Communication Self-Assessment Scale Inventory … Self-Assessment Scale Inventory for Deaf ... The Communication Self-Assessment Scale for Deaf Adults ... standing the subtle differences

J Am Acad Audiol 2 : 164-182 (1991)

Communication Self-Assessment Scale Inventory for Deaf Adults Harriet Kaplan Scott J. Bally Fred Brandt

Abstract

The Communication Self-Assessment Scale for Deaf Adults (CSDA) evaluates difficult communication situations, their importance to the respondent, communication strategies, and communication attitudes . Scale items use simple descriptive language in active declarative form . Each scale is comprised of three or more subscales. The subject responds using a three point semantic differential based on frequency of occurrence or degree of

importance . Item analysis, factor analysis, internal consistency reliability studies, and

collection of normative data have been performed on a population of 290 deaf adults .

Key Words: Communication scale, self-assessment scale, difficult communication situa-

tions, communication strategies, communication attitudes, deaf adults

A

11 aspects of aural rehabilitation for deaf adults focus on improving the indi-vidual's communication in actual life

situations . In order to develop such a rehabili-tation program, it is necessary to determine which communication situations create diffi-culty, the importance of each situation to the client, which coping strategies are used suc-cessfully, which negative strategies need to be unlearned, and which difficulties are simply not handled. Communication style, preferred communication mode, attitudes related to com-munication, and attitudes related to hearing impairment need to be assessed .

Many communication scales are available for assessing communication difficulties, strat-egies, and attitudes of hard-of-hearing people who incurred hearing loss as adults (e.g ., Hear-ing Handicap Scale: High et al, 1964; Denver Scale of Communication Function : Alpiner et al, 1974, Alpiner, 1982 ; Hearing Measurement Scale : Noble and Atherley, 1970; Hearing Per-formance Inventory: Giolas et a1,1979, Lamb et al, 1983 ; McCarthy-Alpiner Scale of Hearing

Department of Audiology and Speech/Language Pa-thology, Gallaudet University, Washington, DC

Reprint requests : Harriet Kaplan, Department of Audl-ology and Speech/Language Pathology, Gallaudet Univer-sity, 800 Florida Ave . N .E ., Washington, DC 20002

Handicap : McCarthy and Alpiner, 1980; Com-munication Profile for the Hearing Impaired : Demorest and Erdman, 1986, 1987). Although all of these scales are useful assessment tools for their target populations, none are totally appropriate for most deaf adults for the follow-ing reasons:

1. These scales include items inappropriate for those who have never experienced normal hearing (e.g ., "I now take less of an interest in many things as compared to when I did not have a hearing problem.") .

2. Situations and attitudes that are important aspects of the deaf experience are not evalu-ated. There are no items exploring communi-cation mode preference, ability to communi-cate with people who do not use manual communication, or strategies for communi-cating with nonsigning people .

3. Many of the items contain language too vague or complex for many prelingually deaf adults . For example, the syntax of the following item can be difficult for an individual who has never experienced normal hearing: "Because I have difficulty understanding what is said to me, I sometimes answer questions wrong."

For these reasons, the Communication Self-Assessment Scale Inventory for Deaf

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Communication Scale for Deaf Adults/Kaplan et al

Adults (CSDA) was developed at Gallaudet University . It consists of four scales, which evaluate an individual's difficult communica-tion situations, importance of each situation, communication strategies, and attitudes re-lated to communication. Each scale consists of several subscales. This article describes the procedures used to develop this inventory and presents data on the various scales . Items, instructions, answer forms, scoring forms, and normative data can be found in the appendices .

CLIENT POPULATION

T he CSDA was developed using deaf mem-bers of the Gallaudet University commu-

nity and off-campus deaf adults as subjects . Demographic data on the 290 subjects used during the second part of inventory develop-ment can be found in Table 1. There were 140 males and 150 females. All had severe or pro-found bilateral sensorineural hearing losses, the vast majority of which occurred prior to age 2. Two hundred fifty-one subjects were Gallaudet undergraduates or preparatory students ; the others were graduate students, staff members, or people from the off-campus deaf community. Ages ranged from 17 to 47, with a mean of 20.9 years. All subjects were high school graduates; approximately two thirds had received their precollege education in mainstream environ-ments rather than self-contained classes for deaf students . Although most were sign lan-guage communicators, more than half reported using speech and speechreading at home, at work, or with hearing people in other situa-tions. Forty-five percent of the subjects re-ported using a hearing aid all the time, 22 percent occasionally, 31 percent not at all. The vast majority of those wearing amplification on a full-time basis reported using behind-the-ear hearing aids ; one subject used a cochlear im-plant and nine others wore binaural in-the-ear instruments.

It should be noted that most of the subjects were young and in the process of acquiring a college education. Therefore, current data col-lected on the inventory should be considered applicable to young deaf adults who have at least a high school education. Further research needs to be performed to determine whether the inventory can be generalized to deaf adoles-cents still in precollege programs, deaf adults who did not complete high school, or deaf el-derly. The normative data presented in this

Table 1 Demographic Characteristics CSDA Subjects

of

Variable Category Number of Subjects

Gender Male 140 Female 150

Onset of Deafness Birth to 2 years 245 3 to 6 years 28 6 to 12 years 6 12 to 18 years 4 After age 18 7

Educational Level Less than High School 4 High School Graduate 156 Some College 95 College Degree 35

Location of Pre- School for the Deaf 38 college Education' Mainstreamed (public 204

or private school) Special Class in 86

Public School

Communication Sign Language 154 at Home t Speech/Speech read in g 173

Communication Sign Language 271 at School t Speech/Speech read in g 91

Communication Sign Language 96 at Work t Speech/Speech reading 177

Frequency of Not At All 97 Hearing Aid Use Occasionally 63

All the Time 130

Type of Aid Behind-the-Ear 127 In-the-Ear 9 Body-Worn/Eyeglass 0 Cochlear Implant 2 None 152

N=290 . The total number exceeds 290 because some sub-

jects reported attending more than one type of school . t The total number exceeds 290 because some sub-

jects reported using more than one kind of communication in some environments .

paper should be considered local norms ; clini-cians in other environments are encouraged to collect their own normative data .

DEVELOPMENT PROCEDURES

tems for the preliminary version of the Communication Self-Assessment Scales

were written using the following procedures . Based on knowledge of the deaf population, a list of items was written to evaluate most com-

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Journal of the American Academy of Audiology/Volume 2, Number 3, July 1991

monly encountered communication situations, positive and negative management strategies, perceived attitudes and behaviors of family, friends, and others, and interpersonal and emo-tional factors related to communication. Exist-ing scales for hard of hearing adults were re-viewed to identify potentially useful items.

