Awareness of Speech and Language Therapy amongst Pakistani women in Edinburgh Alia Yasin* and Ineke Mennen** *NHS Forth Valley, **Bangor University.

Awareness of Speech and Language Therapy amongst Pakistani women in Edinburgh

Alia Yasin* and Ineke Mennen***NHS Forth Valley, **Bangor University

Overview:Background• Awareness of healthcare• Attitudes towards disability

The aim of the studyThe methodologyThe resultsThe conclusion

Awareness of healthcare• Research shows importance of parental

involvement/awareness▫ identifying difficulties in child’s development▫ benefits the therapy process

• Many parents from ethnic minority backgrounds disadvantaged by lack of knowledge of and ability to use health system (e.g. Crutchley et al. 1997; Stow and Dodd, 2003)

• They often “did not know how to access professionals’ help, were not aware that they needed to, or were not willing to do so” (Crutchley, 2000, p72).

Attitudes towards disability/disorder• Disability stigmatised among some cultures,

presenting a barrier between those who need help and those who can provide it (Glogowska, 1998)

• Different cultures have varying perceptions of childhood difficulties which may affect parental expectation of language development (Law, 1992).

• Some cultures put blame on child with communication difficulty (Bebout and Arthur, 1992)

• These attitudes are sometimes taken to explain low service uptake amongst minority ethnic families.

Why Pakistani females?• Pakistanis form the largest minority ethnic group

in Edinburgh (Census, 2001; Mennen & Stansfield, 2006)

• Culturally, it is the female members of this group who tend to provide the day to day care of children

• There is no specific information about SLT service awareness in this group, but it is thought that attitudes towards disability in Asian families (Beresford et al. 1996) causes lower service uptake in this minority ethnic group (Bywaters, 2003)

Target population• 90%Punjab province in Pakistan (Pakistan Society

of Edinburgh)• 1/3 housewives completed questionnaire in Urdu

• Language spoken most often with family:▫36% Urdu▫34% English▫30% Punjabi

• Other languages:▫40% Urdu▫17% Punjabi▫35% English▫2% Pahari/Mirpuri▫6% none

Aim• To investigate awareness of childhood

communication difficulties and the SLT service provision in Pakistani females in Edinburgh • To investigate attitudes towards disability in

this ethnic minority group, which may affect their willingness to seek professional input• Establishing levels of awareness and

attitudes towards disability would inform attempts to empower this particular group to access SLT services

Methodology• Questionnaires and interviews with 110

Pakistani females, aged 16 and over• Participants contacted through visiting weekly

social gatherings within the Pakistani community, such as Nari Kallyan Shagho (NKS)

• Four main areas investigated: Participant descriptors (occupation, age,

whether or not they have children) Awareness of child speech and language

development and communication difficulties Awareness of Speech and Language Therapy Attitudes towards communication impairment

Results• Majority (52%) of women

would expect a child to start talking by age 1

• More so in women with children

0

10

20

30

40

50

60

Yes NO

Children

No children

Child talking at age 1?

0

10

20

30

40

50

60

70

80

Normal Difficulty

Children

No children

Child not talking at age 2 is…

• Majority (66%) considers a child not talking by age of two as having a difficulty

• More so in women with children

• Most awareness of hearing impairment, followed by▫ learning

difficulties▫ dysfluency▫ Down’s

syndrome▫ dyslexia▫ autism

• Housewives were generally least aware (except hearing impairment)

0102030405060708090

housewives professionals students

Communication difficulties

Awareness of SLT service

0

10

20

30

40

50

60

70

80

Yes No

Children No Children

0

20

40

60

80

100

Yes No

Housewives Professionals Students

0

20

40

60

80

100

Yes No

18-25 26-35 36-45 46+

Perceived role of SLT

0

10

20

30

40

50

60

Teach

er

Psycholo

gist

Nurse

Comm.En

hancer

Biling

ual su

pport a

ss.

Interpre

ter

Children No Children

0

10

20

30

40

50

60

70

80

90

Teach

er

Psycholo

gist

Nurse

Comm.En

hancer

Biling

ual su

pport a

ss.

Interpre

ter

Housewives Professionals Students

0

10

20

30

40

50

60

70

Teacher

Psycholo

gist Nurse

Comm. Enhancer

Bilingual s

upport ass.

Interpreter

18-25 26-35 36-45 46-55

Attitudes towards seeking professional advice

0

20

40

60

80

100

Yes No Not sure

18-25 26-35 36-45 46+• In answer to the question

Would you seek professional advice if a difficulty is suspected? the majority (90%) of respondents said yes

• A total of 13% would not seek professional advice, they were all in the age group 46+

• “...the health visitor is professional advice, but motherly advice is advice given with experience so it’s comforting...both are important”.

Attitude towards seeking professional advice

0

20

40

60

80

100

Happy Uncertain Afraid Ashamed

18-25 26-35 36-45 46+

0

20

40

60

80

Happy Uncertain Afraid Ashamed

Housewives Professionals Students

0

20

40

60

80

Happy Uncertain Afraid Ashamed

Children No children

Feelings of shame•All interviewees showed an understanding

of why people feel ashamed with comments such as:▫“...culturally in Pakistan if there’s a problem

they try sort it out internally...it is taboo, but prayer alone can’t solve everything”

▫“...my daughter just had mumps...everyone would stare making me feel uncomfortable and feeling the need to explain it was just mumps all the time...no one wants their child to be stared at like that”.

Summary of results• Large no. of women aware of the SLT service, but

lower awareness of exact role of SLT• Lower awareness of speech & language

development and causes of communication difficulties

• Significant number would be ashamed to seek help• Particularly older women & housewives

• Most would seek professional advice, but a significant number would turn to a family member instead.

• Results from the questionnaires & interviews complement each other.

Conclusion• Overall good level of awareness – 70%• Confusion around exact role and communication

difficulties.• Established foundation level of awareness of

SLT service and communication difficulties, and attitudes towards disability.• Further research on how to increase awareness

& involvement• Identify groups at risk

• Research on most appropriate means of gaining new information to increase awareness & involvement