Our guest chat host tonight on October 30, 2000 is Dr. Terry Saenz,
from the University of California-Fullerton.  Dr. Saenz, Ph.D., is an
Assistant Professor in the Department of Speech Communication,
Communicative Disorders Program.  Her areas of interest include
bilingual/bicultural speech-language pathology, particularly
with the Spanish speaking population.  She is also involved in the
recruitment and retention of culturally diverse students in the profession.
Dr. Saenz will be chatting about bilingual/bicultural speech pathology.

<Terry Saenz> I am more than willing to answer questions about
<Julia> I was curious to hear more about the difficulties faced with bilingual
<Nancy> Great!  What do you do to encourage a diverse undergraduate
    student body?
<Adrienne.> are certain disorders more prominent in certain cultures?
<Nancy> Now you have three questions at once!!!
<Julia> What similarities and or discrepancies do you find among people?
<Terry Saenz> Don't be sorry; to encourage a diverse student body, you need
    to have a program that is student oriented.
<Terry Saenz>  You need to have informed faculty
<Terry Saenz> They need to know about diversity.
<Terry Saenz> You need to have a diverse student body and to acknowledge
    and respect differences.
<Anonymous497> a diverse student body?
<Terry Saenz> There is different incidence of certain disorders.
<Terry Saenz> There is more otitus media in Native Americans
<Adrienne.> any speculations as to why?
<Anonymous497> so that should be taken into consideration if the medical
    issues are evaluated prior?
<Anonymous497> why is that?
<Terry Saenz> Not sure; may have something to do with angle of Eustachian
    tube or sometime
<Terry Saenz> lack of access to medical services on reservations.
<Anonymous497> so possibly structures are different according to race?
<Terry Saenz> There seems to be some evidence to that effect for certain
    structures, although that is not my area.
<Anonymous497> that seems interesting
<Terry Saenz> As far as hospital settings, there is a great need for
<Anonymous497> how come things like this are not addressed as heavily in
    the speech pathology field?
<Robin> are speech disorders treated differently in other cultures?
<Adrienne.> how do you incorporate diversity in slp clinics?
<Terry Saenz> Yes, and there are folk beliefs in every culture.
<Terry Saenz> Mexico offers no treatment in the schools; I volunteer at a
     daycare center
<Anonymous497> so how could a SLP CCC formulate therapy around bicultural beliefs?
<Terry Saenz> You must become familiar with the beliefs of the culture and
<Terry Saenz> incorporate them into your therapy.
<Terry Saenz> Some Asian parents believe that disability is stigmatized and
    may try to hide their child.
<Anonymous497> what if you know there is a need for intervantion and the
    parents will not reinforce it
<Adrienne.> what type of things do we usually do in therapy that are
    offensive or not sensitive to other cultures, Spanish for example
<Terry Saenz> You need to work with them and explain what you can do.
<Terry Saenz> Anglo culture is sometimes perceived as brusque and
<Terry Saenz> You need to take a little time to talk and be personable.
<Nancy> I was a volunteer on a medical mission in Brazil this summer.  Two
    boys, 10 and 14 years old, were brought to us.  Both were profoundly deaf
    and had had no formal education.  This was a rural poor community,
    not in the big cities.
<Terry Saenz> This is not unusual for the third world.
<Adrienne.> wow Nancy, what did you do for them?
<Terry Saenz> There are no services for the poor.
<Terry Saenz> Did you try to teach them some functional signs?
<Nancy> We made a connection to an audiologist in a nearby city, and tried to
    work out a deal with the local school to provide at least a half hour of
    instruction every day.
<Terry Saenz> That is wonderful.
<Robin> Nancy, where are you in school?
<Adrienne.> would the school know how to provide instruction?
<Nancy> The educational system is just beginning to set up special
    education programs in rural areas.
<Terry Saenz> Nancy, do you speak Portuguese?
<Nancy> I'm a faculty member in Plattsburgh State, NY
<Nancy> I studied hard before going and could carry on social conversations.
     For work I relied on a translator.
<Nancy> I've continued to study and am helping a Brazilian woman learn
    English and she helps me continue to study Portuguese.
<Terry Saenz> That is wonderful; we need research in that language.
<Anonymous497> which languages are less known or introduced in the SLP
<Terry Saenz> There are many that are less known; it depends on the part of
    the  country.
<drducttape> I work with Loatians
<Terry Saenz> We have a very large Vietnamese population out
<drducttape> I also work with Vietnamese in Binghamton, New York
<drducttape> I work on artic belive it or not
<drducttape> auditory training and video taping
<drducttape> they are so into it.....and love the techno part
<Terry Saenz> Many are good
<drducttape> I use the computer with quick cam
<Terry Saenz> We are now just training Vietnamese SLPs out here.  Out in
    Southern California
<Visconti79> what are some significant strategies that are noticed in certain
<Terry Saenz> What type of strategies?