These items formed three scales . The Diffi-cult Communication Situations Scale included two types of items: those describing situations requiring language communication and those describing ability to hear important environ-mental sounds such as the telephone ringing and the smoke alarm sounding. The Manage-ment Strategies Scale included randomly inter-spersed positive and negative communication repair strategies, and anticipatory strategies designed to avoid potential problems . The Atti-tudes Scale consisted of items probing emo-tional factors related to communication, com-munication preferences, and perceived attitudes of hearing people . A fourth scale, Communica-tion Importance, was developed using the items ofthe Difficult Communication Situations Scale. Subjects were required to evaluate the impor-tance ofeach difficult communication situation.

Item format was modeled after the Hearing Performance Inventory (Lamb et al, 1983) and the Communication Profile for the Hearing Impaired (Demorest and Erdman, 1986, 1987). Each item described a situation, management strategy, or communication attitude using sim-ple, active declarative sentence structure and clear, unambiguous vocabulary . Embedded forms and passive constructions were avoided. The response format was a three point semantic differential, requiring the subject to indicate whether each item was true: (1) almost always ; (2) sometimes; or (3) almost never.

The Communication Importance scale used another 3-point semantic differential, namely : (1) very important to you, (2) important to you, or (3) not important to you.

Although a 5-point response scale would have allowed a larger range of responses, it was felt that a simpler 3-point response task would be more appropriate because of the English language limitations of the target population. The investigators have observed that many prelingually deaf adults have problems under-standing the subtle differences in meaning in semantic differential scales containing a larger range of choices; a small group of subjects used in this study needed special instruction to han-dle the 3-point scale used in the CSDA.

The preliminary version of the inventory consisted of 186 items. It was reviewed by a group of deaf educators and communication specialists experienced in working with pre-lingually deaf adults, and a group of Gallaudet students for language and content appropriate-ness . Vocabulary, sentence structure, and con-tent of the items were modified and pilot tested on 57 prelingually deaf adults . During the de-velopment phases, two additional response choices were included . Subjects were permitted to indicate responses of: (4) not applicable (mean-ing never experienced) or (5) do not understand.

Item analysis of the four scales was per-formed using an SPSS-X Reliability analysis program (SPSS-X, 1986). Chronbach alpha co-efficients (Chronbach et a1,1972) were obtained for each scale. For each item, the number of (1), (2), (3), (4), and (5) responses, item means, standard deviations, skewness values, item-total correlations, and what the Chronbach alpha might be if the item were deleted were calculated .

An item was deleted if there was :

1. Too narrow a distribution of responses. An item was considered unacceptable if less than 20 percent of the responses fell into any of the (1), (2), and (3) response categories . A second indicator of unacceptably narrow re-sponse distribution was a standard devia-tion smaller than 0.5 .

2. More than 10 responses of (4) or (5). 3. Extreme skewing, indicated by skewness

values of less than 0.9 . 4. Extremely high or low means. All item means

were required to fall within the range of 1.5 and 2.5 .

5 . Low item-total correlation, provided that removal of the item did not lower the coeffi-cient alpha of the scale. The goal was to maintain a maximum coefficient alpha for each scale.

Items on the Difficult Communication Situ-ations scale were eliminated if there were a large number of "not important" responses.

Each item was evaluated by the investiga-tors for its clinical usefulness . If an item dem-onstrated poor statistical characteristics but was considered clinically important, it was rewritten. Redundant items were combined or the weaker item was deleted. Ambiguous items were deleted or rewritten. As a result of the

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Table 2 Descriptive Statistics of Subscale Items

Item Number Mean SD rit Item Number Mean SD rit

Difficult Communication Situations : Sound Awareness Communication Importance : Speech Understanding--Social Alpha =

19 0.92

1 .62 1 .06 63 Alpha = 0.94

2 2.39 0.85 67 20 1 .70 1 .01 63 5 2.37 0.86 78 21 1 .66 1 .03 75 8 2.43 0 .89 72 22 1 .57 1 .07 79 9 2 .16 0.98 75 23 1 .75 1 .16 75 11 2 .43 0 .91 75 24 1 .62 1 .08 79 12 1 .85 0.98 76 25 1 .72 1 .08 75 13 2 .21 0 .94 78 26 1 .52 0 .95 .61 14 2 .50 0 .83 80 27 1 .51 1 .02 65 15 2.45 0.95 72

17 2 .49 0 .81 71 Difficult Communication Situations : Speech Intelligibility Alpha = 0.56 Communication Strategies : Expressive Repair

9 1 .64 0 .94 40 Alpha = 0.66 13 1 .65 0 .87 40 31 1 .56 0 .79 43 18 1 .62 0 .87 32 34 1 .67 0.94 40

39 1 .58 0 .73 40 Difficult Communication Situations : Speech Reception 41 1 .78 0 .97 38 Alpha = 0.81 42 1 .60 1 .07 33

1 1 .79 0 .85 35 45 1 .57 0.88 44 2 1 .93 0.88 39 3 1 .63 0.83 29 Communication Strategies : Receptive Repair 4 1 .77 0 .91 27 Alpha = 0.76 5 1 .81 1 .01 41 28 1 .58 0 .70 28 6 1 .94 1 .13 51 30 1 .57 0 .85 38 7 2.01 1 .07 50 32 1 .55 0.90 .25 8 1 .99 1 .15 46 33 1 .67 0 .79 37 10 1 .86 1 .14 .49 35 1 .69 1 .26 37 11 2.05 1 .07 45 36 1 .67 0 .94 42 12 1 .80 0.84 40 38 1 .60 1 .36 37 14 2.00 1 .03 44 43 1 .87 1 .03 38 15 1 .51 1 .27 39 46 1 .59 0 .82 34 16 1 .59 1 .12 35 48 1 .79 1 .02 37 17 1 .88 1 .11 53 51 1 .58 0 .84 34

60 1 .53 1 .29 40 Communication Importance : Sound Awareness 62 1 .54 0.97 39 Alpha = 0.96 64 1 .56 0 .89 31

16 2 .50 0 .87 69 65 1 .53 1 .15 32 19 2.06 1 .02 80 67 1 .55 0 .77 38 20 2.06 1 .00 83 21 2 .24 0.97 83 Communication Strategies : Anticipatory 22 2.29 0.96 87 Alpha = 0.77 23 2.38 0.94 84 44 1 .58 1 .01 37 24 2.35 0.92 81 49 1 .55 0 .96 25 25 2.30 0.93 78 52 1 .53 1 .05 41 26 2.49 0.87 78 53 1 .55 1 .16 34 27 2.40 0.88 80 54 1 .50 1 .24 53

55 1 .56 1 .07 48 Communication Importance: Speech Understanding-Work 56 1 .54 0.93 34 Alpha = 0.94 57 1 .54 1 .08 49

1 2 .12 0.95 77 58 1 .50 1 .08 34 3 1 .93 0.99 84 59 1 .60 1 .14 45 4 2 .31 0.90 75 64 1 .56 0 .89 24 6 2.15 0.97 85 66 1 .50 1 .01 32 7 2 .19 0.93 84 68 1 .66 1 .24 47

10 2.24 0.92 83 18 2 .13 0.94 75 (Continued on next page)


Item Number Mean SD

Table 2

rit

(continued)

