Dr. Jeremy Sharp (01:20)
Hey everyone, welcome back to the podcast and another clinical episode on a fascinating topic. So we’re talking about linguistic.
Hey everyone, welcome back to the podcast. We’ve got another clinical episode for you today. Today I’m talking with Ashby Martin, who is a neuroscience researcher focusing on clinical neuropsychology, language accessibility, and health equity. He earned his BS in Neuroscience and Behavior from the University of Notre Dame before completing his PhD in neuroscience at the University of Iowa, recently in May 2026.
So Ashby’s research looks at interpreter-mediated neuropsych assessment among patients with limited English proficiency. He’s looking at test performance, clinical interpretation, and validity of assessment practices across these linguistically diverse populations.
So super interesting. You know, we get into a lot of different aspects, primarily centered around Ashby’s research. So we talk about the impact of
Interpreter-mediated assessment versus English language assessment for native English speakers. We talk about some clinical aspects of using an interpreter and what that is going to do to the assessment results. We of course like get into background and just basics around the neuroscience of language and what we’re working with here. We also
So we get into a lot of the different facets of interpreter-mediated assessment. And even if you are not using interpreters, I think there is there’s still a lot to take away from this. And as Ashby points out during the interview, the proportion of second language speakers in the United States is only growing by the year, and maybe even growing exponentially at this point. So at one point I think he says that one out of every three
Children in the US speak more than one language. And even if you don’t work with kids, you’re gonna be working with those kids who grow into adults eventually. And this is super important. So yeah, we talk about a lot of different facets.
Like I said, we get into many nuances, I think, related to Ashby’s dissertation research, which looked at many different things, but we focus on
Interpreter-mediated assessment versus non-interpreter-mediated assessment and the impact of using an interpreter. it’s very interesting. we talk about the impact of having a native language speaker administering the assessments versus using an interpreter. we talk about ways for us as clinicians to interface with interpreters and many other things.
So there’s a lot I think to to take away from this episode. And again, even if it doesn’t seem immediately relevant based on your own work, I think it’s important to be thinking about because we’re all going to run into clients who do not speak English as their native language and may need interpretation services at some point. So I will stop with the introduction and just let you get to this episode with Ashby Martin.
Dr. Jeremy Sharp (04:35)
Ashby, hey, welcome to the podcast.
Ashby Martin (04:37)
Hello, thank you for inviting me.
Dr. Jeremy Sharp (04:40)
Yeah, yeah, I’m excited to chat with you. when we, you know, found you in your research area, you know, it’s relatively rare to find research in an area that we just totally haven’t talked about on the podcast before. And you have a nice niche, I think, that will be relevant for a lot of us. So yeah, really grateful for your time and excited to have this conversation here.
Ashby Martin (05:02)
Yeah, same.
I’m loving that I’m able to actually present some of the area. I find my work to be relevant to a larger population, not only the clinical side, but general audience. And hopefully that kind of comes through and individuals could take something if not from the clinical side, but from the individual personal side.
Dr. Jeremy Sharp (05:21)
Yeah, yeah, for sure, for sure. So I’ll start with a question I always start with, and that is particularly relevant for you, I think, because you just finished a dissertation, finished a PhD, which is awesome. But you know, of
Ashby Martin (05:33)
Thank you.
Dr. Jeremy Sharp (05:33)
all the things that you could spend your time on, it’s time and energy, what drew you to this area of focus in particular?
Ashby Martin (05:42)
Yeah. So my area is looking at neurolinguistics, but specifically for individuals that have limited English proficiency. Those are individuals that have a degree of understanding in at least one language, but sometimes that proficiency within English, whether it be the written, the spoken, or a mix of those senses, might be not at an adequate level, at least not for a neuropsychological assessment when we’re looking at the
Dr. Jeremy Sharp (06:07)
Mm-hmm.
Ashby Martin (06:08)
research later on. But
My intrigue was this is a population where there are 27.8 million people in the US. That’s 8%
Dr. Jeremy Sharp (06:17)
Mm-hmm.
Ashby Martin (06:17)
of the population. It is a very sizable amount. And yet, when I hear from clinicians, they say that there’s sometimes barriers. And we call those language barriers, but those language barriers, they don’t just exist in the hospital. They exist in the day-to-day life. And at least giving some metric to what is occurring.
And then what we could do from a clinical side in order to make that easier. Well, that’s really the ultimate goal of this. And my family were immigrant community. So my parents are from San Juan Salos, Mexico. That’s in Jalisco. And they have limited English proficiency. They came in not really being able to speak the language, but really wanting to give an effortful perspective for what is occurring and allow us as kids to actually do something in the world. So it is meaningful in me from from a personal side as well as a interest side.
Dr. Jeremy Sharp (07:15)
Yeah, yeah. I feel like that’s super common in the work that we do. You know, there’s that that belief, you know, we get into the field to kind of address our own, I don’t know, concerns or whatever it may be. And, you know, that I think that adds another layer. It makes it even more relevant for us as we do this work, which is great.
Ashby Martin (07:32)
Yeah, language is also growing. It’s latest statistics that I’ve seen, it’s one in three kiddos, ages eight and under,
Dr. Jeremy Sharp (07:38)
Mm-hmm.
Ashby Martin (07:39)
now speak more than one language at their home.
Dr. Jeremy Sharp (07:42)
that’s remarkable. That is I mean,
Ashby Martin (07:44)
So that
Dr. Jeremy Sharp (07:44)
admittedly, that’s way higher than I would guess.
Ashby Martin (07:47)
It it’s exceptionally higher than I would have thought it even possible.
Dr. Jeremy Sharp (07:51)
Yeah.
Ashby Martin (07:51)
And if you go twenty years ago, it’s much less than that. It’s going closer towards a tenth. So that growth rate i is getting towards an exponential level.
Dr. Jeremy Sharp (08:02)
Sure, sure. Well, makes it even more important for us, I think, as clinicians to to be aware of some of these dynamics, you know, language and understanding and the work that we do. So maybe we start with some some definitions, I suppose, or like kind of key
Ashby Martin (08:16)
Perfect.
Dr. Jeremy Sharp (08:17)
aspects of the work that you’ve been doing. So
Ashby Martin (08:21)
Absolutely.
Dr. Jeremy Sharp (08:22)
you know, even neurolinguistics, like what does that mean exactly?
Ashby Martin (08:25)
Yeah.
Dr. Jeremy Sharp (08:25)
how does this show up in the assessment process, like why is this relevant? Some questions like
Ashby Martin (08:31)
Absolutely. I think one of the most pertinent things that you mentioned was neuro linguistics as a field. It’s anything that is brain behavior, but within the realm of spoken sense, within the realm of language. Language is broad. And that’s okay because we have applicability in multifaceted ways to where we could focus on a aspect like limited English proficiency, but we could also focus on something like an aphasia. Right.
