Assessing Substance Abuse Problems in Deaf and Hard of Hearing Individuals

Abstract

Professionals who provide services to deaf and hard of hearing individuals may encounter situations related to abuse of alcohol and other drugs. Getting access to an agency that can provide an appropriate chemical dependency assessment for a deaf or hard of hearing person is difficult because there are no formalized assessment tools normed or specifically designed to use with such individuals. Additionally, most assessors are unfamiliar with how to work with deaf and hard of hearing people, less likely to be fluent in American Sign Language, and unaware of appropriate treatment options. The present article provides an overview of chemical dependency, assessment issues, and considerations unique to the deaf and hard of hearing population. A chemical dependency assessment tool developed by the Minnesota Chemical Dependency Program for Deaf and Hard of Hearing Individuals is described, as well as a case study that illustrates application of the assessment process.

Assessment of Deaf dually diagnosed clients

“…As stated above, a common problem in assessing Deaf clients is the use of language and jargon that is not familiar to the individual (Guthmann, 1999; Alexander et al , 2005). In relation to substance use assessment or screening, Guthmann and Sandberg (1998) give an example of the use of the word “black‐out”. This may have to be explained to the Deaf person in addition to, or instead of, using the term “black‐out”.…”

“…For example, the use of time and rating scales is not advisable as they may not be readily understood by the Deaf community. Few clients will ask for an explanation or clarification of terminology, but instead may respond to the question without understanding it completely (Guthmann and Sandberg, 1998). For this reason, also, screening tools may elicit inaccurate results so full assessment and discussion is more beneficial.…”

“…Although there are no alcohol and other drug screening or diagnostic instruments that have been validated for the Deaf population, work has been undertaken by Deaf‐specific organisations to minimise communication barriers during assessment through the development of their own assessment protocols incorporating drawing tasks and roleplaying (Roberts and Mugavin, 2007). These services have tended to develop their own systems or to modify existing instruments normed on hearing people (Guthmann and Sandberg, 1998).…”

Validation of the Substance Abuse Screener in American Sign Language (SAS--ASL).

“…While deaf people's written English may range from functional illiteracy to mastery (Brauer, Braden, Pollard, & Hardy-Braz, 1998), the median reading comprehension for 17- and 18-year-old students is at the fourth grade (Gallaudet Research Institute, 1996). Compounding deaf persons' access to substance abuse information is the lack of expertise on the part of hearing professionals in both the language and the culture of deaf persons (Guthmann & Graham, 2004; Guthmann & Blozis, 2001; Guthmann & Sandberg, 1998; Pollard, 1996). Deaf people are part of a linguistic minority whose primary language is ASL.…”

Validation of a substance use disorder screening instrument for use in vocational rehabilitation settings.

“…Although routine assessment of SUD is important to ensure that customers who are in need of substance use services are identified and referred so they may receive such services, major barriers prevent widespread screening of SUD in rehabilitation populations. These barriers include (a) the lack of a screening instrument specifically validated for persons with disabilities; (b) the lack of an instrument that includes items to assess the abuse of prescription medications (Moore & Polsgrove, 1991; Olkin, 1999); and (c) administration barriers for persons who have sensory (Guthman & Sandberg, 1998), physical (Heinemann, 1993), or cognitive impairments (Degenhardt, 2000). VR and other employment service professionals are pressed for time that is needed for in-depth clinical interviews regarding substance use history.…”