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

基本信息

批准号：
10436180
负责人：
Quynh Diem Dam
金额：
$ 1.48万
依托单位：
SAN DIEGO STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-07-01 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10436180
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 Persons 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 assessment

项目摘要

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.

项目概要/摘要有150万越南人在美国，其中40万是儿童，约4万处于危险之中发育性语言障碍 (DLD)，这是一种影响 7-10% 人口的高发病率疾病。患有 DLD 的儿童的特点是语言能力低下，尽管其他方面发育正常。对于双语者来说，DLD 的定义是表现不佳。在儿童的第一语言和第二语言中，双语儿童经常被误诊为语言障碍。仅以英语进行测试对于处于学习英语初始阶段的双语者，在儿童的第一阶段进行评估。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准确至关重要。及早发现 DLD，这将有助于在需要时及时干预并获得更好的长期结果。儿童 L1 评估面临的一大挑战是双语服务提供商的短缺，不足 6%。言语病理学家（SLP）都是双语的，很少有人会说越南语。 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。远程治疗，经美国言语听力协会批准，可增加获得服务的机会对于文化和语言不同的人群，远程练习可以将双语 SLP 与儿童和儿童联系起来。需要 L1 评估的家庭然而，有关社会有效性和可行性的信息有限。对双语人群的远程治疗：目前还不清楚为什么远程治疗对某些客户来说比传统治疗效果更好该项目使用混合方法，提出远程治疗作为越南语的潜在解决方案。美国家庭通过检查看护者对远程医疗的看法（目标 1）以及可行性和社会性在看护者的帮助下进行学前语言评估的有效性（目标 2）。基于家庭联盟模型（休斯顿，2013 年），该模型认为看护者有能力遵循在专业协助下提供建议，以获取影响儿童行为的技能。框架内的循证实践 SLP 模型（Dollaghan，2007）平等地整合了三个重要的信息来源：客户特征、经验证据和本项目的内部证据。将研究客户特征如何影响远程医疗决策。通过进行准实验设计来比较实施情况来获得远程治疗的经验证据条件；并利用护理人员的意见和经验来收集内部证据该项目的调查结果将有助于更好地了解客户的特征和对远程治疗的反应、让护理人员参与的完善程序以及远程治疗作为一种治疗方法的进一步证据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。