Investigating the Relationship of Parental Factors, Negligence and Language Delay among Children for Speech and Language Centers in the United Arab Emirates: A Literature Review

Investigating the Relationship of Parental Factors, Negligence and Language Delay among Children for Speech and Language Centers in the United Arab Emirates: A Literature Review

Hyrawayne V. Nuique, RPm, ICAP

Xavier University – Ateneo de Cagayan

DOI: https://dx.doi.org/10.47772/IJRISS.2023.7012108

Received: 06 December 2023; Accepted: 14 December 2023; Published: 11 January 2024

ABSTRACT

The involvement of parents in the treatment process is essential for the child to achieve language developmental outcomes. This literature delves into the intricate relationship between parental factors, negligence and language delay of children in the United Arab Emirates. This is intended for reference by Speech and Language Therapists (SLTs) to help them analyze the specific parental factors that may contribute to the development or exacerbation of language delay in children. The findings of this review are substantial, disentangling modifiable parental factors such as socioeconomic status of parents, their education level, family structure and their involvement in their child’s education and activities significantly impact children’s communication development and well-being. This paper review examines a notable association between parental negligence and increased screen time for children, emphasizing the importance of parental supervision in managing screen exposure. The implications of this encourage educational programs from government and private institutions and empower parents and Speech and Language Therapists (SLT’s) to foster positive language development in children. Recommendations include sensitivity and comprehensive approach considering cultural, parental, and environmental factors.

Keywords: parental factors, negligence, language delay, speech and language therapists

INTRODUCTION

The function of language is one of the most complicated processes among all phases of development across lifespan. Blaming parents for language delay in children has been a common misconception, as revealed by a survey conducted by the Communication Trust (Richardson, H., 2012).  Research suggests that the exact cause of such problems is often unknown. The primary caregiver, as such parents may find it difficult to communicate to their children in the early stages of their lives.  Around 70% of parents say they “struggle to communicate meaningfully” with their kids, and 82 % of parents feel like their kids avoid talking to them if they don’t have to (Robinson, 2018).

Children with Autism Spectrum Disorder (ASD) may face additional challenges in communicating with their parents. A systematic review and meta-analysis found that among preschool-age children with ASD and typically developing children, parents’ verbal responsiveness (PVR) has a positive connection with child communication (Edmunds, S.R. et.al.,2022).

Positive communication between parents and children is a key to a healthy relationship and it can safeguard children from health risk and help them achieve better in school. However, parents may struggle to take care of their children adequately and there can be a myriad of reasons behind it. Some common factors include work and career demands, mental health issues, physical health problems, lack of education and parenting skills, family dynamics such as divorce or separation and parenting multiple children.

In the United Arab Emirates, some mothers of children with Autism Spectrum Disorder (ASD) reported not receiving support from their partners and feeling rejected by extended family members (Lamba, N. et.al., 2022).  It is crucial to approach these situations with empathy and focus on interventions to ensure their safety and well-being. Moreover, autism is under-diagnosed and overlooked in the UAE, with limited research on the impact of disability of the individuals and family members (Sopaul., S, 2019). This was propelled with COVID-19 pandemic wherein distance learning for children with disabilities has been difficult (Al Amir., S., 2021). Dubai Statistics Center (DSC) reported in 2017 that the percentage distribution for People of Determination with Speech Disability accumulated 0.4 % for the Emirati population and 1.7 % for the Non-Emirati population. Nonetheless, factors pertaining to the general demographic characteristics of parents, rather than their behavior in predicting child language is evident. If parental behavior can be enhanced, this can gear interventions for professionals dealing with parents (Topping, Keith, et.al., 2011).

The Dubai Chamber of Commerce introduced the Parent-Friendly Label programme to the business community in Dubai to promote the expansion of work practices and environments that enable individuals to effectively -balance their professional and family responsibilities. In 2021, the Abu Dhabi Early Childhood Authority (ECA) launched its first Parent-friendly Label to allow parents to care for their children’s well-being, benefiting individuals, the economy and society as a whole.

Consequently, Speech and language therapists (SLT’s) highlighted the use of parental questionnaires for early detection of the disorder showing to be effective in screening for developmental language disorders (DLD) among bilingual children (Abutbul and Armon-Lotem, 2022).