Item Number Mean SD rit

Communication Strategies : Maladaptive Negative Attitudes : Anger Alpha = 0.78 Alpha = 0.75

29 1 .53 0 .80 39 74 1 .53 0.82 56 37 1 .57 0 .89 34 78 1 .56 0 .81 59 40 1 .65 0 .86 54 81 1 .51 0.82 42 47 1 .55 0 .99 49 83 1 .54 0 .91 .62 50 1 .57 1 .00 42 89 1 .68 0.94 41 61 1 .61 0 .91 60 63 1 .52 0 .91 51 Negative Attitudes : Embarrassment 69 1 .59 0 .89 49 Alpha = 0 .75 70 1 .55 0 .80 44 72 1 .50 0.82 56 71 1 .54 0 .95 53 76 1 .57 0.77 57

82 1 .58 0.65 46 Communication Attitudes : Positive 105 1 .55 0.88 59 Alpha = 0.76 107 1 .57 0.87 34

95 1 .65 0.99 26 113 1 .76 1 .00 44 96 1 .56 0.80 44 106 1 .57 0.87 28 Negative Attitudes : Self Concept 108 1 .76 0 .91 53 Alpha = 0.81 109 1 .53 0.78 48 73 1 .56 0.84 53 110 1 .88 0.96 57 75 1 .63 0.76 51 111 1 .50 0.86 37 80 1 .63 0.76 48 112 2.17 0.95 27 84 1 .53 0.78 .39 114 1 .52 0.92 47 85 1 .59 0.80 61 115 1 .56 0.86 47 86 1 .50 0.69 58

87 1 .55 0.70 57 Communication Attitudes : Negative Alpha = 0.89 Communication Attitudes : Perceived Family Attitudes

72 1 .50 0.82 56 Alpha = 0.79 73 1 .56 0.84 58 79 1 .70 1 .07 33 74 1 .53 0.82 59 88 1 .51 0 .80 54 75 1 .65 0.82 59 92 1 .57 0.86 58 76 1 .57 0.77 61 94 1 .52 0.89 55 78 1 .56 0 .81 57 99 1 .58 0.92 58 80 1 .63 0.76 55 100 1 .59 0.87 58 81 1 .51 0.82 47 109 1 .53 0.78 45 82 1 .50 0.64 53 111 1 .58 0.86 46 83 1 .54 0 .91 54 84 1 .53 0.78 40 Communication Attitudes : Perceived Non-family Attitudes 85 1 .59 0.80 61 Alpha = 0.75 86 1 .50 0.69 52 77 1 .64 0.92 47 87 1 .55 0 .70 56 90 1 .54 0.86 58 89 1 .68 0 .94 53 91 1 .50 0 .81 57 97 2.14 0 .95 53 93 1 .54 0 .91 38 104 1 .50 0 .80 25 98 1 .60 0.77 14 105 1 .55 0 .88 56 101 1 .64 0 .81 50 107 1 .57 0 .87 33 102 1 .52 0.82 46 113 1 .76 1 .00 47 105 1 .53 0.88 46

N = 290 . rit indicates the item-total correlation between each item and the mean of the other items in that particular subscale .

initial item analysis, the inventory was reduced to 142 items, comprising three scales . The items of the Difficult Communication Situations scale also constituted the items for the Communica-tion Importance scale.

The 142-item Inventory was then given to the 290 prelingually deaf subjects described in Table 1. As a result of a second item analysis

based on the same criteria used for the first, additional items were deleted.

The current inventory consisting of 115 items was then divided into subscales to meas-ure different aspects of communicative func-tion . The subscales were constructed using a priori assumptions in a fashion similar to that used with the Hearing Performance Inventory

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Table 3 Internal Consistency Reliability for the CSDA Scales and Subscales

Number of Items

Scale

Alpha SE

Difficult Communication 27 0.86 0.06 Situations

Communication Importance 27 0.98 0 .03 Communication Strategies 44 0.89 0 .04 Communication Attitudes 44 0 .91 0 .05

Subscale

Difficult Communication Situations Sound Awareness 9 0.92 0 .04 Speech Intelligiblity 3 0.56 0 .05 Speech Reception 15 0 .81 0 .09

Communication Importance Sound Awareness 10 0.96 0 .04 Understanding at Work 7 0.94 0 .03 Understanding Socially 10 0.94 0 .06

Communication Strategies Expressive Repair 6 0.66 0.16 Receptive Repair 16 0.76 0.17 Anticipatory/Environmental 13 0.77 0.09 Maladaptive 10 0.78 0.05

Communication Attitudes Positive Attitudes 10 0.76 0.13 Negative Attitudes 20 0.89 0.09 Anger/Annoyance 5 0.75 0.09 Negative Self Concept 7 0 .81 0.09 Embarrassment 6 0.75 0.13

Perceived Family Attitudes 8 0.79 0.10 Perceived Non-family Attitudes 8 0.75 0.06

N = 290 .

standard errors (SE) for the four major scales and the 17 subscales. Note that for all subscales except for Speech Intelligibility and Expressive Repair the alpha coefficients are above 0.75. The investigators believe that the lower reli-ability coefficients for these two scales may reflect the small number of items in each one and are in the process of adding items. It is felt, however, that these subscales are clinically useful in their present form ; data can be inter-preted on an item by item basis.

Table 4 shows normative data for the four scales and the subscales based on the study population . The norm for each scale or subscale has been defined as the mean ± one standard deviation.

DESCRIPTION OF SCALES AND SUBSCALES

A pendix A contains the 115 items of the 7SDA, divided into three sections : Diffi-

cult Communication Situations, Communica-tion Strategies, and Communication Attitudes. Instructions are included . Appendix B contains the answer form and Appendix C contains the Communication Scale scoring form, which clearly shows which items belong to which subscales. Scale norms in profile form can be

Table 4 Normative Data for CSDA Scales and Subscales

(Giolas et a1,1979) . The items within each scale were allocated to specific subscales based on content. Principal components factor analysis, using an SPSS-X factor analysis program (SPSS-X, 1986), was then performed to determine whether the items assigned to these specific subscales clustered together (showed high eigenvalues) . As a result of the factor analysis, some items were reassigned to other subscales, after which additional factor analysis was per-formed .

