How do we define "culture"?
Much too narrowly.
We have traditionally used the term to focus primarily on people’s ethnic and linguistic backgrounds. Such limitation, however, causes us to neglect attention to one of the most important cultures of all—the culture of poverty.
As the politics and demographics of the United States undergo continuing shifts, many speech-language pathologists find themselves serving increasing numbers of clients from low socioeconomic status (SES) backgrounds. A great need exists for information that will help SLPs more effectively serve members of this challenging population.
Most SLPs know from professional experience that a family’s SES and educational level are much greater predictors of children’s cognitive-linguistic development and academic success than skin color or language spoken in the home. Researchers also have begun to identify SES and caregivers’ educational levels as much more highly correlated with linguistic and academic success than children’s ethnic or linguistic background. An understanding of the implications of children’s SES and their caregivers ’ educational levels will, in turn, help us provide more effective services to this population.
We must never equate poverty with dysfunction. Many persons from low-SES backgrounds are very successful, well-rounded individuals who make important contributions to society. Nevertheless, it must be acknowledged that living in a low-SES environment can present several major challenges, especially for children. These include:
1. Access to Health Care. No factor of living in poverty has more implications for services than access to health care for children from low-SES homes. Many families with low income are underinsured or have no health insurance at all. Because of barriers such as transportation and money, many families of low SES are unable to go to doctors and/or medical facilities for care. Clients whose English is limited and/or whose cultural beliefs do not include the necessity of Western medicine face particular problems. In addition, some culturally diverse families are uncomfortable with white, English-speaking service providers and may feel intimidated. Many families with low income also tend to be unaware of available health care services. This is especially true for clients of low SES who do not speak English or who have recently immigrated to the United States.
These families’ inadequate access to health care has numerous implications for SLPs. For example, children who are frequently sick and don’t get medical care are absent from school more, thus missing academic information. When they do attend school, these children are unable to fully concentrate and participate in activities. Also, children who do not see doctors frequently may have ear infections that go untreated. This can be detrimental to auditory discrimination and processing skills, language development, and articulation.
2. Nutrition. Women from low-SES backgrounds tend to receive inadequate prenatal care and are frequently malnourished. Their children also tend to grow up malnourished. It is estimated that 12 million American children have diets that include significantly less than the recommended allowances of nutrients established by the National Academy of Sciences. Malnutrition and disrupted cognitive performance are now being linked. Childhood malnutrition produces permanent, structural damage to the brain. Between birth and 2 years of age, the brain grows to approximately 80% of its adult size; malnutrition during this period is especially devastating to cognitive growth.
3. Educational level and language stimulation. Many people are educationally and vocationally limited because of their lack of opportunities. Research has documented a strong correlation between education and income levels. Welfare dependency is strongly associated with lack of a high school diploma and low literacy levels. The strongest predictors of a child’s academic success have proven to be family income and mother’s educational level, and not ethnic background or language ability.
Early Language Stimulation
Some parents with low income and limited educational opportunities do not believe that talking to babies is important or necessary. Thus, children who are rarely spoken to or given language stimulation during the first year of life have disadvantages from early on. Research indicates that stimulation in the first year of life is critical for linguistic and cognitive development. One study of early-enriched children from various cultural backgrounds showed that, in terms of long-term cognitive-linguistic competencies, infants whose enrichment began at 4 months greatly exceeded infants whose enrichment began at 12 months (Fowler et al., see sidebar).
There is much evidence that the amount of parental language input to children of low SES is often less than the input to children of middle SES. Parents of low SES are less likely to respond to their children’s utterances; when verbal interaction does occur, it is more likely to take the form of directives than to take a form (such as inquiries) that keeps the interaction going. Children from low-income backgrounds have poorer phonemic awareness than children of middle SES; the children of low SES fall farther and farther behind children of middle SES on phonemic awareness tasks and reading ability as they go through school.
