Which of the following illustrates an example of activity limitation caused by hearing loss?

The correct choice illustrates an example of activity limitation caused by hearing loss because it directly relates to the fundamental aspects of auditory perception. Hearing loss can prevent a person from detecting certain sounds, which affects their ability to engage in various activities that rely on hearing. For instance, this limitation can hinder communication in social situations or the ability to respond to auditory signals necessary for safety and interaction, thereby affecting one's overall participation in life.

In contrast, the other options relate more to secondary effects or psychosocial factors. Struggling with written communication, feeling fatigued during conversations, and experiencing social anxiety may be influenced by hearing loss but do not encapsulate the direct limitation of activity caused by the auditory impairment itself. These can be seen as consequences of the limitations but not limitations of the activity arising directly from hearing loss.