| Condition |
T |
B |
F |
VP |
| Skip words while reading or copying |
X |
X |
|
|
| Substitute words while reading or copying |
X |
X |
X |
|
| Reread words or lines |
X |
X |
|
|
| Reverse letters, numbers or words |
|
|
|
X |
| Poor reading comprehension, difficulty remembering what you’ve read |
X |
X |
X |
X |
| Crooked or poorly spaced writing |
|
|
|
X |
| Misalign letters or numbers |
|
|
|
X |
| Poor word recall & recognition |
|
|
|
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 |
| Dislike tasks requiring sustained concentration |
X |
X |
X |
X |
| Avoid near tasks such as reading |
X |
X |
X |
|
| Restless when working at a desk |
X |
X |
X |
X |
| Losing awareness of surroundings when concentrating |
X |
X |
X |
X |
| Excessive eye rubbing |
X |
X |
X |
|
| Sensitivity to light |
X |
X |
X |
|
| Totals |
25 |
25 |
19 |
36 |
| Maximum Possible |
69 |
84 |
54 |
55 |
