Researchers Find Language Gaps Could Interfere with Pediatric Allergy Diagnoses


Language gaps resulted in barriers and underdiagnosing in children with common allergies, limiting support for these patients and their families.

New research presented at the 2023 American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting showed that language barriers could cause children to be underdiagnosed for allergic conditions like food allergy, asthma, and eczema. Further, the results found that pharmacy translation software could interfere with the filling of medications.

Chat bubble concept for language translation idea

Image credit: Cienpies Design |

The study authors noted that around 20% of individuals that reside in the United States speak a language other than English in their home. The researchers found that this could create a gap for patients to receive the appropriate care.

“Among children with a language preference other than English, the diagnosis of asthma was less than half as common, eczema was about two-thirds as common, and allergic rhinitis was slightly more than half as common when compared with children whose preferred language was English. A similar correlation for the diagnosis of food allergy was deemed not statistically significant,” said Hao Tseng, MD, ACAAI member and lead author on the study, in a press release.

A total of 16,517 children were included in the study and were identified through electronic health records (EHR) of individuals under 18 years old that were seen in primary care pediatric clinics from July 1, 2023, to April 30, 2023. The average age of children was 6.2 years and 48.6% were female. According to the study authors, 80.4% of the children were Black, 78.9% were enrolled in Medicaid, and 14.8% reported that they preferred speaking a language other than English. The other languages included Haitian Creole (4%), Spanish (4%), and other (6.5%).

In separate research, the study authors discussed a medical case of a 7-year-old, Spanish-speaking girl. The study authors noted that the girl was diagnosed with a fish allergy and was prescribed an epinephrine autoinjector to prevent future allergic reactions.

A school medication form was filed to ensure that the girl could attain the epinephrine in school. However, the study authors noted that the prescription was translated into Spanish with a translation software when the pharmacy received it, and it made small changes to the prescription. The nurse then declined the prescription because it did not accurately match the form that was completed.

The nurse sent the epinephrine autoinjector and a note home with the girl, but the child’s mother was unable to read it because it was written in English, according to the study authors. After 4 months, the child went back to the clinic with the epinephrine autoinjector and the note that the nurse wrote.

“Patients with limited English proficiency encounter unexpected barriers to care and remain a vulnerable patient population,” said Margaret Huntwork, MD, senior author of the paper, in a press release. “The pharmacy translation software is not the only thing to blame for this case of a delay in securing a potentially life-saving medication in the school setting. Communication between the family, the physician, the school nurse, and the pharmacy is essential to ensure safety and success of students with allergies.”

The findings suggest that language gaps create barriers for underdiagnosed children with common allergies, limiting the support they are able to receive.


Language barriers may cause some children to be underdiagnosed for allergic conditions. EurekAlert!. News release. November 9, 2023. Accessed December 18, 2023.

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