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

项目总结/摘要 美国有150万越南人，其中40万是儿童，约4万人处于危险之中。 发育性语言障碍（DLD），一种影响7-10%人口的高发病率疾病。DLD 其特点是语言能力低下，尽管其他方面发展正常。患有DLD的儿童 有阅读问题和学业成绩差的风险。对于双语者，DLD的定义是低性能 儿童的第一和第二语言。双语儿童经常被误诊为语言障碍 当测试只在英语。对于处于学习英语初始阶段的双语者， 语言（L1）更能反映他们的真实能力。儿童L1的临床评估对于准确和 早期识别DLD，这将导致在需要时及时干预和更好的长期结果。 儿童第一语言评估面临的一个巨大挑战是双语服务提供者的短缺。不到6%的 语言病理学家（SLP）是双语的，很少有人会说越南语。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 远程练习，由美国言语语言听力协会批准，以增加获得服务的机会 文化和语言多样的人群。远程实践可以将双语SLP与儿童联系起来， 需要L1评估的家庭。然而，关于社会有效性和可行性的信息有限， 双语人群的远程练习：目前还不清楚为什么远程练习对一些客户更有效， 他人使用混合的方法，这个项目提出远程练习作为一个潜在的解决方案，越南 美国家庭通过检查照顾者对远程实践的看法（目标1）和可行性和社会 在照顾者的帮助下进行学前语言评估的有效性（目标2）。照顾者的参与 基于家庭联盟模型（Houston，2013），该模型认为护理人员能够遵循 建议在专业协助下获得影响儿童行为的技能。这个项目是 在循证实践的SLP模型（Dollaghan，2007年）中， 重要的信息来源：客户特征、经验证据和内部证据。这个项目 将研究客户的特点如何影响远程实践的决策。它将建立 远程实践的经验证据，通过进行准实验设计来比较实施情况 条件;并收集内部证据，使用照顾者的意见和经验的措施， 远程练习该项目的调查结果将使人们更好地了解客户的特点， 对远程练习的反应，涉及护理人员的改进程序，以及远程练习作为一种 双语人口的服务提供模式。这个项目旨在增加客户获得双语学习计划的机会 改善双语学龄前儿童的语言评估，特别是越南裔美国人。

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.