Please select a rating for each of the following questions. Refer to your state right now. For each item, decide whether the statement is relevant and to what degree.

[Auditory Hypersensitive]
Avoids or refuses to go to noisy places such as restaurants, theaters, malls.

[Auditory Hypersensitive]
Bothered by certain sounds - vacuums, alarms, toilets, etc.

[Auditory Hypersensitive]
Easily startled by unexpected sounds.

[Auditory Hypersensitive]
Has trouble hearing in noisy environments.

[Auditory Hypersensitive]
Covers ears, cries, or screams due to loud or unexpected sounds.

[Auditory Hypersensitive]
Hears things others don't.

[Auditory Hypersensitive]
Asks others to be quiet.

[Auditory Hypersensitive]
Likes or dislikes someone based on the sound of their voice.

[Auditory Hyposensitive]
Prefers music, videos or TV too loud.

[Auditory Hyposensitive]
Unresponsive when spoken to.

[Auditory Hyposensitive]
Produced few sounds as an infant.

[Auditory Hyposensitive]
Talks to self.

[Auditory Hyposensitive]
Seems oblivious to certain sounds.

[Auditory Hyposensitive]
Talks loudly.

[Auditory Hyposensitive]
Made very few noises as an infant.

[Auditory Hyposensitive]
Frequently asks others to repeat themselves.

[Auditory Discrimination]
Has trouble understanding verbal instructions.

[Auditory Discrimination]
Misunderstands often - asks “what” a lot.

[Auditory Discrimination]
Confuses similar sounding words.

[Auditory Discrimination]
Has difficulty telling which direction a sound comes from.

[Auditory Discrimination]
Doesn't follow instructions.

[Auditory Discrimination]
Misunderstands often.

[Auditory Discrimination]
Gets lost in conversations/responds inappropriately.

[Auditory Discrimination]
Has difficulty remembering what was said.