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English Speaking Caribbean Parent Role in Speech and Language Therapy Intervention- A Case Study

Parenting in Jamaica

Jamaicans are a happy and relaxed people residing in a generally a poor country. While Jamaica is home to some wealthy citizens and some middle class, the majority are very poor, many living in a one room shack type home and others being homeless. Despite their plight, most Jamaicans are friendly, warm and welcoming. Most Jamaican families are headed by women who typically bear the full responsibility for supporting and raising children. However, poor parenting has become a crisis and is now viewed as a national dilemma that is further exacerbated by "watered down values and a continued failure to plan for children".

Part of the problem rests in the fact that many people go "straight from childhood to parenting" and more than 75% of Jamaican children are born to couple who will not have a long-term relationship. Many children do not know their father (puppa) and, as the Jamaican Gleaner reports, there is a noted "continued absence of the father's name from the children's birth certificates" (para. 5). Sadly, many of these children are being raised by a single parent-or parents in some cases-who cannot provide for themselves, much less provide for a child.

Most Jamaican children are raised by a single mother or in extended families with relatives and neighbors harboring much of the care for the children. Marriage is less common in Jamaica and many couples marry after the children are grown-if they do in fact have a long-term relationship and decide to marry at all. The delay in marrying could be attributed to the cultural tendency to move at a slower pace than other nations, specifically the United States, which is known as a more-fast-paced, immediate culture. As such, Jamaicans have less of a sense of urgency to accomplish tasks and this procrastination-or neglect to complete tasks in some cases-is most likely passed along to the children and impact the level of interactive parenting the child receives. Parenting practices are in dire need of transforming form the old negative practices to "new practices that reinforce positive values" (Jamaican parenting in crisis, 2008, para. 15).

English Caribbean Language

As a result of the increasing problem with poor parenting, Jamaican resource are also increasing where regional and international organizations have begun to work to educate parents and improve parenting practices where children can learn positive values, the importance of family, and engage these practices in the academic environment. UNICEF is one organization that aids in supporting the establishment of Parent Support Advisory Teams (P-SATs), which are designed to give parents the opportunity to share and learn from one another under the support and guidance of specially trained professionals (Jamaica and Parenting, nd). Specifically, P-SATs unite people from major organizations who have an interest in parenting with organizations including "schools, churches, community-based organizations and citizens' associations, among others" (Jamaica and Parenting, nd, para. 2). Organization representatives are trained to educate parents about good parenting practices. The Coalition for Better Parenting works in conjunction with other local agencies and organizations to engage parents in ways that foster positive parenting practices and focus on various parenting issues.

A common and disturbing issue among Jamaican parents, specifically in single-mother households is the great reliance on corporal punishment which is also proven to led children to be more prone to violence as they grow and mature. When understanding that the family is the most prominent social group that exists and its role in preparing children for the various roles they will perform in society, it is easier to see how children raised in home where corporal punishment is frequent would be more prone to enact their displeasure in similar, physically aggressive ways. Further, as related to parenting and punishment, Jamaican families are the most violent social group with parental violence against children being the most common type of family violence and would be consider child abuse in other countries.

With the parenting crisis and the lack of positive parent-child interaction, the influence expounded in a child's home life impacts the child's academic life. Studies prove that the more involved parents are in the education of their children the better children perform at school and the more connected parents are with their child the better children interact with their peers and other adults in academic social settings. Positive parent-child relationships promote increased "academic achievement of students, improves the attitudes and performance of students in school, increases self esteem and motivation, reduces behavioral problems and lowers students dropout rates, helps parents understands the work of the school and builds school-community relationships in an on-going, problem preventing way" (Murphy, 2002, p. 4). Research also shows that parents who understand more about the education process are more likely to change negative behaviors at home and are apt to show greater appreciation for teachers and the education community.

