| Condition |
T |
B |
F |
VP |
| Reverse letters, numbers or words |
|
|
|
X |
| Poor reading comprehension, difficulty remembering what you’ve read |
X |
X |
X |
X |
| Squint, close or cover one eye while reading |
|
X |
|
|
| Tilt head in an unusual posture when reading or writing |
|
X |
|
|
| Crooked or poorly spaced writing |
|
|
|
X |
| Poor spelling skills |
|
|
|
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 |
| Poor word recall & recognition |
|
|
|
X |
| Does not know math facts automatically |
|
|
|
X |
| Difficulty following instructions (written or verbal) |
|
|
|
X |
| Below grade level on standardized tests |
X |
X |
X |
X |
| Dislike tasks requiring sustained concentration |
X |
X |
X |
X |
| Confuse right and left directions |
|
|
|
X |
| Restless when working at a desk |
X |
X |
X |
X |
| Totals |
19 |
25 |
13 |
33 |
| Maximum Possible |
69 |
84 |
54 |
55 |
