Proficiency Status Research Articles

Cultural Competence in Bilingual Social Communication Assessment: A Case Study

The purpose of this article is to highlight how cultural considerations impact assessment and diagnostic decision making. This article addresses the steps involved in conducting a culturally sensitive, comprehensive evaluation of social communication skills using the Autism Diagnostic Observation Schedule-2nd Edition (ADOS-2). This evaluation was conducted with a 13-year-old, bilingual Cantonese-English speaking teenage girl. She had a history of atypical social behaviors and language disorder, diagnosed at age two. Her complex social difficulties were previously overlooked by professionals and misunderstood as related to her Chinese culture and/or prior history of language disorder. Conducting a culturally appropriate assessment was further complicated by the family's lack of English proficiency and low socioeconomic status, and related challenges they experienced with accessing and navigating the healthcare and special education system. Lisa was referred to a multidisciplinary team, which included a native Cantonese-speaking speech-language pathologist (SLP), to determine the nature of this teenager's social challenges. The team's understanding of the layers of cultural influence on social development—overarching Chinese values, local Chinese community, and the family environment—played a key role in determining whether this teenager's social behaviors were acceptable in either the Chinese or mainstream American culture. Evaluation results shed light on this teenager's long-standing social interaction difficulties, and were consistent with a diagnosis of autism spectrum disorder (ASD). With this newly understood diagnosis, the family reported they felt relief in knowing how to best support their daughter.

Nativity and Health Disparities: Predictors of Immigrant Health

This study examines the differences in the social determinants of health and chronic health conditions of immigrants and nonimmigrants. The logistic regression results indicate that employment, education, poverty, residential status, and neighborhood safety have strong influence on the health of immigrants and native-born Americans; however, gender and place of residence are significant to only nonimmigrant health. For chronic health conditions, age and employment status are significant predictors for immigrants whereas race/ethnicity, age, gender, insurance coverage, and education are important predictors of chronic health conditions among nonimmigrants. Neighborhood safety, English proficiency, and marital status were not significant determinants of the health conditions of both subgroups. The study points to the importance of education, poverty/income, and neighborhood safety as essential determinants of immigrant and nonimmigrant health. However, there are variations in the health predictors for each group.

The revised Stress Measurement of Female Marriage Immigrants in Korea: Evaluation of the psychometric properties

ABSTRACTThe twenty-one item Stress Measurement of Female Marriage Immigrants (SMFMI) was developed to assess stress of female marriage immigrants in Korea. This study reports the psychometric properties of a revised SMFMI (SMFMI-R) for application with female marriage immigrants to Korea who were raising children. Participants were 190 female marriage immigrants from China, Vietnam, the Philippines, and other Asian countries, who were recruited using convenience sampling between November 2013 and December 2013. Survey questionnaires were translated into study participants’ native languages (Chinese, Vietnamese, and English). Principal component analysis yielded nineteen items in four factors (family, parenting, cultural, and economic stress), explaining 63.5% of the variance, which was slightly better than the original scale. Confirmatory factor analysis indicated adequate fit for the four-factor model. Based on classic test theory and item response theory, strong support was provided for item discrimination, item difficulty, and internal consistency (Cronbach’s alpha = 0.923). SMFMI-R scores were negatively associated with Korean proficiency and subjective economic status. The SMFMI-R is a valid, reliable, and comprehensive measure of stress for female marriage immigrants and can provide useful information to develop intervention programs for those who may be at risk for emotional stress.

Lost in Translation: Delivering Culturally and Linguistically Appropriate Interventions to Hispanic Populations

Hispanics became the United States' largest minority in 2012. Lack of culturally and linguistically appropriate interventions in the Hispanic population at the health-care and community levels increases the risk of negative health outcomes, such as obesity and type 2 diabetes. Delivering nutrition education can modify cultural traditions associated with food and decrease diseases associated with food habits. Barriers faced by many Hispanics include, but are not limited to, limited English proficiency and/or immigration status. Developing interventions to improve Hispanics' health outcomes requires understanding of Hispanics' cultural values and diversity. Active recruitment and training of Hispanics into food system fields is crucial to developing and implementing culturally sensitive and language-oriented intervention.

