Informing physician strategies to overcome language barriers in encounters with pediatric patients.
Natalie Guerrero, Alissa L Small, Rebecca J Schwei and 1 others
PMID 29153591WHAT IT FOUND
Physicians said limited-English pediatric visits lost nuance and trust, so they used nonverbal warmth, repetition, slower speech, and interpreter time, but sometimes skipped rapport talk, literacy checks, and prevention issues.
Key findings
01Physicians perceived language-barrier pediatric encounters as different and adapted relationship-building, trust, literacy, flow, assessment, and barrier management.
02Positive adaptations included nonverbal play, a few words in the family's language, repetition or teach-back, slower speech, and written medication names.
03Time pressure and interpretation burden led some physicians to skip light-hearted questions, prevention issues, and deeper life-circumstance discussions.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
All participants were physicians from one healthcare system in Wisconsin, so patients, families, interpreters, nurses, and other clinicians were not represented. Recruitment may have attracted physicians already interested in limited English proficient populations, creating selection bias. The study reports perceptions and reported behavior, not observed visits, tested interventions, or patient outcomes. Access to interpreter services and health system context may differ elsewhere, limiting generalizability. The study was conducted in the United States and may not apply to all settings.
Declared interests
The authors declared no real or potential conflicts of interest. The study is listed as NIH extramural and non-U.S. government research support, but no funder role is described.
The easy way to misread this
Do not read these physician strategies as proven to improve care. The study reports what physicians perceived and said they did, not tested interventions or patient outcomes.