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

项目摘要/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 对于发育性语言障碍(DLD)，这是一种影响7%-10%人口的高发疾病。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 面临阅读困难和学业成绩不佳的风险。对于双语者，DLD的定义是低性能 用儿童的第一和第二语言。双语儿童经常被误诊为语言障碍 当只用英语进行测试时。对于初学英语的双语者，在儿童第一阶段进行评估 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 及早发现DLD，这将导致在需要时及时干预，并获得更好的长期结果。 评估儿童第一语言的一大挑战是缺乏双语服务提供者。不到6%的 言语病理学家(SLP)会说两种语言，很少会说越南语。此外，双语 SLP往往与需要评估的儿童位于不同的地理区域。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 适用于文化和语言不同的人群。远程练习可以将双语SLP与儿童和 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。 与双语人群进行远程练习：目前尚不清楚为什么远程练习对一些客户来说比 其他。使用混合方法，该项目建议将远程实践作为越南语的潜在解决方案 通过检查照顾者对远程练习的看法(目标1)以及可行性和社会性 在照顾者的帮助下进行学龄前语言评估的有效性(目标2)。照顾者的参与 是基于家庭联盟模式(休斯顿，2013)，认为照顾者有能力跟随 在专业协助下提出建议，以获得影响儿童行为的技能。这个项目是 在以证据为基础的实践的SLP模型(Dollaghan，2007)框架内，平等地整合了三个 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远程实践的决策。它将构建 通过进行准实验设计来比较实施情况，为远程实践提供经验证据 情况；并使用照顾者的意见和经验的测量来收集内部证据 远程练习。该项目的调查结果将更好地了解客户的特征和 对远程实践的响应性，让护理人员参与的精细化程序，以及远程实践作为 面向双语人群的服务提供模式。该项目旨在增加客户获得双语SLP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的语言评估。

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.