Hablamos Juntos eUpdate is a periodic electronic newsletter that focuses on current developments in improving patient-provider communication for individuals with limited English proficiency (LEP). Read about the latest language services advancements and activities of the Hablamos Juntos program, our grantees and beyond.

Language Proficiency Testing Options – 2008
New Resources for Language Services
Announcements

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Language proficiency testing options, particularly for health care environments, are more prevalent today than at any other time in our nation’s history. In preparing Language Testing Options 2008 we found three times as many products for language proficiency testing than in 2002, when this report was first published. With the considerable growth in the number of limited English proficient (LEP) persons and growing research findings showing a link between language barriers and poor health care quality and patient safety; health care organizations are steadily recognizing that they must provide language services to LEP patients. The original Hablamos Juntos Language Testing Options identified twelve resources available at the time to assess the foreign language proficiency of prospective interpreters. This relatively small number of resources illustrates what little emphasis was placed on language assessment just five years ago.

Twenty-first-century economic trends and borderless trade are associated with large-scale population shifts worldwide. Since the 2000 Census  we have seen an increase of 8 million; from 47 million to 55 million (2006 estimates) people who speak a language other than English at home. According to a recent Agency for Health Research and Quality (AHRQ) report , language barriers are associated with little to no physician visits in a given year, fewer preventive services, and lower satisfaction with health care services. The good news is that 89% of LEP adults with access to a health care provider (usual source of care) receive some form of language assistance - either through bilingual clinicians or interpreter services. Yet, little is known about the quality of these services.  Although published data is lacking, in our experience bilingual clinicians and employees are the resource-of-choice to provide interpreting services in most health organizations. The cautionary note often overlooked is that bilingualism – the ability to speak two languages – is known to exist along a continuum, representing a wide range of language ability.

In updating the report, we found the link between language proficiency and interpreting ability to be more widely known. In the interest of assuring quality health communication, assessing language proficiency of interpreters is fast becoming the standard. The report looks at how language testing has evolved in the context of an emerging field of health interpreting and includes a sample of 30 public and private resources now available. Although not an exhaustive list, the resources are organized into four sections a) language testing options based on similar scales and guidelines, b) language testing options linked to training programs, c) commercial testing options, and d) testing options that assess interpreter skill in addition to language proficiency. The report reflects on the issues health care providers need to consider in choosing from available testing options. These resources, as well as many others not listed, can be reached through the internet. This is both a blessing and a curse, because the challenge now is in making a decision about which test to use.

Activism in this area has successfully led to the development of many resources for assessing the language and interpreting skills of health interpreters. Still, without consistency and standardization, the options available may merely represent a range of approaches to assessing language proficiency, with wide differences in testing goals and rating scales used. Independent innovation is critical in pioneering different ways to address this unmet need on the other hand unchecked test development may simply add unnecessary complexity. Perhaps now is the time to balance unchecked innovation with the transparency a neutral impartial body – an industry supported National Language Forum akin to the National Quality Forum - to harvest advances in this area and to focus further development.