Fostering Health and Education Equity for Children with Developmental Disabilities of Korean Immigrant Parents

Background & Purpose
Children whose parents have limited English proficiency (who are often likely to be immigrants) face challenges navigating the health care and education systems due to their language barriers. While there is little research on the relationship between limited English proficiency and the receipt of high-quality health care or special education among children with disabilities, it is still less known about the experiences of parent-professional interactions and patterns of interpreter use among Korean immigrant parents of children with developmental disabilities. Therefore, the purpose of this study is to explore Korean immigrant parents’ perspectives on parent-professional interactions and the use of interpreters.

Methods
We conducted one-on-one interviews with 14 Korean-speaking parents of children with developmental disabilities, who identified as immigrants. Participants were recruited in partnership with a large community-based organization serving children with disabilities of Korean immigrant parents. Interviews followed a semi-structured interview guide that first collected basic demographic data and then asked participants about their experiences in interacting with health care and special education professionals and interpreters. Interviews were conducted in Korean, by a native speaker of that language and audio-recorded, transcribed and translated. Analysis was conducted in Korean and English using the transcripts and data were analyzed using thematic analysis and inductive, grounded coding techniques.

Results
Thematic analysis identified several important barriers to effective communication with professionals, some of which overlapped with general population experience, and some which were more unique to Korean immigrants and their children with developmental disabilities, such as meet halfway, unwelcome feelings, and lack of passion/empathy of professionals. These culturally specific barriers to effective communication with professionals were often addressed through benefits of working with culturally matched/competent professionals, but also participants reported that there is lack of skilled and culturally matched professionals. Language barriers, including issues with interpreters, impacted participants’ interactions with professionals, particularly for Korean immigrant mothers. In other words, participants were generally very dissatisfied with their interpreters assigned by hospitals or schools, and identified barriers of receipt of high-quality interpreting services to promote quality of care and education, such as lack of knowledge and terminology on autism and developmental disabilities, not enough meeting time with professionals due to slow interpretations, and concerns of revealing personal issues to total strangers. Participants suggested several ways to promote high-quality interpreting services, such as need for a pre-meeting with an interpreter and trainings for interpreters on disability. Furthermore, they had a strong desire for promoting physical activities for their children as well as the need for a culturally-tailored parent support group providing information on health care system and emotional support.

Conclusions & Implications
Participants reported significant difficulties in building strong and lasting partnerships with professionals and interpreters. As parents frequently relied on self-support, varying with their socio-economic status and levels of English proficiency, there is an urgent need to build community-based, culturally tailored programs to address disparities in health and education among children with developmental disabilities. Further research to implement and test a community-based, culturally tailored health promotion intervention and parent support group is warranted.