Spanish-speaking Adults Research Articles

Test of memory Malingering 2nd Edition: Normative data from cognitively intact adults living in Spain.

This study evaluated the universality of the TOMM 2 and provided a reference sample of cognitively intact adults living in Spain whose native language was Spanish. A total of 203 adults completed the TOMM 2 from June 2019 to January 2020. When using the original TOMM cutoff scores derived from English speakers, all participants scored in a range that would suggest that they passed the TOMM. When using a cut score less than 40 on Trial 1, only one participant in this study would be mistakenly classified as providing an invalid performance. Spanish-speaking adults in Spain from this study achieved a perfect score on Trial 1 at a rate more than double that of English-speaking individuals on the original TOMM. At the item level, all but one item met the minimum standard for performance validity; this item fell only marginally below the standard at 89%. This study found a very low failure rate for the TOMM 2, suggesting that the second edition has at least as high specificity as the original in Spanish adults.

Spanish-speaking Patients' Experiences with Hearing Health Care.

Background/introduction: Health care providers working with Spanish-speaking patients must provide culturally and linguistically appropriate care to meet the communication needs of this population. Disparities related to hearing health care access remain understudied, leaving gaps in clinical practice and guidance for audiologists. The purpose of this study was to explore the experiences of Spanish-speaking patients with hearing loss when accessing hearing health care services through a limited income hearing aid program. Methods: Six Spanish-speaking patients (three monolingual Spanish, three bilingual Spanish/English) with hearing loss from the Oklahoma City metropolitan area completed in-depth, semi-structured interviews. Results/findings: Three main themes emerged: (1) perceived barriers to service delivery (cost, language, and transportation); (2) success with hearing health care (use of interpreters and reduced cost of services and amplification); and (3) cultural factors (family, religion, and use of home remedies). Discussion/conclusion: The themes identified can provide a foundation for service delivery of patient-centered services that are culturally and linguistically appropriate to help improve access to and quality of hearing health care, particularly for this population of patients. This study identified factors that may contribute to hearing health care disparities for Spanish-speaking adults, which may not be observed in other disciplines that are less communication-focused. Suggestions for improving services for audiologists serving Spanish-speaking patients are discussed.

Normative data for tests of visuo-spatial, visuo-constructional skills, and visual memory for Spanish-speaking adults in the United States.

The Rey-Osterrieth Complex Figure Test (ROCFT) and the Clock Drawing Test (CDT) are commonly used in clinical practice. The ROCFT measures constructional praxis, visual perception, and visuospatial learning and memory, and the CDT assesses for visuospatial, constructional, and executive difficulties. Several neurological disorders are associated with visuospatial and visuo-constructional impairments, yet reliable normative data accounting for sociodemographic and acculturative variables are scarce for Hispanics living in the U.S. To generate normative data for the ROCFT and CDT in a Spanish-speaking adult population living in the U.S. The sample consisted of 245 cognitively healthy adults recruited from several states in the U.S. Each participant was administered the ROCFT and CDT as part of a larger cognitive battery. The ROCFT and CDT were normed using a Bayesian approach. Age, age2, education, sex, acculturation, and language proficiency were included as predictors in the analyses. ROCFT performance was associated with education and age, particularly as they interacted with Spanish language proficiency and time spent in the U.S. Education was significantly associated with recall abilities and a lower memory recall on the ROCFT. Age was found to vary depending on a person's bilingual abilities. Sex did not emerge as a predictor of performance, and it did not interact significantly with other variables. This is the first study to include acculturation and language proficiency variables in the creation of norms for the assessment of visuo-constructional abilities. This study will have a large impact on the practice of neuropsychology in the U.S.

Methodology for the generation of normative data for the U.S. adult Spanish-speaking population: A Bayesian approach.