Ongoing efforts are being applied to education Jamaican parents on the importance of positive parenting and the equal importance of the parent-child relationship in molding engaged students who value family, peer, and academic relationships. Further, positive parenting works to shape children who will pass along the positive traits to others both inside and external to the family setting, particularly as the child engages in education settings with peers and educators.

Education in Jamaica for the Preschool Aged Child

The first written Jamaica pre-school curriculum was completed in 1973 in the form of the PECE Manual, a 24-volume instructional guide that provided a step-by-step approach for presenting traditional subject area content. The step-by-step approach was necessary as teachers were inexperienced with little in-depth knowledge of important child development and education principles and practices. Regular meetings were held where teachers were educated based on the founding principles in the guide. In 1979, the Early Childhood Unit of the Ministry of Education conducted a survey that revealed the training meetings were a success and that teachers were "becoming increasingly better trained and better qualified for their teaching roles" (Davies, 2008, p. V).

At the request of teachers the PECE manual was reviewed and rewritten to afford greater flexibility in interpreting and implementing curriculum in individual classrooms, resulting in the 1983 manual consisting the Readiness Programme for 4 Year Olds and Readiness Programme for 5 Year Olds, which replaced the subject-based structure of the PECE manual with an integrated curriculum approach. The revised manual emphasized skills development across multiple developmental domains by implementing strategies and curriculum that integrated themed activities for increased learning engagement. While the manual served current and seasoned teachers well, it was difficult for new or inexperienced teachers to understand. As such, in 1990, the Early Childhood Unit in the Ministry of Education approved another survey, conducted by the University of the West Indies-based Centre for Early Childhood Education (CECE), establishing the provisions necessary to implement the use of the PECE and the "Readiness" in pre-primary schools throughout Jamaica with the outcome being a better structured curriculum design that imparted a balance of the two versions.

Curriculum for children aged birth to three years was developed after the curriculum for children aged four to five as was implemented in various child care organizations including day care facilities. While the importance of early education for four and five year old children was understood, in the 1970s, the need for an education program for children birth to three years of age was becoming increasingly necessary as single parent households (mostly single mother homes) was also increasing. Children aged birth to three year spent more time with caregivers while the mother worked to provide for the family. However, another issue surfaced-the cost of sending a child to a day care center. As a result, the government developed policies in support of publicly funded day care centers, although only a few centers are actually publicly funded.

Day care centers and preschool centers operate under the provisions of The Jamaica Early Childhood Curriculum for Children Birth to Five Years, which consists of four documents as described by Davies:

While under-privileged children and children from low-income, single-parent households are a great reason for the birth to five year old curriculum, the design is geared to children from all social groups in Jamaican society. The intent is not only to educate preschool aged children but to impart positive values and encourage children to remain on task in meeting developmental milestones in ways that may not be achievable outside of a structured learning environment. The potential to engage parents is vast; however, parenting involvement remains an ongoing issue the Ministry of Education is diligently working to improve.

Special Education Services in Jamaica

Among the many areas of childhood development and childhood education areas in need of reform, Jamaica's Ministry of Education, in cooperation with multiple agencies and organizations, is pushing to improve special education services in Jamaica. The issue of special needs children and the lack of services available has been the subject of ongoing criticism for decades. In 1992, a group of researchers conducted a two-stage survey of 2 to 9-year-old children in mid and south Claredon, Jamaica where they analyzed symptoms and disability findings related to each child's visual, hearing, speech, motor, cognitive and fits. Researchers examined the needs of the Jamaican child population by extrapolating figures based on an estimate of one million children under 15. The results revealed that among children with disabilities, "62% needed special education, 29.5% needed community-based services, 21% needed spectacles, 21% needed specialist referral, and 6% required medical treatment" (Thorburn, Desai & Paul, 1992, p. 31). The authors further revealed that the lack of services was believed to be related to the lack of existing health and education personnel and inadequate training related to the basic techniques of screening and assessment (p. 37). However, subseiqnet data reveals inadequate training and the lack of understanding of how to parent a child with a disability was also a major inhibiting factor in successful and progressive childhood development.

