then in my other university, because I studied both at the same time, I studied to be a medical doctor and also psychologist at the same time. Yeah, then I realized he was there too. And I say, Oh, I know you, you are from another faculty, and I say, Yeah, and I say, Oh, maybe you are you are if you like this, think about to become a pediatric neuropsychologist. I didn't know that, I didn't know about it, and then I deeply I mean do a research, and I realized that this was a very good, I mean, interesting um field in this journey. During my specialization, I realized that autistic children were for me very special. They and I connected very easily, and I say, This is what I want to do. I didn't know about it until I became to Mexico. And then I say, okay, this is very, this is something that I feel in my skin that I that fit me, you know. There is something that I I can describe in another way because when I see children, I mean autistic children and their families, my heart is different, my field is different, my thinking is different, and I say, okay, this is something that I want to do. Yeah, I be I began my search in, I mean in the website. Yeah, yeah, yeah. Searching for something different, something that fills with me and fit with my style. Then I figure out early start temperamental in a website. I didn't know anything about it, and I started to read it about it. I mean, it was in 2015, I think, something like that. And I began to read and study, but in Mexico, because in that time I already lived in Mexico, but we don't have access to ESGN. Then I bought my book and started reading, and then I, yeah, it was uh away. I mean, maybe I if I remember okay, um, two or three years later, for the first time in Mexico, came ESDM staff to do a workshop, and I said, This is for me. I remember, yeah, I remember, yeah, the the date, I mean the time, and I okay, yeah, and I do the workshop, and then I realized that I entered into the workshop with my book, my English book, and then I say, Oh my god, there is an Spanish book? Where is it? Yeah, and then I began my my journey in ESBM, and also uh I'm particularly passionate about building bridges between science, cultures, and family connection. Family connection, but I I have to be sure that high quality early intervention is accessible in Spanish, aligned with the values, the relation style that in our region, because we are so worried. It is it is very common that the therapists, mothers, and fathers said, Ah, it's your own. And I said, No, no, no, I'm not, I am your therapist. But yeah, and we have a love, we kiss a lot, children, and we are very, I mean, intimate, and this is very difficult because we have to to make the I mean uh align to separate, yeah, yeah, boundary, yes, and that's my journey. Uh that's how beginning NDPIs. Then when I I do I did the introduct workshop, the advanced workshop, and my trainer and she approached to me and said, You are ready to be a trainer. Do you want? I mean it's something that maybe you want to be. And I say, Yes, I really like it because in my career I love teaching. Um I mean, yeah, many, many years ago I teach in the Tech de Monterey as an associated teacher, and I I realized that is something that I really love. I mean, teach, and I said, okay, this is gonna be fun. Then I apply to the trainer program to become a trainer, and uh I was accepted at the beginning, and I have the fortune to be um trained by Vanessa Avilapont, who was your trainer, your trainer too the program. Yeah, and then uh I'm I'm in love with the NDBIs, not all not only ESDM, because I now a certified therapist in Jasper, who is another beautiful NDBI. And I say, this is for me, this is my journey here. I am, I am the only um trainer who speaks Spanish, right? I mean, now I think um maybe we're gonna have uh another uh trainer soon, but I'm here disseminating MDBIs, especially ESDM in Latin America.
SPEAKER_00Yes, and I want to go back as you had said, um NDBI fit with my style, and that's how I feel about NDBI. I started out with, you know, traditional ABA and I just didn't think it was for me. And then I kind of got into naturalistic teaching, PRT, kind of move in that direction, and then I felt home. I felt connected. I felt, yes, this is my calling, that is what I want to do. I I not for me, and so I really appreciate you saying that, and it really resonates with me. And I think a lot of listeners who also feel that way about NDBI and practice and you know, child-centered motivation, supporting autonomy. It's just things that we do within our practice just as a given. Um, we don't even think about it because it's just done by nature of the models. Um, and I really also appreciate, as a parent myself, how you are focusing on how to get the science to infuse with the culture in which you and the families live, and then to also follow through and connect with the families with their own culture in the culture, the science. Yeah, yeah. That's incredible and incredibly hard to do.