And we see those interactions and how it crosses within a scope like a neuropsychological assessment because it’s comprehensive. So figuring out what something that might appear to be niche looks like when it is actually adjustable and applicable to just about anyone, well, that’s kind of the focus of what I think neurolinguistics might actually be. Seeing at the common thread level.
As well as that individual specificity to what you speak, what you understand, and then what you hope to say.
Dr. Jeremy Sharp (09:34)
Ooh, that’s a good way to put it. Yeah. So can you maybe give us examples of how this shows up in neuropsych testing or, you know, in the assessment process?
Ashby Martin (09:45)
So most of our tools have some degree of language, but how we deal with that language might vary drastically and is especially within different language frames. So something that most clinical neuropsychologists are familiar with are trails. And trails have numbers, letters, and it’s just a set switching task. And we don’t typically see that as a linguistic task, because
Dr. Jeremy Sharp (10:09)
Mm-hmm.
Ashby Martin (10:10)
you’re just going from a symbol to another symbol.
But the thing is, when we think about language as a whole, we do have order to it. We have an A to Z script, and that matters, and that is what we’re checking. A has to go to B, right? One has to go to two. That’s the order that we’re looking for. And yet, that’s not consistent across all languages. So if we look at a Russian script, if we look at a Cyrillic language, well, those symbols shift. Those little things that we take as a given, they’re no longer.
Present in the same fashion. So when we’re taking something as common as how quickly you’re able to complete that task, well, it might diminish. So giving some degree of adjustment for those things, and I know those are norms, but across the entire assessment, those aspects tend to occur, especially if you have an intermediate. We think about a telephone game. The more individuals that we add to the telephone game, the lower the quality. We think.
We think because
Dr. Jeremy Sharp (11:12)
Right, right.
Ashby Martin (11:13)
we hadn’t had that research done yet. So that number value of telling us exactly how much of a change is occurring, that was what I was actually trying to get at. And not only getting a number value for the overall thing, but also is it variable in both directions? Do we have higher scores as well as lower scores? Well, that’s the variability of it. So I wanted to quantify all that in a full scope project that encompasses not just the last five years, but the last 50, at least deny.
Dr. Jeremy Sharp (11:43)
Right, right. Which feels like a big project just hearing about
Ashby Martin (11:47)
It
it it was. It’s forty five thousand case files to read through and compare and figure out which ones are the most adequate because I have to have a prevalent population that was Spanish in our case, and then having something that we could do also in the present tense. So
Dr. Jeremy Sharp (12:03)
Mm-hmm.
Ashby Martin (12:04)
the first part of it was figuring out the interpreter side and figuring out how big of an effect the speech interpreter has on the neuropsychological assessment. But the second
Dr. Jeremy Sharp (12:12)
Mm-hmm.
Ashby Martin (12:12)
part was also including a clinician
That speaks Spanish, has all of our Spanish-speaking norms, is as close of a linguistic match to the patient as possible, and then we do the entire assessment. When we do that,
Dr. Jeremy Sharp (12:24)
Yeah, yeah.
Ashby Martin (12:25)
we do the match and we have everything, whatever effect that we found, which was a very large effect, well, it went away. And that’s the major takeaway to show that, well, it’s not just, or at least we think it’s not just Spanish, it’s not just this language.
It is potentially a training effect for how we work with our interpreters. And if it is a training effect, then let’s work closer with those interpreters and make sure that they have a better understanding of what our instruments are and how we have to deliver those in order to get at a better quality
assessment. And I know neuropsychologists, there’s training that involves more than a decade, right? So it’s gonna be a longer process, but I hope to start to make that process feasible.
And hopefully that increases the quality and makes it better for everyone. I know the interpreters from speaking with them. They’re passionate. They want to do better. They know that there might be issues, but they don’t know what those issues are. So dictating
Dr. Jeremy Sharp (13:23)
Mm-hmm.
Ashby Martin (13:23)
that, that’s a pretty big aspect as well.
Dr. Jeremy Sharp (13:26)
Yeah, yeah, for sure. And I think this is super relevant. I mean, if not a lot I would see a minority of my audience for sure are bilingual neuropsychologists, right? But a lot of us are working with interpreters and it’s a little bit of a a black box, I think, in terms of
Ashby Martin (13:41)
Yeah.
Dr. Jeremy Sharp (13:41)
what’s happening and how we can do it effectively and that kind of thing. So let me I wanna dig into all these details, but maybe we just zoom out a little bit. You talked a bit about the like the structure of the
the study or the research, but can you just give an overview of the project and kind of like lay out the, you know, the
Ashby Martin (13:59)
Yeah, absolutely.
Dr. Jeremy Sharp (14:00)
the key points for folks and then we’ll get into some of the details and the finance.
Ashby Martin (14:04)
Yeah, think that makes perfect sense. So the overall project, it’s taking all the neuropsychological assessments conducted in you the Benton Neuropsychological Clinic here in Iowa, so UIH C. And we’re seeing across a 50 year time period, the earliest study or not study case that I utilized was from nineteen seventy eight. So it’s not exactly fifty years, but within
Dr. Jeremy Sharp (14:30)
Pretty close.
Ashby Martin (14:31)
that time frame, we get
at a comparison of around what a or sorry, I’ll reframe that. So across those 50 years, we’re able to see what effect the speech interpreter has across each individual decade, but also across the entirety of those 50 years and track whether there’s differences in our variability. So what variability is being quantified as is whether we have tests that have higher than expected ratings.
Performances or lower than expected performances. When we say expected performances, that gets at the other portion of the methodology. So every single LEP patient case that we’re looking at, those LEP patients, limited English proficiency, individuals that need a speech interpreter in order to have that assessment done, that person is matched with someone that is a match for four different aspects of their demographic profile.
The largest
Dr. Jeremy Sharp (15:27)
Okay.
Ashby Martin (15:28)
is their neurological as well as their neuropsychological condition. I say neuropsychological, I know that’s not really the best term for it, but what it’s trying to encompass is something like a behavioral abnormality. So whether they have bipolar or a schizophrenic like condition, whether their depression
is an aggravation in addition to their dementia, all those
Dr. Jeremy Sharp (15:48)
Mm-hmm.
Ashby Martin (15:48)
specific details or COVID comparison, lupus, these conditions that are harder to match for, but worth matching for in my eyes.
