McCarthy-Alpiner Scale Form

McCARTHY-ALPINER SCALE

Michigan Department of Labor and Economic Opportunity Michigan Rehabilitation Services
Customer name*
District Office*
MRS counselor*
Date*

MonthDayYear
Date
INSTRUCTIONS:

The following questionnaire will be used to help audiologists understand what it is like to have a hearing loss and the effects of a hearing loss on your life. You are asked to give your reaction to each of the statements included in the questionnaire.

You are asked to mark your reaction to the statement with a checkmark under the appropriate response. Please give only one answer to each question.

In marking your answer, please keep in mind that ALWAYS means at all times or on all occasions. USUALLY refers to generally, commonly, or ordinarily. SOMETIMES means occasionally or on various occasions. RARELY refers to seldom or infrequently. NEVER means not ever or at no time.

If you are currently working, answer questions 19-27 based upon your most recent job. If you have never worked, check "not applicable."

All answers will be kept strictly confidential and used only to help audiologists to understand what it is like to have a hearing loss and the effect hearing loss has had on your life.

Questions*

	Always	Usually	Sometimes	Rarely	Never	Not Applicable
1. I get annoyed when people do not speak loud enough for me to hear them.
2. I get upset if I cannot hear or understand a conversation.
3. I feel like I am isolated from things because of my hearing loss.
4. I feel negative about life in general because of my hearing loss.
5. I admit to most people that I have a hearing loss.
6. I get upset when I feel that people are "mumbling".
7. I feel very frustrated when I cannot understand a conversation.
8. I feel like people in general understand what it is like to have a hearing loss.
9. My hearing loss has affected my life in general.
10. I am afraid that people will not like me if they find out I have a hearing loss.
11. I tend to avoid people because of my hearing loss.
12. People act annoyed when I cannot understand what is being said in a group conversation.
13. Strangers react rudely when I do not understand.
14. I ask a person to repeat if I do not hear or understand what they said.
15. Group discussions make me nervous because of my hearing loss.
16. People in general are tolerant of my hearing loss.
17. I am not interested in group activities because of my hearing loss.
18. My hearing loss has interfered with my job performance.
19. I cannot perform my job well because of my hearing loss.
20. My co-workers know what it is to have a hearing loss.
21. I try to hide my hearing loss from my co-workers.
22. I do not enjoy going to work because of my hearing loss.
23. I am given credit for doing a good job at work even though I have a hearing loss.
24. I feel more pressure at work because of my hearing loss.
25. My employer understands what it is like to have a hearing loss.
26. I try to hide my hearing loss from my employers.
27. My co-workers speak loudly and clearly.

(Revised and printed with the permission of the authors)

The Michigan Department of Labor and Economic Opportunity (LEO) does not discriminate against any Individual or group because of race, religion, age, national origin, color, height, weight, marital status, genetic Information, sex, sexual orientation, gender Identity or expression, political bellefs or disability.
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McCARTHY-ALPINER SCALE