Miguel is 19 months old and lives with a large family that includes his parents, three older siblings, an aunt, and his grandparents. He qualified for early intervention due to delays in gross motor development and low muscle tone. He’s also showing some slight delays in his expressive communication. During his assessment and subsequent intervention visits, you notice that Miguel’s family often carries him around or keeps him in a pack-n-play during the day. His family is also very skilled at meeting his needs, so much so that he barely has to vocalize to get what he wants. The more you get to know the family, the more you wonder…does Miguel truly have developmental delays or are his developmental differences due to how he is cared for?
What’s Causing Miguel’s Delays?
Wondering why Miguel is showing delays is a normal part of the detective work we do as early interventionists. We believe that when we can find an environmental factor, then maybe we can help the family make changes to eliminate it. Sometimes this is true, such as when a child is in an under-stimulating child care environment and we can help the family find a better option. Other times, though, the factors in the environment are grounded in family values and cultural beliefs that are much harder to change. We have to question whether or not it is even appropriate to try to change family values or beliefs? Is that our place?
Cultural Differences in Child Rearing & Independence
Based on their cultural beliefs, Miguel’s family defines their role in his child rearing as taking complete care of him and ensuring his safety. Miguel is included in all family activities and is well-cared for and very well-loved. The female caregivers in his life (mom, aunt, sisters, grandmother) all share the responsibility of caring for him, carrying him around, and meeting his needs. They use the pack-n-play to keep Miguel safe from all of the traffic in the home, fearing that he would be stepped on if left on the floor to play since he can’t move out of the way yet. Developing Miguel’s independence is not a priority for them as, in their culture, he is considered a baby for the first few years of his life. This is different from our typical American view of infancy and early milestones. This difference doesn’t make their cultural view wrong. It does complicate matters, though, since our assessments and intervention processes don’t often adequately consider cultural differences.
Does It Matter?
You might be thinking “does the cause really matter?” and I’d say that yes, it does. Perhaps a more important question to ask is what Miguel’s parents think. Asking them when children are expected to walk and talk in their culture can give you an important clue. If they say that they think Miguel should be walking and talking by now, then the door is open to discuss intervention. If they say no, then talk about their interest in early intervention. It’s fine to talk about what we expect developmentally in typical American culture so that they understand why we are concerned (our perspective) and have information on which to base their decision. It’s important to have this discussion, though, with respect for their cultural values and beliefs.
If you were Miguel’s service provider, how would you support his family? Would you address your observations? How would you provide intervention suggestions that were sensitive to his family’s cultural beliefs?
Does it matter that his delays might be related to his caregiving and culture? Why or why not?
For more information about cultural competence, visit the VA Early Intervention Professional Development Center’s Cultural Competence topic page and the Cultural Competence (PDF, New Window) resource landing pad.