Assessment of the Hispanic community

Type of Psychology: Assessment; Cross-cultural psychology; Psychopathology

A growing proportion of the population is Hispanic. Thus, appropriate assessment approaches are urgently needed in order to accurately and validly work with this community. Assessment of the Hispanic community attends to professional guidelines as well as scientific advancements in the field. Particular attention to bilingual influences in normative and atypical development as well as in the creation and selection of measures is needed.

Introduction

According to the 2010 census, Hispanics constituted 16% (or 50.5 million) of the nation's population. In a decade this ethnic group grew 43% and they accounted for over half the growth of the country's total population. As of 2014, Hispanics represented the largest ethnic minority in the country (55 million people), and it is expected that by the year 2060, 119 million Latinos (or about 30% of the nation's total population) will be living in the United States. When examining Hispanics by country of origin several trends are evident. For example, Mexicans had the largest population increase over the course of this century's first decade and were the largest Hispanic group in the United States. Puerto Ricans constituted the second largest group followed by Cubans. In total, these three groups represent approximately three quarters of the total Hispanic community. Additionally, census data suggests that 75% of Hispanics reside in eight states: California, Texas, Florida, New York, Illinois, Arizona, New Jersey, and Colorado.

In 2014, the average income for Mexican Americans (the largest Hispanic group in the country) was $38,000 (the country's was $51, 400), and more than a quarter of them experienced poverty. Recent household demographic information estimates that over 70% of Latinos speak Spanish at home. Further, Hispanic married couples are more likely to have children compared to the nation's average household. At present, 1 out of 4 children in the United States is Hispanic, and by 2050 it will be 1 in 3. Therefore, these children will be an important part of our future workforce. Unfortunately, more than 60% of Latino children live in low-income families, making them more likely to live in crowded houses and neighborhoods with high crime rates and less likely to access quality health and education services. Studies have also found that they are at greater risk for obesity and mental health difficulties, including depression and suicidal ideation among adolescent girls. Therefore, greater investment in education and health programs could prove invaluable for the Hispanic community. For example, investment in early childhood programs promoting strong foundations for school readiness have been evidenced to be beneficial, particularly for young Hispanic families.

Several protective factors within the Hispanic community are noteworthy. For example, a strong value is placed on close familial ties. Most children live with both parents and report frequent shared family meals. Extended family members are also valued and represent a strong social support system, particularly during times of distress. Furthermore, Hispanic children show strong socio-emotional skills when entering kindergarten and the number of adolescents who drop from high school, smoke, or drink has been steadily decreasing.

Professional Guidelines for Assessing Hispanics

According to the American Psychological Association's Ethical Principles of Psychologists and Code of Conduct, the work of psychologists is driven by the principles of beneficence and non-maleficence, fidelity and responsibility, integrity, justice, and respect for people's rights and dignity. This means that psychologists strive to benefit their clients, promote trusting relationships, and are responsible and transparent in their work. Additionally, they recognize that every individual deserves equal quality of services. In this vein, psychologists strive to protect the right to privacy and confidentiality and consider cultural and socio-demographic factors to avoid prejudice. When conducting psychological assessments with their clients (including Hispanics), psychologists should demonstrate competency in the administration, scoring, and interpretation of measures. Importantly, they use validated measures for the community. If this is not possible, psychologists document and acknowledge the strengths and weaknesses of findings.

The Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists, developed by the American Psychological Association, also encourage psychologists to understand and consider cultural factors when providing services to ethnic minorities, including Hispanics. For instance, acculturation, education, cultural values, beliefs around therapy and testing, and preferred language should be taken into account in assessment. They make sure whether the constructs being measured present similarily or differently amongst cultural groups. For example, studies show that somatic symptoms related to anxiety are more commonly endorsed in Hispanics compared to other ethnic groups. Therefore, culturally competent professionals would consider assessing these symptoms when suspecting that a Hispanic client might suffer from an anxiety disorder. Psychologists strive to communicate test results using language that can be understood, while avoiding discriminatory practices. If psychologists do not feel comfortable assessing a particular ethnic group, they make appropriate referrals.

The Council of National Psychological Associations for the Advancement of Ethnic Minority Interest has also written specific guidelines when working with ethnic minorities. The National Latina/o Psychological Association is part of this group. In the Guidelines for Research in Ethnic Minority Groups, they highlight significant variability within the Hispanic community at the level of language proficiency, country of origin, education attainment, socioeconomic status, and acculturation, amongst other variables. These aspects must be considered when administering a psychological measure. For example, the guidelines note that with paper and pencil tasks, reading proficiency needs to be taken into account while with verbal tasks, psychologists should be mindful that English proficiency does not reflect Spanish abilities (both at the oral and written levels). In sum, heterogeneity in the Latino community should not be ignored when administering and interpreting results. Rather, psychologists should be attentive to differences that exist within the Hispanic community. In achieving such goals, it is recommended that psychologists working with Hispanics seek training to become culturally competent.