<Visconti79> for language development
<Visconti79> how strong are the speech pathology programs in South
<Terry Saenz> CSU Fullerton (mine), San Diego State, Redlands, Cal State
    LA, Cal State Long Beach, Cal State Northridge,  Loma Linda
<Visconti79> how do you know if a strategy you are implementing is not
    accepted by the parent?
<Terry Saenz> You need to check for the nonverbal signs
<Terry Saenz> Look at the body posture
<Terry Saenz> Look and see if parents miss appointments
<drducttape> many parents of my clients are not bilingual
<Terry Saenz> Look and see if they do not carry out instructions
<Visconti79> what if they are not vocal about it?
<Terry Saenz> You need to read the nonverbal signs; it takes practice.
<Adrienne.> how do you tell when they are uncomfortable or just acting in
    their culture, eye contact for example
<Terry Saenz> See if they miss appointments or don't carry out instructions.
<drducttape> I always use an interpreter
<Terry Saenz> Ask your interpreter.
<Visconti79> which body signals are used and not used in certain cultures?
<Terry Saenz> Eye contact is often one.
<drducttape> yes it is is Dr.Saenz...they tend to look away or down most times
<Terry Saenz> A closed body posture may also signal opposition.
<Visconti79> really?
<Terry Saenz> It may be important to be more low-key with people who seem
<drducttape> many will try to appear as if they understand when they have not
    a clue
<Terry Saenz> That's why you simplify and repeat.
<Visconti79> low-key, how so?
<Terry Saenz> You never want people to lose face.  Do it graciously.
<Terry Saenz> Calmer demeanor; softer voice.
<drducttape> I also use the interpreter.....and use short phrases
<Terry Saenz> Good.  You need to make it easy for them
<Visconti79> ok, what if the parents do not want you to help structure their
    sound productions through structural placements?
<Terry Saenz> Why would they object?
<drducttape> out of fear of losing heritage??
<Adrienne.> lack of understanding?
<drducttape> change is scary
<Terry Saenz> They have a right to keep their own accent.
<Terry Saenz> We cannot call a language difference a disorder-ASHA
<Visconti79> well, say if you are helping the production of a /m/ sound
<Visconti79> what if they feel you should not do that or what if they think you
    are hurting a chld while stimulating oral muscles before sound productions
<Terry Saenz> You have to explain what you are doing and have the child
    enjoy it
<Terry Saenz> Remember, they don't know what you are doing or why
<Visconti79> how do you explain it?
<Visconti79> that is very true
<Terry Saenz> Make it simple; emphasize that it will help the child.
<Terry Saenz> They only need to know that it will help and why.
<Visconti79> in what course do you learn about the placements of oral
    structures in sound production?
<Visconti79> is it learned in grad school?
<Terry Saenz> I think so.
<Visconti79> what if they do not understand?
<Terry Saenz> You stay patient and respectful.  Let them save face.
<drducttape> sounds like Dr. Saenz is part counselor...which is a plus
<Adrienne.> is it more difficult to build rapport?
<Terry Saenz> The key word is to respect others and be patient with their
<drducttape> I agree
<Visconti79> hope I can do a good job with showing understanding and
    explain things and strategies correctly
<Visconti79> I bet that is a very hard part to therapy too
<Terry Saenz> Not so much if you are trying consistently  to show respect
<Terry Saenz> It takes a new way of thinking and the determination to do it
<Terry Saenz> It takes study, time, patience with yourself, and wisdom.
<Robin> We have a group of SLPs who work with these issues in the
    workplace, often corporations, where cultural and language differences can
    affect job performance
<Visconti79> what related courses or things do you recommend exposure to to
    understand how to implement this in therapy sessions?
<Terry Saenz> Absolutely.  Any course at conventions or conferences or at
<Terry Saenz> We have a multicultural course and we discuss cultural
<Terry Saenz> I have my students do cultural autobiographies to understand
    themselves better.
<Visconti79> that is not manditory at my college, I am almost positive
<Visconti79> that is a great idea
<Terry Saenz> Then you need to seek it out.  Diversity is on the horizon
<Terry Saenz> We are 50% diverse in Ca.
<Visconti79> on a language sample must you provide the cultural backround
    the patient is from?
<Terry Saenz> That is helpful, but you must be tactful.
<Visconti79> tactful how so?