Hart and Risley (1995, see sidebar) conducted longitudinal studies of families from various ethnic backgrounds. These studies focused on the home environments of 1- and 2-year-old children and, specifically, interactions and language stimulation within these homes. The researchers concluded, "Socioeconomic status made an overwhelming difference in how much talking went on in a family … the family factor most strongly associated with amount of talking was SES." They extrapolated that, in a 365-day year, children from professional families would have heard 4 million utterances, and children from welfare families would have heard 250,000 utterances. Westby (1997, see sidebar), commenting on this research, states, "Even by 3 years of age, the difference in vocabulary knowledge between children from welfare homes is so great that children from welfare homes would require a preschool program for 40 hours per week in which they heard language at a rate heard in the homes of professional families to gain a vocabulary the equivalent of working-class children."
Children from low-SES homes whose parents are not highly educated may not experience language or literacy experiences that are commensurate with the expectations of mainstream schools. Because parents/caregivers are trying to survive and provide the basics of life such as food and shelter, oral and written language stimulation often does not receive priority. Limited funds also means that families may not be able to take their children to many places and expose them to experiences such as they might have at zoos or museums that many mainstream educators take for granted. Lack of assumed literacy and specific environmental experiences often means that children from low-SES homes perform poorly on standardized tests.
Children with low or nonexistent levels of literacy in their home languages tend to have difficulty with formal schooling tasks. For many children of low SES, school is a culture shock. These children present special challenges for the school system because the children technically do not have language-learning disabilities; they simply come from environments where language stimulation and literacy are not readily available. In their study of children from low-income households, Justice and Ezell (2001, see sidebar on listing resources) found that the children had low skill levels on tasks measuring metalinguistic terminology, alphabet knowledge, and print and word concepts. These skills are necessary for kindergarten in many states, and thus children from low-income backgrounds may be at a disadvantage from the beginning of their formal schooling.
Strategies for Service Delivery
Service delivery to these children is always a major issue for schools. There are a number of practical strategies that SLPs can implement to assist families of low SES to help their children succeed:
1. Collaborate with other health care professionals to help women become educated about the importance of proper nutrition and health care. SLPs also can help to make sure that women of low SES have access to these essentials.
2. Help families of low SES by providing information about free, local medical and dental services, as well as information about nearby locations where food and shelter are available at minimal-to-no cost.
3. Provide additional language stimulation activities for children from low-income backgrounds. For families where the caregivers are non-literate, wordless books can be sent home so that adults and children may discuss the books together. Encourage caregivers to have children participate in book reading routines.
4. Implement early literacy screening measures in early childhood centers (such as Head Start) to identify children of low SES who need intervention in early literacy skills.
5. Encourage caregivers to observe in the classroom and in treatment sessions, and encourage their participation. This will help caregivers acquire ideas about how to work effectively with children at home to promote learning.
6. Encourage caregivers to use local public libraries and be aware of their hours of operation. Remind caregivers that many public libraries offer free services.
7. Make sure that, during the week, children are encouraged to use the school library as often as possible.
8. Because many parents work outside the home and have little time to spend with their children, children can be assigned peer tutors in the school. These peer tutors can assist with homework, read to children, and carry out other activities with them.
9. Provide caregivers with information about the necessity of language stimulation beginning in infancy so they can begin appropriate stimulation.
10. Remember that children from low-income homes might not have as much exposure to technology as children from higher-income homes. Ensure that these children from low-income households are not at a disadvantage in situations where technology is used in the school. Help them to take advantage of the many opportunities that technology opens during the learning process.
11. If children are from culturally and linguistically diverse backgrounds, never tell the parents to speak only English at home if their primary language is much stronger than their English is. SLPs should tell parents to speak to their children in the language in which they are most comfortable.
12. Many SLPs give students small toys or objects as a reward for good behavior. We can give rewards such as colorful pencils, erasers, crayons, rulers, and even small notebooks and books that will enhance children’s academic experiences.
13. When assessing children of low SES with standardized tests, remember that these tests may contain inherent bias because the children have not had life experiences and exposure to concepts assumed by the test. Be flexible in utilizing dynamic assessment and informal, non-standardized measures.
Focusing on ethnic background and languages spoken in children’s homes is not enough. Although these variables are important, it is clear that SES and caregivers’ educational levels have a far greater impact on children’s cognitive-linguistic growth and academic success than our field has acknowledged. There are many strategies that SLPs can use to help children from backgrounds of poverty to succeed in school. By using these strategies, SLPs can help these children to be given opportunities to fulfill their academic and, ultimately, life potential to the fullest.