Auditory Processing Disorder Questionnaire - Child

  • ONLINE ARCHES APD Screening Questionnaire

    Adapted from Buffalo Model Questionnaire - Revised Simplified Child Form
  •  / /

  • Please indicate if you are currently receiving or have received any of the services and number of years:

  • Auditory training?
  • Speech Therapy?
  • Phonological awareness training?
  • Special phonics training?
  • Special help with reading?
  • Sensory-intergation training?

  • Please mark 'YES' if the statement applies to you or "NO" if it not a problem.

  • DECODING

  • DEC: 1. My child has a problem saying speech sounds
  • DEC: 2. My child has a problem understanding language
  • DEC: 3. My child has a problem understanding spoken instructions
  • DEC: 4. My child has a problem reading aloud
  • DEC: 5. My child has a problem with phonics (speech sounds)
  • DEC: 6. My child has a problem with spelling
  • DEC: 7. My child responds slowly/delayed to spoken language
  • DEC: 8. My child has a problem learning a foreign language
  • DEC: 9. My child speaks slowly

  • NOISE

  • NOI: 1. My child is hypersensitive to noise
  • NOI: 2. My child is distracted by noise
  • NOI: 3. My child struggles to understand speech in noise
  • NOI: 4. My child is noisy/makes more noises in comparison to their peers

  • MEMORY

  • MEM: 1. My child responds quickly, at times
  • MEM: 2. My child frequently interrupts others talking
  • MEM: 3. My child has a problem with reading comprehension
  • MEM: 4. My child speaks quickly
  • MEM: 5. My child forgets things they have been told
  • MEM: 6. My child has a problem remembering spoken instructions

  • VARIANCE

  • VAR: 1. My child has a problem paying attention
  • VAR: 2. My child has a problem using language
  • VAR: 3. My child has ADHD/ADD
  • VAR: 4. My child has anxiety (e.g., new situations)

  • INTEGRATION

  • INT: 1. My child has extremely poor handwriting
  • INT: 2. My child has a problem integrating auditory and visual info
  • INT: 3. My child has significant reading/spelling difficulties
  • INT: 4. My child has significant visual perception difficulties
  • INT: 5. My child sometimes has very long response delays
  • INT: 6. My child has Dyslexia

  • ORGANISATION

  • ORG: 1. My child has a problem keeping things in organised
  • ORG: 2. My child has a problem sequencing verbal items/information
  • ORG: 3. My child is messy/tends to lose things

  • APD / OTHER SIGNIFICANT HISTORY

  • AUD: 1. My child has a history of ear infections / ear fluid as a child
  • AUD: 2. My child has a problem understanding what is said
  • AUD: 3. My child has a learning disability
  • AUD: 4. My child has a problem following spoken instructions
  • AUD: 5. My child has an intellectual disability
  • AUD: 6. My child has had a head injury
  • AUD: 7. My child has Autism or a related problem

  • GENERAL CHARACTERISITICS

  • GEN: 1. My child is hypersensitive to touch
  • GEN: 2. My child has a problem maintaining eye contact with a speaker
  • GEN: 3. My child has a problem with long-term memory
  • GEN: 4. My child has a psychological problem
  • GEN: 5. My child has a behaviour problem
  • GEN: 6. My child has a problem coordinating body movements
  • GEN: 7. My child may have allergies
  • GEN: 8. My child has a problem learning math concepts
  • GEN: 9. My child has a hearing problem
  • Would you like to be contacted about these results?

  • Thank you for your interest in APD services at Arches Audiology. 

    For more information, please visit www.archesaudiology.com.au.

    We welcome all enquiries: contact@archesaudiology.com.au or 0423 374 684.

     

  • Image field 104
  • Should be Empty: