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In the year 2020, almost 489 million individuals worldwide spoke Spanish as their native language, making Spanish the second most spoken language by native speakers, second only to Chinese1. This number increases to 585 million, 7.5% of the world’s population, when also including Spanish-speakers who learned Spanish as a second language1. Considering all who speak Spanish including native speakers and secondary acquisition, Spanish is the 4th most spoken language in the world, following English, Mandarin Chinese, and Hindi2. In this special edition of the Brain Injury Professional, we have assembled a number of authors who write about various aspects of brain injury among Spanish-speaking individuals in Latin America, Spain, and in the United States. Drs. Longoni and Arango-Lasprilla present an overview of brain injury care in Latin America that highlights some of the challenges faced in receiving medical care as well as services in the subacute phase of recovery. They provide a list of aspirational goals to improve care in Latin American countries.
Editor Bio Anthony H. Lequerica, PhD, is a Senior Research Scientist at Kessler Foundation’s Center for TBI Research and a Research Associate Professor at Rutgers – New Jersey Medical School in the Department of Physical Medicine and Rehabilitation. As Director of the Brain and Behavioral Outcomes Lab, his research focuses on cultural and sociodemographic factors affecting brain injury rehabilitation outcomes. He is Co-Chair of the Inclusion, Diversity, Equity, and Accessibility Special Interest Group within the Traumatic Brain Injury Model Systems sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. He is a Staff Neuropsychologist at Kessler Institute for Rehabilitation where he provides neuropsychological services to Spanish-speakers with a variety of neurological conditions. He has over 50 peer-reviewed publications and has given numerous presentations across the U.S. and abroad to researchers, health care professionals, and individuals with brain injury and their families.
In Spain, the mother country for the origins of the Spanish language, Dr. Olabarrieta Landa provides statistics from a recent survey and highlights the system of care for acquired brain injury. She discusses variations across regions with attention to public and private systems of healthcare coverage, as well as services and resources that are provided through acquired brain injury organizations. In the United States, Hispanics are the largest ethnic minority group, accounting for over 18% of the population. According to the 2019 U.S. Census, 70.6% of Hispanics over the age of 5 in the United States speak Spanish in the home, almost a third of whom speak English less than "very well"5. This amounts to almost 15.7 million individuals for whom cultural and linguistic factors should be taken into account when providing a patient-centered approach to healthcare. Drs. Leal and Karina Pérez discuss assessment considerations in the neuropsychological evaluation of Spanish-speakers, one with a focus on adults, and the other covering important issues in working with children and their families. They highlight the importance of test selection and appropriate normative data. From the area of assessment, we move toward a focus on treatment with a discussion of cognitive rehabilitation for Spanish-speakers by Dr. Krch. Research is in its infancy for evidence-based interventions addressing cognitive deficits after brain injury for Spanish-speakers. Nevertheless, promising findings are beginning to emerge regarding the efficacy strategy-based approaches in Spanish to address cognitive sequelae common to a number of neurological conditions. Finally, we hear from Drs. Pappadis and Sander who provide insights from research into common misconceptions about brain injury among Hispanics and issues of health literacy. The ability of brain-injury survivors to understand and benefit from information they receive from healthcare providers is an important consideration for clinicians striving to improve services for diverse populations. I am thankful for the contributions of the authors to bring light to some of the many pressing issues affecting Spanish-speakers with brain injury around the world and hope that readers can extrapolate from these articles to serve a diverse population of individuals who may differ in language and culture from that of the provider. The recognition that we each see the world through a unique lens colored by our personal experiences is a key element at the basis of culturally humble approaches to providing services and conducting research for the diverse population of brain injury survivors.
References 1.
Fernández Vítores D, Instituto Cervantes. EL ESPAÑOL: Una Lengua Viva. Informe 2020.; 2020. doi:NIPO: 110-20-018-0
2.
Eberhard DM, Simons GF, Fennig CD. Ethnologue: Languages of the World. 24th ed. (Eberhard DM, Simons GF, Fennig CD, eds.). Dallas, Texas: SIL International; 2021.
3.
C G, PP Y, N J, et al. Presence of a dedicated trauma center physiatrist improves functional outcomes following traumatic brain injury. J Trauma Acute Care Surg. 2016;80(1):70-75. doi:10.1097/TA.0000000000000890
4.
Noe-Bustamante L. Facts about U.S. Latinos and Their Diverse Origins | Pew Research Center.; 2019.
5.
U.S. Census Bureau. Language Spoken at Home by Ability to Speak English for the Population 5 Years and Over (Hispanic or Latino) American Community Survey 1-year estimates. https://censusreporter.org. Published 2019. Accessed September 15, 2021.
6.
Judd T, Capetillo D, Carrión-Baralt J, et al. Professional considerations for improving the neuropsychological evaluation of hispanics: A national academy of neuropsychology education paper. Arch Clin Neuropsychol. 2009;24(2):127-135. doi:10.1093/arclin/acp016
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