About the authors:

Lourdes Ramos-Heinrichs works in the Boston public schools as a bilingual speech and language therapist and a specialist consultant in fluency and fluency disorders. She offers telepractice services for adults who stutter.  She has extensively collaborated in ASHA SIG4 organization on issues that impact people who stutter.

Sandra Garzon is a bilingual speech and language therapist working at Boston Public Schools. She continues attending worldwide stuttering conferences and seminars, including workshops at the Michael Palin Center.  She is working toward achieving her BCS-F and continuing deepening her understanding of bilingualism and stuttering.

Edna J. Carlo, M.S. CCC-SLP is an Associate Professor at the University of Puerto Rico, Speech-Language Pathology Program.  She is the author of several publications about stuttering in Spanish speakers.  She is currently conducting clinical research about stuttering diagnosis and intervention with Spanish-speaking populations.

This paper presents a bilingual questionnaire for parents of children who stutter (CWS). The questionnaire elicits important information from parents on how the stuttering is impacting the everyday social/cognitive/emotional life of the child. The questionnaire can be filled out by Spanish speaking parents of CWS and submitted to the child’s local school to request speech-therapy services; or for inclusion in assessment files, for children already in process of evaluation. When children are being referred for a stuttering evaluation, speech-language therapists can utilize the questionnaire by asking parents to provide the information to better understand the stuttering history and how it impacts the family. The information obtained, in conjunction with other assessment data, can be helpful for identification of stuttering issues specific to that child, and for development of a plan that addresses the specific concerns of the family.

The use of parent questionnaires allows the assessor to understand the real stuttering concerns in the natural environment of the child, as perceived and experienced by the caregiver. Stuttering behaviors can be variable and manifest in different ways in various settings and with various audiences. Parents, who know their child best, can be excellent contributors of pertinent information through the questionnaire. The questionnaire becomes an essential component to the evaluation process as it adds pertinent information that can only be obvious to people intimately acquainted with the child. Stuttering is a speech-language impediment with social-cultural-genetic associations that originate within the child’s family. Standardized testing may only reflect a small window into the child’s stuttering world. Therefore, in order to more fully understand the child’s stuttering background, through the questionnaire initially, the family can be engaged into a collaborative partnership. The questionnaire reveals special cultural and linguistic challenges faced by ELL (English Language Learners) children who stutter, such as concerns that bilingualism exacerbates the stutter; or, on the other extreme, parents exerting huge amounts of pressure on a child who struggles with bilingualism to maintain the home language.

Many professionals and families believe that bilingualism causes or makes the stuttering worse. This questionnaire includes one section that elicits information about the parents’ beliefs and concerns about bilingualism and stuttering. Contrary to what many people believe, research shows no relationship between bilingualism and stuttering. In many communities, being bilingual is rather the norm than the exception, and bilingualism in childhood does not increase one’s chances of developing stuttering. As Shenker, Lim et al (2014) stated, bilingualism continues to be misunderstood and parents and educators pose doubts and questions about whether being bilingual negatively impacts the child’s communication development. This questionnaire attempts to capture parents’ opinions and perceptions about bilingualism; and, how they view the development of stuttering in their children and the impact on the family’s cultural identity. Clinicians can use this information for purposes of counseling and educating the family about concerns on bilingualism, cultural identity and decisions to develop the home language in addition to English.

Ramos-Heinrichs et al. (2008) pointed out that language differences present a major obstacle for Speech and Language Pathologists(SLPs) in the US when trying to reach out to Latino families. Language barriers between the school and the home impact the adequacy of assessment and treatment in thousands of ELL children who stutter in American schools. Education experts agree on the importance of integrating families in their children’s education, and federal laws mandate that legal communications with non-English speaking families be delivered in a language that the families can understand (No Child Left Behind Act, 2001).

The Stuttering Inventory for Latino Families (SILF), an English-Spanish bilingual inventory presented at an ASHA Convention (2009), demonstrated an initial attempt at developing an inventory that is linguistically and culturally sensitive to the Latino population. The Spanish questions were developed based on input from SLPs from various Latin America countries including Puerto Rico, Colombia, Mexico, Guatemala and Argentina. For clarity to target population, the questionnaire was provided for feedback to select parents in Mexico and Colombia. Questions that were confusing to parents were either edited or eliminated. The authors (Ramos-Heinrichs et al., 2009) based their inventory on important scientific principles in stuttering research. They used the OASES (Yaruss & Quesal, 2006) as a model for inclusion of important content and structure in the SILF. Adaptations of other established inventories were included (Healy et al., 2004; Esckelson & Morales, 2000; Dodge & Ramig, 2005). The SILF was designed according to International Classification of Functioning, Disability and Health (ICF), a framework established by the World Health Organization (WHO, 2001), which specifies the importance of the following factors: impairment affliction, daily limitations, environmental restrictions, and contextual social reactions.

This bilingual stuttering questionnaire is a shortened version of the SILF; but it retains the major components of the SILF, including overt stuttering behaviors, cognitive/emotional reactions to stuttering, attitudes and reactions of caregivers, and bilingualism. The creation of this shortened version of the SILF is an effort to provide a free of charge downloadable bilingual questionnaire that can be used to obtain important information from families on stuttering background and other related cultural/linguistic factors. The questionnaire requires yes/no as well as open-ended responses, and space is provided for questions or comments. At the bottom of the questionnaire a brief narration provides basic information about stuttering.
A caveat is that this questionnaire is created solely for purposes of gathering information that can be helpful when used in conjunction with other assessments for better understanding of the clinical needs of the bilingual CWS. Presently, this questionnaire has not been research tested and data has not been collected to support diagnostic or research purposes. The authors hope that continued interest in the questionnaire will result in its further development for clinical and research validity.

 

 

References

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Esckelson, D. M. & Aguirre-Morales, A. (2000). Disfluencies/Stuttering: Questions for Parents. Spanish Phrasing for SLPS. [electronic version]

Healy, E. C., Trautman, S. Lisa & Susca, M. (2004). Clinical Applications of a Multidimensional Approach for the Assessment and Treatment of Stuttering. Contemporary Issues in Communication Disorders, Vol. 31, pp. 40-48

No Child Left Behind Act (2001). U.S. Department of Education, Public Law 107110.
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Ramos-Heinrichs, L. , Sandra Garzon, S. , Selle, H., and Yaruss, S. (2009). Stuttering Inventory for Latino Families (SILF). Convention Presentation. http://www.asha.org/events/convention/handouts/2009/1655_ramos-heinrichs_lourdes/

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