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hear
[p.170]

Section N -- Hearing


Item N1

[] HIS-1 page 25 questions asked (N2)
[] HIS-1 page 25 questions not asked (HIS-1 page 25)
Item N2
Mark first appropriate box

1[] HP and/or HA marked (1)
2[] 3+ years old (4)
3[] Under 3 (NP)


Hand Card N. Read answer categories if telephone interview. If "HA" marked, read parenthetical.
Card N

1. Good
2. Little trouble
3. Lot of trouble
4. Deaf


Now I will ask some questions about hearing.
1a. Which statement best describes -- hearing in [his/her] left ear (without a hearing aid)?

1[] Good
2[] Little trouble
3[] Lot of trouble
4[] Deaf


b. Which statement best describes -- hearing in [his/her] right ear (without a hearing aid)?

1[] Good
2[] Little trouble
3[] Lot of trouble
4[] Deaf


Mark box or ask.

0[] Under 3 (Item N3)

2a. (Without a hearing aid) Can -- usually hear and understand what a person says without seeing his face if that person whispers to [him/her] from across a quiet room?

1[] Yes (3a)
2[] No

b. (Without a hearing aid) Can -- usually hear and understand what a person says without seeing his face if that person talks in a normal voice to [him/her] from across a quiet room?

1[] Yes (3a)
2[] No

c. (Without a hearing aid) Can -- usually hear and understand what a person says without seeing his face if that person shouts to [him/her] from across a quiet room?

1[] Yes (3b)
2[] No

d. (Without a hearing aid) Can -- usually hear and understand a person if that person speaks loudly into [his/her] better ear?

1[] Yes (3b)
2[] No (3b)


3a. How old was -- when [he/she] began to have trouble hearing?

00[] At birth (4a)
01[] Less than 1 year old (4a)
Years old ____ (4a)
88[] No trouble (4a)
99[] DK (3c)

b. How old was -- when [he/she] began to have serious trouble hearing or became deaf?

00[] At birth (4a)
01[] Less than 1 year old (4a)
Years old ____ (4a)
88[] No trouble (4a)
99[] DK (3c)


c. Was it before or after -- 19th birthday?

1[] Before
2[] After (4a)
9[] DK (4a)

d. Was it before or after -- 3rd birthday?

1[] Before
2[] After
9[] DK


4a. At any time over the past 12 months, has -- ever noticed ringing in his ears, or has [he/she] been bothered by other funny noises in [his/her] ears or head?

1[] Yes
2[] No (Item N3)
9[] DK (Item N3)


b. Does -- notice this ringing or funny noise all the time, every few days or less often?

1[] All the time
2[] Every few days
3[] Less often
9[] DK


c. When it does occur, does it bother -- quite a bit, just a little or not at all?

1[] Quite a bit
2[] Just a little
3[] Not at all
9[] DK


d. How old was -- when [he/she] began to have this ringing or funny noise?

Years old ____
99[] DK


Item N3
a. Mark first appropriate box.

0[] Under 17
1[] Present for all questions
2[] Present for some questions
3[] Not present

b. Enter person number(s) of respondent(s) to this section.

Person number(s) of respondent(s) _____

[p.155]


H. HEARING CONDITIONS

H1

1[] Condition list 2 asked (H2)
8[] Other (1)
H2
1[] Any CL LTR A or B in C2 (Mark "HP" box for appropriate person(s), THEN 3)
8[] Other (3)


1a. Does anyone in the family now have deafness in one or both ears?

1[] Yes
2[] No

b. Who is this?
Enter "deafness" (or the condition) and "XX" in appropriate person's column and mark HP box.

c. Does anyone else now have deafness in one or both ears?

[] Yes
[] No

2a. Does anyone in the family now have any other trouble hearing with one or both ears?

[] Yes
[] No (3)

b. Who is this?
Enter "trouble hearing" (or the condition) and "YY" in appropriate person's column and mark HP box.

c. Does anyone else now have any other trouble hearing with one or both ears?

[] Yes (Reask 2b and c)
[] No

3a. Does anyone in the family now use a hearing aid?

[] Yes
[] No (Hospital page)
[] DK (Hospital page)

b. Who is this?
Ask: For what condition does -- need this?
Enter the condition and "ZZ" in appropriate person's column and mark "HA" box.

c. Does anyone else now use a hearing aid?

[] Yes
[] No (Hospital page )