This literature covers the existing studies and different experiences faced by parents in the UAE as they endeavor to facilitate effective language development in their children. Capturing the differential profiles of parents as predictors in developing children diagnosed with language delay contributes to a more accurate clinical process and help reduce the challenge of Speech and Language therapists in UAE and address solutions to these predictors. By incorporating the parental perspective and understanding the impact of language delay in clinical processes, speech and language therapists can better support children and families in the UAE. Given that there is a little literature in the United Arab Emirates that pertains to the emergent of literacy and language development of children, it is important to delve into the factors that impede this process, dissecting potential barriers within the distinct cultural and linguistic context of the UAE. Grasping these impediments is essential for tailoring interventions and support systems that adeptly address the needs of children grappling with communication disorders.

BACKGROUND

Negligence, or the lacking of parents’ attention is crucial during the developmental period of children. It is a noteworthy concern when parents are occupied with work and daily responsibilities, leaving minimal time for interaction with their children. Consequently, in order to make up for the lack of parental availability, children resort to using screens to occupy their time, leading to a notable impact on their language skills (Fatima & Akram, 2022).

Some studies have indicated that children experiencing emotional deprivation and neglect may exhibit limitations in expressive language skills (Sylevtre & Merette, 2010). The interplay between family members and siblings appears to mitigate the impact of parental neglect, contributing to children’s language development (Zukow-Goldring, 2002). Research suggested that the way parents interact with their children significantly contributes to the development of expressive language (Tsao, F. M., Liu, H. M., & Kuhl, P. K.,2004). When parents don’t dedicate time to their children and allow them to become habitual users of electronic devices, it negatively impacts the child’s language development (Kuta, 2017). The absence of sufficient parental support and attention raises the risk of language developmental issues, particularly before the age of 6 years. The comparison to children who weren’t neglected, those with a history of familial neglect and institutional child-rearing exhibited lower cognitive and language scores, along with more behavioral issues. (Spratt, et al., 2012). Externalizing behavior problems were identified as predictors of parenting stress.  Factors such as less time in a stable environment was one of the predictive of lower IQ.

When parents remain busy with employment and daily routines, they may have limited time to interact with their children, which can affect language development. Previous studies have demonstrated a robust connection between fathers and child behavior and outcomes (Baker & Vernon-Feagans, 2015; Pancsofar & Vernon-Feagans, 2010).  It’s crucial for parents to be aware of the impact of their availability and to find ways to engage with their children to support their language skills.

Consequently, language development entails receptive and expressive functions. The receptive function is the ability of children to identify and react to someone or to the events in the surrounding environment, to understand the meaning of mimic and tone of voice, and finally to understand words (Soetjiningsih, 2002). In the UAE, the history of research on language and communication disorders is still in its early stages. Although there are studies that exist, this information is relatively limited. According to a study reported by Gulf News, it suggests that overuse of technology may cause communication disorders in UAE children. A report by Khaleej Times in 2005 suggests that about 20% of the UAE population, including children and adults, is suffering from speech impairment. The Middle East Current Psychiatry found that 90.3% of those who have speech and language developmental delay use electronic devices. The study also identified the impact of screen time including TV, smartphones, and tablets on speech language development in children aged 12–48 months in UAE. The awareness of these issues needs further research to better understand the prevalence and causes of these disorders (Al Hosani, S. S., et al., 2023).

ANALYSIS METHOD

This review employed a thematic analysis methodology. The literature examined patterns, themes, and variations in different studies and parents’ narratives out from the literature provided. These are systematically organized to provide a consistent and comprehensive overview. The classification of all articles was conducted according to their primary findings, ensuring a structured presentation of the literature.

THE INFLUENCE OF CULTURAL IMPLICATIONS OF THE UAE AND LANGUAGE DELAY

Unique cultural and linguistic demographics of the UAE influencing communication abilities in children

In a study undertaken by Bakhsh (2020) of Mohammed bin Rashed Center for Special Education, it was stressed that the language practices of Emirati parents raising children with ASD are shaped by both the guidance of professionals and the swift changes occurring in the linguistic landscape of the country. There is a crucial need for professionals to enhance their understanding of matters concerning home language and its repercussions on the well-being of both the children and their families. This is propelled with the study of Eapen, Zoubeidi & Yuni (2004) showing that language delay was found to be associated with rural living, the mother being from a different nationality, and non-involvement of domestic help in child care. Research found that a notably higher proportion of children in rural areas of the UAE experienced Developmental Language Disorder (DLD), possibly due to a deficiency in language stimulation. Previous investigations have indicated that, when comparing language performance between rural and suburban children, a significantly greater percentage of rural children struggled with various verbal ability and auditory comprehension tests. This difficulty was attributed to test items that demanded the use of responsive verbalized language by the rural child.sd

Parent’s View of Reason(s) Behind Language Delay

Research suggests that parents often feel like failures when it comes to their child’s speech or language development, believing that they should have placed more stress on communication development through interactions between the parent and child. Additionally, parents may feel that their child was denied certain opportunities because of the surrounding environment. Family members and parents often times provide feedback on their opinions about a child’s speech or language disorder and development in terms of a physical, biological or medical, personality and emotional, or cognitive standpoint (Marshall, Goldbart, & Phillips 2007).