Culturally competent approaches to diagnosing ADHD in Hispanic adults and overcoming cultural issues with patients and families.

Hispanics in the United States are a diverse population with different countries of origin and a wide range of English language proficiency, socioeconomic and immigration status, values, and traditions. Clinicians must combine what they know about treating adult ADHD in general with a culturally competent understanding of the special needs of Hispanic patients in order to provide effective and accessible treatment. Strategies to treat Hispanic adults may include clear communication during the patient's interview, assessment of comorbid conditions, and affordable treatment options.

Meat intake, cooking methods, dietary carcinogens, and colorectal cancer risk: findings from the Colorectal Cancer Family Registry.

Diets high in red meat and processed meats are established colorectal cancer (CRC) risk factors. However, it is still not well understood what explains this association. We conducted comprehensive analyses of CRC risk and red meat and poultry intakes, taking into account cooking methods, level of doneness, estimated intakes of heterocyclic amines (HCAs) that accumulate during meat cooking, tumor location, and tumor mismatch repair proficiency (MMR) status. We analyzed food frequency and portion size data including a meat cooking module for 3364 CRC cases, 1806 unaffected siblings, 136 unaffected spouses, and 1620 unaffected population-based controls, recruited into the CRC Family Registry. Odds ratios (OR) and 95% confidence intervals (CI) for nutrient density variables were estimated using generalized estimating equations. We found no evidence of an association between total nonprocessed red meat or total processed meat and CRC risk. Our main finding was a positive association with CRC for pan-fried beefsteak (Ptrend < 0.001), which was stronger among MMR deficient cases (heterogeneity P = 0.059). Other worth noting associations, of borderline statistical significance after multiple testing correction, were a positive association between diets high in oven-broiled short ribs or spareribs and CRC risk (Ptrend = 0.002), which was also stronger among MMR-deficient cases, and an inverse association with grilled hamburgers (Ptrend = 0.002). Our results support the role of specific meat types and cooking practices as possible sources of human carcinogens relevant for CRC risk.

Status of Teachers’ Proficiency in Mathematical Knowledge for Teaching at Secondary School Level in Kenya

Mathematical knowledge for teaching (MKT), defined by Ball (Elementary Journal, 93, 373–397, 1993) as knowledge that is needed to teach mathematics, has been used as a framework by researchers to interrogate various aspects of teaching and learning mathematics. In this article, which draws from a larger study, we show how an in-depth analysis of MKT can illuminate what teachers know and need to learn. This study described here uses MKT theory (Ball, Thames & Phelps, Journal of Teacher Education, 59(5), 389–407, 2008) to develop an assessment tool, the MKT proficiency status tool, to measure and describe teachers’ MKT by proficiency status. The study explores Kenyan teachers’ interpretations of secondary school students’ unusual problem solving solutions from across five mathematics strands. In this article, we share findings from data collected using a MKT task questionnaire. Data were analyzed using descriptive statistics and interpreted against the MKT proficiency status tool continuum of fluent, partially fluent, and inadequate. The teacher was the unit of analysis. Findings from the study indicate that teachers’ levels of fluency were not consistent either by mathematical strand or by assessed MKT component. A fluency rate of 9.1 % for mathematical strands and 1.7 % for MKT components was found. The overall description of MKT proficiency status for this study was found to be partially fluent. From this study, we argue that the MKT proficiency status tool details and illuminates teachers’ professional development needs and enables an in-depth analysis of their MKT proficiency status.

Mexican Immigrant Families Under Siege: The Impact of Anti-Immigrant Policies, Discrimination, and the Economic Crisis

Latino immigrants have historically faced many challenges living in the United States (U.S.). The economic crisis combined with new anti-immigration policies and harsh enforcement strategies may exacerbate the stress and anxiety Latino immigrant families already endure as a result of discrimination and financial hardships. The purpose of this study was to understand the current challenges Latino immigrant families encounter within an anti-immigrant social-political environment. Fifty-two first generation immigrants participated in focus group sessions, which lasted between 90 and 120 minutes. The findings reveal that the economic crisis, anti-immigration policies, and enforcement strategies have deleterious effects on Latino immigrant families’ well-being. Participants stated that their limited English proficiency status and racial profiling were the basis for discriminatory practices they endured. Discrimination is experienced through instances of micro-aggression, as well as horizontal discrimination and institutional discrimination. Implications for social policy, social work practice, and research are discussed.

Predicting End-of-Year Achievement Test Performance

Motivated by the multiple-measures clause of recent federal policy regarding student eligibility for alternate assessments based on modified academic achievement standards (AA-MASs), this study examined how scores or combinations of scores from a diverse set of assessments predicted students’ end-of-year proficiency status on statewide achievement tests. Scores from 388 eighth-grade students, both with and without disabilities, from 3 states were compared for the predictive validity of test inferences from a set of brief online screening tests, teachers’ ratings of performance, and students’ previous year’s achievement tests. The research team developed screening tests in reading and mathematics that were found to be internally consistent and added predictive value to the identification of students who would perform at a level below proficient on state achievement tests of reading and mathematics. Although achievement results from the previous year were more predictive of future achievement results, scores from the online screening tests and from Performance Screening Guides could be used as supplements to typical achievement tests. Implications of these findings for educators in the 17 states currently using AA-MAS tests for students with disabilities are discussed, and needed future research is identified.

Culturally Relevant Factors and the Young Parenthood Program

I applaud Florsheim et al.1 for bridging the research to practice gap by developing and implementing the Young Parenthood Program (YPP) for expectant adolescent parents. The influence of intimate relationship factors upon the psychological adjustment and health of parents and children is a critical linkage that warrants more attention in the field of public health. While the aims and outcomes of this study were promising, there appeared to be key issues that were either overlooked in the study or omitted from the article. Mainly, the lack of discussion of cultural factors left me with many unaddressed questions regarding the implementation, results, and implications for the YPP. The authors point out that the study participants were primarily White or Latino. Indeed, the sample descriptive statistics indicate that 65% of the male participants and 50% of the female participants were identified (or self-identified) as Latino or Other. Research literature2 has documented how factors such as historical exclusion, discrimination, and oppression have hindered ethnic minority groups from accessing culturally relevant interventions. It has also been noted that an intervention’s lack of fit with the target cultural population can result in recruitment and retention difficulties,2 and culturally adapted interventions have been linked to participant satisfaction and improved outcomes in parenting interventions for a subgroup of Latinos.3 Thus, I was left wondering how culturally relevant factors were handled in this study. For example, did potential culturally based perceptions of the therapeutic process (e.g., stigma) impact recruitment and retention? How did the match or mismatch of therapist and participant ethnicity impact the intervention outcomes? How much attention was given to cultural factors such as family values, kinship networks, religious and spiritual beliefs, acculturation, and language preferences in the intervention? Finally, it would be valuable to further specify the participants’ ethnic backgrounds given that the Latino population in the United States is very heterogeneous with regard to factors such as country of origin, acculturation, language proficiency, and socioeconomic status.4 Again, the authors’ examination of coparenting factors, and specifically the inclusion of fathers in this research, is refreshing. Nonetheless, attending to culturally relevant factors is critical and could potentially help to move this important intervention from efficacy to effectiveness.

The Effects of Sociocultural Factors on Older Asian Americans' Access to Care

Most Asian American elders are immigrants to the United States, and sociocultural factors such as English proficiency and immigration status are prominent factors in their lives. Using data from the California Health Interview Surveys to focus on Asian Americans over age 50, this study seeks to identify interethnic differences, and the effects of English proficiency and immigration status in the way older Asian Americans access healthcare. The results indicated that Asian ethnicity, English proficiency, and immigration status have significant independent effects on older Asian Americans' access to care. Implications for social work's role in addressing access disparities are discussed.

