Culturally Effective Care for Dual Language Learners: Pediatric Providers' Language Promotion and Developmental Surveillance.

OBJECTIVE: Culturally effective care for dual-language learners (DLLs) should incorporate evidence-based guidance on bilingual language development. This study assessed pediatric providers' knowledge of bilingualism and provision of culturally effective language promotion and developmental surveillance for DLLs. We also investigated provider-level factors related to these practices. METHODS: Pediatric providers (N=349) who conduct birth-five well-child visits completed an online survey that asked about: knowledge of bilingual language development, self-reported language promotion with DLLs, difficulty identifying language delays, and application of culturally effective language promotion and developmental surveillance in clinical vignettes. RESULTS: The percent of providers who agreed with the evidence-based statements testing knowledge of bilingual language development ranged from 26% to 98% depending on the statement. The percent of providers who self-reported frequently providing culturally effective language promotion to DLLs ranged from 36% to 93% depending on the item. Most (79%) providers reported difficulty identifying language delays in DLLs in cases of language non-concordance, compared to 38% in cases of language concordance and 7% for monolinguals. The percent of providers who responded correctly to hypothetical clinical vignettes ranged from 29% to 95% depending on the vignette. Providers who were bilingual, had received bilingualism training, encountered more DLL patients, and were more knowledgeable about bilingualism reported engaging in more culturally effective care. CONCLUSION: This study revealed gaps in pediatric providers' knowledge and provision of culturally effective language promotion and developmental surveillance for DLLs. Promoting a linguistically diverse workforce and providing training on bilingualism may be important ways to support families of DLLs.