Diagnostic and Assessment Recommendations for Hispanics

In addition to the professional guidelines, the assessment of Hispanics should stem from empirically based knowledge and scientific advancements in the field. The cumulative body of this work underlies the following six recommendations:

1) Ask all clients about their racial and ethnic heritage as well as the languages they speak. Clinicians should not assume that a client is Hispanic by skin color, comportment, name, English fluency, or pronunciation. There is tremendous variability within the Hispanic community across all of these dimensions. Misidentification of racial/ethnic heritage and language abilities can lead to incorrect case conceptualizations, along with misestimating neurocognitive abilities. For example, in the case of accents, a client may be fully fluent in two languages and not have an accent in either one. This is particularly the case for individuals who migrated early in life as they are less likely to have accents than those who migrated as adults.

2) Consider the length of residence in the United States when assessing linguistic and learning abilities. Different trajectories exist for the development of language and academic skills over time. Namely, individuals (including children) develop communicative proficiency at a quick pace. Within one to three years of immigrating to a country, individuals acquire receptive and expressive skills and can engage in substantive conversations in their second language. However, it takes five to seven years to fully develop the deeper linguistic skills needed to engage in extensive reading and writing (termed Cognitive Academic Language Proficiency). The timeframe for bilingual development is essentially similar to monolingual development where children learn to speak well around the ages of 2–3 years and then read and write between 5–7 years. Thus, assessment approaches and interpretations of results are improved if these elements are taken into consideration with the immigrant Hispanic community.

3) Assess in the client's multiple languages, to the extent possible. Immigrant Hispanics may have knowledge and abilities within and across their languages. Thus, assessments in only one language may underestimate the abilities of bilingual Hispanics. This is the case even if the client speaks English fluently. Assessments conducted solely in English yield an understanding of present English abilities, rather than complete abilities. Only by assessing in both languages can the full skills of immigrant Hispanics be identified, particularly in the language domain. This is pertinent for a variety of clinical diagnoses, including autism, among others.

4) Both verbal and non-verbal measures are administered to bilingual clients, if consistent with the referral question. Given the influence of bilingualism on language tasks, some psychologists may erroneously consider only administering non-verbal measures to their bilingual clients in an effort to be culturally fair. However, just as English-speaking monolinguals vary in their non-verbal abilities, so do monolinguals. Thus, it is not a suggested approach to obtaining an estimate of overall functioning. Further, completely forgoing language assessments may cause the clinician to miss the presence of a language disorder or other disorder with a linguistic feature.

5) Measures are continually being developed and standardized in Spanish. Thus, psychologists do not need to rely on informal translations of the English measures that they have on hand. Such translations can inadvertently cause a misestimation of the immigrant Hispanics' abilities and/or symptoms. Each item and item order on a published measure has been precisely examined and validated through empirical studies. Consider the word “ball” as an example. Easy to verbalize, it can often be an early item on a developmental screener for young English-speaking children. In comparison, “pelota” is more difficult with its three syllables. Therefore, a developmental screener in Spanish may have such a word listed later. If psychologists informally translated English versions to Spanish without scientific examination of the items and ordering, they can inadvertently bias assessments with the immigrant Hispanic community.

6) The development and standardization of Spanish measures are considered. There are a number of Spanish measures that have been carefully developed with a translation/Spanish team, psychometric analysis and potential reordering of items, large standardization sample, and consideration of cultural and linguistic variations. Complete statistical analyses are needed on the Spanish versions, rather than assumptions that the Spanish and English versions of a measure are equivalent. Indeed, special analytic techniques are used to examine such equivalencies. An additional feature to consider in the assessment of the Hispanic community is how measures incorporate dialectical variations among Hispanic subgroups. For example, some words (like “cake” or “straw”) vary substantially across Latin America and the Caribbean.

Bibliography

American Psychological Association. (2010). Ethical principles of psychologists and code of conduct. Washington, DC: APA.

American Psychological Association. (2003). “Guidelines on multicultural education, training, research, practice, and organizational change for psychologists.” American Psychologist, 58, 377–402.

Barrueco, S., López, M., Ong, C.A., & Lozano, P. (2012). Assessing young children within and across two languages. Baltimore, MD: Paul H. Brookes.

Council of National Psychological Associations for the Advancement of Ethnic Minority Interest. (2000). Guidelines for research in ethnic minority groups. Washington, DC: APA.

Cummins, J. (1979). “Linguistic interdependence and the educational development of bilingual children.” Review of Educational Research, 49(2), 222–251.

Ferdman, R. A. (2014, July 1). The great American Hispanic wealth gap. Washington Post. Retrieved from https://www.washingtonpost.com/news/wonk/wp/2014/07/01/hispanics-make-up-more-than-16-of-the-u-s-population-but-own-less-than-2-3-of-its-wealth/

Murphey, D.A.; Guzman, L.; & Torres, A. (2014). America's Hispanic children: Gaining ground, looking forward. Bethesda, MD: Child Trends.

Paradis, J., Genesee, F., & Crago, M.B. (2011). Dual language development and disorders. Baltimore, MD: Paul H. Brookes.

United States Census Bureau (2011). The Hispanic population: 2010. Retrieved from: http://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf.