What are Auditory Processing Disorders?
Symptoms
Services
About
- Our Expertise
- Parent and Patient Testimonials
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What are Auditory Processing Disorders?
Symptoms
Services
About
- Our Expertise
- Parent and Patient Testimonials
Contact Us

Buffalo Model Questionnaire-Revised (BMQ-R)

"*" indicates required fields

Step 1 of 9

11%

Child Name:*

Date

Month

Day

Year

Email*

Age:*

DOB*

Month

Day

Year

Filled in by:

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

Speech therapy?*

Yes

No

Auditory training?*

Yes

No

Phonological awareness training??*

Yes

No

How long has your child received Speech therapy??

How long has your child received Auditory training?

How long has your child received Phonological awareness training?

Special phonics training?*

Yes

No

Special help with reading?*

Yes

No

Sensory-integration training?*

Yes

No

How long has your child received Special phonics training?

How long has your child received special help with reading?

How long has your child received sensory-integration training?

Please ( ) mark ‘YES’ if the statement applies to you or “NO” if it not a problem.

DECODING

My child has a problem saying speech sounds*

Yes

No

My child has a problem understanding language*

Yes

No

My child has a problem understanding spoken instructions*

Yes

No

My child has a problem reading aloud*

Yes

No

My child has a problem with phonics*

Yes

No

My child has a problem with spelling*

Yes

No

My child responds slowly/delayed to spoken language*

Yes

No

My child has a problem learning foreign language*

Yes

No

My Child*

Never attempted foreign language learning

My child speaks slowly*

Yes

No

NOISE

My child is hypersensitive to noise*

Yes

No

My child is distracted by noise*

Yes

No

My child struggles to understand speech in noise*

Yes

No

My child is noisy/makes more noises in comparison to their peers*

Yes

No

MEMORY

My child responds quickly, at times*

Yes

No

My child frequently interrupts others talking*

Yes

No

My child has a problem with reading comprehension*

Yes

No

My child speaks quickly*

Yes

No

My child forgets things they have been told*

Yes

No

My child has a problem remembering spoken instructions*

Yes

No

VARIABLE

My child has a problem paying attention*

Yes

No

My child has a problem using language*

Yes

No

My child has ADHD/ADD*

Yes

No

My child has anxiety (e.g., new situations)*

Yes

No

INTEGRATION

My child has extremely poor handwriting*

Yes

No

My child has a problem integrating auditory and visual info*

Yes

No

My child has significant reading/spelling difficulties*

Yes

No

My child has significant visual perception difficulties*

Yes

No

My child sometimes has very long response delays*

Yes

No

My child has Dyslexia*

Yes

No

ORGANIZATION

My child has a problem keeping things in organized*

Yes

No

My child has a problem sequencing verbal items/information*

Yes

No

My child is messy/tends to lose things*

Yes

No

APD

My child has a history of ear infections / ear fluid as a child*

Yes

No

My child has a problem understanding what is said*

Yes

No

My child has a learning disability*

Yes

No

My child has a problem following spoken instructions*

Yes

No

My child has an intellectual disability*

Yes

No

My child has had a head injury*

Yes

No

My child has Autism or a related problem*

Yes

No

GENERAL

My child is hypersensitive to touch*

Yes

No

My child has a problem maintaining eye contact with a speaker*

Yes

No

My child has a problem with long-term memory*

Yes

No

My child has a psychological problem*

Yes

No

My child has a behavior problem*

Yes

No

My child has a problem coordinating body movements*

Yes

No

My child may have allergies*

Yes

No

My child has a problem learning math concepts*

Yes

No

My child has a hearing problem*

Yes

No

What are Auditory Processing Disorders?

Symptoms of APD - Auditory Processing Disorder

What is APD? - Auditory Processing Disorder

What is Auditory Processing Disorder?

Symptoms

Services

About

Blog Posts

Contact Information

Up to 43% of Children with Learning Difficulties Have Auditory Processing Disorder (APD)

70% of Children with Dyslexia have an Underlying Auditory Processing Disorder

Auditory Processing Center, LLC
541 Highway 80 West
Suite C
Clinton, MS 39056
Phone: (601) 488-4189
Fax: (601) 488-4888

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