Misophonia Impact Questionnaire (Parent Version)

Please answer each item to the best of your ability as close to your child’s experience as possible.
Over the last 2 weeks, how often would you say the following has occurred because of your child’s intolerance to certain sounds related to eating, chewing gum, lip smacking, mouth noises, sniffling, breathing, clicking, and tapping?

(Use "✓" to indicate your answer)

1. Feeling anxious	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
2. Unable to ignore certain sounds	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
3. Experiencing difficulties in their relationships with family members or friends	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
4. Feeling angry	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
5. Finding it difficult to be around certain individuals because of the noises that they make	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
6. Feeling irritated	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
7. Avoiding certain situations because of the noises that they have to put up with	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days
8. Experiencing low mood because of their intolerance to certain sounds	0 - 1 day	2 - 6 days	7 - 10 days	11 - 14 days