A reliability analysis was performed on the final set of subscales to obtain subscale coeffi-cient alphas and item-total correlations ; in-spection ofitem-total correlations revealed that for none of the subscales would elimination of items increase coefficient alpha. Item means, standard deviations (SD), and item-total corre-lations (rit) may be found in Table 2. Table 3 shows the number of items, the internal con-sistency reliability coefficients (alphas), and

Scale or Subscale Mean SD Norms

Difficult Communication 1 .73 0.19 1 .54-1 .92 Situations

Communication Importance 2.40 0.78 1 .62-3.18 Communication Strategies 1 .50 0.15 1 .35-1 .65 Communication Attitudes 1 .45 0 .24 1 .21-1 .69 Sound Awareness 1 .97 0 .59 1 .38-2 .55 Speech Intelligibility 1 .90 0 .62 1 .28-2 .51 Speech Reception 2.24 0 .39 1 .86-2 .63 Importance-Sound Awareness 2 .31 0 .80 1 .51-3 .11 Importance -Understanding/Work 2.15 0 .81 1 .35-2.96

Importance -Understanding/Social 2.33 0 .72 1 .62-3 .05

Expressive Repair 1 .77 0 .47 1 .31-2.25 Receptive Repair 1 .89 0 .35 1 .54-2.24 Anticipatory/Environmental 1 .99 0.41 1 .58-2.40 Maladaptive Strategies 1 .70 0 .40 1 .30-2.09 Positive Attitudes 1 .87 0 .44 1 .43-2 .31 Negative Attitudes 1 .65 0 .34 1 .31-1 .99 Anger 1 .67 0 .48 1 .19-2.15 Embarrassment 1.60 0.44 1 .16-2.04 Negative Self Concept 1 .58 0 .41 1 .17-1 .99 Perceived Family Attitudes 1 .66 0 .39 1 .26-2.05 Perceived Non-family Attitudes 1 .70 0.36 1 .34-2.05

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found in Appendix D. No one item is used in more than one scale, allowing scales to be used independently of each other. The only exception is the Communication Importance scale, which must be used with the Difficult Communication Situations scale. Within the Difficult Commu-nication Situations and Strategies scales, each item is used in only one subscale . In the Atti-tudes scale, however, some items are used in several different subscales.

Difficult Communication Situations

This scale consists of 27 items, divided into the following 3 subscales:

1. Sound Awareness. This 9-item subscale probes whether the client has difficulty hear-ing a person's voice or specific critical envi-ronmental sounds such as the doorbell or the telephone ring in situations that pose mini-mal difficulty for normal hearing people .

2. Speech Intelligibility. This 3-item sub-scale evaluates how well the client's speech is understood by other people.

3 . Speech Reception. This 15-item subscale probes difficulties the client may experience understanding other people in a variety of situations that pose minimal difficulty for normal hearing people .

Communication Importance

Although the Communication Importance scale is based on the same items as the Difficult Communication Situations scale, the subscales are slightly different. The Communication Im-portance scale is divided into the following three subscales:

Communication Strategies

The Communication Strategies scale con-sists of 44 items, each describing an actual or potential communication breakdown and a spe-cific communication strategy to prevent or re-pair the breakdown. The scale is divided into the following four subscales:

1. Expressive Repair Strategies . This 6-item subscale evaluates the client's use of repair strategies to help other people under-stand his or her speech . A sample item is "A person asks you for your name . He does not understand your speech. You spell your name."

2. Receptive Repair Strategies. This 16-item subscale evaluates use of repair strate-gies such as repetition, rephrasing, or confir-mation to help the client understand the speech of other people . A sample item is "You ask a stranger for directions . You under-stand part of what he says . You tell him the part you understand and ask him to repeat the rest."

3. Anticipatory/Environmental Strategies . This 13-item subscale consists of strategies to try to prevent communication difficulty . An example is "You are going to a job inter-view . You act out the situation in advance with a friend to prepare yourself for the experience ."

4. Maladaptive Communication Strate-gies . This 10-item subscale describes inap-propriate communication strategies such as bluffing, avoidance, or belligerent behavior that the client might use to resolve or avoid communication difficulties . These strategies suggest ineffective handling of communica-tion difficulties, not abnormal or deviant interpersonal behaviors.

Communication Attitudes

1. Sound Awareness. This 10-item subscale evaluates the importance to the client of being able to hear specific environmental sounds .

2. Understanding at Work. This 7-item subscale evaluates the importance to the client of understanding and being under-stood in work or classroom situations .

3 . Understanding in Social Situations. This 10-item subscale evaluates the importance to the client of understanding and being understood in non-work or non-school situa-tions such as a restaurant .

The Communication Attitudes scale con-sists of 44 items that evaluate the client's atti-tudes toward hearing loss, toward himself or herself as a deaf or hard of hearing person, and the client's perception of other people's atti-tudes. The scale is divided into the following subscales:

1. Positive Attitudes. This 10-item subscale describes positive attitudes toward commu-nication such as "I don't mind repeating when other people have trouble understand-ing my speech."

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2. Negative Attitudes. The subscale consists of 20 items describing negative attitudes and feelings about communication. An example of such an item is "It's hard for me to ask someone to repeat things . I feel embarrassed." The subscale can be used as a whole or further divided as follows:

a) Anger/Annoyance, consisting of 5 items; b) Negative Self Concept, consisting of

7 items; and c) Embarrassment, consisting of 6 items.

3. Perceived Attitudes of Family . This 8-item subscale consisting of items such as "My family understands my hearing loss," probes the client's perceptions about deaf-ness-related attitudes and behaviors of family.

4. Perceived Attitudes of Non-Family. This 8-item subscale consisting of items such as "Most people think I could understand better if I paid more attention," probes the client's perceptions ofdeafness-related attitudes and behaviors of people who are not family mem-bers .

SCORING AND INTERPRETATION

A high score on a scale or subscale indicates a high degree of communication difficulty. Although for most of the items, responses of (1, almost always) indicate little communicative difficulty, for some of the subscales (1, almost always) signifies a high degree of difficulty . An example of such a subscale is Sound Awareness, which consists of items such as "I have trouble hearing the phone ring when I am in the same room." To keep response interpretation consist-ent, the examiner must reverse the scoring for these subscales, (e.g., a response of 1 is changed to 3), so that a high score always indicates a high degree of difficulty .

To facilitate the scoring procedure, a Scor-ing Form has been developed to help determine a client's scores for each subscale. This form, shown in Appendix C, is arranged categorically by the scales and subscales of the inventory and shows the items in each subscale . The examiner records each item score in the appropriate box and computes an average for that subscale . After the subscale scores have been computed, they may be plotted on the Communicative Profile Forms, which can be found in Appendix D . Normative data for each subscale, based on the population described in Table 1, are repre-sented by the boxes on the forms. A client's scores may be compared to the norms, so that

specific areas of difficulty that need to be ad-dressed can be seen . In addition, subtest scores may be compared to each other to show patterns of strengths and weaknesses .

Sample Case

JG is a 21-year-old prelingually deaf male who does not use a hearing aid at present. His scores on the various subtests of the CSDA appear in Figures 1, 2, and 3 . Analysis of these scores suggests the following:

1. JG's scores for Sound Awareness and Speech Reception, shown in Figure 1, are higher than the norms, suggesting that he is having difficulty hearing environmental sounds and understanding the speech of other people . His high importance scores for both subscales indicate that he considers these situations important to him. Since the normative data for the Importance subscales cover a large range, interpretation of absolute subscale scores is of greater clinical use than compari-son to the norms. The scores suggest that it is important to the client to develop strate-gies to overcome these difficulties .

2. Apparently JG is having less difficulty ex-pressively than receptively . Perhaps his score on the Expressive Repair subscale, shown in Figure 2, can at least partially explain that result . His use of expressive strategies is well within the norms, suggesting that he is doing a good job clarifying difficulties other people might experience understanding his speech .

