ASD Evaluations in a Language Other Than English

Michigan’s diverse population includes individuals from various linguistic and cultural backgrounds. As the demand for mental health (MH) services increases, it becomes essential to consider the unique needs of individuals with limited English proficiency. In this blog, we will explore the impact of language barriers in accessing autism evaluations in Michigan, focusing on the Hispanic population and discussing the implications for families who speak a language other than English. 

With a population of 10,062,512, Michigan hosts a vast number of individuals who may require mental health services. However, according to census data from Social Explorer, there are only 28,098 mental healthcare providers, pointing to a significant discrepancy between demand and supply. Washtenaw County reflects the state situation, with a population of 372,428 but only 2,080 mental health providers. These numbers indicate a challenge in meeting the mental health needs of the entire population in a general way. This discrepancy becomes even bigger when we think about specialities like evaluating autism in a language other than English.

To understand why language services for mental health evaluations are important, we have to look at the languages spoken in Michigan. Spanish and Arabic are the top two languages spoken in Michigan, other than English. In Washtenaw County, Chinese is the primary foreign language, followed by Spanish.  To get a clearer picture of why this is important we will take a closer look at the Hispanic population. 

In Michigan the Hispanic population accounts for 5.37% of the population (540,036 individuals), while Washtenaw County’s Hispanic population comprises 4.99% of the population (18,578 individuals) (U.S. Census Bureau, n.d.).  So imagine, 18,000 individuals and only about 2,000 mental health providers and of those even fewer are able to provide evaluation services in another language. To further highlight this gap, there are only about 5,000 psychologists in the whole United States who identify as Hispanic, representing a mere 5% of all psychologists in the entire country. Of the 5%, it is uncertain how many of these psychologists are proficient in Spanish let alone provide service in spanish. This indicates a limited pool of professionals to serve the Spanish-speaking population effectively (American Psychological Association, 2021).

These statistics show a language barrier that poses a considerable challenge to the early detection of autism in Spanish-speaking populations. Furthermore, many screening tools used for ASD detection are developed in English, leading to lower sensitivity and potential misdiagnoses when applied to Spanish-speaking individuals. This highlights the urgent need for reliable and valid instruments tailored to Spanish-speaking populations (Alonso-Esteban et al., 2020). Latino children also tend to be diagnosed later, receive fewer specialty services, and have higher unmet service needs because of the statistics mentioned previously (Magaña et al., 2013). These factors reveal the challenges faced by families with limited English proficiency in accessing autism evaluations and necessary services. It can be argued that families that speak non-english languages in general – not just Spanish speakers – face a similar issue.

So what can we do about this shortage of muti-lingual providers? Title VI of the Civil Rights Act of 1964 and the Americans with Disabilities Act (ADA) mandate language access services, including medical interpreters, in healthcare and educational settings. These policies aim to ensure effective communication for individuals with limited English proficiency or disabilities. Medical interpreters in particular play a vital role in facilitating communication during psychological evaluations when language barriers exist. Their specialized training ensures accurate interpretation of psychological terminology, maintaining confidentiality, and addressing cultural sensitivities. By employing medical interpreters, evaluation processes become more effective, inclusive and accessible.

The language barriers faced by families with limited English proficiency in Michigan pose significant challenges in accessing autism evaluations and related services. The demand for specialized assessment tools and proficient professionals is evident. Although there is a policy in place that defines language services as a right, without the professionals- whether it is medical interpreters trained in ASD evaluations or a clinician who provides service in another language – the policy is weakened. We can help bridge the gap and ensure that all families have equal access to essential services for autism spectrum disorder by understanding our rights and advocating for more language access in the mental health professional field.

Resources

Michigan Medicine Interpretation Services https://www.uofmhealth.org/support-services/interpreter-services 

Department of Health and Human Services https://www.michigan.gov/mdhhs/inside-mdhhs/legal/equal-opp/bilingual-interpreter-services 

Certified Languages international- Medical Interpretation Services https://certifiedlanguages.com/medical-interpreter/ 

References 

Alonso-Esteban, Y., Marco, R., Hedley, D., Uljarevié, M., Barbaro, J., Canal-Bedia, R., & Alcantud-Marín, F. (2020). Screening instruments for early detection of autism spectrum disorder in Spanish speaking communities.. Psicothema, 32 2, 245-252. https://doi.org/10.7334/psicothema2019.340.

Magaña, S., Lopez, K., Aguinaga, A., & Morton, H. (2013). Access to diagnosis and treatment services among latino children with autism spectrum disorders.. Intellectual and developmental disabilities, 51 3, 141-53. https://doi.org/10.1352/1934-9556-51.3.141.

Non-English Resources. (n.d.). Autism Speaks. https://www.autismspeaks.org/non-english-resources

Mental Health Providers (MHP) Rate per 100,000 Population [Map]. In SocialExplorer.com. Health Data 2021 Release Retrieved 5 August 2023, from https://www.socialexplorer.com/a9676d974c/view

Population, Speaks Asian or Pacific Island Language (Pop 5+) [Map]. In SocialExplorer.com. Market Profile Data 2021 Retrieved 5 August 2023, from https://www.socialexplorer.com/a9676d974c/view

Population, Speaks Other Indo-European Languages (Pop 5+) [Map]. In SocialExplorer.com. Market Profile Data 2021 Retrieved 5 August 2023, from https://www.socialexplorer.com/a9676d974c/view

Population, Speaks Other Language (Pop 5+) [Map]. In SocialExplorer.com. Market Profile Data 2021 Retrieved 5 August 2023, from https://www.socialexplorer.com/a9676d974c/view

U.S. Census Bureau QuickFacts: Washtenaw County, Michigan. (n.d.). Www.census.gov. https://www.census.gov/quickfacts/fact/table/washtenawcountymichigan/PST045222

(2021). Apa.org. https://www.apa.org/monitor/2018/06/spanish-speaking#:~:text=Yet%20there%20are%20only%20about