Hispanics are the largest growing ethnic minority group in the U.S. Despite significant progress in providing norms for this population, updated normative data are essential. To present the methodology for a study generating normative neuropsychological test data for Spanish-speaking adults living in the U.S. using Bayesian inference as a novel approach. The sample consisted of 253 healthy adults from eight U.S. regions, with individuals originating from a diverse array of Latin American countries. To participate, individuals must have met the following criteria: were between 18 and 80 years of age, had lived in the U.S. for at least 1 year, self-identified Spanish as their dominant language, had at least one year of formal education, were able to read and write in Spanish at the time of evaluation, scored≥23 on the Mini-Mental State Examination, <10 on the Patient Health Questionnaire- 9, and <10 on the Generalized Anxiety Disorder scale. Participants completed 12 neuropsychological tests. Reliability statistics and norms were calculated for all tests. This is the first normative study for Spanish-speaking adults in the U.S. that uses Bayesian linear or generalized linear regression models for generating norms in neuropsychology, implementing sociocultural measures as possible covariates.

WHO-UCLA auditory verbal learning test: Normative data for Spanish-speaking adults in the United States.

Hispanics are a significant demographic in the U.S., with diverse cultures and languages. Assessing cognition in this group is complex as cultural and linguistic factors have been found to affect test performance. To generate normative data on the World Health Organization-University of California Los Angeles Auditory Verbal Learning Test (WHO-UCLA AVLT) in a sample of Spanish-speaking Hispanics residing in the U.S. The sample included 245 Spanish-speaking individuals aged 18-80 across the U.S. (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin). Participants were administered the WHO-UCLA AVLT as part of a comprehensive neuropsychological battery. A Bayesian regression approach was used to estimate normative data, including covariates found to be important for predicting performances on measures of learning and memory. Bayesian models showed a logarithmic link between education and all WHO-UCLA AVLT trials, except recognition. For delayed recall, increased Spanish proficiency benefited women's performance exclusively. Time in the U.S. was a significant predictor for total recall, indicating worse performance with longer residency. Recognizing cultural factors like language proficiency and duration of U.S. residence is essential for accurately evaluating cognitive function among Spanish-speaking Hispanics. This research emphasizes the importance of accounting for cultural nuances in developing norms for neuropsychological assessments, thereby improving their relevance and effectiveness in diverse communities.

Attention and processing speed tests: Normative data for Spanish-speaking adults in the United States.

Hispanics/Latinos are the largest racial/ethnic group among underrepresented populations in the U.S. and multiple sociodemographic, cultural, and linguistic factors have been found to impact their performances on cognitive testing. Despite this, few normative data are available for the heterogeneous Spanish-speaking population in the U.S. To generate normative data on the Trail-Making Test (TMT), Bells Test, Symbol-Digit Modalities Test (SDMT), and the Brief Test of Attention (BTA) for Spanish speakers residing in the U.S. The sample included 245 Spanish-speaking individuals aged 18- 80 from eight states across the U.S. (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin). Participants were administered attention and processing speed measures as part of a comprehensive neuropsychological battery. We used a Bayesian regression approach to estimate normative data, including covariates found to be important for predicting performances on measures of attention and processing speed. Sociodemographic factors including education, time in the U.S., acculturation, age, and/or sex had differential effects on the TMT-A, TMT-B, SDMT, and the BTA whereas the Bells Test was not influenced by any of these sociodemographic factors. Our findings indicate that while sex, age, and educational attainment are important factors to consider, language and acculturation can also influence attention and processing speed performances among Spanish speakers in the U.S.

Newly developed neuropsychological norms for the evaluation of Spanish-speaking adults in the United States.

Newly developed neuropsychological norms for the evaluation of Spanish-speaking adults in the United States.

Executive function tests: Normative data for Spanish-speaking adults in the United States.

