Appendix A.

Questionnaire for parents/caretaker of the child (presented in Portuguese).

Child's name: _________________________________________ Child's age:__________

Child's educational level: _______________ School:______________________________

1) Educational level of respondent:

( ) Elementary uncompleted ( ) Elementary completed ( ) High school ( ) Graduation ( ) Post-graduation

2) Does your child understand speech in silent environments?

( ) Yes, always ( ) Sometimes he/she seems not to hear ( ) He/she always has some difficulty ( ) I don't know

3) Has your child ever complained of ringing in the ears or other sounds in the ear or inside the head?

( ) Yes ( ) No ( ) I don't know

4) Does your child get annoyed by any sound that doesn't bother others?

( ) Yes ( ) Sometimes ( ) No ( ) I don't know

5) How many ear infections has you child had?

( ) None ( ) 1 to 3 ( ) More than 4 ( ) I don't know

6) Does your child go to noisy places, where it is difficult to talk because the sound is too loud?

( ) Yes ( ) No ( ) I don't know

7) Does your child cover his/her ears or complain where there are loud sounds around?

( ) Yes ( ) Sometimes ( ) No ( ) I don't know

8) Has your child ever been close to fireworks, gun shots or explosions?

( ) Yes ( ) No ( ) I don't know