While founded in 1956, the Jamaican Association on Intellectual Disabilities (JAID) was met with obstacles in its outreach efforts to educate parents and get parents to become involved in the academic development of their disabled child. Issues with lack of parenting involvement tend to relate to the tensions of single parent families where there is little to no help with children-healthy or disabled. As such, it has become even more imperative that Jamaica's education system be equipped with the curriculum and training for teachers necessary to help special needs children to meet crucial developmental milestones.

Currently, the JAID provides multiple services including educational assessment and placement, development assessment, early intervention and special education, transition and vocational programming, a continuing education program and skills training, mainstream education, social and recreational programs, guidance and counseling, social services, and professional development. The services are provided through Schools of Special Education, Early Intervention Program, Resource and Professionals in Partnership (PProP), Adult Continuing Education Program, and Primary Intervention Program (PIP). Applicable to this study are JAID's Schools of Special Education, the Early Intervention Program, and PProP.

Special education programs are designed to focus on each student's potential and provides special education services for children aged 4 to 20 with intellectual disabilities. Placement criteria include the Psycho Educational Assessment Report which is used to indicate the diagnosis of intellectual disabilities. Students are educated using two curricula: the Ministry of Education National Primary Curriculum and a Competency Based Curriculum designed to meet the needs of children who cannot fully access the National Primary Curriculum. As of 2011, the student population is 1,600. The Early Intervention program is designed for children aged birth to six years of age with intellectual disabilities and other developmental disabilities with the primary objective being to prepare children for appropriate school placement. JAID's mission in the Parents and Professionals in Partnership (PProP) is to educate parents and teachers to enable them to collectively engage children in areas of weakness, enhance strengths, and build independence in specific learning strategies and study skills.

Special education service agencies, providers and educators find that the lack of parental participation in special education remains an issue. Despite efforts by the Ministry of Education to put different practices in place for children with learning disabilities there remains a lack of parental attention and the drive to become involved is absent. The limit of parental involvement may be due to a lack of understanding the child's disability, becoming overwhelmed, no time because of lack of time management, or no desire to become fully engaged in the child's intellectual development.

The reason most children do not succeed is often due to the lack of parental involvement in the education process and the risks are compounded when the child has a disability. The Jamaican government has enacted policies to encourage parental involvement but there remains a wide gap in the levels of interaction between parents and children and parents and educators. As such, programs such as PProP work not only to encourage parental involvement but also serve as consistent resource where parents can become informed on their child's specific disability and special needs. The program facilitates cooperation between parents and program professionals to further encourage parents and educators to become and remain involved to ensure children receive the appropriate assistance and services to achieve developmental and academic success.

In many western regions, specific laws relating to education and special education milestones aid in ensuring children are learning and retaining the material being taught. In the US, for example, the No Child Left Behind Act of 2001 (NCLB) and the reauthorized Elementary and Secondary Education Act (ESEA) serve as a way for the government to oversee local schools by imposing measurable requirements on Local Education Agencies (LEA) or districts. Under NCLD and ESEA, each state is required to implement statewide academic standards that work to expand local control and flexibility, do what works best for research, and offer more options for parents. While parental involvement is more common in the US and is proven effective in improving homework scores and greater retention of study materials, the level of involvement is reduced greatly in Jamaica because of the majority of children being raised by a single mother with little to no time to devote to their child's education, not to mention the demands of a special needs child.

While Jamaica offers mainstream education services, the full education benefits do not match those of other countries, again, specifically the US. In the US, the Department of Education and individual state and local school systems stress the importance of parental involvement as it is proven effective in helping children to remain engaged in learning. Further, it is extremely important that a parent always assumes an active role in the life of a child especially when a child has a disability. In the US, the Individuals with Disabilities Act of 2001 took away the separation between regular education children and children with disabilities. Prior to the Act, special education had become a place, not a service. Most children in special education classes continued to struggle and there seemed to be little advancement among the majority of special needs students. When special education student began to be integrated (mainstreamed) into regular classrooms with external special education services provided separately (i.e. tutoring, inclusion classes, et al), the number of special education students actually reaching significant developmental and academic milestones increased.

