Translation, Cultural Adaptation and Validation of the British Sign Language Cognitive Screening Tool Into Australian Sign Language

OBJECTIVE: The British Sign Language Cognitive Screening Test (BSL-CST) is a culturally sensitive and linguistically appropriate tool for deaf BSL signing older adults in the United Kingdom. There are no equivalent tools for Australian Sign Language (Auslan) to ensure diagnostic accuracy for Auslan signers. We aimed to translate/adapt the BSL-CST into Auslan and establish its preliminary psychometric properties. METHODS: The Auslan-CST was developed through consultation with deaf Auslan signers and Auslan interpreters, informed by evidenced-based translation standards and production guidelines. A draft version was piloted among 20 Auslan signing older adults. The finalised Auslan-CST was administered to a normative sample of 100 cognitive healthy older deaf adults (M age = 65.59, SD = 9.89) and retested (n = 10) to estimate test-retest reliability. To assess clinical discrimination, it was administered to nine deaf older adults (M age = 78.33, SD = 6.27) diagnosed with cognitive decline. RESULTS: The Auslan-CST demonstrated high test-retest reliability (Cronbach's α = 0.940) and good internal consistency (Cronbach's α = 0.799). The tool had moderate-to-strong (rs > 0.3 to < 0.6) convergent validity with other established measures of cognition (BSL-Verbal Learning Memory Test; modified Digit Span) and excellent clinical discrimination (AUC = 1.00, 95% CI [1.00, 1.00]). A total score cut-off of < 71.50 for dementia screening is proposed. CONCLUSIONS: The Auslan-CST is the first culturally aligned cognitive screening tool for deaf Auslan signing older adults. The tool has demonstrated good preliminary psychometric properties, and early results suggest it is an effective screen for cognitive impairment in this population.