Tinnitus and hyperacusis therapy specialist unit

Sound Sensitivity (Parent)

Over the last 2 weeks, how often has your child been bothered by any of the following problems?

(Use “✓” to indicate your answer)

1. Having a problem tolerating sounds because they often seem “too loud” to them?	0-1 day	2-6 days	7-10 days	11-14 days
2. Pain in their ears when hearing certain loud sounds? Examples: loud music, sirens, motorcycles, building work, lawn mower, train stations.	0-1 day	2-6 days	7-10 days	11-14 days
3. Discomfort (physical sensations other than ear pain) in their ears when hearing certain loud sounds?	0-1 day	2-6 days	7-10 days	11-14 days
4. Feeling angry or anxious when hearing certain sounds related to eating noises, lip smacking, sniffling, breathing, clicking sounds, tapping?	0-1 day	2-6 days	7-10 days	11-14 days
5. Feeling frightened when hearing certain loud sounds?	0-1 day	2-6 days	7-10 days	11-14 days