SPEAKER_01Yeah, and maintaining the high quality, you know. The doing, I mean, it is important. Okay, culture is important, but you have to do it in the right way. Yeah, you have to to consider the principles, you have to think about how to embrace culture, but remember, high quality interventions based on evidence is important too. Okay, is is your your objective is combine that. Be warm with the family, yeah. Be care about, I mean, caring about the child, yeah, it is important too, but remember you have to do your job, doing it in the in the right way, yeah. Because then because we are doing early intervention, early intervention is it is a crucial time in the child's life. Yeah, and we have to remember that we have the future in the child's future in our hands. Yeah, this is this is uh this is a pressure, you know.
SPEAKER_00Yes. How do you do you see challenges within a medical model supporting parents who are the expert in their child? Have you encountered any challenges with supporting families, caregivers who you're the expert, you do it all right? That's very much how I see in Albania as well. You help my child, I will watch, but I don't know what to do.
SPEAKER_01Yeah, um there is uh a process of transforming their intervention, and we have to be patient because the parents are doing the best that they can with the information and the history, you know, the family history. And also they have a child who is different, that's the truth, they are different. And imagine that you are doing something new that you don't have experience, but also more difficult than the other parents doing. And here in Latin America, the medical model is something that is strong, that is very common, and parents do what the doctor said. No questions, no questions, yes. Is the the uh in Spanish we say the uh el phenomeno de la bata blanca that means the what the white suit for medicals and they are using that and they are untouchable. Okay, yeah. Sometimes the doctor said something and you do it, and you don't ask about it, and you and you also don't know why, but it's it's a command, it's an instruction that you have to do it. Now we are talking about what do you need in your life? Yeah, what are what are you struggling with during the day life? And they are like this. I I don't know, you tell me about it, and I say, no, no, no, no, no. Think about your day, think about your life, think your think about your own style of live, you know. And this is very difficult because we invite, we we were the first clinic in Monterrey. We invite people, I mean parents, uncles, grandmothers, and grandfathers to be with us in the session.
SPEAKER_00That's fantastic.
SPEAKER_01Yeah, our reception was so big, now it's so little. We only have three three chairs, no more. We don't need it more. We build another room for them. Yeah, yeah, because we don't we don't need it. I it was it was a big change because our reception was were so so big, yeah. And now it's so small because parents are with us in the session, and it was a very for me, it's a very um great achievement because when parents are with us, and then we treat children until eight or maybe nine, but no more, and they have to move to another clinic. And they say, but in in the older clinic, we are not allowed to be. And I say, Oh, but you you should ask, you know, you should maybe we can say, Okay, I I want to be with you, I want to help you. Um, we we want to, I mean, work together. And I say, This is very, very good. And now, nowadays, when people approach to us through the the assistant, they say, Oh, Doctor, this is not I mean, Maria is asking if they are allowed to be in the session, and I say, Yes, they are always invited. And but it's I mean, it's about it's a work about we're working on it, I mean, during the past 10 years. Wow. To become in another model, in a model where parents are invited, uh, parents are in the session, yeah. And this is something very, very difficult. But Monterrey is a modern city, okay, you know, it's a big city, and this is not the common in the other cities here in Mexico. Yeah, if we are talking about Latin America, this is very common too. Okay, and other countries like Peru, Bolivia, Venezuela, Argentina, the medical model is the most expanded model, and we are doing our work to spread the new ideas and also empowering the therapist to feel sure about what they are doing because when you invite a parent in your session, it is important that that you feel you feel insecure too. And you are uh you are going to be, I mean, sometimes right, sometimes wrong. Yeah, but this is something that happens, yeah, and you have to change your mind and say, This is gonna happen, and it is okay, yeah, because parents, when they see that you are struggling to, but you at the end of the session, you have a regulated child, connected child, a child that is doing a very good job. The parents say, Oh, it is possible, you know. Um yeah, and they feel connected with you in another way together. They they see you in the same level, you know, not like you are at the high level because you know not you are eh, you struggle with the same, and I now I know how to handle it, you know.
