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INTERACTIVE SCREENING TEST

The following questions have been validated and will help you determine if you are experiencing hearing loss. Of course, this questionnaire should not be used as a substitute for a hearing test conducted by a professional. However, it will provide an indication as to whether you should consult with a specialist for a more in-depth assessment.

The results of the questionnaire will be calculated automatically at the bottom of the page.

FOR QUESTIONS 1 TO 14, INCLUSIVELY:

  • Every “yes” is worth 4 points
  • Every “sometimes” is worth 2 points
  • Every “no” is worth 0 points

FOR QUESTION 15

  • Answer “a” is worth 0 points
  • Answer “b” is worth 2 points
  • Answer “c” is worth 3 points
  • Answer “d” is worth 4 points
1

When you are speaking with one person, do you ask them to repeat?

2

Do you have trouble understanding when many people are talking together?

3

Do you have trouble understanding when you can’t see the face of the person talking?

4

Do you have trouble understanding when there is noise around you?

5

Do you find that people are mumbling or not talking loud enough (on tv, friends, doctors)?

6

Do you find that people talk too fast (on tv, friends, doctors)?

7

Do you have trouble understanding on the phone?

8

Do you have trouble hearing the water running from the tap in the sink or bathtub when you are in another room?

9

Do you have trouble hearing the telephone ring when you are in another room or in the bathroom (at home or when visiting someone)?

10

Do you have trouble hearing the doorbell (at home or when visiting someone)?

11

Do you have trouble hearing when someone knocks at the door?

12

Do your family, your friends or neighbours tell you that the volume on your television or your radio is too loud?

13

Do you have a tendency to stay away from others out of fear of not hearing them?

14

Would you rather avoid certain activities because of the noise around you (e.g. dining room, restaurant, family birthdays, bingo, etc.)?

15

How would you rate your hearing?

Get my results

Your total

If your overall result is greater than the number 14, consult an audiologist or healthcare professional for an audiology referral.

Questionnaire developed by Hélène Caron, MSLP, audiologist, Raymond-Dewar Institute, and scientifically validated by Michel Picard, Ph.D., full professor of audiology, Université de Montréal.
The Fondation Surdité et Communication de l'institut Raymond-Dewar.

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