THE AUDITORY PROCESSING DOMAINS QUESTIONNAIRE VERSION 2021 FOR PARENTS AND TEACHERS OF STUDENTS 7 TO 18 YEARS OLD The APDQ was developed by Dr. Brian O’Hara and has a 2016 copyright. It reviews a child’s everyday listening skills. Language, attention, and hearing abilities are all important. Please rate your child or student’s performance on each item below based on your recent observations. Keep in mind what is “expected” for his or her age. “Noisy conditions” refers to background noise from such sources as TV, voices, and machinery. “Listening accurately” means hearing words or statements right the first time, without saying “what?” or needing repeats. Check () Column 1: if skill has been observed Most times Column 2: if skill has been observed Often Column 3: if skill has been observed Sometimes Column 4: if skill has been observed Rarely over ¾ over ½ under ½ under ¼ the time the time the time the time Rate all items. Write N/A if you do not understand or are unable to rate it. * Items 16, 17, 21, 22, 30 and 35 have reversed scoring, therefore: Most times = 0 pts., Often = 1 pt., Sometimes = 3 pts., and Rarely = 4 pts. YOUR CHILD OR STUDENT: 1. pays attention well when spoken to alone. 2. pays attention well when listening with others in quiet places (classes and meetings). 3. pays attention well when listening with others in noisy places (classes and meetings). 4. hears your words right (without repeats) when paying attention in quiet places. 5. hears your words right (without repeats) when paying attention in noisy places. MOST TIMES OFTEN > 3/4 >1/2 4 pts. 3 pts. SOME TIMES <1/2 1 pt. RARELY <1/4 0 pts. YOUR CHILD OR STUDENT: MOST TIMES OFTEN > 3/4 >1/2 SOME TIMES <1/2 RARELY <1/4 6. takes the time to listen more carefully to important information. 7. understands your instructions when paying attention in quiet places. 8. understands your instructions when paying attention in noisy places. 9. understands speakers in places with “echo noise” (gyms, cafeterias, places with loudspeaker echo). 10. understands your conversation while others are talking nearby (at parties, meals etc.). 11. can listen accurately to you while doing something else (games or chores). 12. listens accurately without visual aids (not seeing a speaker’s face or gesturesnot having diagrams or pictures). 13. focuses well when doing non-listening tasks (studying and chores). 14. focuses well when listening to stories and presentations. 15. understands written instructions (as expected for his or her age) 16. tires easily when studying (yawns and * 0 pts. 1pt. 3pts. 4pts. fidgets) 17. tires easily when listening (yawns and * fidgets) 18. explains things fairly well during conversations. 19. concentrates on important tasks even when they are not fun or interesting. 20. hears words right when a speaker’s back is turned (or is spoken to from behind). 2 YOUR CHILD OR STUDENT: 21. says “what?” or needs repeats when conversing with interest in quiet places. * 22. says “what?” or needs repeats when conversing with interest in noisy places. * MOST TIMES OFTEN > 3/4 >1/2 SOME TIMES <1/2 RARELY <1/4 23. pays attention to details and avoids careless errors when studying or crafting. 24. understands and uses longer sentences (as expected for his or her age). 25. understands and answers your questions promptly in quiet places (when attentive). 26. understands and answers your questions promptly in noisy places (when attentive). 27. follows spoken directions with steps or sequences (as expected for age). 28. organizes tasks and activities to do them on time. 29. understands and uses slang expressions common for his or her age. 30. loses or forgets to do things- is absent minded. . * 31. understands speakers who say words less clearly (rapid or mumbled speech, foreign accents). 32. understands soft spoken or high voiced speakers. 33. listens accurately on the telephone without needing information repeated. 34. can listen comfortably and accurately to speakers from 6-8 feet away (when sitting or standing together). 35. mishears and confuses similar sounding words * (“fifty” and fifteen”, “thirsty” and “Thursday”). 3 YOUR CHILD OR STUDENT: MOST TIMES OFTEN > 3/4 >1/2 SOME TIMES <1/2 RARELY <1/4 36. remembers and uses new words correctly (as expected for age). 37. pronounces new words correctly after hearing them a couple of times (including people’s and place names). 38. can read & spell new words right by sounding them out (uses phonics). 39. reads at an ok rate (as expected for age). 40. controls impulses and activity levels to avoid annoying or unsafe actions. 41. remembers details of spoken directions or requests (without repeats a short time later). 42. readily learns by listening (without a strong need for more visual or hands-on instruction). 43. follows the right pitch and rhythm patterns when humming, drumming, or clapping with others. 44. varies speaking voice for emphasis, clarity and pleasantness. 45. notices how things were said when Interpreting comments & following directions (tones of voice and word emphasis) 46. understands what people say without needing more simple words. 47. hears ok without needing louder volumes volu(including voices and signals). 48. talks easily and smoothly for his or her age (without pausing too much or forgetting words) 49. understands conversations & instructions without major noise controls (turning off the TV, closing windows, moving closer). 50. understands speakers without needing them to slow down & talk more clearly. 4 PERSONAL INFORMATION for APDQ Child’s Name Case Number (staff assigned) 1. Today’s date 2. Child’s date of birth 3. Gender 5. Person completing questionnaire: (a) mother 4. Grade (b) father (c) other family member (specify) (d) teacher (e) other (specify) 6. Is the language of instruction in child’s school child’s first language at home? Yes 7. Father’s years of school completed _ _ No 8. Mother’s years of schoolcompleted 9. Please rate your concern level for this child’s listening skills: (a) None (b) Mild (c) Moderate (d) High 10, Please rate this child’s sensitivity and stress levels with loud sounds and in noisy environments: (a) None (b) Mild _ (c) Moderate (d) High 11. Please rate this child’s difficulty localizing sounds (e.g. knowing whether a sound is coming from the right or left, front or back, near or far; knowing who is talking in a group; knowing where a dog is barking ). (a) None (b) Mild (c) Moderate (d) High 12. Please  if any of the following conditions or services have occurred for this child: a. Special education b. Learning disability c. Specific language learning disability(SLD) d. Dyslexia (reading disability) e. History of speech-language delay or therapy f. Permanent hearing loss: 1. mild a. unilateral 2. moderate b. hearing aid(s) Learning English as a 2ND language after age 5 h. Attention deficit disorder (ADHD) j. _ c. cochlear implant(s) g. I. 3. severe Frequent or chronic middle ear infections or surgery (circle or explain) _ Jaundice as newborn: (a) Mild k. Auditory processing disorder ((C)APD) L. Autism (ASD)/Asperger syndrome m. (b) Moderate (c) Severe Developmental delay(s) 5