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

点击翻译按钮获取中文摘要

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.