Adult deaf sign language users and audiology services: a scoping review on cultural competence practices

OBJECTIVE: To examine literature on cultural competence in audiology services for Deaf adult sign language users, identifying themes, evidence gaps, and systemic barriers to inclusive care. DESIGN: Scoping review following JBI methodology and PRISM-ScR guidance, with a narrative synthesis and a light-touch quality assessment. STUDY SAMPLE: Comprehensive searches in CINAHL, EMBASE, Project MUSE, PsycINFO, PubMed, and SSCI, supplemented by hand-searching and grey literature, identified 575 sources, of which 13 met inclusion criteria. RESULTS: Four themes were identified: (1) The gap between intent and practice in sign language use (2) Interpreter access: inconsistency and over-reliance; (3) Recognising Deaf signers as a cultural-linguistic minority and (4) Barriers to fostering a culturally competent environment. CONCLUSIONS: This review synthesises evidence on culturally competent audiology care for Deaf signers. Findings highlight systemic exclusion of Deaf individuals as a cultural-linguistic minority and over-reliance on interpreters, which may create superficial access without broader cultural understanding. There is a critical need for whole-service research to inform more inclusive audiology practice.