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Bulletin vol. 34 no. 1 | 13 This article is the second in a two-part series focused on diversity issues related to language functioning with respect to the field of neuropsychology. The first part provided a general overview of language, reviewed its impact on neuropsychological assessment with an emphasis on individuals using English as a second language or those with no English background, and introduced basic methods for determining the language(s) of assessment for bilingual and multilingual individuals (González, Mullane, Pick & Strutt, 2020). This second part focuses on the advantages, challenges, and recommendations when using interpreter- mediated services in the neuropsychological arena. The United States has approximately 60 million people using over 350 languages (U.S. Census, 2015). An individual's exposure to and use of different languages varies depending on a number of factors including family language background, their access to one or more languages, acculturation, and geographic location. Given the increasing linguistic diversity in this country, there is considerable need for neuropsychologists with the appropriate skills and training to provide direct and equitable care. However, neuropsychologist not familiar or fluent with an examinee's language or culture will need to work closely with an interpreter who can serve to facilitate verbal (spoken, signed, and written languages) and non-verbal interactions. Legal and Ethical Considerations Federal and state laws and regulations have been created requiring various institutions to take "reasonable steps" to support access to language and communication for individuals with limited English proficiency (e.g., Section 1557 of the Affordable Care Act, Language Access; Title VI of the Civil Rights Act of 1964). The Civil Rights Act of 1964 prohibits discrimination on the basis of national origin, which encompasses linguistic diversity. Additionally, the Americans with Disability Act of 1990 (ADA), Subpart E dictates "appropriate steps" be taken to support effective communication for people with disabilities. The Ethical Principles of Psychologists and Code of Conduct (APA, 2017) addresses ethical and professional practice issues related to the provision of equitable care as applied to individuals using a foreign language, having limited English proficiency or being fluent in multiple languages. Some common issues that arise for the neuropsychologist working with such individuals or including interpreters in their work pertain to the following: Boundaries of Competence (2.01), Delegation of Work to Others (2.05), Unfair Discrimination (3.01), Cooperation with other Professionals (3.09), Disclosures (4.05), Bases of Assessments (9.01), Use of Assessments (9.02), Informed Consent in Assessments (9.03), Interpreting Assessment Results (9.06) and Maintaining Test Security (9.11). Interpreter versus Translation Services Interpretation is defined as orally or manually conveying information for parties conversing in two different languages. Translation is the process of transcribing from one written language to another, and there are various guidelines for translation and cultural adaptation of psychological measures. For example, the Standards for Educational and Psychological Testing require assessments to have limited bias and established validity for use in a particular context (AERA, APA, & NCME, 2014; Epstein et al., 2015). Interpreter Certification Certification in the field of interpretation recognizes individuals who have the minimum language and cultural competencies required to accurately communicate. Certification or credentialing Lawrence H. Pick, Ph.D., ABPP 1 , Jesús O. Barreto Abrams, Ph.D., NIC 2 , David Andrés González, Ph.D., ABPP 3 , Paola Suárez, Ph.D. 4 , Adriana Macias Strutt, Ph.D., ABPP 5 1 Professor and Director of Clinical Training, Department of Psychology, Clinical Psychology Doctoral Program, Gallaudet University 2 Postdoctoral Fellow, Hispanic Neuropsychiatric Center of Excellence, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles Medical Center 3 Clinical Assistant Professor, Department of Neurology and Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio 4 Clinical Assistant Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles Medical Center 5 Associate Professor and Director of BCM Cerebro, Department of Neurology, Baylor College of Medicine Language in Neuropsychology Part II - Interpreter-Mediated Neuropsychological Services

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