California School for the Deaf, Fremont, California 94538, USA.
Rehabil Psychol. 2012 May;57(2):140-8. doi: 10.1037/a0028605.
The study objectives were to adapt and validate a substance use disorder (SUD) screening instrument in American Sign Language (ASL) to be used to identify those deaf individuals who have a high probability of having an SUD. The goal was to develop an accurate screening instrument that balanced sensitivity and specificity while imposing minimal response burden on respondents.
A sample of 198 deaf participants in behavioral health, family social service, and educational programs that provide specialized services for deaf individuals was interviewed to obtain clinical diagnoses for current (past 12 months) SUD according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, and completed a 42-item version of the Substance Abuse Screener in American Sign Language (SAS-ASL). We used Rasch and discriminant function analyses to reduce the instrument to 28 items, then divided the sample into a development subsample, used to formulate a scoring routine, and a validation subsample to assess correspondence with clinical diagnoses. To provide validation data on the shortened SAS-ASL, an independent sample of 62 respondents was diagnosed and completed the screener.
The SAS-ASL instrument demonstrated good person reliability (.85), sensitivity (.90), and specificity (.84) in the primary validation sample, and 100% screening accuracy with 62 respondents in the second validation sample.
The SAS-ASL provides a standardized SUD screening for the deaf population. The adaptability of the instrument to electronic administration lends itself to a continuum of technologically supported services for a high-risk population that is disenfranchised for most community-based behavioral health services.
本研究旨在将物质使用障碍（SUD）筛查工具改编并验证为美国手语（ASL）版本，以识别那些有高可能性患有 SUD 的聋人。目标是开发一种准确的筛查工具，在平衡灵敏度和特异性的同时，尽量减少对受访者的应答负担。
对参加行为健康、家庭社会服务和教育计划的 198 名聋人样本进行访谈，根据《精神障碍诊断与统计手册》第 4 版的标准，获取他们在过去 12 个月内的当前 SUD 临床诊断，并完成了 42 项美国手语物质滥用筛查器（SAS-ASL）的测试。我们使用 Rasch 和判别函数分析将工具简化为 28 个项目，然后将样本分为发展子样本，用于制定评分程序，以及验证子样本，以评估与临床诊断的一致性。为了提供关于缩短的 SAS-ASL 的验证数据，对 62 名独立受访者进行了诊断并完成了筛查。
SAS-ASL 工具在主要验证样本中表现出良好的个体可靠性（.85）、敏感性（.90）和特异性（.84），在第二个验证样本中，62 名受访者的筛查准确率为 100%。
SAS-ASL 为聋人群体提供了一种标准化的 SUD 筛查工具。该工具对电子管理的适应性使其适用于一个技术支持的服务连续体，以满足大多数社区为基础的行为健康服务无法惠及的高风险人群的需求。