Shoulder Sport-Specific Impairments After Arthroscopic Bankart Repair

Background: Reports of return to shoulder-dependent sport after surgical stabilization previously underestimated impairments, which were not reflected in the score systems used. Hypothesis: Return to shoulder-dependent sport depends on the type of sport performed. Study Design: Case series; Level of evidence, 4. Methods: Forty-seven athletes (26.9 years of age at surgery) who underwent isolated arthroscopic Bankart repair were longitudinally monitored by shoulder-dependent sport-specific activity (Shoulder Sport Activity Score [SSAS]) and ability (Athletic Shoulder Outcome Scoring System [ASOSS]) scores and visual analog scales for reachieved proficiency level, sport-specific shoulder pain, and functional deficits. Data were assessed at 4 points of treatment: preoperatively, and postoperatively after 6, 16, and 32 months (P0-P3). Athletes were analyzed separately according to shoulder sport: noncollision/nonoverhead (G1), collision (G2), overhead (G3), and martial arts (G4). Results: The G1 and G2 athletes had reachieved the preinjury sport activity and sport proficiency status and excellent ASOSS scores after 32 months (SSASG1 = 7.2, SSASG2 = 8.1, ASOSSG1 = 94.4, ASOSSG2 = 95.2), whereas G3 and G4 athletes remained at an inferior activity level (SSASG3 = 8.0, SSASG4 = 8.3) and proficiency level. The ASOSS documented a prolonged period of shoulder rehabilitation for G3 and G4 athletes to reach a good shoulder-dependent sport ability outcome after 32 months (ASOSSG3 = 89.0, ASOSSG4 = 93.1). All groups recorded persisting limitations in visual analog scales for sport-specific shoulder function and pain. The established scores (Rowe = 95.9, Walch-Duplay = 93.3, Constant = 94.0) did not reflect these sport-specific impairments. Athletes with 5 or more preoperative dislocations had significantly longer surgery-to-sport resumption intervals with a prolonged proficiency recovery. Conclusion: The athletes’ shoulder stabilization resulted in a prolonged rehabilitation depending on the functional demand of the performed shoulder-dependent sport, as shown by the specific shoulder sport score systems.

Within-year oral reading fluency with CBM: a comparison of models

This study examined the type of growth model that best fit within-year growth in oral reading fluency and between-student differences in growth. Participants were 2,465 students in grades 3–5. Hierarchical linear modeling (HLM) analyses modeled curriculum-based measurement (CBM) oral reading fluency benchmark measures in fall, winter, and spring with grade level and student characteristics (including special education and Limited English Proficiency status) as covariates. Results indicated that a discontinuous growth model fit the data better than a linear growth model, with greater growth in the fall than in the spring. Oral reading fluency growth rates also differed by grade and student characteristics. Implications for school practice and research are discussed.

Effects of Using Modified Items to Test Students with Persistent Academic Difficulties

This study investigated the effects of using modified items in achievement tests to enhance accessibility. An experiment determined whether tests composed of modified items would reduce the performance gap between students eligible for an alternate assessment based on modified achievement standards (AA-MAS) and students not eligible, and the impact on student proficiency levels. Three groups of eighth-grade students ( N = 755) from four states took original and modified versions of reading and mathematics tests. Findings indicate modified item conditions were significantly easier for all students and modifications would result in more AA-MAS eligible students meeting proficiency status. Study limitations and follow-up research on item modifications and the performance of students with disabilities are discussed.

