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Language Barrier to Services

Scenario

“Clinical director wants BCBA to take on cases that are fully Spanish speaking with the help of an interpreter. The child speaks no English and programming would need to be done in Spanish – this is out of the scope of the BCBA who speaks English only.”

 

Committee Input (e.g., considerations for pathways forward, potential barriers, potential solutions):

Although the Arizona community includes many families that are non-English speaking, there is not an equal amount of access to services that are offered and implemented in the family’s native language.  If there is not a provider in your organization who speaks the client’s native language (Spanish), it is recommended that the BCBA accept the client with the following accommodations/consideration for exploration:

  • Specific funders require that access to interpreters is provided to non-native English-speaking families and some funders do not specifically require this.
  • Depending on the funding source, there may be a limited number of providers who have ABA services available, and even fewer that have immediate openings and also providers who speak the client’s native language.
  • The Ethics Committee recommends, in alignment with BACB standards, that if there are no available providers at the agency who accept a family’s funding and speak the client’s native language, that an interpreter be requested to attend all client sessions. Not only is it important that the family understands what the BCBA is saying, but they should also be able to communicate with the client’s technician. Additionally, providing documentation in the native language (i.e., Spanish) is a best practice standard to ensure that families understand the services and treatment being offered.
  • Along with the necessity of communicating through the language barrier, it is also important to recognize differences in cultural practices. A funder-assigned or agency-contracted interpreter may help with this, or the family may have a community member who is willing to attend sessions to translate and assist in navigating circumstances that are too nuanced to translate vocally alone.

Additional Considerations:

  • If the agency accepts this client, there should be no cost associated with the interpretation service.
  • If an interpreter is utilized, they should be certified to provide medical translation services to outline ABA treatment procedures and medical necessity criteria.
  • If an interpreter is utilized, they should sign nondisclosure agreements to ensure the privacy of client information.

In summary, failure to (1) provide culturally competent care or (2) to demonstrate clear communication for the consent/assent of treatment due to a language barrier, are potentially reportable offences to the BACB. More information would be needed in the above submission to provide more explicit pathways for exploration.  We would encourage the person who submitted this concern to flush out the context and provide additional details if additional guidance is needed.

 

Ethics Codes (specific standards that could apply to support/oppose):

  • 2.01 Providing Effective Treatment
  • 2.04 Disclosing Confidential Information
  • 2.08 Communicating About Services
  • 2.19 Addressing Conditions Interfering with Service Delivery
  • 3.03 Accepting Clients
  • 3.06 Consulting with Other Providers
  • 3.09 Communicating with Stakeholders About Third-Party Contracted Services
  • 3.12 Advocating for Appropriate Services
  • 4.01 Compliance with Supervision Requirements
  • 4.02 Supervisory Competence
  • 4.04 Accountability in Supervision
  • 4.06 Providing Supervision and Training
  • 4.09 Delegation of Tasks
  • 4.10 Evaluating Effects of Supervision and Training
  • A.R.S. 23-2091 12(c)/12(g)
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