Republic of the Philippines

NORTH EASTERN MINDANAO STATE UNIVERSITY

Formerly Surigao del Sur State University
Tandag City, Surigao del Sur

GRADUATE SCHOOL

Verbal Vortex: Explore Anxiety in English Learning

Among Senior High School Learners

Survey Questionnaire

Name (Optional): _______________________________________________________

Part I. Demographic Information

Thank you for participating in our survey. Your responses to the following demographic
questions will help us better understand our participants. Please note that providing
your name is optional, and your responses will be kept confidential.

Age: ____________ Sex: _____ Parent's Income: ____________________

Part II. Level of Speaking Anxiety

Directions: This instrument is composed of 11 statements adapted from Modified
Foreign Language Classroom Anxiety Scale (MFLCAS). Put the check mark (√) to
indicate which you agree with each of the following:
5-POINT LIKERT SCALE
5 – Strongly Agree (SA) 4 – Agree (A) 3 – Neutral (N) 2 – Disagree (D) 1 – Strongly Disagree (SD)

Statement (SA) (A) (N) (D) (SD)

5 4 3 2 1
1. I never feel quite sure of myself when I am speaking
in my English conversation class.
2. I don’t worry about making mistakes in the English
conversation class.
3. I tremble when I know that I’m going to be called on in
the English conversation class.
4. It frightens me when I don’t understand what the
teacher is saying in English.
5. It wouldn’t bother me at all to take more English
classes in the same academic term.
6. During the English conversation class, I find myself
 Republic of the Philippines
NORTH EASTERN MINDANAO STATE UNIVERSITY
Formerly Surigao del Sur State University
Tandag City, Surigao del Sur

GRADUATE SCHOOL

thinking about things that have nothing to do with the

course.
7. I keep thinking that the other students are better at
languages than I am.
8. I am usually at ease during tests in my English
conversation class.
9. I start to panic when I have to speak without
preparation in the English conversation class.
10. I worry about the consequences of failing my English
conversation class.
11. I don’t understand why some people get so upset
over English conversation classes.

Part III. Language and Physical Manifestations of Speaking Anxiety

Directions: Put the check mark (√) to indicate which you agree with each of the
following:

5-POINT LIKERT SCALE

5 – Strongly Agree (SA) 4 – Agree (A) 3 – Neutral (N) 2 – Disagree (D) 1 – Strongly Disagree (SD)

Indicator (SA) (A) (N) (D) (SD)

5 4 3 2 1
Language Related
1. I frequently encounter challenges with my vocabulary
when speaking the English language in front of others.
2. I've observed instances of mispronunciation when
delivering speeches or presentations in English.
3. There are moments when I struggle with constructing
sentences effectively during oral recitations.
4. I occasionally find myself engaging in code mixing or
switching between languages.
5. Dealing with language interference, specifically issues
related to diction and articulation, has proven to be a
significant challenge for me.
6. I tend to use word fillers in my speech, a habit that I'm
working on improving.
Physical Manifestations of Speaking Anxiety
 Republic of the Philippines
NORTH EASTERN MINDANAO STATE UNIVERSITY
Formerly Surigao del Sur State University
Tandag City, Surigao del Sur

GRADUATE SCHOOL

1. I've observed an increase in my pulse rate when

speaking English in front of others.
2. There are moments when my hands tremble during
oral recitation in English.
3. I often experience sweating of hands while speaking
in front of the class.
4. My knees shake in certain speaking situations.
5. I've felt a whirling sensation in my head with a
tendency to fall during speaking.
6. My voice becomes hoarse under the influence of
speaking anxiety.
7. I tend to add unnecessary words when speaking.
8. Omission of words is something I struggle with during
speech.
9. I make unnecessary movements when feeling anxious
about speaking.
10. I've experienced difficulty in presenting some
important details of a report.

Student Interview Form (SIF)

1. Do you find it hard to present orally using the English language?

Answer:

2. What are the problems have you encountered in using English language in
oral presentation?

Answer:

3. What coping mechanism did you use to address the problem the speaking
anxiety you encountered?

Answer: