| LP130638-2 | Because of your tinnitus do you feel depressed | COMPONENT | 1 |
| LP130639-0 | Does your tinnitus make you feel anxious | COMPONENT | 1 |
| LP130640-8 | Do you feel that you can no longer cope with your tinnitus | COMPONENT | 1 |
| LP130641-6 | Does your tinnitus get worse when are you are under stress | COMPONENT | 1 |
| LP130642-4 | Does your tinnitus make you feel insecure | COMPONENT | 1 |
| LP130643-2 | By age 2, was your child talking in short phrases or sentences | COMPONENT | 1 |
| LP130644-0 | When your child was 2Ys old, were you concerned that they were having difficulty learning to talk | COMPONENT | 1 |
| LP130645-7 | At this time, do people frequently have trouble understanding your child | COMPONENT | 1 |
| LP130646-5 | Has anyone in your child's family had speech or language therapy | COMPONENT | 1 |
| LP130647-3 | What did anyone in your child's family have speech or language therapy for | COMPONENT | 1 |
| LP130652-3 | Details of family having difficulty reading or problems with school work | COMPONENT | 1 |
| LP130653-1 | Has anyone in your child's family been diagnosed with an intellectual disability | COMPONENT | 1 |
| LP130654-9 | Does anyone in your child's family have a hearing difficulty | COMPONENT | 1 |
| LP130655-6 | Has anyone in your child's family been slow in learning to talk | COMPONENT | 1 |
| LP130656-4 | Has anyone in your child's family had stuttering | COMPONENT | 1 |
| LP130657-2 | Anyone in your child's family less talkative | COMPONENT | 1 |
| LP130658-0 | Has anyone in your child's family had a hard time carrying on a conversation | COMPONENT | 1 |
| LP130659-8 | Anyone in your child's family that doesn't like to read | COMPONENT | 1 |
| LP130660-6 | Anyone in your child's family that doesn't read well | COMPONENT | 1 |
| LP130661-4 | Anyone in your child's family that has difficulty thinking of words they want to say when talking | COMPONENT | 1 |
| LP130662-2 | Anyone in your child's family that has a poorer vocabulary than other family members | COMPONENT | 1 |
| LP130663-0 | Anyone in your child's family that is a poor speller | COMPONENT | 1 |
| LP130664-8 | Anyone in your child's family that has awkward sentence structures when writing or talking | COMPONENT | 1 |
| LP130665-5 | Anyone in your child's family that mispronounces long words | COMPONENT | 1 |
| LP130666-3 | Anyone in your child's family that is hard to follow when they tell you something, such as a personal experience | COMPONENT | 1 |
| LP130667-1 | Anyone in your child's family that has difficulty explaining things | COMPONENT | 1 |
| LP130668-9 | Because of your tinnitus is it difficult to concentrate | COMPONENT | 1 |
| LP130669-7 | Does the loudness of your tinnitus make it difficult for you to hear people | COMPONENT | 1 |
| LP130670-5 | Does your tinnitus make you angry | COMPONENT | 1 |
| LP130671-3 | Does your tinnitus make you feel confused | COMPONENT | 1 |
| LP130672-1 | Because of your tinnitus do you feel desperate | COMPONENT | 1 |
| LP130673-9 | Do you complain a great deal about your tinnitus | COMPONENT | 1 |
| LP130674-7 | Because of your tinnitus do you have trouble falling to sleep at night | COMPONENT | 1 |
| LP130675-4 | Do you feel that you cannot escape your tinnitus | COMPONENT | 1 |
| LP130676-2 | Does your tinnitus interfere with your ability to enjoy social activities | COMPONENT | 1 |
| LP130677-0 | Because of your tinnitus do you feel frustrated | COMPONENT | 1 |
| LP130678-8 | Because of your problem, is it difficult for you to walk by yourself | COMPONENT | 1 |
| LP130679-6 | Does walking down a sidewalk increase your problem | COMPONENT | 1 |
| LP130680-4 | Because of your problem, is it difficult for you to concentrate | COMPONENT | 1 |
| LP130681-2 | Because of your problem, is it difficult for you to walk around the house in the dark | COMPONENT | 1 |
| LP130682-0 | Because of your problem, are you afraid to stay at home alone | COMPONENT | 1 |
| LP130683-8 | Because of your problem, do you feel handicapped | COMPONENT | 1 |
| LP130684-6 | Has your problem placed stress on your relationship with members of your family or friends | COMPONENT | 1 |
| LP130685-3 | Because of your problem, are you depressed | COMPONENT | 1 |
| LP130686-1 | Does your problem interfere with your job or household responsibilities | COMPONENT | 1 |
| LP130687-9 | Does bending over increase your problem | COMPONENT | 1 |
| LP130688-7 | Does looking up increase your problem | COMPONENT | 1 |
| LP130689-5 | Because of your problem, do you feel frustrated | COMPONENT | 1 |
| LP130690-3 | Because of your problem, do you restrict your travel for business or recreation | COMPONENT | 1 |
| LP130691-1 | Does walking down the aisle of a supermarket increase your problem | COMPONENT | 1 |