| 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 |
|
| Reverse letters, numbers or words |
|
|
|
X |
| Use a finger or marker to keep place while reading/writing |
X |
X |
|
|
| Poor reading comprehension, difficulty remembering what you’ve read |
X |
X |
X |
X |
| Difficulty with eye‐hand coordination sports such as baseball |
X |
X |
|
X |
| Does not know math facts automatically |
|
|
|
X |
| Difficulty following instructions (written or verbal) |
|
|
|
X |
| Unable to remember a series of tasks |
|
|
|
X |
| Feel sleepy while reading |
X |
X |
X |
|
| Confuse right and left directions |
|
|
|
X |
| Car sickness or motion sickness |
X |
X |
X |
|
| Totals |
25 |
25 |
10 |
20 |
| Maximum Possible |
69 |
84 |
54 |
55 |