SPEAKER_00Yeah, it's a learning opportunity for how to work through that together with the parents' input and the therapist input. It's like when we co-construct jars in the ESDM, we do that together with the child, and it's the same when we support parents. I love the mind shift and the paradigm um change that you guys have really embraced to get that parent to be a more active participant in their child's intervention and to really empower the parents and to help reduce stress and increase their confidence in being able to support their child when they leave the session to go back home and then get into life. So you have that generalization and you have that carryover, but more importantly, I think you have a parent who's gonna feel more comfortable and more confident in parenting their child, which is incredible.
SPEAKER_01Yes, and I mean, we're changing, changing, yeah. This is the the way that we live here, changing the uh the way that we are doing therapy positions, and also changing what people think that is uh a session, you know, because they are struggling too with the um the situation that maybe we can share on the floor objects, toys, and we are doing the session. It doesn't have to look like you are sitting on in a chair and in front of a table, and we have a little kitchen in the clinic, and we also do some activities in the kitchen. We are preparing thumbs and we are doing hot cakes, and we're your parents saying, Okay, yeah, because this is life, this is your life, and be confident about the abilities, you know. Your child has some strong abilities, and also have, I mean, challenges, but try to make another change, and we are we are changing, yeah. Changing the community, the parents, the therapist, the structures. Yeah, this is good, it's good, it's beautiful.
SPEAKER_00It is, and you talked about Latin America, and I know there is a group uh that you facilitate or a meeting of professionals across Latin America. I'm not 100% what that is. Wanna talk about that?
SPEAKER_01Yes, yes, yeah. I'm doing um my my clinic, I mean I'm working on my clinic, but I am also um the I I don't I don't like the the the word teaching, but we are uh with them, yeah, sharing knowledge about ESDM. We are, I mean, we are a trainer, ESDM trainer, and we also offer um advanced workshops. Yeah. That means that a group of professional, a very um unique group because they are also training in psychologists, physical therapists or occupational therapists, I don't know, a lot of uh professions. Um reunion during during three or four days, and we are working with a child, uh, autistic children, and also their families to evaluate, make an evaluation, construct a plan to intern their intervention and see the progress. And it's it's like magic, you know, it's like magic that one day. There is a child. And three days later, there is another child, another child that has and and their family is also different, different in the way that they look at the child, but they would the way that they approach the child and become more active during the activities and during the plays, routines, and this is very, very valuable. We here in Latin America do we have a phenomenon that is that professionals prefer in-person training.
SPEAKER_00Okay. Versus an online webinar. Yeah, yes.
SPEAKER_01This is this is so uh difficult because I have to travel to another country and it's hard, you know. I have to separate my work and then um go to another country, stand with them. But it is beautiful because I know this new culture because even if we are in the same um Latin America, we are in the same uh, I don't remember how to say continente. We are in America, uh continent. We are so different from another country to another. And for me, it's very beautiful to spend time in the city. Um, I like to walk during the days and see how families and I go to the uh one park and I and I spend I mean maybe 30 minutes or one hour to watching what they are doing, how to they play between them. And I yeah, to to feel the culture, you know, because we speak Spanish, yeah, yeah, oh that we are different. And professionals prefers to be in-person trainer, and it is beautiful, but uh also challenge in the way that we have to to learn about it and to learn about this country. This is my mainly work here uh to work directly with the child and their family. For me, it's important uh yeah, in the clinic and during the workshops. This is my um most of the time, this is what I'm doing. Now I'm constructing the first um investigation from ESDM in Spanish because we don't have.
SPEAKER_00Oh, that's incredible.
