Wednesday, February 6, 2008

Screening in Practice: Si Se Puede?

Screening continues to be complicated. A colleague implementing screening at a major medical center points out some of the complications of screening non-English speakers in the office:
"There were questions about using developmental screeners in other languages. The website I used has the PSC only in English, Spanish and Japanese. The PEDS must be ordered - we have copies in Spanish and Vietnamese.
Please be aware, interpreter services only allows on-site interpreters to translate responses at the time the provider and patient are in the room together. This limits the usefulness of printed screens in other-than-English, as I assume the provider will need someone to translate responses back into English. Furthermore, registration is not able to assess a family's need for a survey in another language prior to handing them their stamped packet, change the contents of the packet and keep their flow timely. So, we'll ask staff to use written Spanish surveys in the particular circumstance that an interpreter is present - otherwise you would need to use in-room interpreter time to administer the English survey in another language. Please let me know how significant of a challenge this continues to be."
Now, on the PEDS website, they recognize the difficulty of screening in another language:

PEDS In Other Languages

PEDS Translations In Other Languages

The PEDS response form can be licensed in other languages including Somali, Hmung and Chinese. We can also work with you on other translations as needed. We now have translations in English, Spanish, Vietnamese - and license these: Thai, Indonesian, French, Swahili, Arabic, Somali, Taiwanese, Chinese, Hmung, Malaysian, Russian, Haitian-Creole, Galician and Laotian coming soon. For licensing PEDS translations please contact us with your needs.

Spanish Response Form

PEDS is also published in Spanish. The materials include a Spanish response form for parents. An accompanying guide to scoring and interpretation is written for English-speaking professionals working with Spanish speaking families. Included is the preliminary question to ask parents about whether they can complete the form independently or would prefer to have it administered by interview. This question is spelled out phonetically for non-Spanish service providers and also written in Spanish for providers who can speak and understand the language. When interpreters are not available to help with an interview administration, the guide provides a phonetic version of the statement, “Please take this form home and find someone to help you complete it. Then, please return it in this envelope.” When parents can complete the form in Spanish, the typical responses of Spanish speaking parents are listed in Spanish, along side English categories for parental concerns. This enables professionals who do not speakSpanish to easily score and interpret the Spanish version of PEDS.

Other screens are less available in other languages. Of the screens approved by MassHealth,

ASQ:SE: English, Spanish, French, Korean, and Norwegian. More in development.
BITSEA: English, Spanish
CBCL: More than 80 Languages
CRAFFT: Couldn't find any
PEDS: See above.
M-CHAT: English, Spanish
PHQ-9: English, Spanish
PSC: English, Spanish, Japanese

Our office doesn't have interpreter services available onsite. We have enough Spanish language capacity to use the Spanish form easily, but our Polish-speaking patients have to take a pass, or try to work with an interpreter. I am wondering if others have noticed this difficulty, and how we are going to cope with the array of languages used by our patients. Clearly, even in the relatively easy world of mental health screening, the devil is in the details.

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