Communicating with hearing aids!

1. I have difficulty hearing a conversation with one person at home.  Yes      No

2. When I am in a small office or conference room, interviewing or answering questions, I have difficulty following the conversation.  Yes      No

3. When I am having a quiet conversation with a friend, I have difficulty understanding.  Yes      No

4. When a speaker is addressing a small group, and everyone is listening quietly, I have to strain to understand.  Yes      No

5. When I’m in a quiet conversation with my doctor in an examination room, it is hard to follow the conversation.  Yes      No

6. I have to ask people to repeat themselves in one-on-one conversation in a quiet room.  Yes      No

Your perception of background noise with hearing aids

1. When I am in a crowded grocery store, talking with the cashier, I can follow the conversation.  Yes      No

2. When I am listening to the news on the car radio, and family members are talking, I have trouble hearing the news.  Yes      No

3. When I am at the dinner table with several people, and trying to have a conversation with one person, understanding speech is difficult.  Yes      No

4. I can understand conversations even when several people are talking.  Yes      No

5. I can communicate with others when I am in a crowd.  Yes      No

6. I have trouble understanding others when an air conditioner or fan is on.  Yes      No

Your ability to hear in enclosed spaces (Reverberation with hearing aids)

1. I miss a lot of information when I’m listening to a lecture.  Yes      No

2. I have trouble understanding dialogue in a movie or at the theater.  Yes      No

3. When I am talking with someone across a large empty room, I understand the words.  Yes      No

4. When I am in the theater watching a movie or a play, and the people around me are whispering and rustling paper wrappers, I can still make out the dialogue.  Yes      No

5. It’s hard for me to understand what is being said at lectures or church services.  Yes      No

6. I can follow the words of a sermon when listening to a religious service.  Yes      No

Your reaction to loud sounds with hearing aids (Aversiveness)

1. Unexpected sounds, like a smoke detector or alarm bell or tone are uncomfortable.  Yes      No

2. Traffic noises are too loud.  Yes      No

3. The sounds of running water, such as a toilet or shower, are uncomfortably loud.  Yes      No

4. The sounds of construction work are uncomfortably loud.  Yes      No

5. The sounds of a fire engine siren close by is so loud that I need to cover my ears.  Yes      No

6. The sound of screeching tires is uncomfortably loud.  Yes      No

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