Semester of Graduation
May 2026
Degree
Master of Arts (MA)
Department
Psychology
Document Type
Thesis
Abstract
Background: Deaf community members may be at an increased risk for self-injurious thoughts and behaviors (SITBs). Due to limited American Sign Language (ASL)-fluent providers, many Deaf adults receive mental health care services, including brief assessment of SITBs, through ASL interpreters. Prior research has suggested that small changes in the language of common items used to assess SITBs, specifically single-item questions, impact how patients’ respond to each item (Ammerman et al., 2021).
Aims: It is essential to understand what variation exists within ASL interpretations for single-item measures of SITBs to understand potential inaccuracies in the clinical care of these individuals. This study aimed to document the real-world variation between ASL interpreters when interpreting single-items used to assess SITBs.
Methods: A total of N=44 current or former ASL-English interpreters completed a 90-minute Zoom interview where they interpreted single-item questions from commonly used clinical assessment measures that assess suicidal ideation (SI), suicide attempts (SA), suicide planning, and non-suicidal self-injury (NSSI). Frequency of interpretation approaches were tabulated to assess variation amongst participants.
Results: ASL interpreters exhibited individual differences in their approaches to interpreting commonly used single-items. Across all items, participants inserted material into their interpretations that was not originally present in the English text of the item. Participants also omitted information from their interpretations which fundamentally changed the meaning of the item, such as 60-65% of participants omitting “purposefully” across all items assessing NSSI and 90-97% of participants omitting “some” from the phrase “with some intent to die” across all items assessing SAs.
Conclusions: The variety of approaches to interpreting suicide risk assessment single-items suggests that patients being assessed are unlikely to be receiving identical or highly similar interpretations, even if the English text for the item is presented identically across interpreters. It is possible this variation for SITB-related single-items, especially interpretation approaches which alter the fundamental meaning of a SITB-related question, may lead to misclassification for Deaf adults in clinical care settings. This is noteworthy as single-item risk assessment procedures have well-documented misclassification concerns in English speaking adults, hinting to the possibility of even higher alterations to care for Deaf adults.
Date
1-25-2026
Recommended Citation
Fowler, Halle S., "An exploratory analysis of variability in how American Sign Language (ASL) interpreters sign single-item suicide risk assessment items" (2026). LSU Master's Theses. 6280.
https://repository.lsu.edu/gradschool_theses/6280
Committee Chair
Tucker, Raymond P
LSU Acknowledgement
1
LSU Accessibility Acknowledgment
1