SPEAKER_01Yeah, um, this is this is gonna be my uh I have another investigation, but not in I'm including ESDM. This is the first time, but this is also another uh another issue, another topic, another idea that we have to encourage because professionals here in Latin America are doing a great job. They are very passionate, they are very good, intelligent people, smart people, but register doing the hard work is not something that is very common. And inspire the people and guide the people. That is something that I realized last year that is also I have to do. Yes, yes, yeah, yeah, because we yeah, we need our voice, we need our investigations, our papers, because yeah, our ideas, our culture. That yeah, maybe we are I mean, children are the same progress, have the same progress that another country, but we need to read that is uh a country, a city that represents us.
SPEAKER_00Oh my god.
SPEAKER_01This is this is a new goal.
SPEAKER_00Okay, 2026 goal.
SPEAKER_01Yeah, yeah, this is a new goal and very exciting.
SPEAKER_00I love that. I think that is so important for that family connection and again the culture and going back to the dissemination and implementation of the science, like you talked about high-quality early intervention. Um, one of there is a resource, I'm sure you have families that use it. If the listeners um are not familiar with it, it's help is in your hands. I don't know how you translate in Spanish, but that is in Spanish and that is free and available to parents and caregivers. I always recommend it to professionals. I think they get value out of that. How do we say that in Spanish?
SPEAKER_01La ayuda está en tus manos. And we have two versions, not one. Yes, that's right. Two versions, yes. One version is uh in Spanish but castellano from Spain, and uh they did a great job because they use simultaneous translation and the videos are uh translated. It was a great, great job. We have another version that is Layuda Santos Manos from Argentina. Okay, Argentine professionals they uh uh use closed captions in the videos, but both are great because sometimes you don't have the opportunity to listen, but you have the opportunity to read, and both are free. You have to put your email, create your account, and that's it. You have the opportunity to doing, I mean, measure your progress, doing the tasks, doing the and it's beautiful, but also there is resources in there for professionals at the end. Understand Spanish also, yes, or the English ones. And this is perfect because when we I mean during my career and my formation, beside ESDM, I don't I don't receive information how to talk with parents, you know, how to coach family. I realized that there is a necessity, there is a need that we have to cover. When I uh became a certified trainer, I mean served certified trainer in ESDN. Okay, I I did it, the the work, the the workshop, but uh beside that I don't uh I didn't know that this is part of my formation because I also work with parents too, and grandparents, and uncles, and cousins, and everybody. And for me, layuda está en tus manos is a very useful tool to not only see the videos or say, oh, maybe you should watch this. No, to stay with the parents and see together what they are doing, and it's something that is something in the videos that for me is very special. That on the videos are families, real families in home at home, changing stiper, doing and also the the living room is chaotic too, like real life, and this is something that mothers say, Oh, this is my this is my couch, yeah. Yeah, this is your couch, yeah. It's perfect, yeah, it's perfect because identification that that could be my living room, that could be my son, is totally different. That when I am talking about what you should do, or maybe we should try this, and we see the video together and share ideas and empowering you to try it. Let's gonna try it, that's gonna find if if it is a way that works for you.
SPEAKER_00Another resource we just finished translating into Albanian, which took forever, the infant manual that Sally and Lori have that is also in Spagnase, I believe.
SPEAKER_01Yes, yes. I made my contribution translated manual too, as as you and Albanian too. And that is uh a tool that is free for everybody, and it it is it is something that it happened right now. Something is happening right now that is very for me, is like we are seeing the the results for many years. Here in our clinic we have a four-month old boy, four-month old boy with characteristic suggestion autism, and we are working with the infant manual and another tools to promote and to encourage the family because infants it is very, very unique way you have to do your job through the family.
SPEAKER_00Yeah, yes, early. Yes, it's parent-mediated and supported, and again, they spend their waking hours with their parents and caregivers. So we want them to feel empowered and confident and have those strategies. One of the things that I just love about the ESTM, it's so manualized. There's a group model book, there's the manual, there's a parent manual, the yellow one, there's a parent coaching book, there's so many resources available to support your implementation as a therapist, but also as a coach or a trainer to support parents and providers. So I feel like if I want to do something with ESDM, there is a resource I can find to support me. And I just love that it's so available. That's one of my favorite things about the model.
