| Condition |
T |
B |
F |
VP |
| Skip lines while reading or copying |
X |
X |
|
|
| Lose your place while reading or copying |
X |
X |
|
|
| Skip words while reading or copying |
X |
X |
|
|
| Reverse letters, numbers or words |
|
|
|
X |
| Read very slowly |
X |
X |
X |
|
| Poor reading comprehension, difficulty remembering what you’ve read |
X |
X |
X |
X |
| Crooked or poorly spaced writing |
|
|
|
X |
| Print moves or goes in and out of focus when reading |
|
X |
X |
|
| Poor spelling skills |
|
|
|
X |
| Misalign letters or numbers |
|
|
|
X |
| Clumsiness or poor coordination |
X |
X |
X |
X |
| Poor word recall & recognition |
|
|
|
X |
| Uses fingers to count for math |
|
|
|
X |
| Does not know math facts automatically |
|
|
|
X |
| Difficulty following instructions (written or verbal) |
|
|
|
X |
| Unable to remember a series of tasks |
|
|
|
X |
| Below grade level on standardized tests |
X |
X |
X |
X |
| Confuse right and left directions |
|
|
|
X |
| Car sickness or motion sickness |
X |
X |
X |
|
| Totals |
23 |
26 |
17 |
38 |
| Maximum Possible |
69 |
84 |
54 |
55 |
