Hearing Inventory Questionnaire                       Children 0 through 18 Years
Please answer No, Sometimes, or Yes for each question.
Do not skip a question if your child avoids a situation because of a hearing problem.
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1. Does a hearing problem cause your child to use the phone less often than they would like?
Clear selection
2. Does a hearing problem cause your child to feel embarrassed when they meet new people?
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3. Does a hearing problem cause your child to avoid groups of people?
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4. Does a hearing problem make your child irritable?
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5. Does a hearing problem cause your child to feel frustrated when talking to members of your family?
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6. Does a hearing problem cause your child difficulty when attending a party?
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7. Does your child have difficulty hearing/understanding co-workers, clients/customers, or waitstaff?
Clear selection
8. Does your child feel significantly disadvantaged by a hearing problem?
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9. Does a hearing problem cause your child difficulty when visiting friends, relatives, or neighbors?
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10. Does a hearing problem cause your child to feel frustrated with hearing/understanding co-workers, clients/customers, or waitstaff?
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11. Does a hearing problem cause your child difficulty hearing in the movies or in the theatre?
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12. Does a hearing problem cause your child to be nervous?
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13. Does a hearing problem cause your child to visit friends, relatives, or neighbour less often than they would like?
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14.  Does a hearing problem cause your child to have arguments with family members?
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15.  Does a hearing problem cause your child difficulty when listening to TV or radio?
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16.  Does a hearing problem cause your child to go shopping less often than they would like?
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17.  Does any problem or difficulty with your child’s hearing upset them at all?
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18.  Does a hearing problem cause your child to want to be by themselves?
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19.  Does a hearing problem cause your child to talk to family members less often than they would like?
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20.  Does your child feel that any difficulty with their hearing limits or hampers their personal or social life?
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21.  Does a hearing problem cause your child difficulty when in a restaurant with relatives or friends?
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22.  Does a hearing problem cause your child to feel depressed?
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23.  Does a hearing problem cause your child to listen to the television or the radio less often than they would like?
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24.  Does a hearing problem cause your child to feel uncomfortable when talking to friends?
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25.  Does a hearing problem cause your child to feel left out when they are with a group of people?
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LOTUS-ES therapy protocol (Listen, Organize, Think, Understand, Speak- Endurance, Stamina) for robust communication skills                                                                  
Questionnaire based on Newman, C. W., Weinstein, B. E., Jacobson, G. P., & Hug, G. A. (1990). The Hearing Handicap Inventory for Adults: psychometric adequacy and audiometric correlates. Ear and Hearing, 11, 430-433.
Questionnaire compiled by Dr. Angela Alexander https://www.auditoryprocessinginstitute.com/ 
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