The Strengths and Difficulties Questionnaire (SDQ) is widely used in Child and Adolescent Mental Health Services (CAMHS), and has been translated into over sixty spoken languages. British Sign Language (BSL) is a visuo-gestural language, and the first language of between 50-100,000 Deaf people in the UK. Translating diagnostic tools into BSL is important to provide valid assessment of common mental health problems in Deaf signing young people. We report the process of translation from a written language (English) into a visual language (BSL) using adapted, existing methodologies. We highlight the challenges we faced, with particular reference to the difficulties in translating for a population of signing Deaf young people, followed by suggestions of how to overcome these difficulties.