Children's Hospitals Today - Fall 2023 - 5

COMMENTARY / ROUNDS
Stuck in translation
Why we shouldn't ask children to interpret for their parents.
BY NISHANT PANDYA
T
here are more than 25 million people
with limited English proficiency (LEP)
in the U.S., and more than 60 million people
speak more than one language at home. For
clinicians serving LEP patients, it is tempting
to accept help from an eager family member
willing to translate for their parents. Who
better to help communicate than someone in
the room who knows the parents well and is
accustomed to translating for them?
The truth is that asking
children to serve as ad hoc
interpreters for patients with
LEP is both harmful to the
patient's clinical course and
unfair to the child.
Compared to certified
greater risk for anxiety and depression in
adolescence and young adulthood. Medical
interpretation is emotionally taxing even
for third-party professionals who do not
know the patient.
It is not groundbreaking to say proper
CERTIFIED
medical interpreters, ad hoc
interpreters commit twice as
many errors. Even children
proficient in both languages
may not understand medical
vocabulary, just as many native English
speakers don't. Certified interpreters are not
just bilingual; they have completed medical
interpreter training and passed certification
exams. Their services facilitate a more
accurate conversation and reduce the risk
for clinically significant medical errors.
Asking children to serve as interpreters
INTERPRETERS
FACILITATE A
MORE ACCURATE
CONVERSATION.
use of interpreters for patients with LEP
improves patient care. Implementation is
harder. Time and effort are finite resources.
Wait times to connect to interpreters
remain a barrier. COVID-19 has
also reduced the number of inperson
interpreters available.
In a health care system where
efficiency is gold, connecting to
interpreters demands intrinsic
motivation over response to
external efficiency rewards.
These decisions come with
social costs as well. Telling a
bilingual family member that
a phone or video interpreter is
preferred to their abilities can be uncomfortable.
It can challenge the rapport
building between clinician, patient and
family from the onset.
Phone interpreters are far from perfect.
poses a burden. Children with LEP parents
carry a near daily responsibility to serve as
a language broker. This ranges from answering
home telephone calls to discussing the
family's finances with banks. While it can
feel like just another setting, hospitals can
carry additional emotional weight.
Translating also forces children to step
outside of their parent-child dynamic. It may
inadvertently lead them to disclose difficult
news or explore sensitive topics that can
extend beyond their understanding. While
many have become accustomed to this role,
the stress of serving as the constant translator
accumulates and puts these children at
The extra minutes it takes to connect to an
interpreter feel like hours when a willing ad
hoc interpreter is right there in the room.
Even so, using a certified interpreter is
ultimately the correct decision for patients,
clinicians and families. The patients' clinical
outcomes improve. Clinicians guide care
with consistently effective communication.
And instead of being translators, children
get to be children.
Nishant Pandya, M.D., MPH, is a pediatrics
resident at Yale New Haven Children's
Hospital. The original version of this article
was published by Doximity.
Tell your hospital's story. Email
magazine@childrenshospitals.org.
IN BRIEF
ADMINISTRATOR NEWS
Blythedale Children's
Hospital named John
Flanagan senior vice president
and chief operating officer.
Children's Health named
Dane Peterson chief operating
officer.
Children's Hospital of the
King's Daughters Health
System named Amy Sampson
president and CEO.
Children's Hospital Los
Angeles named Alan S.
Wayne, M.D., pediatrician-inchief.
Children's
Hospital of Orange
County named Jessica L. Miley
senior vice president and chief
development officer.
Oishei Children's Hospital
named Dori Marshall, M.D.,
chief medical officer.
Texas Children's named Debra
F. Sukin, Ph.D., president.
Phoenix Children's named
Michelle Bruhn executive vice
president and chief financial
officer.
HOSPITAL NEWS
Children's Hospital and
Medical Center in Omaha,
Nebraska changed its name to
Nebraska Children's.
Send news to magazine
@childrenshospitals.org.
CHILDREN'S HOSPITALS TODAY Fall 2023
5
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Children's Hospitals Today - Fall 2023

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