Abstract
Background
Limited English proficiency (LEP) is a known barrier to preventive care. Children
from families with LEP face socioeconomic circumstances associated with increased
odds of developmental delays and decreased participation in early care and education
programs. Little is known about developmental surveillance and screening for children
from families who speak languages other than English and Spanish. We sought to compare
developmental surveillance and screening at well-child visits (WCVs) by preferred
parental language.
Methods
Using a retrospective cohort (n = 15,320) of children aged 8 to 40 months with ≥2
WCVs from January 1, 2006, to July 1, 2010, in a community health system, 450 children
from 3 language groups (150 English, 150 Spanish, and 150 non-English, non-Spanish)
were randomly selected. Chart review assessed 2 primary outcomes, developmental surveillance
at 100% of WCVs and screened with a standardized developmental screening tool, and
also determined whether children were referred for diagnostic developmental evaluation.
Bivariate and multiple logistic regression analyses were conducted.
Results
Compared to the English-speaking group, the non-English, non-Spanish group had lower
odds of receiving developmental surveillance at 100% of WCVs (odds ratio, 0.3; 95%
confidence interval, 0.2, 0.5) and of being screened with a standardized developmental
screening tool (odds ratio, 0.1; 95% confidence interval, 0.1, 0.2). There were no
differences between the English- and Spanish-speaking groups. Though underpowered,
no differences were found for referral.
Conclusions
Improved developmental surveillance and screening are needed for children from families
who speak languages other than English and Spanish. Lack of statistically significant
differences between English- and Spanish-speaking groups suggests that improved translation
and interpretation resources may decrease disparities.
Keywords
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Article Info
Publication History
Published online: December 23, 2015
Accepted:
December 20,
2015
Received in revised form:
October 19,
2015
Received:
April 3,
2015
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
Copyright © 2016 by Academic Pediatric Association
