PLEASE READY INSTRUCTIONS CAREFULLY

For ages 7 and above

Answer all questions by comparing this child to other children of similar age and background. Do not answer the questions based on the difficulty of the listening condition. For example, all 8-year-old children, to a certain extent, may not hear and understand when listening in a noisy room; this would be a difficult listening condition for all children. However, some children may have more difficulty in this listening condition than others. You must judge whether or not THIS child has MORE difficulty than other children in each listening condition cited. Please make your judgment using the following response choices, CHECK a number for each item in all categories

KEY:

+1 - Less Difficulty

0 - Same Amount Of Difficulty

-1 - Slightly More Difficulty

-2 - More Difficulty

-3 Considerably More Difficulty

-4 - Significantly More Difficulty

-5 - Cannot Function At All

Listening Condition - NOISE

If listening in a room there is background noise such as TV, music, others talking, children playing, etc., this child has difficulty hearing and understanding compared to other children of similar age and background

Listening Condition - QUIET

If listening in a quiet room (others may be present, but are being quiet), this child has difficulty hearing and understanding compared to other children of similar age and background.

Listening Condition - IDEAL

When listening in a quiet room, no distractions, face-to-face, and with good eye contact, this child has difficulty hearing an understanding compared to other children of similar age and background.

Listening Condition - MULTIPLE INSTRUCTIONS

When, in addition to listening, there is also some other form of input (i.e., visual, tactical, etc.) this child has difficulty hearing and understanding compared to other children of similar age and background.

Listening Condition - AUDITORY MEMORY SEQUENCING

If required to recall spoken information, this child has difficulty hearing and understanding compared to other children of similar age and background.

Listening Condition - AUDITORY ATTENTION SPAN

If extended periods of listening are required, this child has difficulty paying attention, that is, being attentive to what is being said compared to other children of similar age and background.

SCORING:

The CHAPS can be scored two ways. Add the checked responses for each condition and place the sum in the "Total Condition Score" box under each listed listening condition. Be careful to note "+" and "-" values when adding. Transcribe those sums as indicated below and determine the average score for each listening condition. The Total Condition Scores can be compared to the indicated PASS and FAIL ranges and the appropriate box checked. In addition, the average condition scored can be plotted on the graph to display performance as compared to the normal range. See the CHAPS manual for complete validity and interpretition information.