Tinnitus and hyperacusis therapy specialist unit

Hyperacusis Impact Questionnaire (Parent version)

Please answer each item to the best of your ability as close to your child’s experience as possible.

Over the last 2 weeks, how often would you say the following has occurred for your child because of certain environmental sounds which seemed too loud to them but other people could tolerate them well?

For each question please select one number based on how you are feeling now.

(Use “✓” to indicate your answer)

1. Feeling anxious when hearing loud noises
2. Avoiding certain places because it is too noisy
3. Lack of concentration in noisy places
4. Difficulty in being calm in noisy places
5. Difficulty in carrying out certain day-to-day activities/tasks in noisy places
6. Lack of enjoyment from leisure activities in noisy places
7. Experiencing low mood because of their intolerance to sound
8. Getting tired quickly in noisy places
For Hearing Healthcare Professionals