Learning Objectives: Patterns of communication with physicians are important determinants of parental satisfaction with their child's care in the intensive care unit (ICU). ICU physicians communicate with families in multiple formats including at the bedside, during family-centered rounds and during formal family conferences. We hypothesize that differences exist in the communication formats preferred by English and Spanish-speaking families. Our purpose is to describe families' communication experiences and identify potential disparities. Methods: We conducted a prospective, cross-sectional study with English and Spanishspeaking families of children admitted to the pediatric or cardiac ICU at a pediatric tertiary care hospital. Families completed a survey regarding their preferences for communication with ICU physicians. The study was approved by the institutional review board. Results: 134 families were enrolled, including 33 (25%) Spanish-speaking families. Overall, Spanish-speaking parents were more likely to be younger (30 vs. 36 years, p=0.007), reported less educational achievement (p<0.001), and had Medicaid insurance (p<0.001). Most families (60%), both English and Spanish-speaking, reported receiving information from physicians in their preferred setting, which was most commonly during rounds or at the bedside. English-speaking families were more likely to have been invited to participate on rounds (p<0.001), understood material discussed on rounds (p<0.001), reported that the nurse spent enough time speaking with them (p=0.006), and that they were able to rely on the nurse to explain key aspects of medical care (p=0.009). 64% of Spanish-speaking families reported interpreter use on arrival to the ICU; but only 21% of families who would prefer an interpreter reported having one available for communication with the medical team throughout the ICU stay. Conclusions: Most families receive communication in the ICU in their preferred setting. Spanish-speaking families are not as supported during rounds and communication for these families could be improved with ready availability of in-person interpreters.

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