So that’s the primary, in addition to that education profile. Limited English proficiency patients, most of them in the Spanish speaking population that we’ve seen average an education of around eight years. We have individuals from zero years of education all the way to 18. So there’s a wide spectrum, but it is skewed towards the lower end of that spectrum. And because of that, education having a known effect on neuropsychological assessment needs to be a kind
So those are two factors. First one, neuropsychological and neurological condition. Second one, education. Third one, gender. So it is self-reported. Whatever gender that they report are trying to get an exact match for, that’s an easier thing to toggle for. And then the final thing is their age profile. So we try to get as close as possible to whatever it is. If it is a child, if it is a middle-aged adult or a later aged individual, well, we’ll try to get it close to that. and if you’re curious how close of a match we had.
That is shown on the thesis. Education we had within about a year and a half. Age
Dr. Jeremy Sharp (16:55)
Mm-hmm.
Ashby Martin (16:55)
we managed to get within a month on one cohort. And then in the other, we managed to get it within a eight-month period. So it’s relatively close where we got. gender was pretty close as well. I think one group was only around eighty percent, the other one was around to 95%. when there is a sex difference, that’s when it’s more pertinent. When there isn’t quiet, that’s when it gets a little bit less.
But neurological condition being the most pertinent, we always match for that. So Yeah.
Dr. Jeremy Sharp (17:21)
Gotcha, gotcha. That
sounds great. Okay. Okay. Thanks for laying it out for us. Now let’s get to the good stuff. let’s dive into findings. Like what were
Ashby Martin (17:30)
Yeah.
Dr. Jeremy Sharp (17:31)
some of the major findings from all of this?
Ashby Martin (17:34)
There’s some well, there’s multiple major findings. so I explained how we did the matching process. I explained those LAP patients. Those are the interpreter group. We do have a clinician match group. We’ll get to that results after we address those LAP patient groups. So within the LAP patient group that had the interpreter, we saw that there was a drastic change in the overall test performance. When we see the difference.
The average individual that had a neurological condition across all of our cohorts, they landed around the seventh percentile. So 50th percentile being average, seventh percentile, low average, starting to verge towards your borderline, starting to diverge towards impaired, but not quite impaired. When we look at our interpreter-mediated cases, that dropped the average to the second percentile. So second to seventh.
That’s a pretty dramatic thing. And that is average across it. And that leaves very little room in terms of a floor. So
Dr. Jeremy Sharp (18:37)
Sure.
Ashby Martin (18:38)
so when we quantified that overall difference, we also did still see that the variability was
significantly different in a tremendous fashion. So we did see highly supported that not only were the highest test scores coming from our interpreter-mediated group, but also the lowest test scores.
And that variability was across all decades. So it was more dramatic in the nineties. That was probably the most obvious period to see a difference. And it did sort of plateau towards the 2010s into the modern day. That does line up with current speech interpreter legislation, anecdotally.
Dr. Jeremy Sharp (19:17)
Mm.
Ashby Martin (19:18)
Yeah, ninety-five was when we had a state level certification.
And then 2009 was the first national level certification. So those two addresses do line up pretty closely with what our data has indicated. And since then we haven’t seen much of a change. So whether or not we have to do a little bit more for mandates, that could be a correlational thing that could be expressed later on. But in addition to that, we also had something called our impress or I didn’t explain this, but we have impressions. So that tells the patients as well.
As what or so it tells the patients what condition they currently have, and it is written by the evaluating clinician. That is how we tell them what kind of dementia, what the severity is, whether there’s a behavioral aggravation, whether they’re completely fine. All those things get expressed in this paragraph to two-paragraph format. And what we did was we had other clinicians, as well as postdoctoral students, rate and graduate students rate.
These impressions for the degree of concern expressed by the clinician. Now, the degree of concern expressed is a bit of an odd thing to state, but what it means is whether or not there is an uncertainty expressed. So saying that something is of an unclear etiology, that gives
Dr. Jeremy Sharp (20:38)
Mm.
Ashby Martin (20:38)
a little bit of uncertainty and it can be present present on an interpreter immediate assessment as well as any other assessment. Now, we do count language barriers as another thing. So if they say there is a language barrier,
as an issue, but also if the clinician states that, well, I think this potential cultural variability might have been accounted for by the use of the interpreter, that no longer is an issue. So that is not a concern. They are they state the concern, they say it has been addressed. So we don’t take that as a lower degree. There are ways of navigating a potential concern that might be mitigating. And other things like saying that there’s low effort.
That would be another concern. If you rather than having a three-hour time period, only had a two hour or abbreviated one hour and a half because the patient had a spell or they had something distressful occurring during the assessment. Well, that’s another factor.
Or if they came in and they had a broken arm and that happened to be their dominant arm, well, that’s another factor. If any of those things are expressed, then that would be a higher degree of concern.
Overall, we did see a significant difference across those interpreter-mediated patients compared to their comparison group patients. Though that difference overall wasn’t as substantial as we would have thought. So it was a Likert scale, one to five. When we looked at those differences, both were ranged from the two to the three. So a two being or a one being of no concern, a two being of low concern, a three being of a middle and concern.
So it never got to a severity at which where you would say out of five, you would say, do not use this assessment. You have to interpret this with caution because of X,
Dr. Jeremy Sharp (22:24)
Mm-hmm.
Ashby Martin (22:25)
Y factors. So it never really pushed towards that extreme on one side, because it does look like while the clinicians have to deal with factors, they are able to deal with those factors. This is where experience has a large value on where.
Even though there might be a circumstance that might pose issue through experience, through knowledge, most often we see clinicians are able to do some degree of address and have ultimately
Dr. Jeremy Sharp (22:55)
Yeah.
Ashby Martin (22:57)
a diagnosis, a recommendation, something that a person can take away and say, Okay, this might be what is occurring. Whether we get that
Dr. Jeremy Sharp (23:04)
Gotcha.
Ashby Martin (23:05)
right every single time, that’s not as clear. It does look like there’s a few cases where.
It ended up what we said on the first evaluation, didn’t quite come through on the second evaluation, but that’s just a normal process of neuropsychological assessment. So, summary,
Dr. Jeremy Sharp (23:19)
Yeah.
Ashby Martin (23:20)
if if I if I needed to summarize, performance difference, increased variability, and then an increased degree of concern for interpreter-mediated assessment. But so I wanted to ask you though, is this something that you see in your practice?
Do you see that there might be a difference? Do you use interpreters?
Dr. Jeremy Sharp (23:41)
Yeah, yeah. So we use interpreters to a degree. We don’t use interpreters for test administration necessarily, but we do use interpreters a lot for the intake interviews and feedback sessions.
Ashby Martin (23:53)
Right. Yeah.
Dr. Jeremy Sharp (23:55)
the only place where we would veer into test administration is with the ADOS. I don’t know if you’re familiar
Ashby Martin (24:01)
Okay.
