Auditory Processing Disorder Questionnaire

† This questionnaire is designed to assess the level of your child's Auditory Processing disorder. Most children will only exhibit some of the symptoms. Please complete and submit this questionnaire if you would like an informal assessment.



Please select the response which applies to your child


Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Never  Sometimes  Frequently  Unsure 
Required
Required
Required
Required
Required
Required - For us to contact you.
 
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