Center-based care for language minority students

This paper examines the long-term effect of enrollment in center- or school-based care programs on the academic performance of language minority students in the USA. The study applies a longitudinal multilevel analysis to a nationally representative database, the Early Childhood Longitudinal Study (ECLS-K). Of particular interest are the differential effects of the programs on the reading performance of language minority students compared with that of native English-speaking students. Language minority students are further divided into 2 groups according to Limited English Proficiency (LEP) status at kindergarten. Results indicate that kindergarten LEP students who regularly attended center-based programs from preschool through the 5th grade demonstrated a significantly higher reading score than those who did not. The study suggests an important potential benefit of arrangement of afterschool care programs for language minority students in the USA and other countries.

Initiation and Use of Public Mental Health Services by Persons With Severe Mental Illness and Limited English Proficiency

Initiation and Use of Public Mental Health Services by Persons With Severe Mental Illness and Limited English Proficiency

The Impact of Language Status as an Acculturative Stressor on Internalizing and Externalizing Behaviors among Latino/a Children: A Longitudinal Analysis from School Entry through Third Grade

This study examined the relationship between limited English proficiency status, and internalizing and externalizing behaviors among a sample of Latino/a children (N = 2,840) from the US Department of Education’s Early Childhood Longitudinal Study, Kindergarten (ECLS-K) data set. Results of cross sectional regression and hierarchical linear modeling (HLM) analyses suggest that there is a positive relationship between limited English proficiency and externalizing symptoms, particularly by third grade. Additionally, sex and place of birth also helped to explain externalizing behaviors at various time points in the models. Place of birth and family poverty were significantly associated with internalizing symptoms. Implications for future research and interventions related to internalizing and externalizing behavior among the Latino/a school aged population are discussed.

Demographic Profiles of Asian Immigrant Elderly Residing in Metropolitan Ethnic Enclave Communities

This study reports the demographic characteristics of six groups of Asian American elders (Chinese, Korean, Indian, Filipino, Vietnamese, and Japanese) in a regional probability sample (n = 407). The findings confirm the heterogeneity of the Asian American elderly population, who differ in terms of demographics, immigration and acculturation experiences, language proficiency, educational attainment, and financial status. Findings point to the importance of taking careful consideration of the specific needs of different population groups of Asian American elders when planning social and support services. Additionally, cultural competence training for health and social service professionals is needed in order to address the special needs, variability, and differences among these Asian ethnic populations.

Differential significance of tumour infiltrating lymphocytes in sporadic mismatch repair deficient versus proficient colorectal cancers: A potential role for dysregulation of the transforming growth factor-β pathway

The prognostic importance of tumour infiltrating lymphocytes (TILs) in colorectal cancer (CRC) remains controversial. The present study was undertaken to evaluate the role of TILs as prognostic indicators and to investigate the role of transforming growth factor-β (TGF-β) in TIL infiltration. Immunohistochemical staining for components in the TGF-β pathway was performed on a tissue microarray of 1420 unselected CRCs with complete clinico-pathological data. Statistical analyses were carried out on samples stratified by mismatch repair (MMR) proficiency status and TIL counts. TIL infiltration was found to correlate with multiple clinico-pathological features but was a prognostic marker only in MMR proficient CRCs. In all CRCs, findings indicative of insensitivity to TGF-β and increased TGF-β secretion were independent predictors of high TIL counts, suggesting that perturbations in the TGF-β signalling pathway play an important role in the recruitment and retention of TILs within CRC epithelium.

Examining Educational Equity: Revisiting the Disproportionate Representation of Minority Students in Special Education

Continued concerns about educational equity for minority students require looking beyond analysis of enrollment in primary disability categories to additional issues of educational opportunity for students receiving special education services. This study examined the relationship between student ethnicity and language proficiency status with (a) number and type of disability labels, (b) access to the least restrictive environment, and (c) ancillary services using data from a large southwestern school district. Data quality was also examined as part of this study. The results suggest that minority students and English language learners were disproportionately enrolled in special education and placed in more segregated settings. A trend toward increased disability labels for minority students was also identified. Implications for research and practice are discussed.