Dr. Jeremy Sharp (24:01)
with the ADOS. Yeah. and even that, you know, that’s kind of fraught. There’s a whole
I guess discussion around whether that’s appropriate or not. and so yeah, it’s been rare for test administration. But we do use interpreters a lot, like I said, in the intake and the feedback sessions.
Ashby Martin (24:16)
Yeah, how is that? What role do you kind of put them in? If you put them in a specific role, is it just a natural conversation? How does that look for you?
Dr. Jeremy Sharp (24:26)
Yeah, yeah. So I mean, admittedly, this is one of those places I feel like and part this conversation is part of it, but thinking that y we need to do more training with our clinicians around how to interact with interpreters. I
Ashby Martin (24:37)
Mm-hmm.
Dr. Jeremy Sharp (24:38)
know there’s a lot of literature out there. And
I think we’re doing pretty well, but it’s always nice to like tighten it up. So I mean, essentially we’re like having the conversation with the person and then the interpreter or with the client, and the interpreter is
you know, an intermediary. So, you know, we’re talking directly to the client, of course, and hopefully, you know, they’re talking directly to us and the interpreter is interpreting.
Ashby Martin (25:00)
So when you say hopefully, do you ever notice that how long you speak is distinct from how long they might be speaking? Yeah.
Dr. Jeremy Sharp (25:08)
Yeah, a hundred percent.
Yeah. And I I mean, of course, I’m like, what are they saying? You know, like I I mean, I hope that it’s refle it’s accurate, you know, like it’s an accurate translation. But yeah, you know, this is something I wanted to ask about is
Ashby Martin (25:21)
Mm-hmm.
Dr. Jeremy Sharp (25:21)
how do we know if it’s accurate? Like, is there any data on that? Is there I mean and even I don’t know, there’s a lot to to unpack here because like I’m using the term
Ashby Martin (25:31)
Mm-hmm.
Dr. Jeremy Sharp (25:31)
accurate. Like it might be, you know, technically
accurate, but as far as the, you know, inflection or the
Ashby Martin (25:39)
Mm-hmm.
Dr. Jeremy Sharp (25:42)
cadence or the you know, like all the I’m I’m not sure what the term is, but like those underlying sort of factors that influence language and perception and understanding. Like how do we know that all that is intact, you know, when when we’re using interpreters?
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Ashby Martin (28:20)
if you notice, I was very focused on the scores because those are things that we have records of, that we have written documentation of. The spoken side of things at that interview level, at that feedback level, it’s very distinct and variable where our standards, while we think they are consistent, might not always be that consistent. And
Getting at a specific value for how different it is, that’s still not determined in any capacity either.
Dr. Jeremy Sharp (28:48)
Yeah.
Ashby Martin (28:48)
that’s a great future direction for either myself or another individual to look into because yeah, it does look like there’s a difference. And this is another term that I hadn’t spoken of, the register. And the register is what the level of understanding of the speaker as well as the listener is. So there is often a register difference between a patient.
And a clinician if we’re looking at a patient population that has an average education of about eight. So how we speak to an individual that has maybe one, maybe two, maybe no years of education, it shouldn’t be the same as someone that has 20, not because we should treat them differently, but because we want them to understand what is being said, what is being spoken. And that’s a difficult task for an interpreter to do.
They’re also limited by their register. So if you’ve only
Dr. Jeremy Sharp (29:44)
Mm.
Ashby Martin (29:45)
been around and understood around twelve to sixteen years of education and lack some of the translation side skills of what a medical term might be, well, there might
Dr. Jeremy Sharp (29:56)
Yeah.
Ashby Martin (29:57)
be a difference in that register without necessarily wanting to create a difference. But that is the difference between what a interpreter or an interpreter is compared to a translator, right? Translator, they’ll just tell you word for word exactly what’s going on.
The interpreter, they’re trying to get the meaning, or at least as close to the meaning as possible. but it’s not a clear field at all.
Dr. Jeremy Sharp (30:18)
Sure. Okay. Okay. I mean, that’s both validating and concerning, of course. So
Ashby Martin (30:22)
Yes, yeah, yeah, yeah.
Dr. Jeremy Sharp (30:24)
yeah. Yeah. So I I think we can we can talk more about this. I wanna go back quickly just to clarify on some of your findings. You said there’s a performance difference and you said
Ashby Martin (30:33)
Yeah. Yeah.
Dr. Jeremy Sharp (30:35)
seventh percentile versus second percentile. can you give a little bit more detail about exactly what that are we talking about like overall
I mean, is this like intelligence or like what
Ashby Martin (30:44)
Yeah.
Dr. Jeremy Sharp (30:46)
what is falling at the seventh percentile and the second percentile in these
Ashby Martin (30:48)
Right. So that’s that’s
a great thing to cover because yeah, the actual methodology called for every single test administered to be turned into a z-score. Right. So
once we accumulated all those z-scores, and then we have every test be matched. So if a interpreter-mediated patient had 12 tests administered, the comparison patients were also.
Having the same exact 12 or as close to those 12 as possible. Those are the scores that we’re comparing. Overall, we aggregate them. And then once we aggregate them, we have the difference of this comes out to this percentile, that comes out to that percentile, but all within the frame of a z-score. We do try to account for some of those extreme values. So we don’t allow for scores to go past the z-score boundary of negative four.
We have a specific curving methodology to where anything below negative three. We don’t want to just limit at a negative three. So what we do is if your 3Z score is below average, we will reframe it from whatever the lowest score possible is, that being your negative four, to what that state is. So we’ll get a scale value. We’re able to quantify a difference, but it is a special adjustment in order to make sure that.
We’re accounting A for what that difference is, but B not having it give too much of a pull overall in the data. And we do have an adjustment to where individuals that completed more tests were given a slightly higher weight than individuals that completed eight or less on the lower end. Eight is our bottom limit. So you have to at least have had completed eight tests across the assessment battery in order to be in the study. But
Dr. Jeremy Sharp (32:34)
Right. And we’re talking subtests, I imagine. Like when you say eight, eight or twelve subtests. Yeah. Gotcha. Gotcha.
Ashby Martin (32:37)
Yes, yes, yes. Yeah, exactly. Yeah.
Dr. Jeremy Sharp (32:40)
So this might be a completely irrelevant question, but it’s it’s bugging me, so I’ll go ahead and ask it. But so when you’re
Ashby Martin (32:46)
Go for it.
Dr. Jeremy Sharp (32:47)
saying like overall performance fell at you know, seventh percentile versus second percentile, was that the I guess the average or aggregate? I mean, I’m like that seems very low. why are
Ashby Martin (32:55)
Yeah. So so the
Dr. Jeremy Sharp (32:59)
yeah.
