Table of contents III Journal Staff

Synesthesia Battery Pre-screening Questionnaire

Subject #: _________

1. Does seeing, thinking of, or hearing a number (e.g. Arabic or Chinese) cause a perception of color?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

2. Does seeing, thinking of, or hearing a letter cause a perception of color?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

3. Does the concept of dates such as days (e.g. Monday, Tuesday), or months (e.g. January, February) trigger a color?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

4. Do you visualize numbers, letters or time units like weekdays or months as being spread out in a 3D space around you?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

5. Do individual keys on a piano or other instrument cause the perception of different colors?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

6. Do different musical chords cause perception of different colors?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

7. Do different musical instruments cause perception of different colors?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

8. Do individual keys on a piano or other instrument cause the perception of different shapes?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

9. Do different musical chords cause perception of different shapes?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

10. Do different musical instruments cause perception of different shapes?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

11. Do tastes trigger a color for you? For example, does the taste of chocolate, citrus, or banana trigger a color?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

12. Do smells trigger a color for you? For example, does the odor of steak or fries cause the perception of a color in you?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

13. Does pain trigger a color for you? For example, do different levels of pain you experience at different times, say while having a headache, cause you to perceive color?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

14. Does seeing or thinking of a person make you perceive a color?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

15. Do tactile sensations trigger a color for you? For example, when you experience touch sensations of different kinds, on different parts of your body, do you also perceive color?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

16.Do heat and cold trigger colors in you? For example, does touching cold water or feeling warm water in a shower cause you to perceive different colors?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

17. Do you perceive different colors while experiencing a sexual orgasm?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

18. Do different emotions like joy, gloom cause perception of color?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

19. Does seeing a picture or a scene also cause you to hear a sound?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

20. Does hearing a sound cause a distinct odor, like the noise of water gushing arouses the smell of a rose?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

21. Does seeing a picture, object or a scene cause you to perceive a distinct smell?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

22. Does hearing a sound cause a sensation of touch for you? For example, does hearing an airplane fly past cause a distinct sensation of touch?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

23. Does hearing a sound cause a sensation of taste for you? For example, does the ticking of a clock cause a sour taste in your mouth?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

24. Does seeing a picture, object, or a scene cause the sensation of a taste for you?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

25. Does sign language (e.g. American Sign Language, British Sign Language) cause a perception of color for you?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

26. Does the alphabet (e.g. Cyrillic, Greek, Hebrew) cause experiences of color for you?

☐ Never ☐ Rarely ☐ Sometimes ☐ Often ☐ All the time

27. We have described a few types of synesthesia. Many other unusual blendings of the senses have been reported. Do you suspect that you experience an unusual blending that other people do not have (other than the ones listed above)? Those could include automatically hearing a sound when you see movement, or the sense of a shape being triggered by a taste, or experiencing a color when feeling pain.

☐ Yes, I believe I may have other forms of unusual sensory experiences ☐ Not that I know of

28. Please describe any other unusual blending of the senses that you think you might have and that other people do not have. If you would like to add any comments about the experiences that are mentioned in this survey as well, feel free to do so.

29. Do you have any training in music? If so, please describe the extent of your training and address your knowledge of music theory, the instruments you play, and the length of time you have spent studying or playing.

30. Do you have any training in visual art, especially drawing, graphics programming or painting? If so, please describe the extent of your training and address your technical knowledge, the art forms you have studied or practiced, and the length of time you have spent studying or practicing.

Appendix B

Line-shape Stimuli Arrangements with the Line-shape Labels

*These were not displayed during the experiment, but are included here for ease of reference*

Appendix C