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YES   NO
 Has trouble hearing when two or
  more people are talking.
 Appears to have trouble hearing
  when there is a lot of background
  noise.
 Frequently misunderstands you
  when you speak.
 Asks you to repeat what you have
  said.
 Watches your face intently when
  you are speaking.
 Responds inappropriately to what
  are others are saying.
YES   NO

Seems in a world of his/her own at
 times.
Speech is unclear or immature.
 May have trouble with sounds at a
 specific frequency.
Grammar is incorrect or immature.
Has the television sound turned up
 high.
Sits very close to the teacher or
 the television.
Tilts head to listen.
Mouths the words as other speak
YES   NO

Has had recurrent ear infection.
Seem to switch off when listening
 in a group.
Speaks more loudly that is
 necessary.
Watches others and copies them
 when instructions are given.
Does not respond to speech
 when not able to the speaker.
Sits close to the front when given
 the choice.

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Checklist for hearing impaired (sped 314)

  • 1.
  • 2. YES NO  Has trouble hearing when two or more people are talking.  Appears to have trouble hearing when there is a lot of background noise.  Frequently misunderstands you when you speak.  Asks you to repeat what you have said.  Watches your face intently when you are speaking.  Responds inappropriately to what are others are saying.
  • 3. YES NO Seems in a world of his/her own at times. Speech is unclear or immature. May have trouble with sounds at a specific frequency. Grammar is incorrect or immature. Has the television sound turned up high. Sits very close to the teacher or the television. Tilts head to listen. Mouths the words as other speak
  • 4. YES NO Has had recurrent ear infection. Seem to switch off when listening in a group. Speaks more loudly that is necessary. Watches others and copies them when instructions are given. Does not respond to speech when not able to the speaker. Sits close to the front when given the choice.