Normative data for Spanish-speaking populations, particularly Hispanics in the U.S., is notably scarce. This study aims to establish normative data for executive function tests (Modified Wisconsin Card Sorting Test and Stroop Color and Word Test) among Spanish-speaking Hispanics in the U.S. We assessed 245 individuals aged 18-80 from eight U.S. states (California, Connecticut, Florida, Indiana, New Jersey, Oregon, Virginia, and Wisconsin) and employed Bayesian regression to estimate norms, considering various sociodemographic factors influencing performance. The posterior distribution suggests a high probability that age impacts SCWT performance, with older adults likely to show greater declines, particularly among those with high proficiency in Spanish. The posterior distribution suggests a stronger effect of age on M-WCST performance among individuals with longer U.S. residency. Educational attainment demonstrates a robust positive impact on M-WCST outcomes, with lower levels of education associated with a higher probability of increased errors. An interaction between education and Spanish proficiency was observed, influencing SCWT scores differently across proficiency levels. Sex and acculturation levels interact to affect SCWT performance, with distinct patterns observed between men and women. This suggests that the impact of acculturation on cognitive test performance may vary by gender. Establishing culturally sensitive normative data can enhance accurate identification of executive dysfunction and reduce misdiagnosis risks. This study underscores the importance of considering sociocultural factors including acculturation and language proficiency in neuropsychological assessments to better serve diverse populations.

Spanish translation and cross-cultural adaptation of the Box and Block Test: a pilot study in adults with chronic acquired brain injury.

Background The Box and Block Test (BBT) is a highly recommended outcome measure to assess unilateral gross motor activity of the upper limbs. The BBT has not previously been available in a version adapted to the Spanish context. Thus, this study aimed to cross-culturally adapt and translate the BBT's instructions and pilot test the Spanish version of BBT in adults with acquired brain injury (ABI). Methods The BBT was translated and cross-culturally adapted following standard procedures. An expert committee approved the final Spanish version of BBT and it was conceptually validated by four therapists with expertise in ABI. The tool was tested on 14 adults with ABI. Results The Spanish version of BBT included a new section of materials for the test and a record to count the number of blocks transferred from one compartment of the box to the other. Following the pilot study, a modification in terminology was implemented for referring to the dominant and non-dominant hands. Conclusions Our results suggest that the Spanish version of BBT is suitable for assessing manual dexterity in Spanish-speaking adults with ABI.

B - 13 Effects of Individual and Community-Level Adverse Childhood Experiences and Current Psychopathology among Monolingual Spanish-Speaking Adult Neuropsychology Referrals

Abstract Objective The link between adverse childhood experiences (ACEs) and higher rates of psychopathology in adulthood has been well-established, though far less analogue research has examined this relationship among Latinx patients. This study assessed the relationship between ACEs and symptoms of anxiety, depression, and perceived stress among monolingual Spanish-speaking neuropsychology referrals. Method Data were culled from 27 adult neuropsychology referrals (mean age = 61.70; mean education = 8.59) neuropsychological referrals administered the ACE Questionnaire, Beck Depression Inventory (BDI-II), Geriatric Depression Scale (GDS), Beck Anxiety Inventory (BAI), and Perceived Stress Scale (PSS). Linear regression analyses examined the effect of exposure to individual (e.g., emotional, physical, sexual abuse, neglect, domestic violence) and community-level ACEs on depression, anxiety, and perceived stress symptom endorsement. Results Endorsement of more individual ACEs predicted higher levels of anxiety (R2 = 0.281; p = 0.009) and depression (R2 = 0.127; p = 0.075) symptoms, but not perceived stress levels (R2 = 0.037; p = 0.365. By contrast, endorsement of more community-level ACEs marginally predicted higher anxiety symptoms (R2 = 0.124; p = 0.071), but not depression symptoms (R2 = 0.020; p = 0.568) or perceived stress levels (R2 = 0.045; p = 0.319). Conclusions Experiencing more individual-level ACEs predicted greater anxiety and, to a lesser extent, depressive symptoms, whereas community-level ACEs did not predict similar levels of endorsement of active psychopathology among monolingual Spanish-speaking adults referred for neuropsychological evaluation. Findings emphasize the need of neuropsychologists to consider routinely assessing patient’s childhood trauma history and current psychopathology symptoms during evaluation to improve diagnostic accuracy and recommendations for Latinx patients.

Implementing a Diet Risk Score (DRS) for Spanish-Speaking Adults in a Clinical Setting: A Feasibility Study.

