Title: Fall Prevention in ASL-Using Deaf Older Adults
The overarching goal of this project is to improve the safety, independence, and ability of the older adults
who are Deaf, Deaf Blind, Deaf Disabled, and Hard of Hearing (DDBHH) and use American Sign Language
(ASL), to participate in daily life, through fall prevention programs that are effective in reducing fall incidences
among older DDBHH adults. The incidence of falls among older adults who report being deaf is significantly
higher than among those who deny being deaf (CDC 2020). DDBHH adults who use ASL are diverse, yet unique
in that most of them have been deaf congenitally or since childhood, and that they do not share the value of
hearing sensitivity and spoken communication abilities in the same way the rest of the society, particularly the
healthcare providers, does. We lack understanding of how cultural, linguistic, and physiological differences
impact access to and relevance of resources, information, and support network; nor of the impact of life-long or
near life-long vestibular deficit on balance control and fall risk. The potential inequity for ASL using adults cannot
be addressed without gaining further understanding of these factors.
An effective fall prevention program design must consider both the physiological factors as well as the cultural
and behavioral factors impacting Deaf adults’ fall incidences; and be able to reach them at different stages of fall
prevention, including engaging older DDBHH adults in regular physical activities. Therefore, the specific aims of
this project are (1) To identify barriers and opportunities for a successful implementation of a fall prevention
wellness program targeting community-dwelling older DDBHH adults; and (2) To determine feasibility and
potential benefits of a balance exercise program delivered in ASL. For the first aim, qualitative data from eligible
older DDBHH adults will be collected, through (a) individual interviews which will be analyzed for themes re:
individual experiences with fall incidences, fall-related resources, and access to services; and (b) focus groups
to generate ideas and strategies to mitigate fall risks in this population. For the second aim, we will deliver four
8-week exercise programs over a course, each enrolling 10 community-dwelling DDBHH adults 60 years and
older. We will describe the vestibular and physical balance characteristics of the participants, adherence rate,
perceived benefits, and improvements in physical fitness among the participants.
The results of this culturally informed investigation will inform future design of fall preventative care for older
DDBHH persons, success of which will have a significant impact on older DDBHH adults’ fall incidences, health,
and quality of life. The PI, Chizuko Tamaki, AuD, PhD, is a clinician-researcher-educator who has mentored
multiple student researchers in vestibular science and serving the DDBHH community as audiologist. Dr. Tamaki
will work with Janis Cole, PhD, a Deaf researcher with background in social work and studies in cultural and
gender impact on language use; and Carol Riddick, PhD, Professor of Physical Education & Recreation Program
with extensive experience working with older adults and conducting gerontological research.