Limited Language Proficiency Research Articles

A comparative study of how teachers communicate in deaf education classrooms.

This study investigates the communication practices of four teachers in 3rd to 6th grade classrooms with 9 deaf students with limited language proficiency and in stages of emergent writing development. Analyzing language modalities, utterance types, and class interactivity, we found that teachers using American sign language used student-centered approaches, generating a greater number of directives and responsive utterances. They persevered in increasing students' engagement and were successful in clarifying misunderstandings. Teachers using spoken English used teacher-centered approaches, making general comments directed at the whole class, which consequently reduced student participation and responsiveness. They also largely avoided repairing communication breakdowns with emergent writers, focusing instead on those with greater auditory and speaking abilities. These patterns reveal disparities in classroom communication that can affect student learning. Our findings highlight the need for teacher preparation programs to equip teachers with skill sets to employ accessible and effective communication during instruction, especially with deaf students who are still developing foundational language and writing skills.

Impact of limited language proficiency on participation in venous thromboembolism research: a retrospective analysis

BackgroundLimited language proficiency is an established barrier to research participation among racialized populations. While prior studies have highlighted the underrepresentation of racialized populations in venous thromboembolism (VTE) research, the impact of limited language proficiency as a reason for nonconsent among eligible patients is unknown. ObjectivesTo determine the impact of language barrier as the primary reason for VTE research non-participation. MethodsWe reviewed all prospective VTE studies conducted at a research-intensive academic thrombosis research program in Canada between 2014 and 2024. Studies with screening logs that systematically and consecutively captured eligibility assessment and reasons for nonconsent were included. Primary outcome was nonconsent of a screen-eligible patient due to limited language proficiency as the reported reason. We derived pooled estimates of nonconsent due to limited language proficiency as a proportion of consented participants and determined subgroup rates by phase of VTE management, associated medical conditions, and recruitment settings. ResultsScreening logs of 28 studies with 22 057 screening events, 8317 screen-eligible patients, and 3320 consented participants were included. For every 100 consented participants, 3.2 (95% CI, 2.0-5.3) screen-eligible individuals were unable to provide consent due to limited language proficiency. Rates of nonconsent were highest in studies involving cancer (5.6 per 100 participants; 95% CI, 2.9-10.4) and in studies recruiting patients from ambulatory settings outside of the thrombosis clinic (10.8 per 100 participants; 95% CI, 4.8-22.6). ConclusionLanguage proficiency is a key barrier to VTE research participation. Urgent implementation of targeted interventions aimed at mitigating linguistic barriers is essential to ensure equitable opportunities for VTE research participation for racialized patients disproportionately affected by language proficiency.

The capacity of primary school inclusive teachers meets the requirements of the 2018 general education program

The profession of integration teaching is currently receiving considerable attention. The competency framework for teachers is assessed based on the 2018 General Education Program (GEP), which emphasizes the development of students' personal competencies and sets new competency requirements for teachers. This program provides detailed guidelines for teaching and learning in the modern era. The objective of this study is to evaluate the extent to which teachers' training and teaching competencies align with the 2018 GEP. The present study surveyed 611 primary school integration teachers across 32 schools serving disabled students in five provinces and cities within Vietnam. In this study, an assessment of teachers' competencies in various aspects of education and teaching was conducted. The results revealed high levels of proficiency among teachers in assessing and nurturing students' qualities and competencies, as well as in devising pedagogical strategies to enhance students' inherent capabilities. The limited language proficiency, particularly in local and foreign languages, has significant implications for ethnic minority students, who rely on native language instruction for effective learning. This limitation hinders the implementation of the 2018 GEP, especially in regions with a high density of ethnic minority populations. Additionally, teachers showed proficiency in creating safe and culturally educational environments and establishing relationships among students, teachers, and parents. Nevertheless, collaboration with families and communities to achieve educational goals exhibited lower competency levels. Furthermore, teachers demonstrated capabilities in researching and updating subject knowledge, along with supporting colleagues in developing professional competencies. The study also explored stakeholders' perceptions regarding educational practices, indicating varying levels of correctness in responses. This study significantly contributes to the evaluation of current primary school teacher competencies and offers valuable data for school managers, administrators, and teachers to gain a more holistic understanding of this matter.

