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Focus on Bilingualism: When Culture and Therapy Clash

By: Lucy Windevoxhel, M.S., CCC-SLP


When I began my first job as a speech-language pathologist one  of my monolingual, monocultural colleagues asked me why Hispanics gave their children milk in a bottle well into their preschool years. I was certainly offended by her comment. Growing up in Venezuela I never remembered drinking from a bottle or seeing friends drinking from a bottle. I made sure to tell her that was a gross over generalization and I had no idea what she was talking about. Well, I have spent the last 12 years working with children in the South Florida area, and I have learned that although it is not true of all families, many of them, including Cuban, Venezuelan, Colombian and Nicaraguan families among others share the following characteristics:

  • Prolonged use of a bottle: many children will continue drinking milk from a bottle well into their preschool and kindergarten ages.
  • Prolonged use of a pacifier: again, easily seen among 3 year olds and even older.
  • Delayed introduction of solid foods. Many of my children begin eating a very healthy and nutritious homemade pureed mix, usually consisting of a variety of vegetables and meats. However, many of them do not begin to eat small cubed food, cut up veggies and fruits in a timely manner. I commonly see 3, 4 and 5 year olds still eating the pureed mix.

This situation can be tricky for a speech-language pathologist going into a house to work on the articulation, oral motor skills and feeding skills of a young child. Like in any other cultural group some families will view you as the expert and are eager to follow every recommendation you make. However, some families feel very strongly about their customs, or feel their child is too young to follow your recommendations.
So what can you do to obtain the family’s cooperation?

  • Make your initial recommendations like you normally would during the evaluation or initial interview. They may just go ahead and follow them.
  • Respect a family and their choices.
  • Earn their trust. When you begin a relationship with a family they may know your credentials but they don’t know you. Instead of using an aggressive approach you may want to prove to them that you really are going to help their child. I’ve seen many families change these habits once they see that their child is making progress with me, and that I care about their child and respect their family’s values.
  • Offer them tips. Some families don’t change these habits because they don’t know how to. They may be afraid that if the child stops drinking from a bottle their nutritional intake will not be adequate, or that without the bottle or the pacifier they won’t be able to fall asleep. So be prepared for the following questions, concerns or comments.
    • How do I take the pacifier away?
    • He will only drink milk from a bottle. It is very important for me that my son drinks milk.
    • I drank milk from a bottle until I was 10 and my speech is perfectly fine.
    • The homemade puree is very good for her. It’s the only way I can get her to eat vegetables (or meat, or a variety of foods)
    • Acknowledge their concerns and opinions. Validate what is important for them. Offer helpful suggestions. Make them feel that they’re not in this process alone but that they’ll have your support and guidance throughout the process.
    • Be very patient.

Remember, every family is different and every individual wants to feel respected. No two families are the same regardless of where they’re from, but as parents we all want what is best for our child. It always helps for them to feel that you also want what is best for their child too.
Featured Author:Lucy Windevoxhel, M.S., CCC-SLP
Originally from Venezuela Lucy has resided in the United States since 1993. While pursuing a graduate degree she received specialized training in working with individuals with Autism Spectrum Disorders. She is a certified leader in the Hanen Programs: It Takes Two to Talk and Target Word, as well as The Lindamood Phoneme Sequencing (LiPS) program and Visualizing/Verbalizing. In addition she has specialized training in oral motor therapy through Talk Tools and Beckman Oral Motor Assessments and Interventions.
Please support our contributing authors and visit Lucy’s website, A Love for Language.

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