How To Better Serve Muslim Patients/Students Abdul S. Mukati, CCC-SLP. Dr. Ovetta Harris, CCC-SLP. Doctoral Candidate Associate Professor
Purpose: To provide information Generate awareness amongst Speech-Language Pathologists (SLP) 1. About the complex ethnic and cultural aspects of the Muslim communities 2. Religious guidelines that impact service delivery. Disclaimer: As in any religious entity, there are individuals who following the religion Islam and are Muslims, however, may not be following the guidelines presented here.
Population Demographics in the United States: Muslim Americans immigrating into the United States are categorized as Asian (U.S. Census 2010). The Arab Muslims, European Muslims, and the South East Asian Muslims, represent the first and second-generations of immigrants in the United States.
FALSEHOOD: 1 Most people are of the opinion that the majority of Muslims are recent immigrants. Not True First Muslims arrived to the United States in the 1500 as Slaves (Duran & Pipes, 2002).
FALSEHOOD: 2 A major misconception about Muslims is that they are all Middle Eastern. Not True Only 1 in 8 American Muslims are of Arab descent (Blank,1998). The largest Muslim groups in the United States are native born African Americans and immigrants from diverse nations.
Demographic Trends It is estimated that 6-7 million Muslims live in the United States (Bagby, I., Perl, P. M., & Froehle, B. T. 2001). By the turn of the century, the Asian and Pacific Islander population would expand to over 12 million, double its current size by 2010, triple by 2020, and increase to more than 5 times its current size, to 41 million by 2050 (Day, 2010. U.S. Census). Thus, a probability of more Muslims is expected.
Muslim Identity: Islam/Muslim? Muslims are individuals who practice the religion called Islam Islam is the extension of the Judeo-Christian heritage of Abraham. Islam denotes more than fourteen centuries of history, a billion and a third people, in a religion and cultural tradition of enormous diversity Lewis (2003).
Muslim Rituals There are five pillars of Islam Shahaada Salat : 5 plus Friday prayers Zakat : % Saum Haj
Greetings: The word Islam comes from the root-word Salam meaning Peace This greeting is performed by Muslims when meeting someone. This greeting is in Arabic, As Salaam Aliekum meaning may the peace be upon you.
Hijab, Topi and Dress Modesty is prescribed in attire and attitude Muslim men and women may cover The goal of modest dress
Food consumption: for Muslims Speech Language Pathologists (SLP) need to be cognizant of the Islamic guidelines related to food intake. For Muslims, foods need to be from: 1. Permissible source 2. Zabihia / dhabiha in accordance to the Islamic law Halal
FALSEHOOD: 3 A misconception exist that meat and other food items in grocery stores are allowable for Muslim consumption if they are from permissible sources. Not true Muslims must consume food from Halal source. For example, to consume meat, the animal has to be permissible and Zabiha, dhabiha i.e. slaughtered in accordance to the Islamic law to be called Halal.
Gender Reaching puberty Shaking hands Touching of opposite sex Exceptions are: The one touching The one touched
Gender Continued Permission required prior to touching Men and women, same sex allowed to hug and kiss on the face (cheeks)
Gender Continued Specific roles for males and females Roles may be intertwined Mothers, depending on the level of education Parents and Grandparents may
Implications in Dress & Food: Service delivery Women may come to the clinic covered in any of the aforementioned manner or may not have a head cover Permission should be requested/gender Hand shake Male SLP may require Request permission for any physical touch
Implications: Service delivery When performing bed-side evaluations: Recognize and respect religious and cultural differences (Roseberry-McKibbin, C. 2002). Recognize and identify language difference/exposure and its impact on findings Try to gain knowledge of patient s spiritual preferences When conducting swallow trials: Awareness about the ingredients of the pudding, crackers, ice-cream Geriatric patients may be more Gender of the person
Schools Most Muslim students are enrolled in public schools (CAIR, 2005). Name order is important Teachers may need to Muslims may not take same sex showers Initial, co-gender-seating Identify if gender mingling
Schools Continued Students refusing lunch at school: May be because In-service and
Eid Holidays (Eid) 1st Eid Day is celebrated after Ramadan (month of fasting) 2 nd Eid Day on the tenth day of the twelfth Islamic month. Festivities for both holidays include: Congregational prayers Gathering with family and friends Gifts and entertainments for children Holiday/absence from school Missing treatment sessions May not know the specific date
Case Study Suzi, a SLP from Kansas has received a new client, from an Muslim country, who speaks English. This student is10 years old and presents with a severe articulation disorder as well as language deficiencies. What are some important considerations?
Consideration: Language difference vs. disorder Name Is the therapy time scheduled appropriately Who accompanies the individual for therapy ( if in private setting) and their role in the family structure When calling home for information If the child has had adequate nutrition ( if in public school) to perform during session If food is used as a motivator Are the themes incorporated in treatments Sound acquisition hierarchy: When do sounds in the child s first language occur?
Case Study 2 A Muslim man from Afghanistan has arrived in your long-term care facility. He had a mild stroke, hip surgery and a recent episode of pneumonia; therefore, he is on a puree diet and wishes to go to regular. What are some important information that an SLP should know and consider?
Considerations Background information about patient s belief system The patient may be modest in requesting food or services Modest in covering body and cleansing for wudo. (washing of body parts before prayers) Holiday celebrations Not attending treatment session during prayers and especially Friday prayers. Reluctance to meet and mingle with opposite gender Food intake preferences and reluctance
References Bagby, I., Perl, P. M., & Froehle, B. T. (2001, April). The Mosque in America: A National Portrait. Washington, D.C.: Council on American-Islamic Relations (CAIR). Blank, J. (1998 ). The Muslim Mainstream. Islam is growing fast in America, and its members defy stereotypes [Special section]. U.S. News & World Report, 11, 22-25. Day, J. C. (2010). National population projections (Series P25-1104,). Retrieved from U.S. Census Bureau, Population Division website: http://www.census.gov/population/www/pop-profile/natproj.html on September 12, 2011. Duran, K., & Pipes, D. (2002, August). Muslim immigrants in the United States. Retrieved from http://cis.org/usmuslimimmigrants June 2008. Emerick, Y. (2004). The Complete Idiot s guide to Understanding Islam (2nd ed.). New York, NY: ALPHA, Penguin Group. Lewis, B. (2003). The Crisis of Islam. New York, NY: Modern Library. Roseberry-McKibbin, C. (2002). Multicultural Students With Special Language Needs. Practical Strategies for Assessment and Intervention (2nd ed.). Oceanside, CA: Academic Communication Associates. Uddin, Z. (2002, March 1). Muslims in America : Muslims live in every part of the United States, adding greatly to the American mosaic. World and I. U.S. Census Bureau (Version U.S. Interim Projections by Age, Sex, Race, & Hispanic Origin) [Data file]. (2004). Retrieved June 4, 2008, from http://www.census.gov/ipc/ www/usinterimproj/