 A Checklist for Parents CHILDREN'S Pre-Care Questionnaire
This checklist is designed to help parents or teachers access whether a child might be having problems with his or her auditory system (hearing, auditory processing or auditory integration).
Check off any item that describes the child's behavior or history. If you check off many items, consider reading the posted information on Auditory Integration Therapy or scheduling an Auditory Assessment for the child.
Has a history of hearing loss.
Does not pay attention (listen) to instruction 50% or more of the time.
Does not learn well through use of the auditory channel.
Demonstrates below average performance in one or more academic area(s).
Has a history of ear infection(s).
Has difficulty following verbal directions -- often necessary to repeat instructions.
Cannot always relate what is heard to what is seen.
Cannot attend to auditory stimuli for more than a few seconds.
Frequently misunderstands what is said.
Says "Huh?" and "What?" at least five or more times per day.
Forgets what is said in a few minutes.
Has a short attention span.
Daydreams -- attention drifts -- not with it at times.
Easily distracted by background noise.
Experiences problems with sound discrimination.
Has "startle" response to sudden sound or movement.
Notices sounds before others do.
Gives unusual descriptions of sounds, auditory stimulation or sensation.
Constant humming or audible self-talk.
Needs frequent "quiet time" to regain mental energy and composure.
Does not comprehend many words, not grasping verbal concepts appropriate for age/grade level.
Has a language problem (morphology, syntax, vocabulary, phonology).
Is considered to have autism, dyslexia, pervasive developmental disorder, Central Auditory Processing Disorder, Asperger's Syndrome or attention deficit hyperactivity disorder (ADHD).
Has an articulation (phonology) problem. |
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| Services at E.M. Hearing & Speech |
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