Motherhood Penalty and Labour Market Integration of Immigrant Women: A Review on Evidence from Four OECD Countries

Among several reasons preventing the effective labour market integration of immigrant women, the motherhood penalty and unpaid care responsibilities stand out prominently. In line with this, the present scoping review shows how motherhood affects the labour market integration of immigrant women in Australia, Canada, the UK, and the USA. This review shows that parenthood exacerbates the gender pay gap and limits labour market access, favouring men with children over immigrant mothers. Moreover, the effect of the motherhood penalty might be moderated by the level of education, age of the children, and the country of origin/ethnicity of immigrants. In the four countries examined, labour market outcomes for immigrant women are particularly poor. Factors contributing to this include limited language proficiency, traditional gender norms that restrict the full-time employment of certain groups of immigrant women, and institutional barriers like work-permit processing delays. To address these challenges, Australia, Canada, the UK, and the USA have implemented various policies facilitating immigrant mothers’ workforce participation. These measures include language and legal-system education, subsidised childcare, and integration programmes for both mothers and children. Additionally, some programmes in Canada and the USA provide employment assistance and financial support for childcare, while Australia and the UK offer comprehensive integration and settlement services.

Understanding the dynamics of English-speaking challenges for students in Kazakhstan

PurposeThe purpose of this paper is to explore the English-speaking challenges confronted by English as Foreign Language (EFL) students in the context of Kazakhstan, a Central Asian, post-Soviet nation, particularly focusing on the interrelation of English language fluency issues, psychological conditions and the influence of environmental factors.Design/methodology/approachThis qualitative inquiry is firmly situated in Krashen’s second language acquisition theory. The research cohort comprises ten undergraduates from the esteemed Foreign Languages and Translation Studies Department, their narratives forming the basis for data analysis. The author conducted structured interviews with the participants.FindingsThe findings demonstrate that limited language proficiency not only hinders fluency but also initiates psychological challenges, forming a difficult cycle. Additionally, environmental elements, such as interactions with teachers and peers, have both beneficial and adverse impacts on speaking improvement. Acknowledging and tackling these complex dynamics is crucial for developing focused interventions that foster a supportive learning environment conducive to enhancing language acquisition and fluency.Research limitations/implicationsThe limitation of this research is that the triangulation method in the form of additional semi-structured interviews and/or observation was not used to get more in-depth data.Practical implicationsThe study might be helpful for stakeholders to reflect on the English difficulties they experience and to prepare effective teaching and learning strategies. In particular, EFL teachers may need to use more speaking activities in lessons to help students overcome language barriers in speaking. EFL teachers might also adopt strategies such as not judging learners’ mistakes in the first phase of their language practices until they get used to speaking without any psychological blocks and paying additional attention to vocabulary and grammar knowledge in communicative lessons. EFL students may use the strategies to consciously evaluate their skills and not learn the speaking material by heart beforehand. In addition, university administration may organize regular speaking clubs for students in order to create an immersive environment. Moreover, they might require teachers to show up with their speaking capabilities before hiring English teachers, especially in English-related specialization departments.Originality/valueThe research indicates a lack of support and a judgmental environment, passive involvement in communicative pursuits and memorization as instrumental strategies for augmenting oral proficiency. These reasons have created difficulties in speaking English for students studying in English-specialized departments in Kazakhstan.