Tools to briefly assess diet among US Spanish-speaking adults are needed to identify individuals at risk for cardiometabolic disease (CMD) related to diet. Two registered dietitian nutritionists (RDNs) recruited bilingual medical students to translate the validated Diet Risk Score (DRS) into Spanish (DRS-S). Participants were recruited from a federally qualified health center. Students administered the DRS-S and one 24-h recall (Automated Self-Administered 24-Hour (ASA24®) Dietary Assessment Tool) on one day; a second recall was administered within 1 week. Recalls were scored using the Healthy Eating Index (HEI)-2015, a measure of adherence to the Dietary Guidelines for Americans. Spearman correlations, weighted kappa, and ANOVA were conducted using SAS 9.4 to assess the relative validity of the DRS-S. Thirty-one Spanish-speaking adults (female: n = 17, 53%; mean age: 58 (42-69)) completed assessments. The mean DRS-S was 9 (SD = 4.2) (max: 27; higher score = higher risk) and the mean HEI-2015 score was 65.7 (SD = 9.7) (max: 100; higher score = lower risk), with significant agreement between measures (r: -0.45 (p = 0.01)), weighted kappa: -0.3 (p = 0.03). The DRS-S can be used in resource-constrained settings to assess diet for intervention and referral to RDNs. The DRS-S should be tested in clinical care to assess the impact of dietary changes to reduce CMD risk.

Abstract MP10: A Remote Pharmacist Intervention for Monitoring and Treating Hypertension for Patients Living in Rural Areas

Background: Hypertension is a significant, but modifiable, cause of morbidity. Many people are unaware that they have hypertension, and of those with a diagnosis, many do not have controlled blood pressure (BP). Undertreatment may be especially problematic in medically unserved rural areas with reduced access to medical care. The goal of this study was to evaluate whether a remote pharmacist-based intervention improves BP management for patients in rural areas. Methods: We recruited English- and Spanish-speaking rural adults from University of Iowa Health Care with at least 2 previous clinically measured BP values &gt; 145 mmHg systolic or &gt; 95 mmHg diastolic, for a 12-month study. Patients submitted up to 14 home BP measurements via text messaging pre-randomization. They had one conversation with the research pharmacist, and then they were randomized to the intervention or control group. The control group received only usual care for the rest of the study period. The intervention group received calls as often as once a month from a remote pharmacist who reviewed their home BP, gave medication recommendations to patients’ providers through the electronic medical record, and provided lifestyle recommendations. Research BPs and antihypertensive medication use were measured at baseline, 6 months, and 12 months. At the end of the study, patients were asked about their experiences with the remote pharmacist and the study in general. Results: There were 211 patients in the control group, and 209 in the intervention group. Average age was 58 years. Four percent of participants were Black, and 23% were Hispanic. Average BMI was 33, and 29% had diabetes. The decrease in systolic BP in the intervention group was 9.5 mmHg lower than the control group at 6 months (p&lt;0.001), and 4.8 mmHg lower than the control group at 12 months (p=0.019). There were no changes in the probability of being treated, but the intervention group had 75% more medication changes in the first 6 months compared to the control group (p&lt;0.001). Many patients commented about the ease of participation and were interested in continuing communications with the pharmacists and reporting home BP readings after the study finished. Conclusions: Our bi-directional texting and remote pharmacist intervention successfully lowered BP levels. Future work will expand this study to other populations and examine this study’s cost effectiveness.

Normative data for verbal fluency and naming tests in Spanish-speaking adults in the United States.

Linguistic deficits are common across neurological and neurodegenerative disorders. Currently there are limited neuropsychological norms available for Spanish-speaking adults residing in the U.S. To generate norms for two verbal fluency tests and the Boston Naming Test (BNT) in a Spanish-speaking population in the U.S., with adjustments for demographic and cultural variables. The sample consisted of 245 adults from the U.S. Participants completed phonological and semantic verbal fluency tests and the BNT. A standardized two-step statistical procedure was used. For the phoneme F, interactions between Spanish proficiency, age, and education arose. Better performance on phonemes A, S, and M was related to education. Spanish proficiency, acculturation, and time in the U.S. were associated with the phonemes S, A, P, M, and R. An age by education interaction was found for phonemes M and R. The FAS and PMR triads were related to age, sex, time in U.S., and Spanish proficiency. For the semantic verbal fluency tests, an interaction between education and Spanish proficiency arose. For the BNT, test scores were related to education, and significant interactions were also found based on education's interaction with Spanish proficiency and acculturation. This study highlights the importance of accounting for sociodemographic and acculturative factors when developing normative data for verbal fluency tests and the BNT for dominant Spanish-speaking adults in the U.S. These sociodemographically-adjusted norms will help improve accuracy of diagnosis and interpretation of linguistic test performance in Spanish speakers living in the U.S.