Ashby Martin (33:00)
Yeah, yeah. So well, everyone included
Dr. Jeremy Sharp (33:01)
Why aren’t folks scoring higher, even with limited English proficiency?
Ashby Martin (33:05)
in the study has a neurological, neuropsychological condition. So this is all within
Dr. Jeremy Sharp (33:10)
Okay, okay.
Ashby Martin (33:12)
a clinical population that has a condition that is actively affected. This is not normal population. Normal population would often score around the 50th percentile. These are individuals with
Dr. Jeremy Sharp (33:22)
Okay.
Ashby Martin (33:23)
A current condition that might not be something that you could live a normal life with. So that seventh percentile could have been any score. That could have been the
Dr. Jeremy Sharp (33:36)
Okay.
Ashby Martin (33:37)
20th percentile, that could have been the 25th percentile. The point of that value is just to give you across that entire comparison group population. So someone that has the same neurological, neuropsychological condition.
same age, education, and gender profile, what that group looks like, they scored at the seventh percentile. So these tended to be more impaired individuals. And then for that same condition, what did the interpreter media individuals get? They got around the second when we would have expected them to get a seventh percentile. That’s across the entire thing. That’s 132 different individuals.
Dr. Jeremy Sharp (34:15)
Right. So I mean that and again I’m hoping I’m understanding
the data correctly and just
Ashby Martin (34:20)
Mm-hmm.
Dr. Jeremy Sharp (34:20)
you know, correct me if I’m off base on this. I mean I would assume that interpreter mediated clients would do better. Is that
Ashby Martin (34:29)
So I I fully understand why you would think that. Yeah, because you’re giving a degree of language assistance and there’s tests that could be well spoiled where they would have an elevated performance. But the overall lock lack of detail or the prolonged time issue, those are all things that come into play where what we’ve seen is many, not just language tests, but all tests across the entire neuropsychological assessment battery.
So if you look at the data, it wasn’t just the language test. It was things that have been well adjusted for. Things like the ways where you would not expect a language effect to be occurring. And yet, because you have an intermediate, because you have a delay, because you have all these other factors, it does look like the overall score is a little bit different. And when we think about dialect and we think about all these little things, tone, those can come into play, especially when we think about words that what might exist.
within a specific subsection of language that doesn’t exist for the general population. So an example of that would be
Dr. Jeremy Sharp (35:32)
Mm-hmm.
Ashby Martin (35:33)
in Mexican Spanish, we say things like aguas. Aguas being be careful, but it literally means water, right?
Dr. Jeremy Sharp (35:40)
Mm.
Ashby Martin (35:40)
That doesn’t really translate well, but it is what we commonly say, or things like chido, which means cool, that doesn’t actually exist. So Spanish doesn’t have a formal word for the word cool. It does not exist, but Mexican Spanish does.
Now, those aren’t normal items on an inventory. What is a normal item is something like stating fruits. So kind of fruit that we have and we commonly eat in Mexico is something called a tuna. Now, this is on the prickly pear cactus. That is the fruit that comes out of it. Very common. But common in Mexico, common in our Central American populations. If our interpreter happens to be a Spaniard,
Where it is much less common to see tuna. Well, it might be that that specific item they hear and they go, well, tuna, that’s a fish. Then they mark it incorrect rather than it was a very clear, precise item that is a fruit in that category. So there’s items like that to where we would mark incorrect, even though it might have potentially been correct, as well as accented speech and all these other variables to where someone that has a Chilean accent.
To me, that is a very difficult accent to understand. There is different word forms being utilized in comparison to, say, a Venezuelan. Those I could understand a little bit better. A Spaniard, even because of how common it is in teaching, has become a little bit more known and is able to be adjusted for a little bit better. But when we get to rural populations, when we get to lower education populations, sometimes that accented speech is a lot more aggressive than is typical.
And those are factors that come into play once you get at a score level difference. But it’s important to give recognition towards there are parts that are better, right? The variability did come out significant in both directions. It wasn’t just one side of things. It was just
Dr. Jeremy Sharp (37:33)
Right.
Ashby Martin (37:34)
the overall test average being lower when you compare it to other individuals with those same conditions.
Dr. Jeremy Sharp (37:42)
Gotcha, gotcha. Okay, okay.
Yeah, I appreciate you digging into this. this is fascinating.
Ashby Martin (37:46)
Hey, ask follow-up questions.
I’m very excited I I hadn’t even talked about group group two being the matched clinicians, right?
Dr. Jeremy Sharp (37:55)
Yeah, yeah. Okay. So let’s talk about that a little bit. Yeah. Dig into to those findings if you could.
Ashby Martin (37:59)
Yeah, so what we did,
now this isn’t across 50 years. Some of the comparison cases are older, but what those group two patients were were still limited English proficiency, but rather than utilizing an interpreter-mediated assessment, we had a clinician that was a linguistic match. Now,
Dr. Jeremy Sharp (38:17)
Mm.
Ashby Martin (38:18)
she s is from Puerto Rico, so that has a slightly different accent than some of our other.
lower Central American, I’m thinking of like a Guatemalan Spanish, is a little bit different, but it is pretty similar in terms of our Mexican Spanish, and I was present as well for a lot of that to give any kinds of corrections for some of those little details. when we accounted for it as close as we as we could with those factors, all of our effects for variability as well as for our performance differences and our impressions, all of them went away. And it was.
something that was global and apparent, very clear in group one, where we had interpermediated, and yet was not present at any level in any capacity, regardless of what metric we were utilizing. It just looked the same. I mean that’s what it’s supposed to be. It’s supposed to look like if you do something, it looks the same as the other comparison group patients, right? So it did what it was supposed to, but it was surprising because it
Did occur in Spanish, everything was done in Spanish. So that major finding is that A, whatever language effect that we might have seen that is related to the interpreters can be adjusted for. And then B, anecdotally, we saw that the patients were a little bit more familiar, acclimated, and encouraged during that assessment. It looks like being able to ask follow-up questions, being able to at the feedback and interpreter stage.
get clarifying details more often and interact not only with the patient, but also your collaterals. That seemed to have some
Dr. Jeremy Sharp (39:55)
Sure.
Ashby Martin (39:55)
degree of effect. And that that’s what we think is actually occurring with some of our impressions to where the degree of detail that you’re able to get in terms of a baseline, well, it’s probably going to be a little bit higher if you have better collaterals, better reporting, but if you have a intermediate and that intermediate being an interpreter often, where they’re present at points. Some
hospitals they’ll have it present only during the test period. And this is not often your in-person interpreters, but some service like your globos or a CIRICOM to where they’ll zoom in and they’ll be present for the assessment, but not necessarily for the feedback, not necessarily for the interview, or they might change that individual. Those are all factors that can create a difference. None of those factors occurred in group two when we had the clinician do the entire assessment in Spanish.
