Print off the chart below or follow along on a piece of paper. Answer Yes, No, or Sometimes for each question. Do not skip a question if you avoid a situation because of a hearing problem. If you use a hearing aid, please answer according to the way you hear with the aid.
Give yourself points for each answer: No = 0, Sometimes = 2, Yes = 4.
Total Your Score
0 - 8 = no handicap; 10 - 24 = mild to moderate handicap; 26 - 40 = severe handicap
*Adapted from Ventry I, Weinstein B. Identification of elderly people with hearing problems. ASHA. 1983; 25:37-42.