F OCUS ON I NDIVIDUAL L EARNING


Auditory Integration Training

A Checklist for Adults

This checklist is designed to help an adult access whether he/she might be having problems with his/her auditory system. A Parent's Checklist is also available.

Check off any item that applies to you. If you check seven or more items, read about Auditory Integration Therapy and consider scheduling an auditory assessment

I . . .
     have a history of hearing loss:
     have a history of ear infection(s):
     have difficulty following verbal directions and/or often request that verbal instructions be repeated:
     have difficulty following conversations:
     rely on lip-reading, gesture, context -- or just plain guessing -- to understand what is being said:
     frequently misunderstand what is said:
     Say "Huh?" and "What?" at least five or more times per day:
     am easily distracted by background noise:
     experience problems with sound discrimination:
     have "startle" responses to sudden sound or movement:
     give unusual descriptions of auditory stimulation or sensation:
     engage in constant humming or audible self-talk:
     need frequent "quiet time" to regain mental energy and composure:
     can be irritable or picky "by nature":
     am often negative or depressed without identifiable cause:
     have difficulty organizing the day:
     experience growing fatigue as the day progresses:
     have difficulty keeping track of a sequence of actions:
     have difficulty taking notes during speech or lecture:
     experience painful discomfort with sounds that others find untroublesome:
     notice that sounds upset or agitate me but not others:
     notice sounds before others do:
     frequently notice sounds that others do not hear:
     can learn a foreign language through reading and writing, but have difficulty learning a foreign language by listening to conversation:
     am considered to be dyslexic:
     am unable to sing on key:
     have problems relating an entire story:
     have problems with balance, equilibrium or coordination:
     have problems with directions, such as left and right:
     have a strong preference for sitting in a corner or next to a wall:
     need constant activity or visual stimuli:
     try theories, groups, seminars and workshops one after another in an effort to find physical and mental health:
     suffer from tinnitis (ringing or other sound in the ear):
     have problems with sleep:
     experience overriding stress over things inconsequential to others:
     have frequent compulsive thoughts and feelings:
     have feelings of fragmentation and loss of orientation throughout the day:
     avoid social contact or interaction:
     engage in excessive internal arguing: "What to do about . . .," "Why am I the way I am?", "Why did I do that?", etc.:

Please indicate your interest below.

If you have scored 7 or more 'yes' answers please contact June at Focus On Individual Learning, Singapore to discuss the results

In this case please print the questionaire and send it to June with your contact details.

  Name [Required]:
EMail [Required]:
  I would like to make an appointment for an Initial Consultation to discuss my auditory processing:
Details of concerns:

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