Investigating Teachers and Students’ Views on Debate Activities as a Tool to Improve English Speaking Skills: A Case of Rulindo District, Rwanda

This research is entitled ‘investigating teachers and students’ views on debate activities as a tool to improve English-speaking skills. Its main objective was to examine the role of debate activities in the English-speaking proficiency of lower-level secondary school students in Rulindo District. The study was guided by the theory of Vygotsky, titled Zone of Proximal Development (ZPD). To achieve the current study’s objective, a technique of questionnaires that contains open-ended and closed-ended questions was used to gather needed information. The research design used was a descriptive research design with a mixed method of data interpretation. The target population was 598, including students, teachers, and school authorities. For the learners’ sampling technique, we purposefully chose all students who participated in debate activities who were equal to 57 students. In this regard, 72 respondents (4 school leaders, 11 teachers, and 57 students) were surveyed. Findings revealed different benefits of participating in debates, including but not limited to acquiring speaking skills, improving critical thinking skills, and enhancing teamwork skills and collaboration. In addition, some challenges are faced, such as anxiety, nervousness, and limited language proficiency. Some strategies to improve oral skills in English, as proposed by the surveyed respondents, include providing practice opportunities and offering constructive feedback. Students were recommended to give value to English, the medium of instruction, and the official language and make efforts to practice through different techniques to learn and improve their oral skills in English. Teachers were recommended to define clear learning objectives for debate activities in English learning and help students make real-world connections through debate.

Perceptions of supervisors and their doctoral students regarding the problems in writing the doctoral dissertation results section

In the past, whereas much attention has been paid to exploring doctoral dissertation writing as a whole or the move analysis of results section, there is a dearth of studies examining how the problems keep posing for doctoral EFL students in writing such a section. The current study focused on students' problems when they write the results section of their dissertations in the fields of education and chemistry, and investigated the degree to which students' understanding was in line with that of their supervisors through semi-structured interviews with ten pairs of supervisors and students. The results showed that (1) disciplinary differences played an important role in writing the results section; (2) supervisors and students in the same discipline understood the purposes of writing the results section to a certain extent, but the overall result varied in different disciplines; (3) there was a lack of agreement between supervisors and students regarding the reasons for the students' problems, especially in the field of chemistry; and (4) students, regardless of discipline, tended to attribute their problems to limited language proficiency while their supervisors provided reasons other than that. In light of the findings, the pedagogical implications for writing instruction are discussed.

Connecting collaborative practicums to beliefs: The development of nonnative student teachers’ self-efficacy in native-nonnative trainee collaboration

This qualitative study aimed to fill a research gap by examining the development of self-efficacy beliefs among nonnative-speaking student teachers (NNSTs) in teaching languages other than English. Situated in an international teacher education program for Chinese as a second/foreign language, this study explored the impacts of collaborative practicums on the self-efficacy beliefs of 17 NNSTs while they worked with 28 native-speaking student teachers (NSTs). The collaborative tasks included peer discussions, microteaching, peer observations, and peer feedback. The NNSTs' reflective essays were collected as primary data, supplemented by peer discussion and microteaching videos and peer feedback questionnaires. Using a qualitative methodology that integrated emotion coding and thematic analysis, the study revealed that all four tasks positively influenced NNSTs' self-efficacy beliefs by satisfying their professional engagement intentions. However, tasks involving verbal interactions between NNSTs and NSTs had adverse effects on NNSTs' self-efficacy beliefs, attributed to the limited academic language proficiency of NNSTs and the unsympathetic reactions and linguistic superiority displayed by NSTs. Finally, a three-phase collaborative practicum framework was proposed for language teacher education programs involving mixed native and nonnative trainee groups. This framework highlights the importance of developing inclusive interventions to foster the mutual recognition of nonnative-speaking teachers' values.

Factors Impacting on Patient-Centered Communication Skills and Their Opportunities to Be Involved in Decision-making From the Perspective of Patients With Cancer, Informal Caregivers, and/or Healthcare Professionals: A Systematic Review.