Action plans increase advance care planning documentation and engagement among English and Spanish-speaking older adults.

Advance care planning (ACP) has been reconceptualized as a health behavior. Action plans (APs), or patient-directed mini contracts, improve behavior change. However, no prior studies have assessed whether APs can increase ACP documentation and engagement. We included English and Spanish-speaking primary care patients from San Francisco, ≥55 years of age, with ≥2 serious or chronic illnesses. Participants were in the intervention arm of the PREPAREforYOURcare.org trial and asked at baseline to choose 1 of 5 actions (e.g., choose a surrogate). At 6 months, we assessed whether participants completed their AP and if completion was associated with demographics, electronic health record (EHR) ACP documentation, and five-point ACP Engagement Survey scores. We used t-tests, chi-squared, multivariate analysis adjusted for baseline ACP and clustering by physician, and qualitative thematic analysis to explore reasons for non-completion. The mean age of 586 participants was 65 ± 10 years; 44.0% women, 45.9% Spanish-speaking, 31.4% had limited health literacy, and 43% completed an AP at 6 months; surrogate-related (47.4%), tell others about medical wishes (33.7%), ask clinicians questions (13.7%), and decide what matters most in life (5.2%). Participants with limited versus adequate health literacy were less likely to complete an AP (25.4% vs 35.9%, p = 0.01). Completing an AP was associated with greater ACP EMR documentation 49.8% vs 35.6%, p < 0.001 (adjusted odds ratio: 2.06; 95% CI [1.43-2.97]) and engagement (adjusted five-point scores [3.69; 95% CI 3.57-3.81 vs 3.10; 95% CI: 2.98-3.21], p < 0.001). Themes for non-completion included not being ready and logistical issues (e.g., surrogate deceased). Among English and Spanish-speaking older adults, creating an ACP AP resulted in greater documentation and engagement. APs may help facilitate ACP behavior change as part of effective ACP interventions. Additional support may be needed for patients with limited health literacy and those facing logistical barriers.

Psychometric examination of the Multidimensional Psychological Flexibility Inventory Short Form (MPFI-24) and the Psy-Flex Spanish versions in individuals with chronic pain.

Acceptance and Commitment Therapy (ACT) has been found to be beneficial for individuals dealing with chronic pain. The theoretical mechanisms of change proposed by ACT are based on the Hexaflex model. To comprehensively reflect this model, the Multidimensional Psychological Flexibility Inventory (MPFI) and Psy-Flex have been developed. The study aimed to adapt the MPFI-24 and the Psy-Flex for Spanish-speaking populations with chronic pain and to examine their dimensionality, internal consistency, convergent validity and incremental validity. This cross-sectional study involved 309 Spanish-speaking adults with chronic pain who completed an online survey. The majority of the participants were women (88.3%). The ages ranged from 18 to 79 years. Factor analysis showed that the Spanish version of the MPFI-24 has 12 factors, consisting of six flexibility and six inflexibility factors, similar to the original version, but lacking second-order general factors. The Psy-Flex demonstrated a single-factor structure, maintaining the general factor of psychological flexibility seen in the original version. The MPFI-24 showed good internal consistency and adequate convergent validity, with the exception of the Acceptance and Experiential Avoidance subscales. The Psy-Flex showed good internal consistency and convergent validity. Notably, both the MPFI-24 and Psy-Flex scores significantly explained additional variance in psychological distress beyond other ACT-related measures of Hexaflex processes; however, only the Psy-Flex explained pain interference. The Spanish adaptations of the MPFI-24 and Psy-Flex are valid and reliable instruments for assessing the Hexaflex model processes in Spanish-speaking adults with chronic pain. Practitioners and researchers in chronic pain will find the Spanish versions of the MPFI-24 and the Psy-Flex here, along with recommendations for their use and scoring based on a robust psychometric rationale. It should be noted that these measures surpass the Chronic Pain Acceptance Questionnaire (CPAQ) and the Psychological Inflexibility in Pain Scale (PIPS), which are considered gold standards in chronic pain assessment.

