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A sample of children from Spanish-speaking homes who are hard-of-hearing demonstrated less than optimal outcomes following cochlear implantation. The authors developed a unique diagnostic protocol to identify potential causes. Inclusion criteria included hearing loss identified by 3 months of age, amplification, a Spanish-speaking home, and enrollment in the statewide early intervention system by 6-months of age. The authors collected extensive demographic data from participants, and the participants completed the same language assessments in 6-month time intervals, examining receptive and expressive language as well as parent-child interaction. Additional assessments included cortical auditory-evoked potentials (i.e., P1), infant speech perception, auditory skill questionnaires, and audio recordings taken over a 12-16 hour period in the child's natural language environment. This auditory spoken language matrix allowed identification of good auditory performers who performed poorly on expressive language measures and poor auditory performers with poor expressive and receptive language outcomes. The comprehensive nature of the assessment allowed examination of spoken language input and helped determine if poor language outcomes were associated with a lack of spoken language input (Hart & Risely, 1995). This matrix allowed the authors to rule out audibility, discrimination, auditory development, and quality of exposure to auditory spoken language as causes of delayed development. The article discusses additional benefits of using this protocol.

This article describes the increase of English language learners (ELLs) in the preschool population across the United States and the pressing need for audiologists and other individuals performing preschool hearing screenings to adequately screen this population. The authors then present a university-based, regional, early childhood collaborative screening program. The authors also present general strategies for screening preschool-age populations as well as specific strategies to screen the audiometric status of young ELLs.

This survey study investigated current hearing loss prevention practices among 300 certified occupational hearing conservationists (OHCs) with regard to service delivery to Spanish-speaking workers. OHCs responded to a written survey designed to investigate the current service delivery methods and strategies used by OHCs when providing services to Spanish-speaking workers specific to the audiometric testing, hearing protection, and training program components of hearing loss prevention programs (HLPPs). Data analyses outcomes indicated that there is a statistically significant relationship between certified OHCs' perceived proficiency in Spanish (ability to speak, understand, and/or read/write Spanish) and their perceived ability to communicate (effectively exchange information), their competence level (possessing the requisite knowledge and skills), and their confidence (self-perceived ability) when providing HLPP services to workers who primarily speak Spanish. There is a significant difference between the services provided to Spanish-speaking workers by Spanish-speaking and non-Spanish-speaking OHCs. Consequently, Spanish-speaking workers may not be receiving care comparable to their English-speaking coworkers. Implications from this study suggest the need for expanded training of certified OHCs relative to multicultural/linguistic issues and additional language-relevant hearing loss prevention resources to effectively provide HLPP services to this growing minority population.

Health literacy is recognized as one of the major factors related to positive health outcomes and involves understanding, accessing, and using health information to make necessary health decisions. However, many members of multicultural populations demonstrate limited health literacy due to language barriers, health-care providers' limited knowledge of cultural variations, health-care communication restrictions, and low literacy levels as related to educational attainment. These problems become more complex for people with speech, language, and hearing problems and result in higher risk for inadequate health literacy. In this article, we review the status of health literacy and health-care communication of multicultural populations and offer suggestions for speech-language pathologists and audiologists to improve health literacy.