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Reading the signs: impact of signed versus written questionnaires on the
prevalence of psychopathology among deaf adolescents.





OBJECTIVE: There are no empirically validated measures of
psychopathology that can be easily understood by signing deaf children
and little reliable data on the prevalence of psychiatric disturbance in
this population. The aim was to meet this need by developing an
Australian Sign Language (Auslan) version of a widely used measure (the
Youth Self-Report; YSR) which could be administered in an interactive
CD-ROM format, to assess its reliability, and to compare the prevalence
of clinically significant psychopathology in deaf adolescents when using
the Auslan questionnaire versus the standard written version. This would
also allow examining the validity of written questionnaires in this
population.



METHOD: Twenty-nine male and 25 female adolescents with severe or
profound hearing loss from public and private schools in the Australian
States of Tasmania (n = 11) and New South Wales (n = 43) agreed to
participate and completed the written and the interactive Auslan
versions of the YSR. Parallel forms were completed by parents (Child
Behaviour Checklist) and teachers (Teacher's Report Form).



RESULTS: The Auslan version showed comparable reliability to that
reported for the standard YSR: internal consistency (alpha) ranging from
0.77 to 0.97 and test-retest agreement (r) from 0.49 to 0.78. The
interactive Auslan version yielded a prevalence of clinically
significant emotional and behavioural problems in deaf adolescents of
42.6% compared with 21.4% when using the standard English version.
Prevalence for the wider Australian adolescent population (18.9%) was
similar to that obtained among deaf adolescents when using the standard
YSR (21.4%). However, it was higher among deaf adolescents (42.6%) when
using the Auslan version (OR = 3.2, 95% CI = 1.83-5.58). According to
the Auslan version, the syndromes Withdrawn/Depressed (OR = 6.5, 95% CI
= 2.96-14.25), Somatic Complaints (OR = 4.8, 95% CI = 2.53-9.22), Social
Problems (OR = 8.3, 95% CI = 4.16-16.47) and Thought Problems (OR = 5.7,
95% CI = 2.50-12.80) were much more prevalent among deaf adolescents
than in the wider adolescent population, while Attention Problems (OR =
1.1, 95% CI = 0.39-3.17) and Rule-Breaking Behaviour (OR = 1.5, 95% CI =
0.73-3.17) were not.



CONCLUSIONS: An interactive Auslan version of the YSR is reliable,
better accepted and yields higher rates of disturbance than the standard
written questionnaire. Clinicians should be aware that using written
instruments to assess psychopathology in deaf adolescents may produce
invalid results or may underestimate the level of disturbance,
particularly emotional problems.



Cornes A, Rohan MJ, Napier J, Rey JM.

Aust N Z J Psychiatry. 2006 Aug;40(8):665-73.





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