<Terry Saenz> Toya Wyatt says some African American parents are sensitive
    to labels
<Visconti79> why?
<Terry Saenz> You should provide linguistic information if it is relevant and
    affects performance
<Terry Saenz> Also be careful about a student who speaks English as a
    second language
<Terry Saenz> Sometimes they take years to catch up in every language area-
<Terry Saenz> although they have normal skills in the first language.
<Visconti79> what if you do not find out about a second language until a
    language sample is being collected and do not understand some utterances?
<Terry Saenz> You should always ask beforehand.
<Visconti79> what if it is not provided?
<Terry Saenz> That is pretty fundamental information
<Visconti79> I mean if a parents does not want a label on a child or want the
    child treated differently they might not state it, right?
<Terry Saenz> That affects your whole test battery.  I would always ask.
<Terry Saenz> Surnames help as a clue.
<Visconti79> never thought of that
<Visconti79> they always provide the correct information?
<Terry Saenz> No, but they may say a child is exposed to another language
    and does not speak
<Adrienne.> explaining how important accuracy of history questionnaire is
    would help
<Terry Saenz> That is true, but some people won't fill out a questionnaire
<Visconti79> why not?
<Adrienne.> I would think the questions relating to drug use during
    pregnancy, etc would be more likely to be fudged
<Terry Saenz> Lack of English, lack of education,
<Terry Saenz> Objections to the personal nature of some questions
<Terry Saenz> You may want to go over the questionnaire with them
<Visconti79> ok, so information is withheld and they do not sign for a release
    of information to you, how do you strategize therapy?
<Terry Saenz> I used to call parents and talk to them in Spanish.
<Adrienne.> what if you don't know spanish?
<Terry Saenz> A child who has another language will have an accent usually
<Visconti79> In Caliornia I bet it is a big plus if you do
<Terry Saenz> I speak if fairly fluently
<Adrienne.> Florida too
<Visconti79> what if utterances are hard to differentiate due to the accent?
<Terry Saenz> Bilingual skills are incredibly valuable and helpful in this field.
<Visconti79> I take Spanish classes
<Terry Saenz> If utterances are hard to differentiate, maybe get a native speaker
    to listen
<Terry Saenz> Also look for sounds that are produced differently in another
<Visconti79> which are the most common?
<Terry Saenz> It depends on the language.  th substituted by d is common in
<Terry Saenz> ch and sh in Spanish
<Terry Saenz> differences in vowels, fewer in Spanish
<Visconti79> should have picked up on the Spanish one :)
<Adrienne.> are those things we would try to change or does that count as
    part of accent?
<Terry Saenz> It's part of an accent.
<Adrienne.> ok
<Terry Saenz> It is only an error if incorrect in both languages.
<Adrienne.> ahh
<Visconti79> so that is how they assesses a significant language delay
<Visconti79> or deviance
<Terry Saenz> This differential diagnosis is tricky
<Terry Saenz> Yes, that is how.
<Visconti79> interesting :)
<Terry Saenz> The language sample is very important and informals are
<Visconti79> I would love to see how that is assessed and done
<Visconti79> Which battery test is most beneficial for this?
<Terry Saenz> There are a number of books out
<Terry Saenz> It varies with the part of the country
<Visconti79> why?
<Terry Saenz> Southern California has a lot of tests normed for that area.
<Terry Saenz> Very little in the East Coast
<Terry Saenz> The TVIP (Spanish Peabody) is often used
<Visconti79> I thought the artic tests would be the only ones used for sound
    productions assessment
<Visconti79> wow
<Terry Saenz> The Spanish CELF has been normed for the country
<Terry Saenz> La Meda is a Southern California artic assessment; there are others
<Visconti79> La Meda?
<Terry Saenz> Some use the Spanish Spelt
<Visconti79> Never heard of that before
<Adrienne.> me neither
<Terry Saenz> The Spelt with Spanish protocol
<Terry Saenz> The La Meda is pretty old
<Visconti79> I wonder which professors are willing to send information about
    what you have been discussing
<Terry Saenz> We have some information on Vietnamese attitudes toward
<Robin> Dr. Saenz, I see that you will be presenting at ASHA
<Terry Saenz> Yes
<Robin> I will try to attend your session
<Terry Saenz> Thanks! 
<Terry Saenz> It is just a poster session, but introduce yourselves.
<Adrienne.> Thank you so much for the info Dr. Saenz!
<Visconti79> thank you
<Terry Saenz> My great pleasure.  Thank you for listening in and talking
<Visconti79> being given information about the field is always apppreciated
<Robin> this has been a most interesting chat!
<Terry Saenz> Thank you and good night!