Because of the structure of Jamaican families, there is little attention given to whether a child is succeeding in life or in school. Work and leisure tends to come before the children and children with disabilities tend to fall even further behind. Intellectually disabled students often have weak memories, so teaching these children has to include strong focus on basic skills and memorization rather than problem solving and decision making and parental involvement is a predominant aid in improving the child's abilities. However, parents have to be educated on the best practices of meeting the needs of disabled children. When the efforts are put forth, the outcome is most often impressive as students with disabilities are quite capable-they simply need adjusted types of education and parenting services.

Past studies reveal that children with disabilities are known to score higher on many tests than their counterparts. However, some educators believe students with special needs cannot benefit from being taught to think at a higher level, but the most successful special needs child has been given the chance to try and to reach goals typically viewed as acceptable for "normal" children. The key to reaching higher goals is tied to the child's ability to apply critical thinking skills, an essential element in the field of special education.

Observing, describing, organizing, questioning, problem solving and time management are higher order thinking skills that must be mastered if students with special needs are to be independent learners using all their mental ability. Labeling and reciting have been proven effective in increasing memory retention among disabled children and are easy tasks parents can do to engage with their children. When parents and educators work together to with parents taking an active role by being involved in the child's activities, the child become encouraged and works harder to succeed.

While the statement may seem redundant, it is imperative to stress that the most important thing in a child's life-and even more important in the life of a special needs child-is the parent being involved in learning about their child's disability and what it takes to help them succeed. A parent has to be educated on the child's disability and the Ministry of Education, as well as other local and national organizations, has worked to provide programs that help parents understand their child's disability. The severity of the disability can make it difficult for the parent when they do not understand what their child is or may go through. Sadly, many parents find that raising a special needs child takes a lot of energy and some stop trying. Through JAID and similar organizations, there are programs that work to reach out to parents and help them deal with the struggled that often lead to becoming overwhelmed with the responsibilities of parenting.

How Jamaican Immigrants Perceive Healthcare in the US

Immigrants from English-speaking Caribbean countries make up the majority of Black Caribbean immigrants in the US with Jamaicans accounting for 36% of all Caribbean immigrants in 2008-2009. Between 2006-2008, Caribbean immigrants comprised 49% of all naturalized US citizens, 28% legal permanent residents, 16% unauthorized immigrants, 7% refugees, and 1% legal temporary. In 2010, among persons granted legal permanent residence by class of admission, Black Caribbean immigrants comprised 41% immediate relative of US citizens, 34% family-sponsored preferences, 24% refugees and asylees, 1% employment-based preferences, 0% diversity, and 0% other.

Black Caribbean immigrants are not are geographically dispersed as other immigrant groups as they tend to migrate to specific states to "increase their economic and political influence in local communities" (Thomas, 2012, p. 8). In 2007, 66% of all Caribbean immigrants lived in New York and Florida (38% and 28% respectively) with the remaining immigrants residing in New Jersey (7%), Massachusetts (4%), Georgia (3%), Maryland (3%), and Connecticut (3%).

From 2005 to 2009, Black Caribbean immigrants were over-represented among less-educated groups in the US as one in five aged 25 or older had less than a high school diploma. The reason for low education ratios is believed to be linked to "low levels of educational attainment" and the "highly educated migrants [may] have more flexibility to go elsewhere" (p. 9). Caribbean blacks are underrepresented among highly skilled workers and among those born in the Caribbean were less likely to have a master's, doctorate, or professional degree (7% in 2005-2009) and less likely to have college degrees than other immigrants. Further, Caribbean Blacks are more likely to be English-speaking, less likely to be bilingual, with about 60% speaking exclusively English at home. Of all Jamaican immigrants, 90% use English as their primary language at home with language skills that exceed the average for all immigrant groups.

