Communication Disorders in Turkish (Communication Disorders Across Languages): 4 - Hardcover

Seyhun Topbas

Hardcover

ISBN 10: 184769246X ISBN 13: 9781847692467

Publisher: Multilingual Matters, 2010

Synopsis

This volume is the first to deal with Turkish communicative development and disorders, reflecting the use of Turkish by a sizeable population in multilingual settings in Europe, USA, and Australia. In addition to Speech-language Pathologists, the book will be of interest to professionals from related fields such as clinical linguistics, psychology, psycholinguistics, neurolinguistics, audiology, and special education. This book presents a compendium of information about the profession of speech-language pathology, cultural differences, assessment materials and research done in communication disorders in Turkey. It also covers acquisition and disorders in multilingual contexts where there is significant Turkish immigration.

About this title

About the Author

Seyhun Topbas is professor of Speech & Language Pathology at Anadolu University, Turkey. She is one of the pioneers of Speech and Language Pathology profession in Turkey; the founder of the graduate programs in Speech and Language Therapy and DILKOM (Education, Research and Training Centre for Speech and Language Pathology) at Anadolu University. Dr. Topbas has developed the first standardized Turkish Articulation and Phonology Test and published on phonological disorders in a variety of books and journals. She is currently on the editorial board of Clinical Linguistics and Phonetics. Mehmet Yavas is professor of Linguistics at Florida International University, Miami, Florida. His main area is phonology and its application to language acquisition and to speech and language disorders. His articles on Applied Phonology have appeared in numerous journals. He is the principal author of Avaliacao Fonologica da Crianca (a phonological assessment procedure for Brazilian Portuguese). His other publications are Phonological Disorders in Children (Routledge, 1991), First and Second Language Phonology (Singular, 1994), Phonology: Development and Disorders (Singular 1998), Applied English Phonology (Blackwell, 2006).

Excerpt. © Reprinted by permission. All rights reserved.

Communication Disorders in Turkish

By Seyhun Topbas, Mehmet Yavas

Multilingual Matters

Copyright © 2010 Seyhun Topbas, Mehmet Yavas and the authors of individual chapters
All rights reserved.

ISBN: 978-1-84769-246-7

Contents

List of Figures, 
Acknowledgments, 
Conventions Used within this Book, 
Contributors, 
Preface, 
Part 1: Prologue, 
1 A Closer Look at the Developing Profession of Speech and Language Pathology (SLP) in Turkey Seyhun Topbas, 
2 The Sound Inventory of Turkish: Consonants and Vowels Handan Kopkalli-Yavuz, 
3 Some Structural Characteristics of Turkish Mehmet Yavas, 
Part 2: Communication Development and Disorders in Monolingual Settings, 
4 The Course of Normal Language Development in Turkish Ayhan Aksu-Koç, 
5 Mean Length of Utterance as a Tool for Morphological Assessment in Turkish Children Pinar Ege, 
6 Turkish SALT: Computer-Assisted Language Sample Analysis Funda Acarlar and Judith Johnston, 
7 Specific Language Impairment in Turkish: Adapting the Test of Early Language Development (TELD-3) as a First Step in Measuring Language Impairments Seyhun Topbas, 
8 Speech Characteristics of Hearing Impaired Turkish Children Umran Tüfekçioglu, 
9 Language Characteristics of Hearing Impaired Turkish Children Umran Tüfekçioglu, 
10 Characteristics of Aphasia in Turkish tlknur Mavis, 
11 Semantic Relatedness Judgments in Normal Turkish-English Adult Bilinguals tlknur Mavis and Swathi Kiran, 
Part 3: Communication Disorders in Multilingual Settings, 
12 Aspects of Acquisition and Disorders in Turkish-Dutch Bilingual Children Kutlay Yagmur and Elma Nap-Kolhoff, 
13 Language Impairment in Turkish-Dutch Bilingual Children Jan de Jong, Nazife Çavus and Anne Baker, 
14 Measuring the Language Abilities of Turkish-English Bilingual Children Using TELD-3: Turkish Theodoros Marinis and Duygu Özge, 
15 Aspects of Language Acquisition and Disorders in Turkish-French Bilingual Children Mehmet Ali Akinci and Nathalie Decool-Mercier, 
16 Specific Language Impairment in Turkish-German Bilingual Children: Aspects of Assessment and Outcome Solveig Chilla and Ezel Babur, 
References, 
Index, 

