Free Dyslexia Assessment - Part I

Questionnaire (can be given to yourself or your child)

1. Do you read, write, or spell below grade level?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

2. Have you ever been labeled as lazy, dumb, careless, immature, "not trying hard enough," or having "a behavior problem?"

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

3. Do you feel that you can understandinformation better if it is read aloud to you rather than if you read it toyourself?"

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

4. Do you test well orally but not on written exams?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

5. Do you try to sound out words but struggle with even simple ones, often missing sight words such as the, an, it?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

6. Do you quickly seem to forget how to spell words you just learned?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

7. Do you feel dumb, have poor self-esteem, and feel emotional about school, reading, or testing?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

8. When you read aloud, do you regularly substitute simpler words for other words (for example, "dog" for "puppy" or "house" for "home")?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

9. Is your handwriting sloppy, with poor letter formation, size, and spacing, and/or do you have difficulty with keeping numbers lined up when adding, subtracting, multiplying, or dividing?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

10. Does your reading or writing show repetitions, additions, transpositions, omissions, substitutions, and reversals in letters, numbers, and/or words?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

11. Is your spelling poor and inconsistent?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

12. Do you have difficulty putting thoughts into words; leave sentences incomplete; mispronounce long words; or transpose phrases, words, and syllables when speaking?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

13. Do you have a difficult time with short-term memory, especially for sequences of information that have little meaning?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

14. Is there a family history of reading/spelling problems on either side of the family?

Absolutely____(3)

Somewhat____(2)

Rarely or Never____(1)

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