This quiz was field-tested on 71 older patients in five cities;'audiograms were also run on them.' Results showed that those whose quiz scores indicated a need to see a physician were confirmed, on the audiogram, as having a hearing impairment.
Mark the column that best describes the frequency with which you experience each situation or feeling.
| 5 Minute Hearing Test | Almost Always | Half the Time | Occasionally | Never |
|---|---|---|---|---|
| 1. I have a problem hearing over the telephone. | ||||
| 2. I have trouble following the conversation when two or more people are talking at the same time. | ||||
| 3. People complain that I turn the TV volume too high. | ||||
| 4. I have to strain to understand conversations. | ||||
| 5. I miss hearing some common sounds like the phone or doorbell ringing. | ||||
| 6. I have trouble hearing conversations in a noisy background such as a party. | ||||
| 7. I get confused about where sounds come from. | ||||
| 8. I misunderstand some words in a sentence and need to ask people to repeat themselves. | ||||
| 9. I especially have trouble understanding the speech of women and children. | ||||
| 10. I have worked in noisy environments (assembly lines, jackhammers, jet engines, etc.). | ||||
| 11. Many people I talk to seem to mumble (or don't speak clearly). | ||||
| 12. People get annoyed because I misunderstand what they say. | ||||
| 13. I misunderstand what others are saying and make inappropriate responses. | ||||
| 14. I avoid social activities because I cannot hear well and fear I'll replay improperly. | ||||
| To be answered by a family member or friend:
15. Do you think this person has a hearing loss? |
Scoring: To calculate your score, give yourself 3 points for every time you checked the "Almost always" column, 2 for every "Half the time", 1 for every "Occasionally", and 0 for every "Never".?If you have a blood relative who has a hearing loss, and another 3 points. Then total your points.
The American Academy of Otolaryngology-Head and Neck Surgery recommends the following:
©1992. This leaflet is published as a public service. The material may be freely used so long as attribution is given to the American Academy of Otolaryngology-Head and Neck Surgery, Inc., Alexandria, VA
