Youth and Caregiver Agreement of Youth Symptoms in Language Concordant and Discordant Dyads: Is Something Lost in Translation?

Caregivers are primarily responsible for seeking care on behalf of youth, so understanding how primary language relates to caregiver–youth agreement of youth symptoms is critical to extending the reach of mental health services. In this study, 145 youth (61% female; ages 12–17 years) and their caregivers, who received behavioral health services at primary care clinics, completed measures of youth symptoms in their primary language. We hypothesized primary language concordant caregiver–youth dyads would show higher agreement when reporting on youth symptoms than language discordant dyads, and youth and their caregivers would show higher agreement when reporting on behavioral (e.g., doing drugs, getting into arguments) rather than on internal (e.g., worrying, feeling worthless) symptoms. Overall, agreement in language concordant dyads ranged from r = 0.551 to 0.615, while in discordant dyads agreement ranged from r = 0.279 to 0.441. Consistent with our hypothesis, language concordant dyads demonstrated significantly greater agreement than discordant dyads for most of the analyses. Contrary to our hypothesis, agreement was similar for internalizing and externalizing symptom clusters. Results suggest primary language differences between youth and caregivers are associated with lower agreement about youth problems; youth generally report higher symptom frequency than their caregivers.