Auditory Problems Checklist

Scoring key:   
0              =              NONE                   1             =              VERY MILDLY
2              =              PROBLEMATIC        3             =              SEVERELY DISRUPTING

1. History of middle-ear infections before three years age
2. History of middle-ear infections
3. History of grommet operations
4. Does not pay attention to instruction (teaching) 50% or more of the time
5. Has difficulty following spoken directions
6. Often necessary to repeat instructions.
7. Does not learn well through auditory channel
8. Slow processing of auditory input
9. Cannot always relate what is heard to what is seen
10 Cannot attend to purely auditory input for more than a few seconds
11. Frequently misunderstands what is said
12. Often asks for repetition of what was said /says “huh?” & “what?”
13. Forgets what was said in a few minutes
14. Has a short attention span
15. Daydreams, attention drifts
16. Easily distracted by sounds
17. Ability to work deteriorates in groups or crowds
18. Experiences problems with sound discrimination
19. Has difficulty with phonics
20. Has problem repeating or remembering sequences
21. Is bothered by sounds/ covers his ears/painful discomfort reaction.
22. Notices sounds before others do.
23. Has “startle” reaction to sounds that don’t bother anyone else.
24. Needs loud music to be able to concentrate on homework
25. Seeks “quiet time”.
26. Does not comprehend many words/ concepts for his age
27. Has a language problem (grammar, vocabulary, etc)        
28. Has/ had an articulation problem (speech).