Breaking the Language Barrier
As many of us look forward to Christmas and the New Year, those who work in hospitals are frequently reminded that this jolly, and often stressful, time of year is peak season for stroke admissions (see the Framingham study in Stroke, 1995).
With emergency departments full and swallowing assessment referrals up, the busy SLP doesn't always have time to wait for an interpreter to show up, especially when a non-English speaking patient is awaiting the SLP's OK before starting a diet.
Acute care clinicians are experts in "charading" their way through an oral mechanism exam when faced with linguistically diverse patients. We present a taste of food and drink, probably the most appealing hospital procedure, but occasionally a patient will refuse the "kind offer" or request more of an explanation of what's going on and why. The few words we learn of the most common languages often get us through, but what happens when the patient has just immigrated from Greece, only speaks Korean, or is a Hindi speaker?
For routine instructions, finding out information from family members, and obtaining consent when an interpreter is not available, Google Translate is a must-have app. It's free, runs on Android and iOS (limited functionality on Blackberry and Windows), and works on phones and tablets. This amazing app does both text and voice translation in more than 20 languages (60-plus for text translation only). Select your output language, type or speak into the device in English, and a text translation will appear. Touch the speaker icon to hear the translation or press the expand button to see the translation enlarged on the screen for the patient to read.
Mark the translation with the star button to save to the Starred list for quick and offline access. The biggest drawback of the app is that it requires Internet connectivity to do its magic, but saving common phrases will make it useful in wifi dead zones. The history will also work offline, and can be easily cleared in the settings.
Copy and paste patient education information from documents or websites into the app for longer informal translations. Type in notes written in other languages to read them in English. If the patient's speech is clear enough, you can use it to go from their language to yours for short bits of information. Note that text-to-speech is limited to 100 characters and voice-to-text takes in only a few seconds of speech. Text output in 14 non-Latin scripts is accompanied by a phonemic translation to help with pronunciation. The Android version of the app has optical character and handwriting recognition, as well as a conversation mode to make it even more useful!
As with any voice-to-text or translation technology at this point in time, there is a chance of errors, which is why I do NOT recommend this app for any type of speech, language, or cognitive assessmentit's — it's just not reliable enough. A professional medical interpreter, or at least a bilingual family or staff member, should always be used for these assessments and to translate material for print. But for nurses trying to get a quick medical history, SLPs doing a dysphagia assessment, or PTs giving mobilization instructions, it's a great communication aid. And if you're vacationing abroad this holiday season, it's a no-brainer: "Una cerveza por favor!"
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