3. In contrast, Figure 2 shows that his Recep-tive Repair and Maladaptive Communica-tion Strategies scores are higher . than the norms, suggesting the need to help JG de-velop more positive strategies to overcome problems understanding others and substi-tuting these strategies for his current nega-tive behaviors such as avoidance of commu-nication situations and manipulation of con-versation.

4. Figure 3 reveals a high score in Negative Attitudes, specifically Embarrassment and Negative Self Concept; scores on the Anger subscale are well within the norms and sig-nificantly below the other two subscales con-stituting Negative Attitudes. His high score on the Positive Communication Attitudes subscale is barely within the norms, suggest-ing difficulty in that area .

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Scale Norms - Difficult Comm Situations

Figure 1 Subscale norms and client scores for the Difficult Communication Situations and Communication Importance Scales of the Communication Self-Assess-ment Scales for Deaf Adults .

Scale Norms - Comm Strategies 3

2.5

2

1 .5

Exp Repair Rec Repair Ant Env Maladapt Strat

Figure 2 Subscale norms and client scores for the Communication Strategies scale of the Communication Self-Assessment Scales for Deaf Adults .

Scale Norms - Attitudes

Figure 3 Subscale norms and client scores for the Communication Attitudes scale of the Communication Self-Assessment Scales for Deaf Adults .

5. Although the relatively low score on Per-ceived Attitudes of Family suggests little communicative difficulty with family, the same is not true for non-family members. The high score on the Perceived Attitudes of Non-Family suggests the need to focus on improving communication with people out-side the family .

The information obtained from JG's CSDA scores can be used to plan therapy for remed-iation of specific areas of difficulty . The rehabilitationist may choose to refer to specific items within one or more of the scales to obtain more specific information. The information ob-tained from the scales may result in evaluation of hearing aids and assistive devices to improve receptive skills, speechreading or auditory train-ing if appropriate, training to improve receptive repair strategies and reduce inappropriate com-munication strategies, and counseling to em-phasize positive attitudes and perceptions about communication.

DISCUSSION

T he Communication Self-Assessment Scale Inventory for Deaf Adults may be used in

several ways .

Baseline Data

Results may be used to establish baseline data to focus rehabilitative efforts on reinforce-ment of strengths and remediation of weak-nesses . Subscale scores can be used to identify specific areas of difficulty to target in therapy. The Sample Case discussed in the previous section is an illustration ofthis type ofuse ofthe inventory.

Counseling

Display of a client's scores on the profile form makes it very clear to the client where strengths and weaknesses lie; the client can be helped to understand better how he or she functions communicatively. Subscale scores may be compared to each other and/or to norma-tive data . A client's responses on individual items of a particular subscale may be discussed if that is considered useful by the clinician to facilitate rehabilitation goals.

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The investigators feel that communication related counseling is within the boundaries of the aural rehabilitationist's services . The cli-ent's responses to items on the Communication Self-Assessment Scale Inventory, particularly questions about attitudes and communication strategies, can facilitate such counseling . It is also the responsibilityofthe aural rehabilitationist to refer a client to a counselor or psychologist, should attitudinal problems outside the realm of communication surface during therapy. Re-sponses to scale items and subsequent discus-sion can help determine when communication boundaries have been crossed and referral is suggested.

Research

The scales may be used to compare sub-groups within the target population . Several studies are in process, including comparison of: prelingually deaf subjects from mainstream and non-mainstream environments, hearing aid and non-hearing aid users, and subjects reporting use of speech and speechreading in the home with those reporting use of sign lan-guage only . Effects of gender are also being evaluated. Results of these studies will be re-ported in a future paper.

The scales may be used to evaluate results of intervention procedures . For the most part, internal consistency is high ; for all the scales and most of the subscales correlation coeffi-cients exceed 0.75. Test-retest reliability will be evaluated in a future study.

These scales were standardized and normed on a prelingually deaf young adult population . Local norms should be developed for other populations such as prelingually deaf adoles-cents, prelingually deaf adults with less than a completed high school education, or postlingually deafened adults .

SUMMARY

W e consider the Communication Self-As-sessment Scale Inventory for DeafAdults a useful tool for the development of relevant rehabilitation programs . The information ob-tained from the four scales may be used for counseling, planning specific intervention strat-egies, and evaluation . The inventory has been standardized on prelingually deaf adults with


at least a high school education from a variety of communication and educational backgrounds.

Acknowledgment. Development of the Communica-tion Self Assessment Scales for Deaf Adults was partially funded by the Gallaudet Research Institute. The authors would like to acknowledge the assistance of Marilyn Demorest, University of Maryland and Judith A. Holt and Carol Traxler, Center of Assessment and Demographic Studies, Gallaudet Research Institute, for help with test construction . We would like to give special thanks to the following aural rehabilitationists from Gallaudet Univer-sity for their assistance with scale development and data collection : Judith Bergan, Linda Frazier, Mary Hughes, Janet Kurtz, Mary Kinsella Meier, Mary June Moseley, Beth Singer, and Mary Pat Wilson . In addition, we would like to thank the following Gallaudet graduate students for their help : Lauri Jackson, Susan Jacoby, Carol Powell, Cecilia Rieman, and Elizabeth Wigginton.

Development of the Inventory was partially funded by a grant from the Gallaudet University Research Insti-tute .

Portions of this paper were presented at the 1989 meeting of the American Speech Language and Hearing Association and at the 1990 meeting of the American Academy of Audiology.

REFERENCES

Alpiner JG, Chevrette W, Glascoe G, Metz M, Olsen B. (1974) . The Denver Scale of Communication Function . University of Denver: Unpublished Manuscript.

Alpiner JG . (1982) . Handbook of Adult Rehabilitative Audiology. Baltimore: Williams & Wilkins, 41-46, 193-205.

Cronbach LJ, Gleser GC, Nanda H, Rajaratnam N. (1972) . The Dependability of Behavioral Measurements: Theory ofGeneralizability for Scores and Profiles. NewYork:Wiley .

Demorest ME, Erdman SA . (1986) . Scale composition and item analysis of the Communication Profile for the Hear-ing Impaired . J Speech Hear Res 29(4):515-535 .

Demorest ME, Erdman SA. (1987) . Development of the Communication Profile for the Hearing Impaired . JSpeech Hear Disord 52(2):129-142 .

Giolas TG, Owens E, Lamb SH, Schubert ED . (1979) . Hearing Performance Inventory. J Speech Hear Disord 44:169-195 .

High WS, Fairbanks G, Glorig A. (1964) . Scale for Self-Assessment of Hearing Handicap . J Speech Hear Disord 29:215-230.

Lamb SH, Owens E, Schubert ED . (1983) . The revised form of the Hearing Performance Inventory. Ear Hear 4:152-157 .

McCarthy PA, Alpiner JG . (1980) . The McCarthy-Alpiner Scale of Hearing Handicap . Unpublished study.