And it is important to say for both groups, we did utilize Spanish norms for the test. So we were trying to utilize norms as often as possible, the best items that we had and the most adequate for that time period. So for whatever norms that we had in the nineteen nineties, we would try to utilize those for the nineties cases.
Dr. Jeremy Sharp (41:02)
Gotcha, gotcha. That’s great. So I have some reactions to that, of course. And
Ashby Martin (41:07)
Yes, please.
Dr. Jeremy Sharp (41:10)
I would love to hear what y’all what
you what conclusions did you draw from that? Like how how did you make meaning of those findings?
Ashby Martin (41:18)
Yeah. So would do do you wanna just start with the meaning part of it or do you wanna do your questions as well?
Dr. Jeremy Sharp (41:25)
I
I don’t know. I’m I’m hesitating. I don’t know if I want to offer my thoughts before I hear your thoughts. But okay, I’ll just say. So in my mind, like this makes intuitive sense. If you eliminate the intermediary, you know, the the interpreter and you’re just working with someone in their native language, that to me makes intuitive sense that they would do better.
Ashby Martin (41:43)
Mm-hmm.
Dr. Jeremy Sharp (41:44)
that’s as far as I got though. So I’m curious if that like matched y’all’s or I keep saying y’all, your
expectations, you know, or not and
Ashby Martin (41:53)
Yeah, I mean that
that it did match what we thought. We did think that being as close of a match would account for any language disprepancies, any cultural based differences that well, to a degree. Culture’s still distinct given Puerto Rican versus other cultures that can be quite different. But those
Dr. Jeremy Sharp (42:10)
Course.
Ashby Martin (42:11)
adjustments, making it as proximal as possible, do have an effect. And that is the main takeaway to where we can encourage clinicians to train to utilize these things. And something I hadn’t talked about.
That I would recommend is to use an interpreter, but in a slightly different fashion. So many clinicians they have an understanding of another language, at least newer clinicians do. Language abilities have come to be an important differentiating factor for newer clinicians to where if you do speak another language, maybe you do have a slightly better opportunity in order to get into a certain clinic. Well,
How many of those individuals actually utilize those language abilities? Now,
Dr. Jeremy Sharp (42:53)
Hmm. Great question.
Ashby Martin (42:55)
from from well, I I I’ve seen some of the data to where it is low. So from the individuals that do speak another language, this was an APA survey, I think given 2021. I’m not absolutely certain on that, but it was a more recent but not today study to where they asked those individuals, do you utilize your language abilities? And only about one intended.
So a significant
Dr. Jeremy Sharp (43:19)
Wow.
Ashby Martin (43:20)
drop-off to the individuals that did have a second language. And when asked, well, why didn’t you utilize that language? And they go, Well, we do have someone that is a fluent language speaker. And that’s a very valid thing because they’re in they’re talking about the interpreters. They are fluent. But what is missed across that is the training, is the familiarity with the tools at hand. So what I recommend is actually using it in a slightly different frame.
So I we call this, at least I did in the introduction, a shadow interpreter, to where it is an individual that is almost shadowing, as another individual does. Shadowing is very common where they’re present, but they’re not actively participating. And in that role, they’re only adjusting for language discrepancies. We want the clinicians, if they do speak another language, to try and utilize that, especially if they have formal documentation that they are fluent in administering.
the language to a capacity, let’s utilize that and build it a little bit better. The first assessments will likely have errors. They will likely be at a lower quality. I understand that that is the case. But when a clinician practices, they’re not practicing for months. They’re not practicing for a year. They are practicing for a full career. So building that familiarity and having someone that can correct for language, those interpreters, I think can be a very powerful tool, though it is daunting.
I I think making someone speak in a language that they’re less familiar with, a second or third language, that could feel like a lot. And I very much understand that. But if the ultimate goal of a clinician is to help patients, then I think that’s worthy al effort. I think that is something that we should pursue
or at least try out in order to get at the highest level of care that we can administer. Right. So that is my recommendation. Do try it. And if there’s a hospital on here listening in.
Please pay your interpreters while they train for a national certification. Very few
Dr. Jeremy Sharp (45:22)
Sure.
Ashby Martin (45:23)
interpreters have a national certification. Currently we have three of our nine on staff interpreters, and that is well above average. You might be lucky to have one. And
Dr. Jeremy Sharp (45:32)
Gotta gotta.
Ashby Martin (45:34)
they they here at the University of Iowa hospitals and clinics were not paid while they were training to get that. They didn’t get a pay bump afterwards, but
Dr. Jeremy Sharp (45:43)
Nice.
Ashby Martin (45:43)
they did it out of the goodness of their heart.
They did it because they thought that there would be a difference. And anecdotally, it does look like it is causing a little bit of an improvement. I don’t know
Dr. Jeremy Sharp (45:52)
Okay.
Ashby Martin (45:52)
that because that’s a small sample size, three out of nine, it’s not sufficient to cause any claims. But I think it’s worth doing. I think that’s something that we should be able to do, especially if we’ve had the certification for at least a decade and it’s national. So it’s not state-specific.
Dr. Jeremy Sharp (46:04)
Right. Right.
Ashby Martin (46:06)
We do have state-specific certifications, but if we get a national certification,
You as an interpreter can be licensed to practice at multiple clinics and have that as leverage in comparison to your peers. use that, encourage that, and if you’re a hospital, please pay them for that because it’s worthy.
Dr. Jeremy Sharp (46:23)
Well, yeah, I mean you said at the beginning that it appears that implementing these certification standards for interpreters is making a difference. Is that fair? I mean making a difference in the quality of the
Ashby Martin (46:35)
Mm-hmm. Yeah. Yeah, we think.
So that that part the we don’t have the data on it outside of anecdotal evidence where we’ve seen those changes from the last two or three years. That sample size, it’s less than 15. So I can’t
Dr. Jeremy Sharp (46:46)
Yeah. Okay.
Ashby Martin (46:48)
make firm claims on it, but I have passionate claims on it if that makes a difference. To where I I mean, I I spoke with our lead interpreter here and he saw the data and he went, We could do better. We can we can improve
Dr. Jeremy Sharp (47:02)
Mm.
Ashby Martin (47:03)
this. It’s not a
my God, I can’t believe we got no. Everyone looks at that and goes, We should do something. It’s not a,
Dr. Jeremy Sharp (47:10)
Yeah, yeah.
