| Condition |
T |
B |
F |
VP |
| Lose your place while reading or copying |
X |
X |
|
|
| Reverse letters, numbers or words |
|
|
|
X |
| Tilt head in an unusual posture when reading or writing |
|
X |
|
|
| Unusually tired after completing a visual task |
X |
X |
X |
|
| Crooked or poorly spaced writing |
|
|
|
X |
| Misalign letters or numbers |
|
|
|
X |
| Make errors when copying |
X |
X |
X |
X |
| Difficulty tracking moving objects |
X |
X |
|
|
| Clumsiness or poor coordination |
X |
X |
X |
X |
| Difficulty with eye‐hand coordination sports such as baseball |
X |
X |
|
X |
| Uses fingers to count for math |
|
|
|
X |
| Does not know math facts automatically |
|
|
|
X |
| Confuse right and left directions |
|
|
|
X |
| Totals |
18 |
21 |
9 |
23 |
| Maximum Possible |
69 |
84 |
54 |
55 |