Noble WG, Atherley GRC. (1970) . The Hearing Measure-ment Scale: a questionnaire for the assessment of audi-tory disability . JAud Res 10:229-250.

SPSS-X. (1986) . Statistical Package for the Social Sci-ences. 2nd Ed . Chicago: SPSS-X Inc.

Journal of the American Academy of AudiologyNolume 2, Number 3, July 1991

APPENDIX A: Communication Scale Instructions and Items

Instructions

We want to find out how your hearing loss affects your daily life. The following questions are about different communication situations, ways of managing situations, and attitudes about different situations .

Some of the items ask you whether you understand conversation . The word "understand" means knowing enough of what is said or signed to be able to answer appropriately. Always assume you are interested in what is being said .

We know that some people are easier to understand than others. Please answer the questions according to the way most people talk to you or understand you. We know that sounds and speakers vary . Please answer the questions as best you can.

If you wear a hearing aid, answer the questions as though you were wearing your aid.

Section I-Difficult Communication Situations

Please read each situation. Decide if the situation is true : 1) Almost always, 2) Sometimes, or 3) Almost never. If you have not experienced this situation DO NOT answer the question . GO on to the next question .

Then indicate if the situation is : 1) Very Important to you, 2) Important to you, 3) Not Important to you.

1. 2. 3.

4.

5.

6.

7.

8.

9 .

10 .

11.

12 .

13 .

14 . 15 .

You are in class. The teacher is easy to lipread but is not signing. You understand You meet a stranger on the street and ask for directions . He does not sign . You understand him You are at work. It is quiet. Your supervisor gives you an order. She is not signing but her face is clearly visible. You understand her You are at work. It is noisy. A hearing co-worker asks you to eat lunch with her. She does not sign but you can see her face . You understand her You are visiting a friend . His hard-of-hearing child speaks to you about his school . The child does not sign . You understand You are at a meeting. A hearing person speaks but does not sign. You know the subject. You understand You are in class. A hearing person speaks but does not sign . You know the subject. You understand You are at the dinner table at home . All your relatives are hearing. Your grandmother is talking. She does not sign . You do not know the topic. You understand her You are introduced to a hearing person . You sign and speak at the same time . He understands you You are at a meeting with five hearing people . No one signs but everyone's face can be seen. One person talks at a time . You understand the conversation You are watching a movie on television. There is no captioning . It is quiet in the room . You understand You are talking to the doctor . It is quiet. She does not sign . You can see her face clearly. You understand her You are ordering lunch at McDonald's . You speak to the person behind the counter. She understands you You are talking to one person at a noisy party. The person does not sign . You understand You are talking to a family member on the telephone. It is quiet in the room. You understand

174


16 . You are reading in a quiet room . Someone calls you from the next room . You hear the person's voice

17 . You are sitting in a car next to the driver . The driver is talking. He is not signing. You understand him

18 . You must give directions to hearing people at work . They understand your speech 19 . 1 have trouble hearing fire alarms in buildings when other people can hear them . 20 . I have trouble hearing fire engines and ambulances when other people can hear them . 21 . 1 have trouble hearing cars or buses when other people can hear them . 22 . I have trouble hearing the telephone ring when I am in the same room . 23 . I have trouble hearing the telephone ring when I am in the next room . 24 . 1 have trouble hearing the doorbell when other people can hear it. 25 . 1 have trouble hearing a knock on the door when other people can hear it . 26 . I have trouble hearing music when it is loud enough for other people . 27 . I have trouble hearing a person's voice when he is talking in the same room .

Section 11-Communication Strategies

Please read each situation . Decide if the situation is true : 1) Almost always, 2) Sometimes, or 3) Almost never. If you have not experienced this situation DO NOT answer the question . Go on to the next question .

28 . You are talking with someone you do not know well . You do not understand . You ask her to repeat.

29 . You are talking with two people . You are not understanding. You change the topic so that you can control the conversation .

30 . You ask a stranger for directions . You understand part of what he says. You tell him the part you understand and ask him to repeat the rest .

31 . You answer a question but the other person doesn't understand . You repeat the answer. 32 . You are at work . Your boss gives you instructions . You do not understand . You ask him to say

the instructions in a different way. 33 . A friend introduces you to a new person . You do not understand the person's name. You ask the

person to spell her name . 34 . A person asks you for your name. He does not understand your speech . You spell your name . 35 . A stranger spells his name for you. You miss the first two letters. You ask him to say each letter

and a word starting with each letter. (A as in Apple, B as in Boy) . 36 . A person tells you his address. You do not understand . You ask him to repeat the street number,

one number at a time . 37 . You are talking with one person but are not understanding. You interrupt the person before he

finishes to say what you think. 38 . Your friend asks you to buy seven hamburgers . You do not understand how many he wants. You

ask him to start counting from zero and stop at the correct number . 39. You are in a restaurant. The waitress does not understand what you want . You point to the item

on the menu. 40. You are in class . The teacher says something you do not understand . You pretend to understand

and hope to get the information from the book later. 41 . You are at the dinner table with your family . Someone does not understand you. You say the

same thing a different way. 42 . Someone who does not sign asks you for your phone number . You say each number and show

the correct number of fingers as you speak. 43 . Two people are talking. You do not understand the conversation . You ask them to tell you the

topic. 44 . You are talking with one person in a restaurant . His face is in the shadows. You know you could

understand better if you changed seats with him. You ask to change seats.

175

Journal of the American Academy of AudiologyNolume 2, Number 3, July 1991

45 . You are at the airport. You want to buy a ticket for a flight home . The clerk does not understand

you. You write the information. 46 . You are visiting the doctor . He tells you what to do for your sickness . You do not understand

his speech . You ask him to write. 47 . You are at a meeting. The speaker does not look at you when he talks. You feel angry but do

nothing about it . 48 . You meet a deaf friend who is with another person . The other person talks to you but does not

sign . You ask her to sign . 49 . You are at a meeting. You realize you are too far from the speaker to understand. There are

empty seats in the front of the room . You change your seat . 50 . You are at a meeting at work . You are the only deaf person . You are afraid that you will not

understand but you do not ask for help . You do the best you can. 51 . You are talking to the dentist. He speaks very fast . You cannot lipread him. You ask him to slow

down . 52 . You are in class. The teacher talks while she writes on the board. You talk to her after class .

You explain that you need to see her face in order to speechread. 53 . Your teacher likes to move around the room while she teaches. You have problems reading her

signs. You ask her after class to lecture from one place so you can understand her signing.

54 . You are going to a series of meetings or lectures . The speaker does not sign . You ask the speaker to use the slides, pictures or the overhead projector whenever possible .

55 . You are going to a series of meetings or lectures . The speaker does not sign . You ask him to find a person to take notes for you.

56 . You are going to a series of meetings or lectures . The speaker does not sign . You ask for an interpreter.

57 . You are going to a series of meetings or lectures . The speaker does not sign . You ask for an outline or a reading list .

