Household language, parent developmental concerns, and child risk for developmental disorder

Area of Science:

• Pediatric Health
• Developmental Pediatrics
• Health Disparities

Background:

• Developmental and behavioral (DB) surveillance relies on provider elicitation of parental concerns.
• Language barriers may impede effective assessment of parental DB concerns by healthcare providers.

Purpose of the Study:

• To compare children in English- versus Spanish-primary language households regarding risk for DB disorders.
• To examine differences in provider elicitation of parental DB concerns based on household primary language.

Main Methods:

• Analysis of the 2003 National Survey of Children's Health data.
• Comparison of 29,692 children (0-71 months) in English vs. Spanish primary language households.
• Logistic regression to assess associations between household language, child DB disorder risk, and parent-reported concern elicitation.

Main Results:

• Children in Spanish-primary language households had a slightly lower risk for DB disorder (AOR 0.68).
• Parents in Spanish-primary language households reported less provider elicitation of concerns (AOR 0.70).
• This disparity in elicitation persisted, particularly for children at moderate/high risk (AOR 0.63).

Conclusions:

• Primary language appears to influence both the reported risk of DB disorders and the likelihood of developmental surveillance.
• Lower elicitation of concerns in Spanish-primary language households may indicate missed opportunities for early intervention.
• Addressing language barriers is crucial for equitable developmental and behavioral surveillance.