Background: The Activities-specific Balance Confidence Scale (ABC) is a widely used self-report measure to assess balance confidence and, in turn, fear of falling. It has been translated into several languages, but it is not available in American Sign Language (ASL). A high prevalence of vestibular and balance disorders among individuals who are deaf necessitates an accessible balance-related self-report measure such as ABC. Purpose: We aimed to translate and validate ABC in ASL. Research Design: A multi-phase, mixed-methods were used, including qualitative expert panel review, pilot, and psychometric analyses from a larger-scale survey. Study Sample: The study included individuals who were deaf, ASL-using, community-dwelling adults 50 years of age or older. Individuals with blindness, diagnosed cognitive impairment, or neurological conditions were excluded. Data Collection: Translated ABC, along with PROMIS-Deaf Anxiety and Depression domains, were administered to 75 participants; 36 repeated ABC. Forty-five participants also participated in vestibular and balance testing, including vestibular-evoked myogenic potentials, modified Clinical Test of Sensory Integration of Balance, Timed Up and Go, and sit to stand. Results: Internal consistency and testretest reliability were excellent, with Cronbachs 0.92 and interclass correlation r 0.89. Six- and four-item ABC (ABC-6 and ABC-4, respectively) yielded acceptable internal consistency ( 0.83 and 0.85) and good testretest reliability (r 0.90 and 0.89). Further, full and shortened ABC were significantly different between those who reported fear of falls and those who did not (p 0.001) as well as between those with a history of fall and those without, though the discriminating ability is much reduced for fall history compared to fear of falls. Full and shortened ABC were all significantly correlated with physical function and behavioral health measures but not with vestibular functions. Conclusions: ABC in ASL, both full-item and shortened, are valid measures that yield equivalent results to the original ABC and ABC-6. Clinical Relevance Statement: Clinicians can offer deaf patients who use ASL the option to complete ABC in their most accessible language.
Tamaki et al. (Thu,) studied this question.