ERIC Identifier: ED438663
Publication Date: 1999-12-00
Author: Valdivia, Rebeca
Source: ERIC Clearinghouse on
Disabilities and Gifted Education Reston VA.
The Implications of Culture on Developmental Delay. ERIC Digest
Developmental delay refers to a lag in development rather than to a specific
condition causing that lag. It represents a slower rate of development, in which
a child exhibits a functional level below the norm for his or her age. A child
may have an across-the-board developmental delay or a delay in specific areas.
When a child's development appears to lag, many service providers prefer to
apply the less specific term "developmental delay," rather than a more specific
disability diagnosis, since symptoms of specific disabilities may be unclear in
young children. It is possible that a child with a developmental delay who
receives services will not develop a disability; whereas if the same child did
not receive services, the delay would become a disability.
Because it is based on a comparison of the child's functional level with that
of other children of the same age, "developmental delay" can be seen as a
statistically defined, socially mediated construct that depends on cultural
expectations and the definition of what constitutes a delay.
DEVELOPMENTAL DELAY UNDER THE LAW
Prior to 1997, IDEA
defined infants and toddlers with disabilities as individuals from birth through
age two, inclusive, who need early intervention services because they
* Are experiencing developmental delay as measured by appropriate diagnostic
instruments and procedures in one or more of the following areas: cognitive
development, physical development, language and speech development, psychosocial
development, or self-help skills, or
* Have a diagnosed physical or mental condition that has a high probability
of resulting in developmental delay.
The 1997 reauthorization of IDEA added that "for children 3 through 9, the
state and local education agency (LEA) may define 'child with disability' as a
child who is experiencing developmental delays and needs special education and
related services." Thus, these children do not have to be labeled with a
specific category to receive special education services.
Developmental delay is often interpreted as the precursor to the label
'disabled' for children from birth to nine years old. For children of diverse
cultural and linguistic backgrounds, professionals must be careful to avoid
errors in diagnosis that stem from differences among various cultures and
professionals about what constitutes a disability or delay.
When determining whether a child has a
developmental delay, the law requires use of appropriate diagnostic instruments
and procedures. Professionals working with young children have long accepted the
shortcomings of standardized tools, since young children with or without delays
are in a process of constant growth and change, which makes it difficult to
capture the child's development accurately at any one 'measurement' or
observation. In addition, young children seldom 'cooperate' according to the
expectations of the developers of the assessment tools, thus contributing to a
Many professionals have chosen to use instruments and procedures referenced
to local norms in order to obtain a more reflective picture of the child's
development (i.e., they develop a tool that reflects the norms of their
community rather than national norms). In determining the appropriateness of
norm-referenced instruments for children from diverse backgrounds, it is
essential to examine the populations on which the norms were based. The
following questions apply:
* Were the norms inclusive of the diversity of families found in the
communities across the United States with which the tool will be applied?
* Did these 'diverse' children also represent variations that typify the
communities in which the tool will be applied? For example, children within a
group may vary in socioeconomic status, languages spoken, immigration status,
and diversification within a more global category (e.g., Hispanic [Spanish-,
Cuban, Puerto Rican-, Peruvian-, Salvadoran- or Mexican-American]).
In addition, professionals involved in this step of the child's developmental
evaluation should ask themselves the following:
* Does the tool or process include provisions to conduct the assessment in
the child's dominant language(s)?
* Will specially trained personnel familiar with the family's culture,
practices, and beliefs conduct the assessment?
If even one of the answers to any of the four questions was "no," then either
the instrument or the process may be inappropriate for use with culturally and
linguistically diverse families.
Furthermore, the domains of development (e.g., cognitive, self-help, etc.)
and the items subsumed in each area are predominantly reflective of a Western
approach to the discussion and examination of early childhood development
(Srinivasan & Karlan, 1997; Hehir & Latus, 1992). Although early
childhood professionals may recognize the totality of the child, they may still
feel comfortable separating aspects of the child's development into these
component parts. Not only that, specialists (e.g., speech therapists) may
address each component (e.g., speech and language) separately from the other
components (e.g., gross motor). This may be in direct contradiction with
monitoring the child's development from a more holistic, functional, situational
approach common in other cultural groups (Kagitcibasi, 1996).
The age norms assigned to these various developmental domains are also quite
arbitrary; they are primarily reflective of white, middle-class child rearing
norms (e.g., Lynch & Hanson, 1992; Mangione, 1995). For instance, the entire
self-help paradigm is indicative of the value of 'early independence' in these
skills promoted by families in this group. Many families feel just as
comfortable encouraging their child to independently spoon-feed shortly before
the child attends public school at 5 or 6 years of age instead of at 18 months
as expected in many developmental checklists. Many families also see no purpose
in having their child drink from a cup before 3, 4, or 5 years of age. When
there are other family members around to help the child dress, there is no
pressure to encourage independent dressing early in the preschool years. These
are a few examples of different attainment of developmental milestones
influenced directly by different child-rearing values and practices.
