Interesting and challenging topic Neelaysh. I think you've got a couple gem-like ideas in here so let me pull them out and try to polish them up for inspection. You mention challenges of recruitment and the need to engage the deaf community perspective. One productive approach might be to actively partner with folks in the deaf community for this study. There can be drawbacks to working with disease/illness-advocacy groups/communities in qualitative research but in this situation -- where you're trying to devise a new instrument -- the community expertise is likely to be much more helpful than it is a source of bias (which is the challenge). Also, their help recruiting is likely to make things go much easier on that front. The drawback: working with a community group inevitably makes things go more slowly. You need to build in a lot more time for working together collaboratively and oftentimes community groups have a slower timeline than researchers. But, in this case I think the benefits would be enormous so I would consider how you might partner together.