As the demographics of the U.S. population change, immigration stands out as a leading factor in this transformation.  Children living in immigrant households represent one group that deserves particular attention in this demographic shift.  A child is said to reside in an immigrant household if he or she is an immigrant or the son or daughter of immigrant parents.  Children in immigrant families make up approximately 25% of the child population in the U.S.¹ Of this group, more than 50% are of Hispanic origin.¹ For these children, their immigration status or their parents’ status shapes their childhood experience.

One of the most exclusive experiences of an immigrant child’s life is the concept of language brokering.  The idea of language brokering involves the interactions that take place when children in immigrant households have to act as translators for their parents, friends, or relatives.² These interactions go beyond translating information from an individual’s primary language to English or vice versa. Language brokers assume adult decision-making duties despite being unable to understand the information they are asked to translate. In these scenarios, the language broker(child) is the primary communicator; without them, interaction would be limited/non-existent for both parties.

When children bear the role of language brokers, their responsibilities expand beyond translating everyday exchanges.  A language broker’s duties may include translating phone and in-person conversations, school forms, utility bills, employment applications, and legal documents.  Additionally, they may find themselves in a situation where they may have to translate in a hospital or other medical settings.  This broad range of interactions produces a combination of positive and negative outcomes for them.

Language brokers report an increase in self-esteem, improved academic performance, and feeling accomplished when they translate for others.^3,4 But the process is also associated with adverse consequences.  Amongst Hispanic language brokers, the process has been linked to feelings of burden, stress, depression, and alcohol and illicit drug use.^5,6,7

In addition to the impact on the child, one must consider the ramifications that language brokering may have when it involves sensitive topics such as medical diagnoses and procedures. Patients with limited English proficiency (LEP) are more likely to receive poor quality treatment, experience more harm, delay seeking medical attention, and report more dissatisfaction with the medical system due to language and communication barriers.⁸ Thus, it is essential for healthcare systems to provide interpretation services and to make these services accessible to all patients with LEP.

October marks Hispanic Heritage Month and Health Literacy Month. The intersection of these two key events is an ideal time to emphasize that although being a language broker can be an asset, the responsibility of translating, especially in a medical setting, should not fall on a child. In a time when health inequities are at the forefront due to the COVID-19 pandemic, it is worth noting that Hispanics account for approximately 63% of the LEP population.⁹ Patients with LEP have the right to obtain information and receive care in a linguistic and culturally-sensitive manner. However, a child should not be the person telling his or her mom, “mamá, dice el doctor que te va a operar – mom, the doctor says you’re going to need surgery.”

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