1

Y

N

2

Is there any hearing problems:

Y

N

3

Difficulties in telling time (reading Clock)           

Y

N

4

Difficulties in finding the right word to express themselves           

Y

N

5

Poor hand/eye coordination ( fine handwriting/parallel lines)

Y

N

6

Short attention span/easily distracted

Y

N

7

Tendency to reverse letters (eg d/b, p/q) or miswrite (s/z,v/x, n/h)           

Y

N

8

Poor reading skills

Y

N

9

Words reversals  (e.g. Was/Saw)           

Y

N

10

Reluctant to read aloud or reading to others

Y

N

11

Poor homework and presentation of written work           

Y

N

12

Great efforts and labour in completing homework or simple task

Y

N

13

Poor or no organizational skills

Y

N

14

Difficulties in copying words from books/blackboard/OHP

Y

N

15

Becomes frustrated with tasks leading to tantrums/bad temper

Y

N

16

Poor self esteem due to literacy difficulties

Y

N

17

“It is unfair” and Why me” attitude because others do better

Y

N

18

Poor/gross mistakes with simple words

Y

N

19

Good at oral communications to ideas, reluctance to put in writing

Y

N

20

Good at practical skills e. g. with Tools, DIY, drawings

Y

N

21

Poor short term memory or poor working mental memory (maths)

Y

N

22

Difficulties with sequence logic or number/words relationships

Y

N

23

Difficulties with place value/ ratio value/ fractions value

Y

N

24

Difficulties in estimating answers/ use of finger counting

Y

N

25

Misreads familiar words e.g. Home=House, Mother =Mom

Y

N

26

Reluctance to have a go at reading difficult words or simple tasks

Y

N

27

Drifts away from looking at texts when reading/ loses reading place

Y

N

28

Little or no expression and intonation with reading

Y

N

29

Doesn’t recognize the same word on next page or else where in the story

Y

N

30

Uses finger with reading, loses patients, irritable with reading

Y

N

31

Attempts to spell phonetically

Y

N

32

Difficulties in distinguishing Vowel sounds from Vowel Combinations

Y

N

33

Poor use of capital letters and punctuation, capital letters in mid word

Y

N

34

Messy handwriting to hide poor spelling, leading to dislike of writing

Y

N

35

Reluctance to ask for help or being helped by parents

Y

N

36

Negativism and bad temper when faced with even simple school task

Y

N

37

Whining and sibling rivalry

Y

N

38

Cannot read what he/she wrote

Y

N

39

Dictation is fair, but copying is poor top impossible

Y

N

40

Word blindness, misses out words altogether and can skip a line

Y

N

Ishihara:

City University

Right Eye:

Left Eye:

Flash at 20-25cms

Special Allowance

Hop cat and
Car ant eat
In a not man
On us I all to my the dog me We in up air do see for not look is play come let be dad was in by at old out.

Cause known vision  either certain optical result often the mirror type be yet tried place loss test ball face read was before number home jump measure their design line loss another school Find mean near date call lead has come

in 
I
on
to
me
dad
at
door
ant
cat
dog
let
to
hop
bee

Read as many words as possible from the words listed below in one minute:

Man one
                            see ear use
                         win come now
                        even in zoo saw
                     race coin swan our
                   mess nose six cow sin
                 we rise car sun oar rise
                scan miss wise mare roar
            on river  sea omen mace cave
         even swim see nice sir crow zone
   maze wine raw cress rain rum cure bed
sum nine use seam man  air arm cove sky

Phonetics Score

Full Marks <9 Score

Full Marks Stage 2 Score=

Full Marks Stage 3 Score=

Full Marks Stage 4 Score=