Professionals must determine if they are truly measuring all the skills that
this child has learned or if they are only measuring those skills they value
based on their upbringing and professional training. For example, Garcia Coll
(1990) examined developmental skills such as tactile stimulation, verbal
interaction, nonverbal interaction, and feeding routines. These skills were
studied in multicultural families, including African- American,
Chinese-American, Hopi, Mexican-American, and Navajo families. The study found
that "minority infants are not only exposed to different patterns of affective
and social interactions, but that their learning experiences might result in the
acquisition of different modes of communication from those characterizing Anglo
infants, different means of exploration of their environment, and the
development of alternative cognitive skills." (p.274). Therefore, teachers and
other service providers must distinguish between a developmental or maturational
lag and behaviors that can be brought about by learning. For example, if a child
is unable to spoon-feed, is it because she lacks the needed musculature and fine
motor skill? Is it because she is neurologically unable to perform the complex
movement? Or is it simply because she has not learned that skill and will easily
learn it given the opportunity?
DISABILITY OR DELAY WITHIN A CULTURAL PERSPECTIVE
discussion has thus led us to accept that disability is a socially and
culturally situated construct (Danesco, 1997; Harry, 1992; McDermott & Varenne, 1996). Therefore, families of children of diverse cultures (and
languages) may not identify a certain series of behaviors or symptoms as being
descriptive of a 'delay' or 'disability'. For instance, in her review of the
literature, Danesco (1997) found that many culturally diverse parents explained
their child's condition as a combination of biomedical and sociocultural or folk
beliefs. Families often saw their child's condition as temporary or something
that could be remedied. Therefore, it is not uncommon to see families following
a combination of 'professional/medical' prescriptions along with home remedies,
folk or alternative practices in order to help their child. It should be noted
that families varied in how much weight they ascribed to professional,
educational, or medical interventions as compared to alternative interventions.
Because families had different interpretations of what constituted a delay or
disability, even having their child labeled led to misunderstandings and
mistrust between them and the professionals who were attempting to be helpful.
For example, if everybody else in the family had followed similar developmental
patterns, what would the label 'developmentally delayed' given to the youngest
child say about the rest of the family? If the child functioned well in the life
of the home and community and the concern only existed in the clinic, school, or
agency, was the child truly delayed?
IMPLICATIONS FOR PRACTICE
The cultural implications of the
developmental delay category underscore the importance of having a broad array
of tools for assessment and instruction as well as a good understanding of the
child's culture. Responsive, family- centered programs and professionals have
taken many steps to ensure effective communication between them and the children
they serve. These have included making interpreters available, making printed as
well as audio/audio-visual materials available in the families' dominant
language, and connecting parents to a network of other parents with similar
Instruction for children with developmental delay should reflect the goals
identified and mutually agreed upon by the interventionist, educators,
specialists, and, of course, the family. The learning objectives should include
the child's strengths as the foundation. They should be aimed at bridging the
gap between what the child is currently able to do in his or her environment and
what he or she needs to learn to do in order to be optimally successful in the
current or upcoming environments. For instructional strategies and materials,
professionals and families are encouraged to implement multicultural practices
which honor and respect every child's culture and language.
Danesco, E. R. (1997). Parental beliefs on
childhood disability: Insights on culture, child development, and intervention.
International Journal of Disability, Development, and Education, 44(1), 41-52.
Garcia Coll, C. T. (1990). Developmental outcome of minority infants: A
process-oriented look into our beginnings. Child Development, 61(2) 270-289.
Harry, B. (1992). An ethnographic study of cross-cultural communication with
Puerto Rican-American families in the special education system. American
Educational Research Journal, 29 (3) 471-494.
Hehir, T. & Latus, T. (Eds.) (1992). Special education at the century's
end. Cambridge, MA: Harvard Educational Review.
Kagitcibasi, C. (1996). Family and development across cultures: A view from
the other side. Mahwah, NJ: Lawrence Erlbaum Associates.
Lynch, E. W. & Hanson, M. J. (1992). Developing cross-cultural
competence. Baltimore, MD: Paul H. Brookes.
Mangione, P. L. (Ed.) (1995). A guide to culturally sensitive care.
Sacramento, CA: California Department of Education.
McDermott, R. P. & Varenne, H. (1996). Culture, development, disability.
In R. Jessor, A. Colby & R. A. Shweder (Eds.) Ethnography and human
development. Chicago: The University of Chicago Press.
Srinivasan, B. & Karlan, G. R. (1997). Culturally responsive early
intervention programs: Issues in India. International Journal of Disability,
Development, and Education, 44(4), 367-385.