title: Developmental Screening Disparities for Languages Other than English and Spanish.
abstract: Limited English proficiency (LEP) is a known barrier to preventive care. Children from families with LEP face socioeconomic circumstances associated with increased odds of developmental delays and decreased participation in early care and education programs. Little is known about developmental surveillance and screening for children from families who speak languages other than English and Spanish. We sought to compare developmental surveillance and screening at well-child visits (WCVs) by preferred parental language.
  
  
  
  Using a retrospective cohort (n = 15,320) of children aged 8 to 40 months with ≥2 WCVs from January 1, 2006, to July 1, 2010, in a community health system, 450 children from 3 language groups (150 English, 150 Spanish, and 150 non-English, non-Spanish) were randomly selected. Chart review assessed 2 primary outcomes, developmental surveillance at 100% of WCVs and screened with a standardized developmental screening tool, and also determined whether children were referred for diagnostic developmental evaluation. Bivariate and multiple logistic regression analyses were conducted.
  
  
  
  Compared to the English-speaking group, the non-English, non-Spanish group had lower odds of receiving developmental surveillance at 100% of WCVs (odds ratio, 0.3; 95% confidence interval, 0.2, 0.5) and of being screened with a standardized developmental screening tool (odds ratio, 0.1; 95% confidence interval, 0.1, 0.2). There were no differences between the English- and Spanish-speaking groups. Though underpowered, no differences were found for referral.
  
  
  
  Improved developmental surveillance and screening are needed for children from families who speak languages other than English and Spanish. Lack of statistically significant differences between English- and Spanish-speaking groups suggests that improved translation and interpretation resources may decrease disparities.
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo; Community Health Services, Denver Health and Hospital Authority, Denver, Colo. Electronic address: Kristine.Rodrigues@dhha.org.
authors.forename: Kristine
authors.initials: K
authors.lastname: Knuti Rodrigues
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo; Colorado School of Public Health, University of Colorado, Aurora, Colo; Community Health Services, Denver Health and Hospital Authority, Denver, Colo.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Hambidge
authors.affiliation: Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colo; Colorado School of Public Health, University of Colorado, Aurora, Colo.
authors.forename: Miriam
authors.initials: M
authors.lastname: Dickinson
authors.affiliation: Community Health Services, Denver Health and Hospital Authority, Denver, Colo.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Richardson
authors.affiliation: Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colo; Colorado School of Public Health, University of Colorado, Aurora, Colo; Denver Public Health Department, Denver Health and Hospital Authority, Denver, Colo.
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Davidson
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis*; D054242:Emigrants and Immigrants; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D007223:Infant; D007802:Language; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D016017:Odds Ratio; D010290:Parents; D012036:Refugees; D012189:Retrospective Studies; D014481:United States
keywords: developmental disabilities; health care disparities; limited English proficiency; screening; well child care