Study Explores the Impact of Language Differences on Risk for Developmental Disorder and Elicitation of Parental Concerns

April 6, 2009


MCH Alert, National Center for Education in Maternal and Child Health and Georgetown University

"We found that pediatric providers ask parents about developmental concerns at low rates, and that language or ethnic differences may significantly impact whether providers ask parents about their concerns," state the authors of an article published in the March-April 2009 issue of Academic Pediatrics. Pediatric health professionals monitor child development and behavior through developmental and behavioral (DB) surveillance, which involves observation of a child and elicitation of concerns from parents and other caregivers. Language differences may affect whether health professionals ask about parental concerns and thus whether DB surveillance is performed in the primary care setting. The article presents findings from a study to assess whether language differences are associated with variation in (1) provider elicitation of parent DB concerns during health visits and (2) child risk for DB disorders.

The study used the 2003 National Survey of Children's Health (NCHS) to compare children in households where English was the primary language to children in Hispanic households where Spanish was the primary language. The sample comprised 29,692 NCHS households with parents reporting on children under age 6 who had received preventive care in the previous 12 months. The analysis assessed the association of household primary language with child risk of DB disorder and elicitation of DB concerns.

The authors found that

  • After adjusting for child and family sociodemographic factors, children in Spanish primary language households were less likely to be at any risk or at moderate-high risk for DB disorders when compared to children in English primary language households.
  • Parents in Hispanic, non-English language households had statistically similar levels of elicitation compared to parents in Hispanic, English primary language households. Parents in non-Hispanic English primary language households reported the highest levels of elicitation of DB concerns.
  • Among households with children at moderate-high risk for DB disorders, parents in Spanish primary language households were less likely to report elicitation of concerns than were parents in English primary language households.

This study is important because it shows that language and ethnic differences may be one of the reasons that pediatric providers perform developmental and behavioral assessment at variable rates, and that language differences may correlate with differential child risk on standard developmental screening instruments," conclude the authors.

Zuckerman KE, Boudreau AA, Lipstein EA, et al. 2009. Household language, parent developmental concerns, and child risk for developmental disorder.

Academic Pediatrics 9(2):97-105. Abstract available online here.

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