Telepractice with Vietnamese-speaking Children: A Mixed Methods Study of Caregiver Perspectives and Feasibility

越南语儿童的远程治疗：看护者观点和可行性的混合方法研究

• 批准号: 10314833
• 负责人: Quynh Diem Dam
• 金额: $ 3.83万
• 依托单位: SAN DIEGO STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10314833
• 关键词: Address; Affect; Age; American; American Speech-Language-Hearing Association; Analysis of Variance; Belief; California; Caregivers; Characteristics; Child; Child Behavior; Child Language; Client; Clinical assessments; Decision Making; Development; Diagnosis; Disease; Early identification; Evaluation; Evidence based practice; Family; Family member; Geographic Locations; Gold; Happiness; Health Services Accessibility; Home; Incidence; Intervention; Interview; Knowledge; Language; Language Development Disorders; Language Disorders; Learning; Linguistics; Measures; Methods; Modeling; Needs Assessment; Nursery Schools; Outcome; Parents; Pathologist; Performance; Population; Population Heterogeneity; Procedures; Quasi-experiment; Questionnaires; Reading; Recommendation; Respondent; Risk; Sampling; Schools; Service delivery model; Services; Source; Speech; Surveys; Testing; Time; Treatment outcome; Work; base; bilingualism; clinical decision-making; evidence base; experience; improved; insight; interest; language impairment; nonEnglish language; power analysis; preference; recruit; response; service providers; skills; social; virtual

Project Summary/Abstract There are 1.5 million Vietnamese people in the US, of which, 400,000 are children and about 40,000 are at risk for developmental language disorder (DLD), a high incidence disorder affecting 7-10% of the population. DLD is characterized by low language performance despite otherwise normal development. Children with DLD are at risk for reading problems and poor academic attainment. For bilinguals, DLD is defined by low performance in children’s first and second languages. Bilingual children are often misdiagnosed for a language disorder when tested only in English. For bilinguals in the initial stages of acquiring English, assessing in children’s first language (L1) is more reflective of their true ability. Clinical assessment in children’s L1 is vital for accurate and early identification of DLD, which will lead to timely intervention when needed and better long-term outcomes. A large challenge to assessing in children’s L1 is the shortage of bilingual service providers. Less than 6% of speech-language pathologists (SLPs) are bilingual, and very few speak Vietnamese. Furthermore, bilingual SLPs are often not located in the same geographic area as the children in need of assessment. One solution is telepractice, approved by the American Speech-Language-Hearing Association to increase access to services for culturally and linguistically diverse populations. Telepractice can connect bilingual SLPs to children and families in need of L1 evaluation. However, there is limited information on the social validity and feasibility of telepractice with bilingual populations: it remains unclear why telepractice works better for some clients than others. Using mixed methods, this project proposes telepractice as a potential solution for Vietnamese American families by examining caregiver perspectives on telepractice (Aim 1) and the feasibility and social validity of preschool language assessment with the help of a caregiver (Aim 2). The involvement of caregivers is based on the family-allied model (Houston, 2013) that considers caregivers capable of following recommendations with professional assistance to acquire skills to influence child behavior. This project is framed within the SLP model of evidenced-based practice (Dollaghan, 2007) that integrates three equally important sources of information: client characteristics, empirical evidence, and internal evidence. This project will examine how client characteristics can influence decision-making about telepractice. It will build the empirical evidence for telepractice by conducting a quasi-experimental design to compare implementation conditions; and collect internal evidence using measures of caregivers’ opinions and experiences with telepractice. Findings from this project will provide a better understanding of client characteristics and responsivity to telepractice, refined procedures to involve caregivers, and further evidence for telepractice as a service delivery model for bilingual populations. This project aims to increase clients’ access to bilingual SLPs and improve language assessment for bilingual preschoolers, particularly for Vietnamese Americans.

项目摘要/摘要 美国有150万越南人，其中40万是儿童，约40,000人处于危险之中 对于发育语言障碍（DLD），一种影响7-10％人群的高入射障碍。 DLD 尽管有正常的发展，但其特征是语言表现低下。 DLD的孩子是 有阅读问题和学术成就不佳的风险。对于双语者，DLD由低性能定义 在儿童的第一和第二语言中。双语儿童经常因语言障碍而被诊断 仅以英语进行测试。在获取英语的最初阶段，要评估儿童的第一阶段 语言（L1）更反映其真实能力。儿童L1的临床评估对于准确和 DLD的早期识别将在需要时及时干预，并更好地进行长期结局。 在儿童L1中评估的一个巨大挑战是双语服务提供商的短缺。少于6％ 言语病理学家（SLP）是双语的，很少说越南语。此外，双语 SLP通常与需要评估的儿童不在同一地理区域。一种解决方案是 Telepractice，获得美国语音语言听力协会批准以增加服务的访问 在文化和语言上多样化的人群。远程治疗可以将双语SLP与儿童连接起来 需要L1评估的家庭。但是，关于社会有效性和可行性的信息有限 具有双语人群的远程治疗：目前尚不清楚远程处理对某些客户的效果比 其他的。使用混合方法，该项目提案将远程制品作为越南人的潜在解决方案 通过检查关怀者的视角（AIM 1）以及可行性和社会的看法，美国家庭 学龄前语言评估的有效性在护理人员的帮助下（AIM 2）。护理人员的参与 是基于家庭盟友模型（休斯顿，2013年），该模型认为护理人员能够关注 提供专业帮助的建议，以获取技能以影响儿童行为。这个项目是 在基于证据的实践的SLP模型中构建（Dollaghan，2007），该实践同样整合了三个 重要信息来源：客户特征，经验证据和内部证据。这个项目 将研究客户特征如何影响有关远程疗法的决策。它将建立 通过进行准实验设计来比较实施，对远程疗法的经验证据 状况;并使用护理人员的意见和经验来收集内部证据 远程治疗。该项目的发现将更好地了解客户特征和 对远程疗法的响应，涉及护理人员的精制程序以及远程疗法的进一步证据 双语人群的服务交付模型。该项目旨在增加客户获得双语SLP的访问 并改善双语学龄前儿童的语言评估，特别是对越南人的语言评估。