Additionally, in studies of parental beliefs, some parents reflected on their own behavior as being a reason a child has developed a speech or language disorder. Often, it is questioned what could have been done differently in raising the child to prevent the disorder (Marshall, et al. 2007).

Multilingual environment

The prevalence of a multilingual environment, where children are exposed to multiple languages, can sometimes lead to language delay. In a study of Emirati toddlers, 29% of children were exposed to languages other than Arabic at home, and the proportion of children with delayed language decreased with exposure to more foreign languages.

In summary, it becomes evident that addressing language-related challenges in children necessitates a holistic understanding of the contextual factors at play, such as geographical location and sociocultural dynamics.  Findings illuminates the multifaceted factors associated with language delay, including rural living, maternal nationality, and the absence of domestic help in child-care. The linguistic characteristics of the UAE, such as the prominence of Arabic and English, as well as cultural and environmental factors, can impact children’s language delay. The UAE’s linguistic landscape includes Arabic as the first language and English as a second language, with English serving as the country’s lingua franca due to the diverse expatriate population. The linguistic diversity may pose challenges for children’s language development, especially when they are exposed to multiple languages from an early age. Moreover, parental perspectives on the reasons behind language delay reveal a common sentiment of self-perceived failure among parents in terms of their child’s speech or language development. There is a prevailing belief that greater emphasis on communication development through parent-child interactions could have made a difference. Parental beliefs highlight instances where parents reflect on their own behavior as a potential factor contributing to their child’s speech or language disorder.

PARENTAL FACTORS AS PREDICTORS TO LANGUAGE DELAY

Social Economic Status and Low parental education

The child’s language development showed a predictive association with the social status of both parents. Additionally, it was highlighted that the mother’s concerns regarding her child’s delayed language acquisition should be taken into consideration when evaluating the need for specialized support. The primary environmental factors influencing language acquisition encompass the mother’s educational level, the number of siblings, the family’s socio-economic status, family income, and cultural heritage (Hackman and Farah, 2009; Horwitz et al., 2003; Henrichs et al., 2011; Hoff, 2006; Zubrick et al., 2007).Top of Form

This is in correspondence on a speech and language delay study of children in the UAE wherein low parental education is a familial cause of language delay. This suggests that parental education may be a factor contributing to language delay in children in the UAE. In a study, result suggested that exposing children to more than one language other than Arabic language spoken at home results in a lower prevalence of language delay (Almekaini., A., 2017).  Moreover, in the study by Horwitz et al. (2003), it was revealed that low maternal education, reduced maternal expressiveness, and heightened parenting stress were the most influential factors predicting expressive language delays at 18–23 months. The family’s socio-economic status is identified as a crucial determinant of early language proficiency, extending to the neurocognitive and neurofunctional levels (Hackman and Farah, 2009; Tomalski et al., 2013). Adverse familial employment conditions may contribute to an economic environment that, in turn, adversely affects the subsequent development of the already disadvantaged child.

Parent’s Involvement in child’s education and activities

According to Lowry (2017) from the Hanen Center, the comparative effectiveness of therapy administered by Speech-Language Pathologists versus parents has been underscored. Their findings indicated that children showed improvement when therapy was directed by either a professional or their own parent. Notably, it highlighted that children’s language comprehension benefited more from parent-led involvement. Another noteworthy outcome of the study was that parents reported reduced stress levels after learning how to assist their child. This underscores that parents can play a decisive role in enhancing a child’s language skills, principally in cases of language delay. Numerous studies have indicated that parents can be as effective as SLT’s in improving a child’s language abilities, with instances where children showed greater improvement under parental intervention. Parent-implemented intervention led to even better command and grammar than therapy from an expert.

This is similar with the case study conducted by Alias & Ramly (2021) revealing the essentiality of parental involvement in implementing speech activities at home. It comprised of two (2) parents whom each have a child with speech delay, as they were interviewed using semi-structured questions. The speech activities, even though the parents did not necessarily know the techniques and instructional methods, boldly involved themselves based on the learning expedited by the therapists. Supportive spouses, family and speech therapists stirred them to continue implementing speech activities at home for the children’s benefits.