Active participation of cancer patients and their caregivers in decision-making, along with high-quality communication, is crucial in patient-centered cancer management. Although numerous factors affecting patients' communication and decision-making involvement have been identified, it is still unclear which ones are the most prevalent and critical. To identify factors that contribute to high-quality patient-centered communication and decision-making participation from the perspectives of cancer patients, informal caregivers, and/or healthcare professionals. A systematic review was conducted, using 9 databases to retrieve primary research articles published from 2010 to February 17, 2023, updated on December 13, 2023. Methodological quality was assessed using the Mixed Methods Appraisal Tool (version 18). The socioecological model of communication was utilized as analytical framework for summarizing the results. Fifty-two studies were included. The most frequently reported factors were predominantly articulated at the individual, interpersonal, and societal levels. Although the patients' lack of knowledge and limited language proficiency were the frequent patient-level barriers, the perceived lack of knowledge and lack of training of professionals were the crucial and current professional-level barriers, as reported in studies published in 2016 onward. To circumvent these factors, it is critical to enhance professionals' knowledge, communication skills, and patient relationships. Recognizing barriers and facilitators could help in the development of strategies to overcome these barriers and enhance patient participation in clinical communication. The findings could guide the development of programs to enhance patient-professional communication skills. Further cross-cultural studies are needed to understand culture's impact on communication effectiveness and decision-making participation.

Barriers to use of interpreters in outpatient mental health care: Exploring the attitudes of psychotherapists.

The support of professional interpreters is an essential component of adequate mental health care for migrants with limited language proficiency. Nevertheless, for varied reasons, only a small proportion of outpatient psychotherapists provide interpreter-mediated psychotherapy for migrants. This study explored the perspectives of psychotherapists who have not worked with professional interpreters in outpatient mental health care to identify factors that may prevent the use of interpreters in outpatient care and explore possible incentives to provide interpreter-mediated psychotherapy for migrants with limited language proficiency. Semi-structured interviews were conducted with 13 outpatient psychotherapists in Northern Germany who had not yet worked with professional interpreters in outpatient care. The interviews were audio recorded, transcribed and analysed using a structured content analysis approach. The psychotherapists named structural as well as subjective barriers and concerns. Findings suggest that improving structural factors, such as secure funding, minimal additional work, better preparation and training could facilitate the integration of professional interpreters into everyday treatment. Psychotherapists also mentioned concerns about their own confidence (e.g., insecurities regarding the triadic situation), the patient (e.g., reduced openness), the interpreter (e.g., doubts about suitability, motivation and empathy), as well as the therapeutic process (e.g., unclear allocation of roles). However, positive aspects and opportunities of interpreter-mediated psychotherapy were also described. These could be enhanced by the presence of conducive factors, such as existing trust between all parties and professional cooperation between interpreter and psychotherapist.

Design of a business didactic unit for “Tierno Encanto” Association to promote communicative skills, Guanacaste, Costa Rica 2021

Community associations in Costa Rica engage in projects requiring members to communicate in a lingua franca to effectively lead and negotiate with foreign investors contributing to social welfare initiatives. Consequently, the implementation of comprehensive training programs focusing on English language proficiency for this sector is imperative. This study aims to evaluate the design of an English didactic unit emphasizing Business speaking skills for the "Tierno Encanto" Association in Guanacaste, 2021. Qualitative data collection methods, including needs tests, Likert scales, and focus groups, are employed to triangulate the data, ensuring convergence and integration of qualitative findings. The results indicate that despite possessing limited instrumental language proficiency, the participants recognize the necessity to enhance and acquire English language skills, particularly in the context of business, to improve their job prospects and professional competencies within the region. This evaluation serves as a foundation for developing tailored English language training programs that address the specific needs and goals of community associations in Costa Rica, empowering members to effectively engage in business communication and maximize the benefits of collaborations with foreign investors.

Caregivers with limited language proficiency and their satisfaction with paediatric emergency care related to the use of professional interpreters: a mixed methods study

ObjectivesCommunication is a main challenge in migrant health and essential for patient safety. The aim of this study was to describe the satisfaction of caregivers with limited language proficiency (LLP)...

