Tara Alexander, PhD, Our Lady of the Lake University.
Saturday, 14 January 2006 - 4:30 PM
Substance Abuse Screening for the Deaf: Development of a Culturally Sensitive Scale
This presentation reviews the author's creation and validity and reliability testing of a substance use screening video for the Deaf, the Drug and Alcohol Assessment of the Deaf (DAAD). Numerous obstacles had to be overcome in order to conduct the research, including, but not limited to: difficulties with translation from English to American Sign Language (ASL), a lack of tools to assess psychometric properties of the video, assessing a non-homogenous population, and cultural diagnostic dilemmas.
Standardized assessments for the Deaf are few because of the variety of language preferences, etiologies of deafness, types of education, regional signs and difficulty reading written hearing scales. In a recent study, Alexander, DiNitto & Tidblom (in press) reported Deaf participants had difficulty with commonly used screening tools, the CAGE, developed by Ewing (1984) and the Alcohol Use Disorders Identification Test (AUDIT), developed by the World Health Organization (Saunders, Aasland, Amundsen, & Grant, 1993). Deaf individuals reported not understanding a number of the CAGE words or phrases, such as the phrase “steady your nerves,” which was unclear for 69% of the participants. The AUDIT was more problematic, as 81-88% of participants did not understand frequently used English words such as “containing,” “typical,” and “occasion.”
To fill this dearth in substance abuse assessment tools for the Deaf, this author created and validated a screening tool in American Sign Language (ASL), administered via video. The tool was given along with a translated version of the Structured Clinical Interview for the Diagnostic and Statistical Manual (SCID-IV), Modules E and A.
The final validation of 131 Deaf individuals across five sites in the United States indicated a Cronbach's alpha of .87 for ten items. Convergent validity was established using the Major Depression section of Module A of the SCID. A significant relationship was found between major depression and score (r =.305, p = .000). There is a significant correlation on the DAAD for individuals who have an alcohol dependence diagnosis (r = .555, p =.000, á = .01) or a substance dependence diagnosis (r = .569, p = .000, á = .01). Known-groups validity was evidenced via using ANOVA on the transformed data, and Eta was significant at the .05 level (Eta = .626, Eta˛= .392), indicating a strong association.
References: Alexander, T. DiNitto, D. & Tidblom, I. (in press). Screening for substance use problems among the Deaf. Alcohol Treatment Quarterly
Ewing, J. (1984). Detecting interventions for alcohol problems: a review. Addiction, 252(14), 1905-1907.
Saunders, J. B., Aasland, O. G., Amundsen, A., & Grant, M. (1993). Alcohol consumption and related problems among primary health care patients: WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--I. Addiction, 88(3), 349.
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