Family Composition and Language

Sigurdardottir, Lipkin and Shapiro (1999) noted that preschool children diagnosed with language disorders’ occurrence of an additional handicapping condition is more pronounced among those residing in households with both parents, as opposed to those in single-parent or foster families. Remarkably, results appeared that 65% of children living together with their parents had additional handicapping conditions (mental retardation, pervasive developmental disorder, cerebral palsy), whereas only 27% in the other group had such conditions.

This indicates that family structure may influence the manifestation of language disorders. This suggests that family structure and the home environment can play a role in children’s language development. The presence of a supportive and stimulating environment, as well as the education and mental well-being of parents, may influence the language development of children.

Overuse of Technology and Parental involvement in child’s education and activities

In an article published by Gulf News in 2016, the widespread use of electronic devices to engage children is contributing greatly to communication disorders in the UAE. Experts have warned that overuse of technology can impair children’s ability to communicate effectively. In Abu Dhabi, 14% of children’s cases at the psychiatric division of Shaikh Khalifa Medical City (SKMC) pertain to communication delays and disorders. Moreover, Dr. Ahmad Almai, a consultant and head of child and adolescent psychiatry at SKMC, has highlighted the role of excessive screen time in contributing to communication disorders. Some studies also suggest that increased screen time is associated with melanopsin-expressing neurons and decreasing gamma-aminobutyric acid (GABA) neurotransmitter, and thus results aberrant behavior, decreased cognitive, and language development in children. Early exposure of electronic media in the first 2 years of life gives an impact on language, although inconclusive (Hermawati., D., et al., 2018).

In summary, in the context of socio-economic status and low parental education, studies show a predictive association between both parents’ social status and the language development of children. Environmental factors such as the mother’s education, number of siblings, family’s socio-economic status, family income, and cultural background are identified as crucial in determining language development. Low parental education is identified as a familial reason of language delay in children in the UAE. Regarding parental involvement in a child’s education and activities, the comparative effectiveness of therapy administered by Speech-Language Therapist versus parents is explored. In the context of family composition and language, this proposes a potential influence of family structure on the display of language disorders, indicating the role of the home environment in children’s language development. Experts caution against the overuse of technology and parental involvement in a child’s education and activities.

Collectively, these studies contribute to a nuanced understanding of the multi-layered dynamics prompting language development in children. Therefore, addressing the complex interplay of socio-economic status, parental education, parental involvement, family composition, technology use, and negligence is paramount for fostering optimal language development in children within the UAE. The outlined policy implications, educational programs, and recommendations offer a multifaceted approach to support families and enhance the language skills of children. By implementing targeted interventions, promoting parental education, fostering collaboration between schools and parents, and ensuring cultural sensitivity, stakeholders can collectively contribute to creating an environment that nurtures effective language development. Additionally, the emphasis on early identification, support linkage, and continuous research demonstrates a commitment to providing comprehensive and evolving strategies to meet the unique needs of children in the dynamic socio-cultural setting of the UAE.

NEGLIGENCE AND LANGUAGE DELAY

The study of Fatima and Akram (2022) has found a significant relationship between parental negligence and screen time, but no direct relationship was found between parental negligence and expressive language delay among young children. Interestingly, the study does not identify a significant relationship between parental negligence and expressive language delay. This contrasts with some existing research, such as the work by Sylevtre and Merette (2010), which suggests that emotionally deprived and neglected children may exhibit a lack of expressive language. The divergent results could be attributed to factors such as the joint family system and the number of siblings, which are considered potential confounding variables in this study.

Moreover, the concept of a joint family system and the presence of siblings might act as compensatory factors, influencing the main findings of the study. The interaction of family members and siblings with children may potentially mitigate the impact of parental neglect, serving as a supportive environment for language development (Zukow-Golding, 2002).

Nevertheless, while the study establishes a positive association between parental negligence and screen time, it does not find a significant link with expressive language delay. The potential role of confounding variables, such as the joint family system and the number of siblings, is acknowledged as factors that may influence the overall relationship between parental negligence and language development in young children. This recognition underscores the complexity of the interplay between parental behavior, environmental factors, and language outcomes in early childhood.

THE THEORETICAL FOUNDATION

Albert Bandura’s Social Learning Theory suggests that people learn by observing, imitating, and modeling others’ behavior. In the context of language delay, this theory implies that children learn language skills by observing and modeling the linguistic behaviors of others in their environment, including their parents and caregivers. The theory also highlights the influence of environmental factors, such as rural living, mother’s nationality, and non-involvement of domestic help in child care, on the quality and quantity of linguistic stimulation a child receives, potentially contributing to language delays.

