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Paediatric Throat Disorders Outcome Test – T14

How to complete this Questionnaire:

  • Below you will find a list of symptoms and problems that may be caused by your child's throat problems.
  • We would like to know more about these and would appreciate your answering the following questions to the best of your ability.
  • There are no right or wrong answers, and only you can provide us with this information.
  • Considering how severe the problem is when your child experiences it and how often it happens over the past 6 months for your child, please rate each item below on how 'bad' it is by circling the number the appropriate number.
  • If a certain question is NOT a problem for your child, please circle '0'.
0 - 4 Rating Scale
0 = NO problem
1 = Very mild problem
2 = Mild or slight problem
3 = Moderate problem
4 = Severe problem
5 = Problem as bad as it could be

Snoring loudly during sleep

Irregular or stopped breathing (apnoea) during sleep

Many visits to the GP or emergency department

Many phone calls to the doctor or nurse-on-call.

Taking antibiotics over and over for less than 2 weeks at a time

Taking antibiotics for more than 2 weeks straight.

Frequent ear ache or ear infections

Repeated short-term throat infections that last less than 2 weeks

Constant, or chronic, throat infections that last more than 2 weeks.

Breathing through the mouth during the day.

Noisy breathing during the day

Problems with poor appetite, or poor eating habits (choking on foods, etc)

Missing school days due to sore throat

Daytime Sleepiness

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Time's up

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  • For Patients
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  • Refer Patients
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  • Perform Examinations
Contact

1300 952 808
info@melbentgroup.com.au
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