II. Criteria: Questions

  1. Embarrassed when meeting new people due to hearing problem
  2. Frustrated when speaking to family due to hearing problem
  3. Difficulty hearing whispered voice
  4. Feel impaired by hearing problem
  5. Hearing interferes with visiting with family and friends
  6. Attends religious services less often due to hearing problems
  7. Hearing problem result in arguments with family
  8. Hearing problem interferes with listening to television and radio
  9. Hearing problem interferes with social life
  10. Hearing problem interferes with communication in a restaurant

III. Protocol

  1. Rate each question with either a Yes, Sometimes or No
  2. Scoring: Total the score for each of the 10 questions
    1. Yes: 4 points
    2. Sometimes: 2 points
    3. No: 0 points

IV. Interpretation

  1. Severe hearing handicap likelihood (refer): 26-40
  2. Moderate hearing hadicap likelihood (refer): 10-24
  3. Low hearing handicap likelihood: 0 to 8

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