Understanding the Challenges of Language Barriers in Healthcare

This study aims to explore the challenges posed by language barriers in healthcare settings, examining their impact on communication, patient safety, access to services, cultural understanding, and professional practices. The goal is to identify effective strategies for mitigating these barriers to improve healthcare delivery and outcomes for patients with limited language proficiency. This qualitative research employed semi-structured interviews to gather in-depth insights from 27 participants, including healthcare professionals and patients from diverse linguistic backgrounds. Data collection continued until theoretical saturation was reached. The interviews were transcribed and analyzed using NVivo software, following a thematic analysis approach. Key themes and subthemes were identified to understand the multifaceted challenges of language barriers in healthcare. Thematic analysis revealed five primary themes: communication issues, patient safety concerns, access to services, cultural barriers, and professional challenges. Language barriers led to frequent misunderstandings, incorrect diagnoses, and treatment errors. Patient safety was compromised due to medication errors and delayed treatments. Access to services was hindered by limited availability of interpreters and inadequate translation services. Cultural misunderstandings and trust issues further complicated healthcare interactions. Healthcare professionals faced stress and burnout due to inadequate training and resource constraints. These findings align with existing literature, emphasizing the pervasive impact of language barriers on healthcare delivery. Language barriers significantly affect healthcare quality and patient outcomes, necessitating comprehensive strategies to address these challenges. Effective interventions include investing in professional interpreter services, training healthcare providers in cultural competence, establishing clear institutional policies, and leveraging technology to improve communication. By implementing these strategies, healthcare systems can enhance patient safety, satisfaction, and access to care, ensuring equitable healthcare for patients with limited language proficiency.

MentalHealth4All: mapping and assessing existing multilingual resources in mental healthcare

The aim of this article is to illustrate the goals, process and results of the first stage of a European project: MentalHealth4All. Partners from 9 different European countries have worked together to design a multilingual validated repository targeted at third-country nationals with limited language proficiency (LLP TCNs) and healthcare providers, which contains resources to improve this population’s knowledge and understanding of how to access interlinguistic support in mental healthcare services in the main languages of the countries involved in the project. The present article provides a detailed overview of the assessment process of resources and its main results.

Crossing Linguistic Barriers: The Court Interpreter's Balancing Act with Limited Language Proficiency in Legal Discourse

Crossing Linguistic Barriers: The Court Interpreter's Balancing Act with Limited Language Proficiency in Legal Discourse

Use of Peer-Assessment in ESL Writing Classes: Learners’ Perception

Although peer-assessment tends to offer various benefits, and teachers and learners hold positive perception about peer-assessment, conventional paper-based assessment remains dominant in most of the educational programmes, including university English as a Second Language (ESL) courses. Hence, more studies are needed to make teachers, course designers and material designers aware of the potential benefits of peer-assessment. Most importantly, it is useful to examine what learners think about peer-assessment. Therefore, the present study, involving eighty three (N=83) first-year students following a compulsory English as a second language (ESL) course and forty-two (N-42) second year students pursuing English as a major at a state university in Sri Lanka, investigated the learners’ perception of peer-assessment. The study adopted the mixed methods approach in research. After the participants gained hands on experience in peer-assessment in an ESL writing class, they shared their views regarding their experience through a questionnaire, focus group discussion and reflective essay. The qualitative data were analyzed using deductive content analysis method while the quantitative data were analyzed using Microsoft Excel that produced descriptive statistics. The findings revealed that the ESL undergraduates generally hold positive perception about peer-assessment. However, limited language proficiency of the learners and friendship biases remain as challenges to implement peer-assessment practices effectively. The generalizability of the findings of the present study is subject to certain limitations as the sample was drawn from one particular state university. Further studies with a larger sample representing several universities are recommended in order to shed light on the potential of peer-assessment.

