Puerto Rico
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Puerto Rico is an island U.S. territory in the Caribbean. The majority of Puerto Ricans speak Puerto Rican Spanish.
History
The Caribbean Island of Puerto Rico was originally inhabited by the Taíno indigenous people. In 1508 Spain laid claim to the island. The Taíno people were soon forced into slavery and were nearly eliminated due to foreign illness and slave labor. During Spanish rule Christianity, the Spanish language, and new infrastructure were introduced. In 1898, during the Spanish-American war, the United States acquired the island and soon became its trading partner. Puerto Ricans acquired the ability to gain United States citizenship and protection under the Bill of Rights in 1917. In 1947 Puerto Rico was given the right to elect their own governor and in 1950 they drafted their own constitution as part of the Puerto Rico Federal Relations Act.
Culture
When working with clients who identify with Puerto Rican culture, it is important to educate oneself about cultural values and experiences that may be different from your own. The values of power distance, masculinity/femininity, individualism/collectivism and high/low context differ from those of mainstream American culture. In addition, it may be helpful to learn about the religious history of Puerto Rico and how it has shaped healthcare beliefs. These cultural differences are discussed further in the “Implications for the SLP” section.
Power Distance
In Puerto Rico, there is a high power distance. Roles are clearly defined, and subordinates are expected to treat their superiors with respect.
The elderly are considered to be in a position of respect and should be treated as such by those who are younger.
Obedience is greatly valued in children. In the education system, teachers are viewed as authoritative figures, and are direct in their teaching and discipline strategies.
Masculinity/Femininity
Puerto Rico is a largely feminine culture. While children are often raised with specific gender roles in mind, nurturing and cooperative efforts among both genders are generally valued.
Females may have been raised with the concept of marianismo, which refers to obedience and responsibility for domestic tasks. Males are often raised as machismo, and are encouraged to take risks and participate in social activities outside the home.
Individualism/Collectivism
Puerto Rico is considered to be a collective society. Puerto Ricans often value and spend time with their extended family and community members. There is pride in identifying as a member of the group.
Maintaining harmony within the group may be a priority. It is considered by some to be better to avoid conflict than to be honest about one’s own opinion.
High Context/Low Context
Puerto Rico is a high context culture. When information is shared, the context may provide more information than the words spoken themselves.
Religious Influences
Most Puerto Ricans are Roman Catholic. However, the Commonwealth Constitution served to guarantee religious freedom for all faiths in the country. Given the history of Spanish colonialism and support of slavery, catholicism was not immediately accepted by Puerto Ricans. After the United States acquired Puerto Rico, the number of Protestants on the island grew. Most natives supported the idea of the separation of church and state.
Once the Puerto Ricans adapted the Catholic church, they made several adjustments to their religious practice. There is some belief in magic and occultism, called espiritismo, that was blended with traditional Catholic practices. There are several spiritual beliefs that continue today. One is that spirits of the dead (jipia) sleep during the day and search for wild fruit to eat at night. For many years families kept fruit out in their kitchens, and in modern times some have chosen to display a bowl of plastic fruit for these spirits. Many Puerto Ricans also believe in the evil eye (mal de ojo), which discourages one from coveting another’s possessions, as this may lead to sickness or death. In addition, some islanders engage in folk medicine and follow specific rules for healing.
Attitudes Toward Education
Puerto Rico’s educational system is based on that of the United States. Although the language of academic instruction wavered throughout Puerto Rican history, instruction is currently provided in Spanish throughout the public schools.
According to the constitution of the Commonwealth of Puerto Rico, all citizens have the right to a free, non sectarian, public elementary and secondary education.
According to the Department of Education, Puerto Rico's education system spends roughly $8,000 per student each year.
With a large percentage of educated people emigrating from Puerto Rico, in hopes for greater economic opportunity, this cost of education is a significant loss of investment for them. Puerto Rico invests a significant amount of money into educating students only to have them move to mainland US and contribute to society there. This is especially devastating in times of such financial crisis for the island.