CHAPTER 1

A Closer Look at the Developing Profession of Speech and Language Pathology (SLP) in Turkey

SEYHUN TOPBAS

Introduction

Speech and language pathology (SLP) in Turkey is a young profession but is growing rapidly. Bleile et al. (2007: 1) has stated that 'the amount of attention a country gives to communication disorders depends on its history, cultural ties on language and disability, economics and availability of services; and that the impact of a communication disorder varies depending on where a person is born and lives'. Thus, a glance at the whole system is necessary to visualize the developmental status of SLP within this country. In this chapter, I will first simplify the complicated nature of the Turkish health, education and special education systems and the financing of services, followed by a closer look at the history of the profession and education of speech and language pathologists (SLPs). Finally, I will present the current developments in lieu of my previous report (Topbas, 2006a), and will articulate the problematic issues in service delivery within this system.

An Overview of the Turkish Health and Education Systems

Turkish health system

The Turkish health care system has a complex structure. To simplify the matter only the basic structure and service delivery will be summarized. Several old laws, although subjected to various changes, still constitute the basis of the practice system. Health policies implemented until 1980 were formed within the Socialization of Health Services Law (1961, No: 224), which attempted to establish a national health service free of charge although this was not achieved until recently. Currently, the health system, including the social insurance system, is undergoing the effects of a reform package, by the Health Transformation Program (Akdag? et al., 2007).

Health services in Turkey are supplied by a multitude of public and private providers. The Turkish Ministry of Health (MoH) is the main government body responsible for health sector policy making, implementation of national health strategies and direct provision of primary and secondary health care, maternal health services, children and family planning services and preventive health services. The two key public providers are the MoH and the University hospitals. The MoH operates an extensive network of health facilities through several affiliated public, quasi-public, private and philanthropic organizations, depending on the advocates' concern with policy formulation, provision of health care, finance of health care and whether they have administrative jurisdiction over the delivery of health care (MoH, 2004). Apart from policy making, the provision of health services is supplied by public and private hospitals, outpatient polyclinics, laboratories and diagnostic and rehabilitation centers, providing primary, secondary and specialized inpatient and outpatient care. University (state and foundation) hospitals are under the responsibility of The Council of Higher Education of Turkey (CoHE) as they support medical training. Each medical school has its own university hospital, acting as a main referral hospital as well as providing comprehensive and modern health care.

The MoH also focuses on school health services organized jointly with the Turkish Ministry of National Education (MoNE), which includes vaccination, screening programs (eye, oral and general physical examinations that check height and weight) and primary care services. A recent attempt has been made to implement a health-promoting schools project, in collaboration with the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF), as well as mother and child health centers and family planning centers. Services for those with special needs and necessary rehabilitation services after treatment are also rendered in collaboration with MoNE (MoH, 2004).

Turkish education system

The Turkish National Education System (Act No: 1739) is highly centralized. The MoNE is responsible for all formal and non-formal educational services in the country excluding higher education. Formal regular education includes preschool education, basic education (primary), secondary education and higher education. Both private and public state educational institutions are prominent. Education is free at every level in state institutions. Preschool education is optional for children aged 0–6. These may be infant or nursery schools, or preprimary classes within a primary school. An important step carried out by the MoNE is the mobile kindergarten project for 36–72-month-old children who live in villages and cannot attend preschool and/or for those with a low socioeconomic backgrounds. Primary education, being compulsory, involves the education and training of children in the age group of 6–14 (in total, eight years of education). A national curriculum is implemented across the country. Secondary education, which is not compulsory, consists of four years of education following primary education and includes general, vocational and technical high school training for the 14–16 age group (MoNE, 2007).

In accordance with Law No. 2547 of 1981, the CoHE is the planning, coordinating and policymaking body for higher education cooperating with MoNE to fulfill the principles of national education objectives. Higher education is based on secondary education and comprises a variety of institutions at every level, affiliated with university or non-university institutions, such as police and military academies and colleges. Universities (state or private foundations) consist of two-year vocational schools offering associate's degree (prebachelor's level) programs and four-year faculties and colleges offering bachelor's degree programs. Faculties consist of departments and each department within a faculty is made up of divisions. Distance education is also available from Anadolu University, offering two- and four-year programs. Admission to higher education is based on a very competitive nationwide Student Selection Examination, held every year and administered by the Student Selection and Placement Centre. In addition to formal education, non-formal and other open-education facilities to increase literacy, and/or for other purposes are also available with the objective of national education at all levels of basic and higher education. Graduate-level education is offered by the coordination of graduate institutions affiliated with the universities. Such programs are based on master's and doctoral degrees in education, applied sciences and social and health sciences. The opening of a degree program at any level is subject to ratification by the Council (CoHE, 2008).

