According to the national census, approximately a fifth of the adult population in the United States uses a language other than English in their home. Less precise information is available regarding ...the language preferences of children and adolescents, D/deaf individuals, and other individuals in the United States who are not represented in national surveys. The field of psychology has increasingly acknowledged and addressed the lived experiences of culturally and linguistically minoritized individuals in the United States through relevant research and clinical practice guidelines. As a result, more accessible and equitable practices for psychological assessments have been developed when working with linguistically minoritized clients. Unfortunately, there is a paucity of information in the extant literature regarding drafting psychological assessment reports for linguistically minoritized clients. This article explores the ethical and professional responsibilities of psychologists when engaged in this work and provides proposed practices for drafting and delivering accessible assessment reports for linguistically minoritized clients. Recommendations are provided regarding how psychologists can share the results of an assessment with a referral source using written English and also support a client in accessing the information in their primary language.
Public Significance Statement
Psychologists have ethical and professional responsibilities to consider the primary language and culture of their clients when conducting psychological assessments, including when drafting the final assessment report. This article discusses these issues and provides proposed practices for drafting assessment reports for clients from linguistically minoritized groups to ensure each client has appropriate and equitable access to the results of their psychological assessments.
Abstract
Acculturative stress is associated with negative mental health among culturally diverse individuals. Deaf and Hard-of-Hearing (DHH) individuals experience acculturative stress as they ...navigate within and between the Hearing and Deaf communities, yet, research has not examined the relationship between deaf acculturative stress and psychological functioning. This study examined the relationships between deaf acculturative stress, well-being, and symptoms of depression and anxiety. One hundred and ten DHH adults (71.6% female, 82.7% White, median age = 30–39) completed an online survey including the Multidimensional Inventory of Deaf Acculturative Stress (MIDAS), demographic questions, and measures of psychological functioning. After controlling for relevant sociodemographic factors, the MIDAS Stress from the Deaf and Hearing Community scales emerged as significant predictors of well-being and symptoms of anxiety and depression. Findings are discussed within the context of DHH sociocultural experiences, and suggestions for future research are offered to inform clinical work with DHH individuals.
While there are many benefits of bilingualism and biculturalism, it is increasingly recognized that individuals may also experience acculturative stress as they navigate between different cultural ...environments. Acculturative stress results from struggles to acculturate, including pressures from the dominant culture and one’s heritage culture to maintain specific languages, values, and customs. This study sought to explore experiences of acculturative stress among Deaf and Hard of Hearing (DHH) adults. Thirteen ethnically and racially diverse DHH adults, aged 21–52, participated in semi-structured focus groups.
Krueger’s (1994) framework analysis was used to analyze the data. Participants reported pressures from the Hearing community as Hearing, Speaking, and English Pressures; Hearing Cultural Expectations; and Family Marginalization. Pressures from the Deaf community included ASL Pressures; Deaf Cultural Expectations; and Small Community Dynamics. Participants also discussed unique stressors related to their intersecting cultural identities (Intersectionality). The psychosocial impacts of acculturative stress included anger, anxiety, depression, exhaustion, resentment, and trauma. Coping resources were also discussed. Results highlight the saliency of acculturative stress among DHH adults and the need for continued investigations of the construct, particularly as it relates to mental health.
Deaf adults may experience acculturative stress as they navigate within and between the Hearing and Deaf communities. However, no measure has been developed to assess levels of deaf acculturative ...stress. This study aimed to develop the Multidimensional Inventory of Deaf Acculturative Stress (MIDAS). The MIDAS was developed through a sequential and iterative scale development procedure and then tested on a sample of 104 deaf adults across the United States (age range = 18-79; 74% female). Principal component analyses were run for item refinement and selection. The final analyses yielded four factors for Stress from the Hearing Community, three factors for Stress from the Deaf Community, and two factors for Intersectionality. Construct validity was demonstrated through correlations in the expected directions with measures of Hearing and Deaf acculturation identity and ethnic/racial identity. The utility of the MIDAS is discussed with regard to future research.