Ashby Martin (47:11)
my God, I don’t care about it’s I want to do better. People want to improve. This is a human to another human talking to another human about human care. We care about each other. That is why we’re in neuropsychology. That is why we work at hospitals so that we can improve each other. And if we find something that is an improvement, or at least we think is an improvement, it’s worth doing.
At least until we figure out how much of a difference it makes.
Dr. Jeremy Sharp (47:36)
Yeah.
Ashby Martin (47:37)
interpreters are one of the few things that is not an added charge for patient care. So if you have one present, if you don’t, the patient will never pay more. So if you ever feel a doubt, if you’re a
patient in your language abilities, have one present. Your bill will not increase. It will not make it a negative. If anything, you could have them present, still do the entire assessment.
And then only have them work as a shadow interpreter, only have them be present for those slight things that we get wrong. It could be a dialectical difference to where, hey, they say, hey, wait, tuna? No, that is a fruit. That that is a thing. And then they’ll be able to tell you that you’re like, I didn’t know. And that’s good. That’s a learning experience. yeah. What are your thoughts too? What were your
Dr. Jeremy Sharp (48:20)
Right, right. Yes. Are there other f yeah, go ahead.
Ashby Martin (48:26)
I was gonna say, what are your thoughts? What are your feelings on this?
Dr. Jeremy Sharp (48:30)
yeah. Well, I’m a general fan of certification across the board. I mean, it seems like that should, you know, raise the raise the standard. I mean, I think that’s the idea. So yeah, having certification in place seems great. I totally agree. I mean honestly, from a practice owner standpoint, bringing on an interpreter is, you know, increased overhead. Now it’s necessary, of course, right?
Ashby Martin (48:51)
Yeah it is. Mm. Mm.
Dr. Jeremy Sharp (48:53)
So don’t don’t get me wrong, but I’d be lying if I
didn’t acknowledge that part of it. You know, there might be some practice owners who are like, my gosh, like I have to pay for an interpreter. But, you know, I think it’s totally worth it, at least in our experience, it’s been totally worth it just for a client care standpoint that we’re you know getting closer, I think, to a better assessment. although, now that I say that, I mean, thinking about your data, it sounds like the interpreter assisted assessments were actually worse.
So
Ashby Martin (49:21)
Yeah.
So they’re they’re worse than individuals that had it done in English that were fluent in English, right? The part
Dr. Jeremy Sharp (49:27)
Yeah.
Ashby Martin (49:28)
that we don’t have represented in that data is if there was no language accommodation. Right.
Dr. Jeremy Sharp (49:34)
Right.
Ashby Martin (49:35)
So if you had nothing there, well, you’re probably not getting a neuropsychological assessment. You’re probably not getting any kind of opinion. So that that
Dr. Jeremy Sharp (49:43)
Yeah.
Ashby Martin (49:44)
is the slight difference to where some care is better than no care, but also
In mind of what that data represents, we also should look at those decades differences to where it was much worse in the nineties. It got better into the 2000s, it got better into the 2010s, then it did plateau. But
Dr. Jeremy Sharp (50:04)
Okay.
Ashby Martin (50:06)
maybe maybe we are we have a future direction. Maybe we could make it improve even more with those certifications. I don’t know that. That’s why I do say maybe on that, but
We see a directionality effect, some some degree of improvement, especially in comparison to the nineties.
Dr. Jeremy Sharp (50:22)
Yeah, yeah. So that’s an important clarification. So those individuals, you know, like you said that did better were fluent in English, but it was a second language. It was not their native language. So
Ashby Martin (50:34)
So so w when you th you say second individuals, do you mean the comparison group patients or do you mean the LEP patients?
Dr. Jeremy Sharp (50:39)
Well, when we if we go
way back like to the like the seventh percentile performance versus the second percentile performance, the seventh percentile individuals
Ashby Martin (50:49)
So the seventh percentile individuals are people with the same demographic variables, but they had it done in English. They were English speakers. So there was no second language. There was nothing of a language. They they were fluent English speakers in English taking an English assessment, right? So your standard
Dr. Jeremy Sharp (51:08)
Okay.
Ashby Martin (51:08)
practice care things. That if you want to move that towards the front, absolutely do. That that could be an important clarification.
Dr. Jeremy Sharp (51:16)
Yeah, yeah, for sure. For sure. that sounds good. That sounds good. I will I will do that. Let me see.
Ashby Martin (51:26)
Yeah, so comparing LEP patients with the interpreter mediate assessment, two individuals, fluent English speakers, took it in English. So your compare that’s why it’s a comparison, almost your control. Obviously not a control, it’s human population data. But
Dr. Jeremy Sharp (51:42)
Sure. Yeah. No, that was misunderstanding on my part. That’s good. Yeah, we’ll throw that at the beginning, just to make sure it’s extra clear. cool.
Ashby Martin (51:49)
Yeah, no, definitely ask those questions.
Dr. Jeremy Sharp (51:52)
Yeah, yeah, yeah. so let’s see. I’ll like pause for th three seconds or something and then I’ll ask another question so that I can, you know, cut the editing. It’ll be a little easier.
So this is fantastic. you know, there’s so much I think that I could ask about and we could talk about here, but as we start to wrap up, are there other findings from the research that you feel like is relevant for clinical practice that we haven’t touched on up to this point?
Ashby Martin (52:19)
Yeah, I did a lot of follow-up analysis. So if you ever check that thesis, the
Dr. Jeremy Sharp (52:25)
Yeah.
Ashby Martin (52:25)
appendix is about another hundred pages in comparison to the
Dr. Jeremy Sharp (52:29)
my gosh.
Ashby Martin (52:31)
original thesis because I was trying to be thorough. I was trying to look at any kind of difference that might be occurring, whether it be specific to how we did the demographic matching, whether it be towards other variables that we might not have adjusted for properly. So
I did another analysis on whether there was even a sex difference for those cases where I I I said I had a high match rate, but not every single one was perfectly matched. So those that had a slight difference, was there a difference in scoring? It didn’t look like it. Legal cases we also looked at because we did have some cases that were from active litigation or prior active litigation. And it didn’t
Dr. Jeremy Sharp (53:08)
Mm-hmm.
Ashby Martin (53:08)
look like there was a difference, but it was growing towards it. Other things we looked at were there differences in
The cognitive domains. So language, executive function, overall intelligence. So those those little categories that we could terse out from a neuropsychological assessment, was there a difference? The answer was no. We could not find firm difference across any of those things, not even the degree of verbalness on the test. So, what I mean by degree of verbalness is how often you have to speak or write or utilize some language ability during that item.
So something where you’re doing groove pegboard
Dr. Jeremy Sharp (53:45)
That’s interesting.