Parallel to this, Bronfenbrenner’s Ecological Systems Theory emphasizes the multiple layers of influence on a child’s development, with parental factors and negligence operating within the microsystem (immediate family and home environment) and impacting a child’s language development, particularly in terms of socioeconomic status, low parental education, and various environmental factors. The mesosystem, representing the interaction between microsystems, is apparent in how family composition and language practices influence a child’s communication development. The exosystem factors, such as the socio-economic status of the family, also influence language development. The unique cultural and linguistic characteristics of the UAE, influencing language choices for children with language impairments, align with the macrosystem concept in Bronfenbrenner’s theory as well as the linkage of parental negligence and screen time. The possible role of confounding variables, such as the joint family structure and the number of siblings, is known as factors that may influence the overall relationship between parental negligence and language development in young children.

IMPLICATIONS AND RECOMMENDATIONS

The intricate relationship among parental factors, negligence, and language delay necessitates specific recommendations for the welfare and language development of children in the United Arab Emirates (UAE). This literature proposed some targeted recommendations and implications for specialists and stakeholders for language development of paediatric population in the UAE:

1. Instructive Programs on Policy-making: Government and educational institutions in the UAE should deliberate individualized interventions and support for families with low socio-economic status and parents with lower education levels. This may comprise employing programs that provide informative resources and sustenance for parents, especially mothers, to enhance their child’s language development.
2. Parental Education Drive thru Speech and Language Therapists: Cultivating parents about the importance of their participation in their child’s education is central. Workshops, seminars, and informational campaigns by SLT’s can be systematized to empower parents with the familiarity and skills needed to vigorously contribute to their child’s language development.
3. Incorporation in Education System: Schools can include strategies to involve parents in their child’s education, nurturing a collective approach between teachers and families. This integration can include regular communication channels, workshops, and joint activities.
4. Support Programs: Families with numerous structures should be offered support programs that consider the unique dynamics influencing language development. This may involve counseling services, childrearing workshops, and resources personalized to specific family structures.
5. Public Awareness: Community-based ingenuities can raise awareness about the impact of family composition on language development. This includes educating parents, caregivers, and community members about forming helpful environments for children’s language growth.
6. Child care Education: Parents are essential to be informed about the possible risks of excessive screen time and provided with guidelines on healthy technology use for their children. SLT’s can assist parents on this matter.
7. School Guidelines: Educational institutions should establish clear policies on screen time during school hours and communicate these policies efficiently to parents. Collaboration between schools and parents is indispensable in creating a sensible approach to technology use.

RECOMMENDATIONS

To address language development issues in the United Arab Emirates (UAE), the following policies can be realized:

1. Cultural Sensitivity: Develop interventions and instructive materials that are culturally sensitive and applicable to the diverse population in the UAE to ensure that policies to improve language development resonate with the cultural values and practices of the community.
2. Parental Training Plans: Implement accessible and inclusive parental training programs that lodge parents with varying levels of education and diverse family compositions and cultural upbringings.
3. Screen Time Guidelines: Establish clear guidelines on screen time for children and publicise this information widely through SLT’s, institutes, and public and private organizations to allow parents with the knowledge needed to make informed decisions about technology practice.
4. Early Identification and Intervention by parents, educators and SLT’s: Reinforce early identification processes for language delays and disorders by implementing routine screenings in healthcare settings and educational institutions to recognize children at risk, enabling sensible intervention and support.
5. Continuous Research: Further research in these areas could provide a better understanding of parental factors towards a child’s speech or language disorder, and help speech and language therapists provide better support to parents and children.

CONCLUSION

This literature elaborates exploration of possible factors on language delay in children within the UAE. It distinguishes the complex nature of challenges faced by children in their language development journey, accentuating the relationship of several factors such as socio-economic status, parental education, parental involvement, family composition, technology use, and negligence. It stresses the importance of addressing this complexity to foster optimal language development in children within the UAE. The outlined policy implications, educational programs, and recommendations offer different approaches for families and enhance the language skills of children. By employing targeted interventions, promoting parental education, fostering alliance between schools and parents, and ensuring cultural sensitivity, stakeholders can collectively contribute to creating an environment that nurtures effective language development. Additionally, the emphasis on early identification, support networks, and continuous research demonstrates a commitment to providing comprehensive strategies to meet the unique needs of children in the dynamic socio-cultural implications of the UAE.

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