Given the aging of the population in the United States, older adults (ages 65+ years) will increasingly be referred to psychologists for evaluation and treatment. The potential for onset of a primary ...or secondary disability (e.g., physical, sensory, cognitive, or emotional) significantly increases during older adulthood and may or may not be the reason for referral to a psychologist. The overarching aims of this article are to discuss the more common ethical and professional considerations for psychologists working with older adults with disabilities and offer suggested practices to optimize these interactions. This discussion focuses on a collaborative model in which the psychologist partners with the older adult to learn of their specific preferences and needs with the goal of providing equitable, appropriate, and accessible assessment services and therapeutic support. Service provision during the novel coronavirus disease 2019 (COVID-19) pandemic and the related use of telepsychology are also examined as part of this position.
Public Significance Statement
This article reviews the common disabilities experienced by older adults (ages 65+ years) and offers practical suggestions for psychologists who provide services to this population. Additionally, it underscores the importance of psychologists collaborating with older adults with disabilities to best meet their needs in the provision of equitable and accessible behavioral health care.
Purpose/Objective: Members of minority groups may face stress as they navigate between their native culture and the dominant culture. No measure exists for evaluating acculturative stress among deaf ...individuals in the United States. The current study examined the psychometric properties of a modified version of the 24-item Social Attitudinal Familial and Environmental Acculturative Stress Scale (SAFE; Mena, Padilla, & Maldonado, 1987) for use with deaf undergraduate students (SAFE-D). Research Method/Design: 145 (88 females and 57 males), deaf, undergraduate students (Median age = 20.0; SD age = 4.9) from a bilingual, multicultural university were included in the study. Seventy-four percent were White, 10.4% Hispanic/Latino, 9.7% Black/African American, 0.7% Asian, and 9% multiracial. The SAFE-D included 23 items. Ten items were modified, 2 items were deleted, and 1 item was added. Results: The SAFE-D demonstrated high internal reliability (α = .931). Four factors were identified: Perceived Societal Barriers, Social Difficulties, Family Marginalization, and Discrimination. Evidence for construct validity was demonstrated through the association of SAFE-D scores with Deaf and Hearing acculturation. Conclusions/Implications: Levels of acculturative stress in the current sample were close to those reported among late immigrant and English as a Second Language undergraduate students. The 4 factors did not match those of the original SAFE scale but reflected a bidirectional model of acculturative stress unique to deaf individuals. These findings suggest that acculturative stress is a serious concern among deaf undergraduate students and that the SAFE-D can be used to assess deaf acculturative stress in this population.
Impact and Implications
Similar to other cultural minority groups, deaf individuals in the United States also experience acculturative stress when navigating between Deaf culture and Hearing culture. However, to date, there has been no scale to evaluate this experience. This study examines the use of a modified version of the Social Attitudinal Familial and Environmental Acculturative Stress Scale (SAFE) for use with deaf undergraduate students (SAFE-D). Preliminary evidence for the reliability and construct validity of the SAFE-D is outlined in this paper, and directions for future modifications and use of the scale with diverse samples of deaf individuals is discussed. Acculturative stress appears to be a serious concern within the deaf population. Considering research findings that link the experience of acculturative stress to negative mental health outcomes, it is critical that researchers continue to investigate the unique acculturative stress experiences of deaf individuals to identify risk and protective factors, as well as inform clinical practice.
Abstract
Psychological assessment plays a large part in the practice of psychology. Over the years, steps have been taken towards ensuring ethical and culturally sensitive psychological assessment ...for underserved populations, but little is known about the current state of the field of assessment of deaf and hard-of-hearing (DHH) individuals. An exploratory survey of school and clinical psychologists who work with DHH clients (n = 30) was conducted to obtain a snapshot of the state of the field. The current article focuses on sociodemographic characteristics, clinical training, clinical experiences, and language abilities of clinical psychologists who work with DHH clients. Participants averaged 15 years of assessment experience and almost all participants had some type of specialized training in assessing DHH clients. More than half of participants reported their ability to use multiple languages and communication approaches as either excellent or good. Current findings were compared with a similar survey from nearly 50 years ago (Levine, E. S. (1974). Psychological tests and practices with the deaf: A survey of the state of the art. Volta Review, 76, 298–319), and significant differences were found in participants’ self-reported experience with DHH clients, training, and methods of communication.