Ashby Martin (53:46)
and you’re not speaking much, you’re just doing the actual task, there would be limited information from the interpreter. Would that have a lower effect? Would that have a higher effect? It turns out that there was no difference. So whether the interpreter was present or not was the bigger determinant than whether that specific item had a specific
language based effect. That might just be because of norms. Norms were are able to adjust for language ability. So using the best norms for each individual test might have made those equal, but not overweighted for the use of an interpreter.
Dr. Jeremy Sharp (54:19)
Gotcha. Gotcha. Yeah. That’s that is interesting. Cool. Cool. Where do you feel like the research is headed from here? You know? Like what’s missing?
Ashby Martin (54:28)
Mm-hmm. So
Dr. Jeremy Sharp (54:29)
What would you do if you had unlimited funds?
Ashby Martin (54:32)
Yeah. So what practical measure we’re doing now is we’re looking at the other languages. I talked about there was one hundred and twenty-four for or sorry, one hundred and thirty-two cases in group one. And then an additional
32, an additional 32 for our group two. But that isn’t all the languages that are possible. I focused on Spanish. We have multiple other ones, not to the same level. So Spanish takes up 70% of our cases. But from those other 30%, we have 5% in Arabic, we have 5% in Vietnamese, 5% in Chinese languages, all those other little language differences might also present at a same.
level of difference, discrepancy when it’s interpreter-mediated, it might not. So there are 104 additional cases that would have that criteria met for a different language that’s not Spanish, but does have an interpreter-mediated assessment. And we’re looking at that difference and whether or not it is the same, whether or not it is higher, whether or not it is lower, across different languages, just to really push towards is this different across languages? Is this
Identical as long as there is an interpreter and give the number value so that way there is some degree of adjustment. education profiles are vast and different across these groups. I mean, that does encompass some of your cultural differences. But yeah, look at languages that are not just Spanish, look at what effects they have for interpreters, and then moving forward, hopefully, do something with training, right?
If an interpreter
Dr. Jeremy Sharp (56:07)
Sure.
Ashby Martin (56:08)
has a national certification, does that make a difference? That would be a great step. And it would encourage clinicians, especially if you’re like private practice. You’re like, I don’t know if I want this. Well, maybe you would if you see that the one that has the certification does really, really well and is not different from a clinician. That well, it it with the clinician assisted thing. But that framework might be pretty powerful and encourage private practice as well as institutions to go and say,
Yeah, let’s train them. Let’s have these certifications. And if there is an inadequacy, well then let’s change the training a little bit. Let’s improve it and figure out what the data says. Yeah. But what do you want to see though? I
Dr. Jeremy Sharp (56:46)
Yeah, yeah. Hello.
Ashby Martin (56:48)
I’m very curious at what changes you would like to see from your side.
Dr. Jeremy Sharp (56:52)
Well, yeah, I mean, like I acknowledged at the beginning, I feel like I’m coming at this from a relatively naive perspective, you know, ’cause we just don’t
Ashby Martin (56:58)
Hey, that’s most people.
Dr. Jeremy Sharp (57:00)
Well, yeah, I suppose that’s true. Thank you. That was very validating. I feel I feel supported here. So yeah, I would love more maybe more resources on just for clinicians on working with interpreters. I think that would be
Ashby Martin (57:11)
Yeah. Mm-hmm.
Dr. Jeremy Sharp (57:14)
I think that’d be great. you know, we jump into it and don’t have a whole lot of training on
How to do it really well. So that’s the first thing that comes to mind for me. I mean, you did address one of my questions, which is sort of like the, you know, is something better than nothing question when it comes to assessment. I think that’s something that we wrestle with a lot. we’re in it’s not a rural area, but it’s certainly an area where there are not a ton of bilingual clinicians, you know, especially once we get outside the
outside the the Spanish realm, you know. and so we often run into this question of like, is something better than nothing? if we were you know, are you know, seeing a client that’s not a native English speaker. So yeah.
Ashby Martin (57:57)
Yeah, I I think so. I or at least
genuinely I hope so.
Dr. Jeremy Sharp (58:04)
Sure.
Ashby Martin (58:05)
efforts you would want versus efforts you see are successful, though they tend to vary, but hopefully this is one with a finding that is supportive of more training, of use, of applicability. not only
in Iowa, not only in the US, but hopefully across the world. So that way we have a foundation to build upon.
Dr. Jeremy Sharp (58:26)
Yeah, yeah, yeah, yeah. I think that’s a good a good place to close. I mean, if folks want to learn more about this topic, I know you have your own research of course, but are there other resources that might be helpful for people to look into? any yeah, any organizations and of course, you know, any of your own contact info that you might be willing to share.
Ashby Martin (58:49)
Yeah,
please do reach out to me. currently, ashreymartin at uioa.edu, as well as ashreymartin one at gmail dot com. Please email me, ask questions. I am earlier in research, so my publications are limited, but do read them. So if you’re curious on those recommendations, I have a checklist for clinicians that they could utilize to have
a interpreter media assessment with some standards, with some boundaries. So please do read and then ask questions because I think that’s the best way of learning.
Dr. Jeremy Sharp (59:24)
Yeah, yeah, absolutely. Where can people find that checklist? Just to be super clear. I’m guessing people might be interested.
Ashby Martin (59:30)
Yeah, so it will be at the end of my publication.
So the full title of my publication is Linguistic Barriers in US Neuropsychological Assessment. And right at the end, you’ll see a full checklist that I put down what you could do prior to the neuropsychological assessment, during the neuropsychological assessment, and then after. So that prior being that interview stage.
During being while you have active interactions, as well as afterwards when you’re doing your feedback session. So what I was trying to figure out and highlight was those little bullets. So those allow you to see the differences where it is with an interpreter, as well as when it’s just a linguistically mediated communication. And why I make
Dr. Jeremy Sharp (1:00:16)
Mm.
Ashby Martin (1:00:17)
that difference is you could have a clinician that does speak the same language as
the individual, those are still standards you could apply. So if you have an interpreter or if you have some other form of language accommodation, all these recommendations are built in order to be applicable and useful, hopefully, in clinical practice.
Dr. Jeremy Sharp (1:00:38)
Great. Great. Well, this has been fascinating and again I am really grateful that you’re willing to come on and and talk through this.
Ashby Martin (1:00:45)
I’m grateful
for the invitation. Genuinely.
Dr. Jeremy Sharp (1:00:48)
Yeah, yeah. No, it was a good conversation. And it’s really cool. I mean, I can tell that you are pretty excited about this and passionate about this area and I’m really looking forward to any future research that you end up doing.
Ashby Martin (1:01:01)
yeah.
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