Education at all levels is one of the main priorities of state policies, which are based on equal opportunities for every individual as mandated by the Turkish Constitution. However, the impact of rapid population growth, economics and mass internal migration inhibits the expected quality and quantity of services both in urban and rural areas. According to the 2007/2008 Human Development Report (HDI, 2007–2008), the adult literacy rate is 87.4% (% ages 15 and older). The combined primary, secondary and tertiary gross enrollment ratio is shown as 68.7%. The MoNE (2007) statistical report shows that, based on the latest population projections, the percentage of children enrolling in schools increased to 90.13% for primary education, and 56.51% for secondary education in 2006–2007. However, although there seems to be a rapid change, the expected primary school enrollment ratio is 93% for males and 82% for females, and the actual school attendance is lower than this. Thus, nationwide projects, some of which include Kardelenler (Snowdrops), Baba Beni Okula Gönder (Father, Let Me Attend School) and the girls' education campaign Haydi Kizlar Okula (Let's Go to School, Girls!), E itime %100 Destek (100% Support for Education), have been initiated in the 2000s to support the right of access to education as well as financing those individuals, specifically girls, who have not been educated for various reasons (OECD, 2007). These are important steps taken by the collaboration of MoNE, UNICEF, UNESCO, WORLDBANK, universities, volunteer associations, foundations and large companies toward eliminating poverty, advancing sustainable human development and promoting gender equality (MoNE, 2008).

Speech-language disordered individuals (SLDs) in the context of special education legislation

The educational rights of special needs children have been monitored under the MoNE by the National Education Act (No: 2916) since the first special education act came into force in 1983. The Act has been under consideration for considerable change due to accommodation to European Union (EU) regulations (1997, Decree Law: 573). A new reorganized system has recently been put into place by the new Special Education Legislation Act (2005, No: 5378) with the principle of 'Education for All', creating equal opportunities for the disabled. The execution of some articles of the law was implemented in 2006–2007. Accordingly, the public and private schools, and supportive special education and rehabilitation institutions that were previously a part of the health system are now affiliated with the MoNE. Obligations to offer supportive SLP services to individuals with speech-language disorders (SLD) are currently provided under the regulations of the MoNE (MoNE, 2008). This operational definition of people with disabilities is used by authorities in deciding entitlements for people who apply for related benefits and/or pensions with a criterion-based degree of disability based on the International Classification of Functioning, Disability and Health (ICF) (WHO, 2007a).

In Turkey, services for disabled people are provided by both governmental and nongovernmental organizations. The MoNE and the General Directorate of Special Education Guidance and Counselling Service Department of MoNE are responsible for implementing educational policies. In provinces and sub-provinces, the Guidance and Research Centres and Special Education Boards affiliated with the General Directorate are responsible for the implementation of policies. The Board defines the principles and procedures of the Guidance and Research Centres, which are responsible for governing evaluation and assessment, placement and supervision for the special needs children. Furthermore, the MoH, the Ministry of Labour and Social Security, the Social Services through theTurkish Employment Organization, the Social Services and Protection of Children Agency, and the General Directorate of Social Assistance and Solidarity were organized at both central and local levels to serve people with disabilities. To properly coordinate these services, the Prime Ministry Administration for Disabled People was established in 1997.

The new Disability Law has facilitated improvements in the education of disabled people and removed most of the obstacles to their receiving services. All children are covered, whether they have social security or not, and governmental support has been provided to educate all children who are judged by the Special Education Assessment Board to have a need for special education.