Translanguaging in the Saudi EMI Classroom: When University Instructors Talk

The past few decades have witnessed a growing interest in using English as a Medium of Instruction (EMI), especially in higher education. Although the English language has rapidly shifted from being taught as a foreign language to becoming a medium of instruction, empirical research in this area is still limited in the context of the Middle East and North Africa (MENA), especially in Saudi Arabia. Therefore, the present case study explores translanguaging in the EMI classroom. The study used semi-structured interviews to investigate teachers’ perceptions and practices regarding translanguaging, the rationale behind such practices, and the pedagogical effect of implementing translanguaging practices. The data was collected from five university professors majoring in medicine, physics, electrical engineering, and computer science using purposive sampling. It was analyzed using thematic qualitative analysis. The findings show that the participants generally have a positive attitude toward translanguaging, as it was triggered by students’ limited language proficiency and the contextual and psychological situation of the students in the classroom. The results also indicate that it facilitates content comprehension and aids in raising student engagement and reducing language anxiety. Consequently, adopting translanguaging strategies in EMI classrooms with caution is recommended to provide a wealth of advantages and chances for students’ linguistic growth, engagement, and academic success. Professional development programs and assessments of students’ needs are necessary to ensure the prudent use of translanguaging in class and improve EMI classrooms.

A longitudinal study of immigrant mothers' destination-language proficiency and their children's psychological well-being: Evidence and mechanisms from a study in South Korea

RationaleDespite the well-established link between an immigrant's destination-language proficiency and psychological well-being, little is known about the relationship between an immigrant's destination-language proficiency and well-being of their children. ObjectiveThis study investigated whether and how immigrant mothers’ Korean proficiency is associated with life satisfaction and depressive symptoms among their children in South Korea. A comprehensive set of potential underlying mechanisms was also examined. MethodsUsing four waves of data from the Multicultural Adolescents Panel Study (MAPS), this study estimated fixed effects regression models to reduce the possibility of bias due to individual-level heterogeneity. To test for mediation formally, Sobel mediation tests were conducted. ResultsFixed effects estimates suggested that immigrant mothers' Korean proficiency is positively associated with their children's psychological well-being. Specifically, a one-standard-deviation increase in Korean proficiency was associated with an increase in life satisfaction by 13% of a standard deviation and a decrease in depressive symptoms by 9% of a standard deviation. Mediation tests revealed that this association is explained by a combination of social-psychological factors. Friend support was the most salient mediator, followed by lower acculturation stress, positive perceptions of local community, and teacher support. ConclusionsThe findings of this study suggest that efforts to improve immigrant mothers' destination-language proficiency would also benefit their children's psychological well-being. Furthermore, promoting children's relationships with peers at school may mitigate the negative psychological consequences of immigrant mothers' limited language proficiency.

