4c Tinnitus Management Questionnaire (Parent)

Tinnitus is the sensation of sound in the ears or head without any external sound source. It may sounds like a buzzing, whistle, ringing, humming, pulsing or other types of sound
For each question please select one number based on your view about how your child is feeling now.

1. How certain is your child that she/he is able to carry out their day-to-day tasks even with tinnitus (e.g., learning in the classroom, having a conversation with others, read, etc.)?

Not certain at all (My child would not be able to cope at all)

Very certain (My child would have no problems managing the situation and is confident being in these situations)

2. How certain is your child that she/he is able to relax and rest even with tinnitus?

Not certain at all (My child would not be able to cope at all)

Very certain (My child would have no problems managing the situation and is confident being in these situations)

3. How certain is your child that she/he can enjoy their leisure time even with tinnitus (leisure time is hobbies such as playing, music and dance classes, computer games, sports, etc.)?

Not certain at all (My child would not be able to cope at all)

Very certain (My child would have no problems managing the situation and is confident being in these situations)

4. How certain is your child that she/he can carry on with their day to day activities, relax, and enjoy life, without using any distraction or avoidance strategies to help them (e.g., background music or tinnitus maskers)?

Not certain at all (My child would not be able to cope at all)

Very certain (My child would have no problems managing the situation and is confident being in these situations)

For Hearing Healthcare Professionals