According to statistics reported by the General Directorate of Special Education Guidance and Counselling Service Department of the MoNE (2008), about 282,369 school-age children up to the age of 18 years received special education services in both regular and separate education schools in the 2008–2009 academic year. It should be emphasized herein that early childhood and preschool education has become compulsory for special needs children with the new special education act. Thus, 28,252 students are placed into state special education schools, organized mainly for hearing impaired, mentally retarded (educable and trainable), autistic, visually impaired, physically handicapped and gifted children. There are no special schools or classes for SLD. The special education classes under state primary schools serving 9252 children, are mainly for those who are mentally retarded but educable. A total of 4138 students receive services at separate private primary special education schools. The establishment of separate schools differs from the current educational practice in the United States, but may be similar in part to the system in some European countries. The logic underlying the existence of such schools is that they provide education throughout the child's entire curriculum. Integration (main-streaming) of the disabled is a mandatory principle of the new law, designed to promote a 'least restrictive environment.' A total of 67,756 children receive inclusive education in state primary and secondary schools. The childhood age restriction has also been renewed for those who need lifelong services, and supportive rehabilitation. As a result, 181,665 individuals receive supportive education and/or therapy in private rehabilitation institutions. A related requirement of the law is to provide supportive services such as teacher consultations, in-class support or resource room services whenever necessary. However, the implementation of this aspect lags due to the lack of several support personnel, specifically SLPs and audiologists.

Although there is considerable growing interest in the area, implementation of health and education services in special needs categories (both child and adult) is still inadequate, lacking systematic individualized programs, assessment and intervention materials, due to lack of enough support service personnel. Nevertheless, public awareness is growing on the educational rights of disabled people, and several projects, such as Umut Adimlar Projesi (The Project of Hopeful Steps) for the counseling of families of special needs children, are in progress through the collaboration of the Prime Ministry Administration for Disabled People, MoNE and some universities. In line with the goals of UNESCO project on 'Education for All', a national action plan was prepared to reach the objectives of providing equality of opportunity at all levels and kinds of education until 2015 (UNESCO, 2008). The implementation of this goal is considered as a priori to reach the European Union indicators as well.

Financing of services

The financing of health services is complicated as well. Turkey has a mixed financing structure based on two main models: One of them is financing from public resources and the other is financing from those who demand the service. Three main sources are the state budget, social security institutions and personal expenses of the individuals. The structure relies heavily on the individuals' employment status subsidized by the social security institutions. The main public social security institutions are affiliated with the Ministry of Labour and Social Security. The coexistence of budgetary and non-budgetary sources of funding in the health sector has resulted in the emergence of a multi-tier health care system in Turkey, defined by who provides health care, who pays for it and how much and the quality of care of that service. The World Bank statistics showed that 30% of the Turkish population is not covered by any social security; hence, they do not have access to any health care systems (Acar, 2008). Thus, the government proposed a reform package to organize a uniform social security institution and a general health care insurance, which the government claim will bring equality and efficiency to the health care system.

The financial support provided by the government (either from MoNE or MoH) for the health care and education of special needs children is free of charge. Thus, the families of the children receive services whether they have social security or not. Up to the present, the social security system has not worked properly for communication disorders; many institutions gave services to SLD by labeling them under mental retardation categories in order to supply financial funding for the families. The cost of speech therapy is now covered to some extent by national insurances after the new legislation was enacted in late 2005. However, there is no well-established coordination among the Social Insurance Institution and hospitals and MoNE; therefore, planning of services and investments cannot be carried out in parallel with the needs of the SLD. As an example, the ICD-10 principles and criteria (WHO, 2007b) are adapted for SLD in order to get financial support. When a client suffers aphasia due to stroke, he or she can receive medical treatment and rehabilitation within a state hospital, or in a private physical rehabilitation center free of charge, if there is an SLP employed there. Likewise, an articulation-phonologically disordered child can be medically diagnosed free of charge; however, she or he cannot get therapy support if the ICD-10 criteria of disability is below 20%. Even if clients' disorder rates exceed this percentage, they can receive support for therapy in special private centers or hospitals only if they have insurance; but they cannot receive financial support if they have to be treated at a university center that is not affiliated with a hospital. Thus, the clients have to pay for their personal expenses. As a result, the implementation of ICF cannot be monitored properly.

(Continues...)

Excerpted from Communication Disorders in Turkish by Seyhun Topbas, Mehmet Yavas. Copyright © 2010 Seyhun Topbas, Mehmet Yavas and the authors of individual chapters. Excerpted by permission of Multilingual Matters.
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Edition details

• Publisher: Multilingual Matters
• Publication date: 2010
• Language: English
• ISBN 10: 184769246X
• ISBN 13: 9781847692467
• Binding: Hardcover
• Edition number: 1
• Number of pages: 384
• Editor: Seyhun Topbas, Mehmet S. Yavas