Attitudes Toward Disability
When considering any person’s views on disability, it is important to take into account variation among individuals and families, as well as possible effects of acculturation when working with immigrants. The clinician must use his/her judgment in order to discern the extent to which the following generalities fit a particular client/family.
Puerto Rican cultural values of collectivism and feminism described above, as well as increased value on the family unit may be important factors when considering views on and expectations of individuals with disabilities. Goals oriented around client “independence” may be less of a priority for those with Puerto Rican backgrounds.
Ganotti et al. (2001) describe the concept of aguantar, or “enduring,” as a Puerto Rican parent’s possible attitude of assuming s/he will become a lifelong caregiver for a child with a disability. This mentality may cause disconnects between parents and clinicians when discussing goals oriented around independence or a future outside the parents’ home.
Ganotti et al. also discuss the possible influence of spiritual and folk beliefs of some Puerto Rican families (keeping in mind the date of this publication, 2001, the following may be less and less of a factor as time goes on). Folk beliefs in mal ojo (evil eye), susto (fright), and empacho (food getting stuck) may center parental responses to sickness or disability around dietary problems and protecting children from traumatic events or overstimulation. Some spiritual beliefs may lead parents to believe children with disabilities may die at an early age, and thus place limited value or expectations upon interventions.
Because public education in Puerto Rico is closely modeled after that of the U.S., Puerto Rican families may have already had experience with the American special education approach. Families may then be very responsive and even have high expectations when clinicians propose specialized services.
Schooling in Puerto Rico
In 2002 the overall literacy rate in Puerto Rico was 94.1%, with no significant discrepancy between rates of males and females. According to the 2010 Census, 60.0% of the population attained a high school degree or higher level of education, and 18.3% has an undergraduate degree or more.
Implications for the SLP
Regarding family involvement with your clients:
In a study conducted by Correa, Bonilla, & Reyes-MacPherson in 2011, Puerto Rican single mothers of children with disabilities were interviewed in order to assess the nature of their social support systems and to what degree they viewed professional support systems such as school faculty as helpful. Their findings have implications for early childhood practices related to (a) the need for accurate assessment and understanding of family social support (immediate and extended female family members and non-family members such as godmothers, or madrinas, were often indicated as playing significant roles in Puerto Rican families), (b) the importance of including these key support persons in the intervention process, and (c) the need for understanding the role of informal and formal support networks in intervention.
As professionals, it is important to treat older family members with respect. Family members will likely expect the SLP to have a clear plan for how to treat their client. However, if one typically employs naturalistic, client-directed strategies (such as playing, conversing with client) it may be a good idea to explain the reason for these activities and be open to adjusting the session in order to best support the client and their family.
It will be important to learn the roles of family members before beginning intervention with a client. Because nurturing family members is valued, teaching self-help skills may not be a priority for the family.
Because confrontation may be avoided by members of this culture, there is a chance that a client or family members may not admit that they do not agree with therapy goals.
When working with a client from Puerto Rico, notice how your client converses and pay attention for subtleties and allusions. While your language style may be more direct, remember that this may be off-putting to your client.
Regarding family receptiveness to professionals, in the same 2011 study, school faculty, administration and other professional support persons were viewed as helpful but not as helpful as family members. The authors related this to the mothers’ sense of having an ongoing positive relationship with these professionals.
Cultural influences on beliefs about disability will shape interactions with Puerto Rican parents. It will be important to know each family’s perceived cause of a disability, expectations for survival/maturation, and what they believe appropriate social roles are for individuals with disabilities (Ganotti et al. 2001).
Resources/Websites for Puerto Rico Topics
Culture
Correa, Vivian I., Zobeida E. Bonilla, and Maria E. Reyes-MacPherson. "Support Networks Of Single Puerto Rican Mothers Of Children With Disabilities." Journal Of Child And Family Studies 20.1 (2011): 66-77. ERIC. Web. 3 Mar. 2015.
Gannotti, M E, et al. "Sociocultural Influences On Disability Status In Puerto Rican Children." Physical Therapy 81.9 (2001): 1512-1523.MEDLINE. Web. 3 Mar. 2015.