•This case report highlights the intricacies and challenges of conducting a comprehensive neuropsychological evaluation and Wada test with a deaf adult.•In the absence of ASL proficiency on the part ...of the neuropsychologist, consultation, extensive review of the literature, and close collaboration with qualified interpreters are instrumental.•ASL interpreters must be involved prior to the evaluation to ensure test instructions and content are understandable and relevant. It is also helpful to score tests and discuss behavioral observations with the interpreter subsequent to testing.•Tests that are heavily verbal and depend on knowledge in English may not be appropriate.
In high-stake cases (e.g., evaluating surgical candidacy for epilepsy) where neuropsychological evaluation is essential to care, it is important to have culturally and linguistically appropriate and accessible neuropsychological instruments and procedures for use with deaf individuals who use American Sign Language (ASL). Faced with these ethical and professional issues, clinicians may be unable to provide equitable services without consulting with other psychologists and collaborating with the patient and interpreter. This is a case report describing a 43-year-old male with bilateral sensorineural deafness and a lifelong history of drug-resistant temporal lobe epilepsy who presented as a candidate for a comprehensive neurological workup to determine surgical candidacy. He was bilingual (ASL and written English). We describe all aspects of the evaluation, including functional magnetic resonance imaging (fMRI) and Wada testing, using an ASL interpreter. Results from the neuropsychological evaluation were not clearly lateralizing, but suggested greater compromise to the non-dominant right hemisphere. fMRI and Wada test results revealed language and verbal memory functions were lateralized to the left hemisphere. The patient was deemed to be an adequate candidate for surgical resection of portions of the right hemisphere. Comprehensive assessment of neuropsychological functioning in deaf persons who use ASL is feasible. This case report illustrates the important considerations relevant to neuropsychologists providing culturally and linguistically informed assessments to deaf ASL users with epilepsy. Additional research in this area will support future efforts to develop effective and efficient models that could be implemented across different settings. Moreover, clinical guidance is warranted to guide professionals interested in promoting access to high quality neuropsychological services.
Approximately 25% of hearing women in the United States experience rape in their lifetime, whereas deaf women have been found to experience increased rates of assault consistent with other ...marginalized populations. This study explored sexual assault prevalence and characteristics of assault in deaf female undergraduate students. Results revealed that more than two-thirds of the participants (69%) endorsed experiencing at least one assault and more than half (56%) experienced multiple types of assault. Most assaults were committed by a man known to the survivor. Characteristics (e.g., hearing status, primary language, and ethnicity) of the survivors and the assailants are explored. The implications of this data are discussed as well as the development of culturally and linguistically sensitive outreach and educational programs.
Verbal pragmatic aspects of discourse production were
examined in 16 right brain-damaged (RBD), 16 left brain-damaged
(LBD), and 16 normal control right-handed adults. The facilitation
effect of ...emotional content, valence hypothesis, and relationship
between pragmatics and emotion were evaluated. Participants produced
monologues while recollecting emotional and nonemotional
experiences. Transcribed monologues were rated for appropriateness
on 6 pragmatic features: conciseness, lexical selection, quantity,relevancy, specificity, and topic maintenance. Overall,brain-damaged groups were rated as significantly less appropriate
than normals. Consistent with the facilitation effect, emotional
content enhanced pragmatic performance of LBD aphasic participants
yet suppressed performance of RBD participants. Contrary to the
valence hypothesis, RBD participants were more impaired for positive
emotions and LBD participants for negative emotions. Pragmatic
appropriateness was not strongly correlated with a measure of
emotional intensity.