58 . You are going to a play . It will not be signed . You read the play or reviews of the play before you see it .

59 . You are going to a job interview. You act out the situation in advance with a friend to prepare yourself for the experience .

60 . You are talking with a clerk at the bank . A fire truck goes by . You ask him to stop talking until the noise stops .

61 . You ask a person to repeat because you don't understand . He seems annoyed. You stop asking and pretend to understand .

62 . You ask a stranger for directions to a place. You really want to understand his speech . You ask

very specific questions like ; "Is this place north or south of here? Do I turn left or right at the

corner?" 63 . You need to ask directions . You avoid asking a stranger because you think you will have trouble

understanding him. 64 . You must make a phone call to a hearing person . The person does not have a TDD. You ask a

hearing friend to make the call and interpret for you. 65 . You are at a store. You have trouble hearing the clerk because his voice is soft . You explain you

are hearing impaired and ask him to talk louder . 66 . You are at home . You ask your family to get your attention before they speak to you.

67 . You are with five or six friends. No one is signing. You miss something important. You ask the

person next to you what was said . 68 . You have trouble understanding a man who is chewing gum. You explain that you need to

speechread . You politely ask him to remove the gum when he talks. 69 . You try to avoid people when you know you will have trouble hearing them. 70 . You hate to bother other people with your hearing problem. So, you pretend to understand.

71 . 1 avoid wearing my hearing aid because it makes me feel different.


Section III-Attitudes

Please read each situation. Decide if the situation is true : 1) Almost always, 2) Sometimes, or 3) Almost never. If you have not experienced this situation DO NOT answer the question . Go on to the next question .

72 . I feel embarrassed when I don't understand someone. 73 . I get upset when I can't follow a conversation. 74 . 1 become angry when people do not speak clearly enough for me to understand . 75 . I feel stupid when I misunderstand what a person is saying . 76 . It's hard for me to ask someone to repeat things . I feel embarrassed. 77 . Most people think I could understand better if I paid more attention. 78 . I get angry when people speak too softly or too fast . 79 . Sometimes I can't follow conversations at home . I still feel a part of family life . 80 . I feel frustrated when I try to communicate with hearing people . 81 . Most hearing people do not understand what it is like to be deaf. This makes me angry. 82 . I am ashamed of being hearing impaired . 83 . I get angry when someone speaks with his mouth covered or with his back to me. 84 . I prefer to be alone most of the time . 85 . I am uncomfortable with people who communicate differently than I do . 86 . My hearing loss makes me nervous. 87 . My hearing loss makes me feel depressed. 88 . My family understands my hearing loss . 89 . I get annoyed when people shout at me because I have a hearing loss . 90 . People treat me like a stupid person when I don't understand their speech . 91 . People treat me like a stupid person when they don't understand me. 92 . Members of my family don't get annoyed when I have trouble understanding them . 93 . People who know I have a hearing loss think I can hear when I want to . 94 . Members of my family don't leave me out of conversations . 95 . Hearing aids don't always help people understand speech but they can help in other ways . 96 . I feel speechreading (lipreading) is helpful to me. 97. I feel the only useful communication system for a deaf person is sign language . 98 . Even though people know I have a hearing loss, they don't help me by speaking clearly or

repeating. 99 . My family is willing to make telephone calls for me. 100. My family is willing to repeat as often as necessary when I don't understand them . 101. Hearing people get frustrated when I don't understand what they say. 102. Hearing people get embarrassed when they don't understand my speech . 103. Hearing people pretend to understand me when they really don't. 104. I feel the only useful communications system for a deaf person is speech and lipreading. 105. I feel embarrassed when hearing people don't understand my speech . 106. I do not mind repeating when people have trouble understanding my speech . 107. 1 prefer to write when I communicate with hearing people because I am ashamed of my speech . 108 . I feel that most hearing people try to understand my speech . 109. I feel that my family tries to understand my speech . 110. I feel that strangers try to understand my speech . 111 . Members of my family make it easy for me to speechread them . 112. Strangers make it easy for me to speechread them. 113. 1 am embarrassed to use my voice in public . 114. I would like to improve my speech . 115. 1 would like to improve my speechreading ability.


Identifying Information

Name: Last First

Social Security #

Middle Initial

Age

(Gallaudet Student use ID Number)

Sex 0 Male El Female

When did you become deaf? Education 1) Birth - 2 years of age 0 1) Less than High School

0 2) Age 3 - 6 years of age F-1 2) High School Graduate

0 3) Age 6 - 12 years of age 0 3) Some College 0 4) Age 12 - 18 years of age El 4) College undergraduate El 5) After age 18 0 5) Postgraduate

El 6) Ph.D .

Degree

How long did you attend each of the following : (Enter 0 if you did not attend and .5 if you attended less than a full year.)

Residential School for the Deaf year(s) MO. Private School for the Deaf year(s) MO. Public School - Mainstreamed year(s) MO. Public School - Special Class year(s) MO. Private School - Mainstreamed year(s) MO. Private School - Special Class year(s) MO.

How long did you attend each of the following: (Enter 0 if you did not attend and .5 if you attended less than a full year .)

Gallaudet University year(s) MO. National Technical Institute for the Deaf year(s) MO. Other program for Hearing Impaired year(s) MO. Hearing Jr . College, College or University year(s) MO. Program not specifically for Hearing Impaired year(s) MO.

How do you communicate most of the time : At Home: Ej ASL 0 PSE 7 Speech At School : ASL 0 PSE 0 Speech At Work: 0 ASL Ll PSE El Speech In the Community: ASL El PSE El Speech

How often do you use a hearing aid now? Type of aid currently in use: 0 1) Do Not own a Hearing Aid 7 1) Behind-the-ear aid 0 2) Not at all F-] 2) In-the-ear aid 7 3) Occasionally 3) Body-worn or eyeglass aid El 4) All the time 4) Vibrotactile aid

5) Cochlear Implant Do you wear an aid in :

0 One ear F-1 Both ears

Indicate the degree of your hearing loss :

0 1) Mild 7 2) Moderate 0 3) Severe 0 4) Profound

178


APPENDIX B: Communication Scale Answer Sheet

Name:

Social Security #

Section I Difficult Communication Situations

Response Scale for Communication Response Scale for Importance 1) A lmost Always True 1) Very Important 2) Sometimes True 2) Important 3) Almost Never True 3) Not Important

1) 1 2 3 1 2 3 15) 1 2 3 1 2 3 2) 1 2 3 1 2 3 16) 1 2 3 1 2 3 3) 1 2 3 1 2 3 17) 1 2 3 1 2 3 4) 1 2 3 1 2 3 18) 1 2 3 1 2 3 5) 1 2 3 1 2 3 19) 1 2 3 1 2 3 6) 1 2 3 1 2 3 20) 1 2 3 1 2 3 7) 1 2 3 1 2 3 21) 1 2 3 1 2 3 8) 1 2 3 1 2 3 22) 1 2 3 1 2 3 9) 1 2 3 1 2 3 23) 1 2 3 1 2 3

