Stuttering in Bolivia: A Public Education Initiative

By Elizabeth Haynes, MA, R.SLP, S-LP(C), Marilyn Langevin, PhD, R.SLP, S-LP(C), CCC-SLP and Ricardo Ibañez Robert, B.Ed., M.Sc.

This article has been republished from the Summer 2013 issue of Communiqué.

Please note that this article was originally published when Speech-Language and Audiology Canada (SAC) was called the Canadian Association of Speech-Language Pathologists and Audiologists (CASLPA).

Stuttering as a specialty is recognized in several South American countries including Argentina and Brazil. Both countries recently hosted international conferences on stuttering. Public education about — and reactions to —stuttering differ from country to country. Unfortunately, these reactions are often negative. Within Brazil, the attitudes toward stuttering differ from state to state (St. Louis & Andrade, 2003).

The professions of speech-language pathology and audiology are absent in three-quarters of the world’s countries; typically the most impoverished nations (Bleile, Ireland & Kiel, 2006). In South America, the training and practice of the joint profession of speech-language pathology (S-LP) and audiology (Fonoaudiologia) varies widely. Argentina has 18 S-LP/audiology training programs including three doctoral programs and the profession has been practiced for 40 years. In Brazil, the professions have been practiced for over 50 years and there are over 90 training programs. Paraguay has recently begun training Fonoaudiologists. Bolivia has no training programs and only 30 S-LPs and audiologists in the nation (Fernandes, Andrade, Befi-Lopes, Wertzner & Limongi, 2010).

Bolivia is a South American country bordered by Peru, Chile, Brazil and Argentina and has a population of over 10 million. Spanish is spoken by 60.7% of the population, Quechua by 21.2% and Aymara by 14.6%. The current government is focused on improving access to health, education and social services.1

There are 49 private and public universities in Bolivia.2 The Universidad Tecnológica Privada de Santa Cruz (UTEPSA) is a private university in Santa Cruz de la Sierra, which is Bolivia’s second largest city, located in eastern Bolivia with a population of 1.584 million.3 The university offers bachelors and masters degree programs in the faculties of business sciences, science and technology, law and judicial sciences. Areas of study include financial administration, international business, engineering (petroleum, systems and electronic, mechanical, telecommunications), law and international relations.

In 2009 and 2011, Elizabeth Haynes, at the request of Professor Ricardo Ibañez Robert, delivered presentations on stuttering at UTEPSA. The 2011 presentation was free of charge, open to the public and was advertised in local newspapers. The two-hour presentation, entitled Stuttering: Facts, Myths and Help, covered basic information about the disorder; evidence-based treatments used at the Institute for Stuttering Treatment and Research (ISTAR), at the University of Alberta, including Marilyn Langevin’s teasing and bullying program (Langevin, 2000); and information about how to react when speaking with people who stutter. The presentation included an interpreter and all of the slides were translated. Approximately 60 people attended — parents of children with speech and language problems, representatives from the federal Department of Education, professors, people who stutter, speech-language pathologists and teachers, including teachers of the deaf and special education teachers. To evaluate the relevancy of the presentation and material, the authors developed an evaluation form and gave it to a random sample of approximately 40% (25) attendees. The evaluation form was completed anonymously.

Attendees were asked to rate the presentation on a four-point scale ranging from 1=not important or relevant, 2=somewhat relevant or important, 3=relevant or important and 4=very relevant or important.

The questions were:

Did you find the material presented by the facilitator interesting?
Do you consider the topic of stuttering important for the people of Bolivia?
Did the specific information presented about stuttering interest you?
In the future, would you like to receive more information about this topic?

Participants were also invited to briefly comment on which part of the information presented was helpful for people in Bolivia and which part was not relevant to the Bolivian experience.

For question 1, 96% (24/25) of the attendees answered relevant or very relevant/important. For questions 2, 3 and 4, 92% (23/25), 96% (23/24) and 96% (23/24) of the participants, respectively, rated the information as relevant or very relevant/important. Most of the participants requested further information about stuttering.

Comments from the participants indicated that they found the following information most helpful: 1) how to communicate with people who stutter; 2) teasing and bullying; 3) the importance of acceptance of people who stutter in society; and 4) causes and treatment information. Several participants commented on the discrimination faced by Bolivians who stutter. For example, “In this society, instead of respecting people who stutter and their problems people laugh at them and bully them.”

For the question on what was not useful in the Bolivian context, one participant stated, “the treatment needs to be studied in Bolivia because this context is different but maybe this treatment could work in our country.”

In conclusion, these results are consistent with the findings of Fernandes et al. (2010) regarding the need for further education for S-LPs in South America. Further, it appears there is a need for continued education to enhance the public’s understanding of stuttering and mitigate the negative stereotyping and discrimination as well as the effects of teasing and bullying. Finally, as Fernandes and colleagues indicated, more accessible speech-language pathology services are needed. There is also a need for improved treatment services in Bolivia for people who stutter. We look forward to working with UTEPSA and others interested in stuttering education and treatment in Bolivia.

References

Bleile, K,. Ireland, L, Kiel, T. (2006). The Professions around the World. The ASHA Leader, December 16, 2006.

Fernandes, F., Andrade, C., Befi-Lopes, D., Wertzner, H. Limongi, U. (2010). Emerging Issues Concerning the Education of Speech and Language Pathologists and Audiologists in Brazil and South America. Folia Phoniatrica et Logopaedica, 62, 223-27.

Langevin, M. (2000). Teasing and bullying: Unacceptable behaviour. Edmonton, Alberta: Institute for Stuttering Treatment & Research, www.tab.ualberta.ca.

St. Louis, K. and Andrade, C. (2004). Public Attitudes toward Stuttering and Other Human Attributes in Brazil. In the Proceedings of the 4th World Congress of Fluency Disorders.