It’s C because anguish means “severe mental or physical pain or suffering.”
        
             
        
        
        
If extremely is underlined then it's adverb
        
             
        
        
        
1.  The National Association of the Deaf
2.  National Family Association for the Deaf-Blind
3. The American Association for the Deaf-Blind
4. The Helen Keller National Center
5.  American Society for Deaf Children