How do culturally Deaf people experience neuropsychological assessment?

The lack of consideration of cultural factors within neuropsychological literature
has been argued to be due to the assumption that assessment tools are
measuring universal constructs (Nell, 2000), supported by the medical
discourse with which neuropsychology has aligned itself and the subsequent
implications of neutrality. However, evidence suggests that people experience
assessments differently which may undermine the validity of the assessments.
This is increasingly likely for participants from a different culture to that in which
the assessment tool was developed, due to a greater degree of inference in any
claims made. Evidence also suggests that cognitive processes are not only
related to cultural experience, but that between-group differences increase
exponentially with increased exposure to different cultures and formal
education.
Whilst the dominant construction of deafness is that of a disability, this is in
direct contrast to many people who identify as culturally deaf, or Deaf. Whilst
Deaf culture is difficult to define, it is felt to encompass shared experiences,
traditions and beliefs and centre around a shared language, British Sign
Language (BSL), whilst also covering the heterogeneity of experience of deaf
and Deaf people.
The researcher recruited eight participants to explore how culturally Deaf
people experience neuropsychological assessment tools. Six participants were
BSL users who identified as culturally Deaf, two of whom had experience of
working with neuropsychological assessment tools. Two additional participants
had experience of working as BSL-English interpreters. A ninth participant was
recruited for the purpose of respondent validation. The data was analysed using
Grounded Theory. Categories were constructed suggesting participants
experienced the relationship with the researcher as unequal in power, due to
the researcher being hearing, a professional and seen as linked to the mental
health system and the assessment tools were experienced as lacking relevance
to the participants. These categories were understood to load upon an axial code of 'not being understood'. The details of this, along with implications for
both the assessment procedures and future research are discussed.

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