Objective: This study evaluated the preliminary clinical utility of the Paediatric Hyperacusis Questionnaire (P-HQ) for identifying auditory sensitivity in children with autism spectrum disorder (ASD) and assessed the initial psychometric properties of the Turkish version for ages 2–6 years. Design: The study was conducted in two phases: cultural adaptation/psychometric evaluation and discriminative validity analysis. After removing one developmentally inappropriate item, a 10-item version was used. Validity was assessed via factor and ROC analyses. Study Sample: The sample consisted of 101 typically developing (TD) children for the first phase and an additional clinical group of 30 children with ASD for the second phase (Total N = 131). Results: A two-factor structure explained 53.85% of the variance (Cronbach’s α = 0.81). Children with ASD had significantly higher scores than TD peers (p < 0.001). ROC analysis showed good accuracy (AUC = 0.814). A cut-off score of ≥9 yielded 60% sensitivity and 88% specificity, indicating its utility as a preliminary, sample-specific screening threshold for risk stratification rather than a standalone diagnostic tool. Conclusions: The Turkish P-HQ is a valid preliminary tool for identifying children at risk for hyperacusis. It serves as a practical aid for clinicians to identify cases requiring further, more comprehensive audiological and behavioural evaluation.