10) 1 2 3 1 2 3 24) 1 2 3 1 2 3 11) 1 2 3 1 2 3 25) 1 2 3 1 2 3 12) 1 2 3 1 2 3 26) 1 2 3 1 2 3 13) 1 2 3 1 2 3 27) 1 2 3 1 2 3 14) 1 2 3 1 2 3

Section II Communication Strategies

1) Almost Always True 2) Sometimes True 3) Almost Never True

28) 1 2 3 50) 1 2 3 29) 1 2 3 51) 1 2 3 30) 1 2 3 52) 1 2 3 31) 1 2 3 53) 1 2 3 32) 1 2 3 54) 1 2 3 33) 1 2 3 55) 1 2 3 34) 1 2 3 56) 1 2 3 35) 1 2 3 57) 1 2 3 36) 1 2 3 58) 1 2 3 37) 1 2 3 59) 1 2 3 38) 1 2 3 60) 1 2 3 39) 1 2 3 61) 1 2 3 40) 1 2 3 62) 1 2 3 41) 1 2 3 63) 1 2 3 42) 1 2 3 64) 1 2 3 43) 1 2 3 65) 1 2 3 44) 1 2 3 66) 1 2 3 45) 1 2 3 67) 1 2 3 46) 1 2 3 68) 1 2 3 47) 1 2 3 69) 1 2 3 48) 1 2 3 70) 1 2 3 49) 1 2 3 71) 1 2 3

179


Section III Communication Attitudes

1) Almost Always T 2) Sometimes True 3) Almost Never Tr

rue

ue

72) 1 2 3 94) 1 2 3 73) 1 2 3 95) 1 2 3 74) 1 2 3 96) 1 2 3 75) 1 2 3 97) 1 2 3 76) 1 2 3 98) 1 2 3 77) 1 2 3 99) 1 2 3 78) 1 2 3 100) 1 2 3 79) 1 2 3 101) 1 2 3 80) 1 2 3 102) 1 2 3 81) 1 2 3 103) 1 2 3 82) 1 2 3 104) 1 2 3 83) 1 2 3 105) 1 2 3 84) 1 2 3 106) 1 2 3 85) 1 2 3 107) 1 2 3 86) 1 2 3 108) 1 2 3 87) 1 2 3 109) 1 2 3 88) 1 2 3 110) 1 2 3 89) 1 2 3 111) 1 2 3 90) 1 2 3 112) 1 2 3 91) 1 2 3 113) 1 2 3 92) 1 2 3 114) 1 2 3 93) 1 2 3 115) 1 2 3

APPENDIX C: Communication Scale Scoring Form

Difficult Communication Situations

Sound Awareness Item #

Answer (1-3) 19 20 21122 23 24 25 26 27 Average

' This is a reverse scored scale . For this subscale, record every number 1 response as a 3 and every number 3 response as a 1 .

Speech Reception Item # 1 2 3 4 5 6 7 8

Answer (1-3) I

Item # 10 11 12 14 15 16 17 Average

I Answer (1-3)

Speech Intelligibility Item # 9 13 Answer (1-3)

Sound Awareness Importance Item #

Answer (1-3) 1 1 -F 6 1-9

1 ~q :Lviagq 20 21 22 23 24 25 26 27 Average

180


Work Communication Importance Item #

P

3 4 Answer (1-3)

Social Importance

6 7 10 18

Item # 2 5 8 9 11 Answer (1-3)

Item # 12 13 14 15 17 Average

L Answer (1-3)

Communication Strategies

Expressive Repair Item # 31

Answer (1-3)

Receptive Repair

34 j

39 41 42 ~45 Average

Item # 28 30 32 33 35 36 38 43 Answer (1-3)

Item # 46 48 51 60 62 64 65 67 Average Answer (1-3)

Anticipatory Environmental Item # 44 49 52 53 54 55 56 Answer (1-3)

Item # 57 58 59 64 66 68 Average Answer (1-3)

Maladaptive Strategies* Item # 29 37 40 Answer (1-3)

47 50 61 63 69 70 71

* This is a reverse scored scale. For this subscale, record every number 1 response as a 3 and every number 3 response as a 1 .

Communication Attitudes

Negative Attitudes-All'` Item # 72 73 74 75 76 78 80 Answer (1-3)

Item # 81 82 83 84 85 86 87

Answer (1-3)

Item # 89 97 104 105 107 113 Average Answer (1-3)

* This is a reverse scored scale . For this subscale, record every number 1 response as a 3 and every number 3 response as a 1 .

Negative Attitudes-Anger & Annoyance* Item # 74 Answer (1-3)

78 81 83 89 Average

* This is a reverse scored scale. For this subscale, record every number 1 response as a 3 and every number 3 response as a 1 .


Negative Attitudes-Embarrassment*

Answer(1-3) 72 76 82 105 107 113 Average

This is a reverse scored scale . For this subscale, record every number 1 response as a 3 and every number 3 response as a 1 .

Negative Attitudes-Negative Self Concept* Item #

Answer (1-3)

73 75 80 84 85 86 87 Average

This is a reverse scored scale . For this subscale, record every number 1 response as a 3 and every number 3 response as a 1 .

Family Attitudes* Item # 79 88 92 94 Answer (1-3)

Item # 99 100 109 111 Average

Answer (1-3) * This is a reverse scored scale . For this subscale, record every number 1 response as a 3 and every number 3 response as a 1 .

Non-family Attitudes

Answer(1-3)

77 90 91 93 98 101 102 103 Average

" This is a reverse scored scale . For this subscale, record every number 1 response as a 3 and every number 3 response as a 1 .

Positive Attitudes Item # 95 96 106 108 109 Answer (1-3)

Item # 110 111 112 114 115 Average

Answer (1-3)

3.5

2.5

2

1 .5

1

Department of Audiology 8 Speech-Language Pathology

2.5

2.247 2.236 2.094

1.542 1 .5 78

1 .307 1.304

Exp Repair Rec Repair Ant Env Maladapt Strat Gallaudet University

Department of Audiology 8 Speech-Language Pathology

Scale Norms - Attitudes 3

2

1 .5

182

APPENDIX D: Communication Scale Norms

Scale Norms - Difficult Comm Situations Scale Norms - Comm Strategies

3.112 3.052 2.961

2.629 2 554 . 2.512

1 .857

1.51 1.384

1 .28 1 .345

Snd Awar Sp Intell Sp Recept end Awar Sp Und Work Sp Und Soc

Gallaudel University Importance

. 1 Neg Ail Anger Ember Nep Sit Cpt Faro Att Non Far, Att Poe Att

Gallaudet University Daparfmen( of Audiology 8 Speech-Languaga Pathology

2.314 2.147

1.985 2.042 1.993 2.04 6 2.052

1.428 1.305

1.191 1 .284

1 .338

1 2 1.169 1

Communication Self-Assessment Scale Inventory … Self-Assessment Scale Inventory for Deaf ... The Communication Self-Assessment Scale for Deaf Adults ... standing the subtle differences

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