Factor structure of the Impact of Events Scale-Revised in Latin American young adults.

More than 550 million people speak Spanish and, yet, psychometric data on psychological instruments in Spanish lags. Given evidence of significant traumatic exposure and distress among Spanish speakers, the aim of the current study was to examine the factor structure of the Impact of Events Scale-Revised (IES-R), in a large sample of Spanish-speaking adults. Participants (n = 725) were university students living in Latin America (M = 21.02; SD = 3.12). Most were born in Mexico (77.6%) and the next largest subgroup was from Ecuador (18.9%). Respondents completed the 22-item IES-R. The IES-R mean score was 20.08 (SD = 21.34) and 26.6% of the sample met the cutoff score for clinically significant symptoms. Regarding factor structure, eight different factor structures that have demonstrated a good fit in the extant literature were examined. The one-factor model demonstrated an acceptable fit, χ²(209) = 839.13, p < .0001; root-mean-square error (RMSEA) = 0.06, 95% confidence interval (CI) [0.06, 0.07]; comparative fit index (CFI) = 0.91, Tucker-Lewis index (TLI) = 0.90. The two-factor model demonstrated good fit, χ²(208) = 746.70, p < .0001; RMSEA = 0.06, 95% CI [0.05, 0.06]; CFI = 0.92, TLI = 0.91, and nested model comparisons of the two-factor and one-factor models using the chi-square difference test supported the two-factor model. The most parsimonious of the multifactor models, a two-factor model with Avoidance symptoms as one factor and Intrusions and Hyperarousal combined into a second may be of greatest use for this particular version of the IES-R. The current research demonstrates strong psychometric support for Intrusion/Hyperarousal and Avoidance subscales when measuring traumatic stress in Spanish speakers and underscores the need for culturally and contextually sensitive assessment in this population, in which posttraumatic stress is prevalent. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Characterizing "collateral damage" in men and women with metastatic breast cancer (mBC) from diverse racial and ethnic backgrounds in New York City.

Patients from diverse racial, ethnic, and socio-economic backgrounds may be particularly vulnerable to experiencing undue social and financial burdens ("collateral damage") from a metastatic breast cancer (mBC) diagnosis; however, these challenges have not been well explored in diverse populations. From May 2022 to May 2023, English- or Spanish-speaking adults with mBC treated at four New York-Presbyterian (NYP) sites were invited to complete a survey that assessed collateral damage, social determinants of health, physical and psychosocial well-being, and patient-provider communication. Fisher's exact and the Kruskal-Wallis rank-sum tests assessed differences by race and ethnicity. Of 87 respondents, 14% identified as Hispanic, 28% non-Hispanic Black (NHB), 41% non-Hispanic White (NHW), 7% Asian American Pacific Islander (AAPI), and 10% other/multiracial. While 100% of Hispanic, NHW, and AAPI participants reported stable housing, 29% of NHB participants were worried about losing housing (p = 0.002). Forty-two percent of Hispanic and 46% of NHB participants (vs. 8%, NHW and 0%, AAPI, p = 0.005) were food insecure; 18% of Hispanic and 17% of NHB adults indicated lack of reliable transportation in the last year (vs. 0%, NHW/AAPI, p = 0.033). Participants were generally satisfied with the quality of communication that they had with their healthcare providers and overall physical and mental well-being were modestly poorer relative to healthy population norms. In our study, NHB and Hispanic mBC patients reported higher levels of financial concern and were more likely to experience food and transportation insecurity compared to NHW patients. Systematically connecting patients with resources to address unmet needs should be prioritized to identify feasible approaches to support economically vulnerable patients following an mBC diagnosis.