SPEAKER_01All books, uh I mean ESDM books, parents, coaching, professional are in Spanish. Yeah, you have to pay for it. Yeah, yeah, I know that. But all are translated in Spanish. This is uh an advantage for us.
SPEAKER_00Do you know if the second edition is translated yet? The second edition manual or checklist? Not yet, right? Not yet. Okay, but it's coming.
SPEAKER_01We are we are offering our help and offering some ideas to improve and doing something different, yeah. But because Spanish speakers, we are, I mean we are uh like a big family, you know, and we are trying to do something, but no. I think it there is no language than English that is the second for the second, yep, that's what I thought I saw on Guilford.
SPEAKER_00Any advice for practitioners who are who want to implement NDBI in their practice, whether they're in the the US listening, if they're in Europe, if they're in South America, Latin America listening to us. Any advice for how to get started? What they could do?
SPEAKER_01Where first of all, yeah, yeah, I know. There is a lot of resources on the web. Before you enter to a workshop, try to read something, try to figure out the principle, you know. Maybe see some videos. I mean uh fidelity's videos, I mean the the the official videos. Yes, that is something I in my time when I when I became my researchers, and I I really I really spend the time to read, be sure that's gonna be something that I would like to do because it's a for in our region it is expensive, you know. And uh we don't earn dollars, we're in another. And it is very expensive, and be careful about what you want, try to read first, for expensive, yeah, yeah. Doing your own research, and when you feel and realize that it's something for you, go for it, but go for it deeply, not for the so in the surfaces, you know. No, go for it and embrace that model. There is a lot of information nowadays, and people uh is like duplicating between doing this or doing this and influence for another professional when you find your way like like a horse, you know.
SPEAKER_00Oh the uh blinders, yeah.
SPEAKER_01Yes, find your way, find the way that that works for you, be deeply in the principles, read about it. There is something that um I really understand now, but I don't know if I understand deeply enough. Yes, relationship is the foundation of learning. Try to build really beautiful, care, and profound relationships with the child and the family. Follow shy leads. This is a very and be careful about how to interpret that because it's not doing what the child wants to do it. No, no, no, no, it's not that, and observing the development carefully, carefully. Be sure about the the child's development, the preference, this the strongs, yeah, the challenge to, but before doing uh investment in a course, read. There is a lot of information. Select what is for you, and then when you are sure, do it, but do it in the right way, do it deeply, go for it, embrace the NDVIs, know the ADVI. I say people laugh when I say that I I married to with my husband and with the early start Denver model. Yeah, because this is yeah, this is my model. Yeah, and this is for me, this is the way that I feel that is right, and I embrace it. And now here we are doing that we love.
SPEAKER_00Yes, and it's such an important emphasis on the relationship as the foundation for learning for I think all of us as humans. And I always will say, you need to reach before you teach, you need to have that foundation and that connection before any meaningful learning is gonna come. So I I appreciate you sharing that as well, that same vision. And for sharing all of the resources that are out there available for caregivers and parents and providers that are in Spanish, as well as all of the paradigm shifting mission that you are doing in Latin America to change the ways that families and caregivers get to support their children. As a parent myself, that is so meaningful for me to feel like my voice could be heard. And I am sure that other families feel deeply about that as well. This is incredible. Thank you so much for coming on and joining us today.
SPEAKER_01No, thank you, Jamie. It's always a pleasure to see you through the cam. Your smile, your warmth, your your voice. It is always uh a hug for me. I mean, from the distance. Thank you so much. I hope the information is go through the families and also the professionals that are sharing with us the passion about autistic children, intervention, early intervention in autistic children and their families. And thank you, thank you for so much for your time and see you later.
SPEAKER_00Yes, yeah. Thank you.