In 2005-2009, among Caribbean immigrants aged 18 to 64, about 75% were employed. Similar to other immigrant groups-as well as natural born citizens in any racial or ethnic group-female immigrant employment rates were 13%, 11% and 9% lower than their male counterparts, although Black Caribbean women were 75% more likely to be employed than females in Black African groups with Jamaican women comprising the largest employed group of Caribbean female immigrants. There is a higher percentage of single-parent households among Caribbean immigrants and these groups tend to be disadvantaged due to "socialeconomic disadvantages including high poverty levels, limited parental supervision and poor schooling outcomes" (Thomas, 2012, p. 16). As noted in Jamaica, extended family arrangements among Jamaican immigrants is more common than in other immigrant groups.

According to Wheeler and Mahoney, the status of Caribbean immigrants in the US is not massive, but some populations are "making great strides in their education, income, and social mobility in which they are poised to realize the American dream" while other "segments of the population face a range of challenges in measures of education and other indices of well-being" (p. 238). While immigrants have clear benefits and more opportunities, there remain a significant number facing worsening health status as a result of "socio-structural factors that affect their access and use of health services" (p. 238). Further, as Wheeler and Mahoney (2008) point out, "the unique psychosocial risk factors faced by immigrants from the region [and] their distinctly different clinical and social needs are often misunderstood" (p. 238).

Jamaican immigrants face many barriers to both the use and access of health care in the US ranging from lack of insurance, immigration status, health beliefs and practices, and stigma associated with mental health care. Under the 1996 welfare reform law that provides that immigrants arriving after August 1996 are denied Medicaid for five years, the Jamaican immigrant group is especially impacted as they are more likely to be employed in jobs that do not provide health benefits and most cannot afford mainstream medical services. As a result, many immigrants rely on the use of traditional health beliefs and practices that generally consist of a mixture of traditional folk health and mainstream medical systems. The authors specifically state:

A substantial segment of the Caribbean population continues to rely, in varying degrees, on these alternative therapies, which may include herbal and alternative treatments, traditional folk healing, and the use of herbal baths. Among the troubling aspects to the use of these indigenous health practices is the fact that the approach to health care use is reactive rather than proactive, which further undermines the urgent need for preventive care among this population.

There is also a stigma associated with health care, particularly when needing mental health services. Caribbean immigrants suffering from depression were three to six times more likely to cite stigma-related concerns as the reason why they avoid mental health treatment.

Jamaican Family Dynamics

Women are the primary financial providers in Jamaican families and they hold the primary responsibility for child rearing. Jamaican men are viewed as unreliable, controlling and peripherally engaged in household and child-rearing tasks. While there are many common-law relationships that comprise the Jamaican family, the majority result in a single parent-most often the mother-being left to care for the children and provide for the family. While a two-parent household is rare, when present Jamaican fathers "displayed a range of involvement in playing with and providing physical care for the children in their household" (Yearwood, 2001, p. 9). Child fostering is common in the Jamaican culture as most parents rely on extended family members or friends to help care for the children, especially when food and economic resources are limited. Fostering also occurs when the primary provider leaves the country to seek employment, in which case the individual generally sends money back to their home country to help support their family and children.

Among Jamaican immigrants in the US, one study found that education was a priority for the family's children and that the parents tend to be strict believing that children should be "mannerly, obedient, and respectful to adults" (Sewell-Coker, Hamilton-Collins & Fein, 1985, p. 565). However, because many immigrant families do not have the assistance of their extended families, they were more likely to be urbanely isolated. Among families with adolescent children, children were "particularly vulnerable because of acculturation conflicts involving competing values between traditional views held by parents and those held by the host culture" (Yearwood). Jamaican families tend to have strong religious and spiritual values where values are passed down from generation to generation. Among families with strong values, the church is a strong source of support and serves as the family's main source of socialization opportunities.


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