Spanish–English bilinguals’ use of demonstratives esta and esa

Abstract The limited research on bilinguals’ demonstratives suggests that bilingualism may result in a reduced number of demonstrative forms in bilinguals’ linguistic systems as well as a shift in the factors that constrain demonstrative usage. The current study investigates Spanish nominal demonstrative use among Spanish-speaking monolingual adults in Mexico and two groups of Spanish–English bilingual adults in New Mexico: Adult Arrivals, who were born and raised in a Spanish-speaking country, and U.S. Raised bilinguals, who were born in the U.S. or arrived by age seven. Proximal demonstratives este/esta ‘this’ and medial demonstratives ese/esa ‘that’ were elicited using a puzzle task. All groups varied between este/esta and ese/esa. The monolinguals were likelier than the bilinguals to produce ese/esa when referring to referents farther from themselves and closer to the addressee. Whereas the monolinguals and Adult Arrivals tended to produce este/esta rather than ese/esa when the experimenter selected the incorrect referent, thereby creating a misunderstanding, the U.S. Raised bilinguals showed the opposite trend. The findings are interpreted in the context of typological research indicating that distance between the addressee and the referent impacts demonstrative usage in Spanish but not English. It is hypothesized that increased exposure to English may correspond to reduced attention to the addressee when choosing which demonstrative to use.

Longitudinal profiles of late phonological development in children with Williams syndrome

Williams syndrome (WS) is a genetic neurodevelopmental disorder characterized by language skills above what is expected considering non-verbal intelligence. Research on phonological development is scarce, with many studies focusing on grammar in children and adolescents. In one of our previous studies transversally explored the profiles of late phonological development in Spanish-speaking WS children, adolescents, and adults, while our objective is to longitudinally determine these profiles for WS children based on present error indexes in spontaneous speech. Participants were seven WS children (aged 3;7–8;2), engaging in two spontaneous conversations within a 6-month interval. They were compared cross-sectionally with 240 typically developing (TD) children aged 3–6 years, divided into six groups. All speech samples were transcribed and analyzed with the CLAN software package of the CHILDES Project. Phonological profiles were established on the basis of phonological error indexes obtained dividing absolute frequency of errors by the total number of words produced. WS children showed a mean reduction of more than 25% in the absolute frequency of phonological errors after 6 months. As for the comparison with the normative groups, their error index was consistent with the stage of expansion in TD, however, after 6 months, this was consistent with the stage of stabilization. This atypical acceleration in phonological development could be related to lexical growth in the context of relative preservation of phonological memory. Furthermore, the trajectories of late phonological development in WS children might not be linear, as postulated by neuroconstructivist models, suggesting the need for intervention approaches specifically adapted to the phonological profiles of WS children.

Enhancing End-of-Life Care Knowledge Among Older Spanish-Speaking Adults: Results From a Pilot Educational Intervention on Advance Care Planning and Care Options.

Disparities in advance care planning (ACP) among older Latinos necessitate targeted interventions to enhance engagement and knowledge in end-of-life care. This study aimed to evaluate the effectiveness of a resource-efficient, culturally tailored educational intervention in improving ACP readiness and knowledge among older Latino adults in the community. A quasi-experimental pretest-posttest design was used to assess the impact of the intervention. The study involved community-dwelling older Latinos (aged 61-94) in the U.S. attending community wellness centers. Measures included participants' knowledge of ACP, care options, familiarity with hospice and palliative care, and attitudes toward hospice, assessed using pre- and post-intervention surveys. Statistically significant improvements were observed in ACP knowledge, understanding of care options, and attitudes towards hospice and palliative care post-intervention. Demographic factors influenced knowledge scores, with no significant gender differences in the intervention's efficacy. The educational intervention effectively enhanced end-of-life care planning readiness and knowledge among older Latinos. The study highlights the potential for sustainable, accessible, and culturally sensitive educational strategies to reduce disparities in ACP knowledge and possibly engagement.