| 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 |
|
|
| Substitute words while reading or copying |
X |
X |
X |
|
| Read very slowly |
X |
X |
X |
|
| Squint, close or cover one eye while reading |
|
X |
|
|
| Tilt head in an unusual posture when reading or writing |
|
X |
|
|
| Unusually tired after completing a visual task |
X |
X |
X |
|
| Difficulty tracking moving objects |
X |
X |
|
|
| Difficulty following instructions (written or verbal) |
|
|
|
X |
| Below grade level on standardized tests |
X |
X |
X |
X |
| Restless when working at a desk |
X |
X |
X |
X |
| Losing awareness of surroundings when concentrating |
X |
X |
X |
X |
| Excessive blinking |
X |
X |
X |
|
| Totals |
29 |
35 |
17 |
13 |
| Maximum Possible |
69 |
84 |
54 |
55 |
