Hearing and Honoring the Voices of Families with Limited English Proficiency

DeAnna Bay, M.Ed, CCLS, CTRS


Pediatr Nurs. 2021;47(5):252-255, 258. 

In This Article

Abstract and Introduction


Certified Child Life Specialists (CCLSs), as members of the interdisciplinary health care team, work to maximize the coping abilities and minimize the stress of pediatric patients and their families facing medical encounters (Romito et al., 2021). In my own work as a CCLS, I have also frequently found myself called to provide care to families with limited English proficiencies (LEPs), who because of their linguistic background, had difficulties with a number of logistical concerns, understanding guidelines easily lost in translation, and/or just generally navigating the complexities of the health care system. As Yu and colleagues demonstrated in 2006, patients and families with LEPs face a number of additional complications and stressors in health care environments that English-speaking families simply do not. Although further empirical literature regarding the experiences of patients with LEPs in health care is limited, the information available paints a bleak picture for patients and families with LEPs; they are less likely to receive patient- and family-centered care, have inconsistent access to appropriate interpretation services, and are more likely to experience adverse medical outcomes (Galinato et al., 2016). The results of multiple studies also document increased risk factors when families were unaware of their child's medical condition, as well as NICUs in particular that had a distinct lack of resources available once a child was discharged (Miquel-Verges et al., 2011; Obregon et al., 2018).

Despite anecdotally and empirically understanding the hardships faced by LEP populations during hospitalizations, my experiences propelled me to reflect deeper on why I would more frequently receive requests to check-in on families who are considered as having LEPs, even sometimes more regularly than those that were having more evident psychosocial issues. This clinical question led me to conducting interviews with CCLSs having similar experiences, to identify opportunities for improved multidisciplinary service delivery for patients and families with LEPs that could decrease the risk of psychosocial distress during health care encounters. As was heard in these interviews, corroborated by the literature to date and is transferable across health care disciplines, there are several ways in which health care providers can make a difference for patients and families with LEPs: first, by ensuring provision of patient- and family-centered care; second, by attending to the intersections between culture and language that affect families' health care choices and interpretations; and third, by reflecting on the ways in which our own strengths as providers can maximize the strengths of patients and families with LEPs. These differences are further delineated below and also summarized in Table 1.