Multilingual communication in Speech Language Therapy

Multilingualism can both enrich and complicate interactions in health care. Several studies (Ferguson, 2002; Jacobs, 2017) point out that language differences between care providers and patients can lead to less access to and lower quality of care. More specifically, challenges regarding communication, mutual understanding and shared decision making are often present (Cox & Maryns, 2021; Schouten et al., 2017) in health care situations. A specific type of care where communication is both instrument and goal of therapy is Speech language therapy (SLT). This profession offers guidance for people who experience difficulties with communication. In the daily practice of speech language therapists (SLTs) clients are vulnerable in their communication in different ways (Blackstone, 2015). For example, in multiethnic cities in the Netherlands many people have limited language proficiency in Dutch and they can also have a communication disorder These converging communication vulnerabilities form a challenge for SLTs. Several studies within the field of SLT have been performed to improve the diagnosis and treatment of complex multilingual cases (Hyter & Salas-Provance, 2023), but little research has been done on the actual interaction during those multilingual encounters (Hand, 2006). Although SLTs are experts in communication, experiences from the work field indicate that these professionals often feel less competent when interacting with multilingual clients or their parents (Lagendijk, 2021). As these situations occur very often in SLT practice and are quite complex due to interfering communication vulnerabilities, they need to be critically explored. The current PhD study LIMINA (Logos In Multilingual InterAction) aims to gain insight into multilingual communication in Speech language therapy in order to enhance inclusive care. By carrying out various research methods (discourse analysis, in depth interviews, focus groups and design based research) different perspectives in the SLT setting are being explored. Data from the actual interaction will be compared and synthesized with the perspectives of clients and professionals in order to create a kaleidoscopic view. Moreover, the project intends to design a practical intervention in co-creation with representatives from the work field in order to enhance inclusive communication in SLT care. For the purpose of the first sub study, students of the Rotterdam University of Applied Sciences collected transcripts from conversations between SLTs and parents, representing their underaged children. Two datasets were composed for the current analysis: a) transcripts of intake sessions (n = 15) and b) transcripts of test results discussions (n = 18). Parents have diverse linguistic backgrounds and most of the conversations took place in Dutch, without an interpreter. By performing a critical discourse analysis (Ten Thije, 2001) multilingual interactions are currently being reconstructed in order to gain insight in patterns, structures and (un)successful actions. Preliminary results show that both SLTs and parents use several interactional strategies for inclusive multilingualism (Backus, 2013) during consults. Mostly supporting materials, such as reports, were used by the SLT to facilitate the verbal interaction; especially during the test result discussions. Also gesturing, writing and drawing were often used as strategies to facilitate the conversation. In five (out of fifteen) intake sessions no strategies were used during interaction. These parents were considered to be sufficiently fluent in the Dutch language by the researchers who analyzed the transcripts. In none of the test result discussions (n = 18) an interpreter was present to enhance understanding. First conclusions regarding inclusive multilingualism in SLT care reveal that although participants choose different ways to support their verbal message, this does not guarantee an adequate transfer of knowledge within the institutional setting of Speech language therapy. Specific conversational goals from both SLTs and parents were often not achieved during the intake sessions and test results discussions. This seems to correspond with the earlier reported experiences of SLTs (Lagendijk, 2021) and underlines the importance of the current study. The present poster gives a textual and graphical overview of the research design for the overarching PhD study LIMINA. The indicated colors represent the different sub studies and the image shows an authentic fragment of a resolved misunderstanding between a parent and a speech language therapist. Furthermore, the poster provides a table of preliminary results concerning the interactional strategies used by SLTs and parents during institutional encounters.

Migrant-Native Disparities in Obstetric Neuraxial Analgesia Use: The Role of Host-Country Language Proficiency.

Neuraxial analgesia (NA) is the most effective modality in managing labor pain with widespread availability in high-income countries. Previous research has reported a differential obstetric NA use among migrant and native women, but the contribution of language barriers is not well understood. We aimed to investigate whether host-country language proficiency among migrant women influences NA use and satisfaction with pain management during labor, when compared to natives. We conducted a secondary analysis of data collected from 1024 native and 1111 migrant women who had singleton vaginal deliveries between 2017 and 2019 and were enrolled in the nationwide Portuguese baMBINO prospective cohort study. Obstetric NA use, satisfaction with labor pain management, and migrants' Portuguese language proficiency were self-reported. Data were analyzed using robust multilevel Poisson regression, adjusted for maternal region of birth (characterized by the Human Development Index), age, and education. Overall, 84.4% of native women gave birth with NA, compared to 81.6%, 71.3%, and 56.9% of migrant women with full, intermediate, and limited language proficiency, respectively. Compared to native women, migrants with intermediate (adjusted risk ratio [aRR] = 0.91 [95% confidence interval {CI}, 0.82-0.99]) and limited (aRR = 0.73 [95% CI, 0.56-0.94]) proficiency were less likely to receive NA. However, no significant differences were observed in pain management satisfaction by language proficiency level. Compared to native women, we observed a differential obstetric NA use across migrant women with different host-country language proficiency levels in Portugal, without affecting satisfaction with labor pain management. Although defining the mechanisms underlying NA use discrepancies requires further research, our findings support systematically evaluating pregnant migrant women's linguistic skills and ensuring their access to adequate obstetric analgesia-related information and interpretation services.