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Q.1
Did your child struggle to learn to count?
*
Yes
No
Q.2
Does she say numbers out of order — long after peers have mastered this skill?
*
Yes – frequently
Sometimes
No – never
Q.3
Does your child not seem to understand the connection between the symbol “4” and the word “four?” Does he make mistakes when reading or following directions involving number words and symbols?
*
Yes – frequently
Sometimes
No – never
Q.4
Does your child struggle to connect the concept of numbers to real-world items? When you ask him how many cookies are left, for example, does he seem confused by the question or answer incorrectly?
*
Yes – frequently
Sometimes
No – never
Q.5
Does your child not seem to understand the difference between adding and subtracting? Does she confuse the + and – symbols when completing math problems?
*
Yes – frequently
Sometimes
No – never
Q.6
Does your child still count on his fingers past third grade?
*
Yes
No
Q.7
Does your child have difficulty telling time on an analog clock?
*
Yes – frequently
Sometimes
No – never
Q.8
Does your child struggle to understand money, and have difficulty making change or sticking to a budget?
*
Yes – frequently
Sometimes
No – never
Q.9
Does your child get lost, even in familiar surroundings?
*
Yes – frequently
Sometimes
No – never
Q.10
Does your child struggle to read graphs or charts without help?
*
Yes – frequently
Sometimes
No – never
Q.11
Does your child have difficulty writing numbers clearly or keeping his work neat when solving math problems?
*
Yes – frequently
Sometimes
No – never
Q.12
Does your child struggle to sort objects by shape, color, or size?
*
Yes – frequently
Sometimes
No – never
Q.13
Does your child have trouble solving word problems or multi-step math problems? Does she struggle to articulate what strategies she’ll use along the way?
*
Yes – frequently
Sometimes
No – never
Q.14
Does your child seem disinterested in keeping score or playing any game that involves math, however indirectly?
*
Yes – frequently
Sometimes
No – never
Q.15
Does your child ever get unnaturally upset or complain of feeling ill while completing math homework?
*
Yes – frequently
Sometimes
No – never
Q.16
Does your child have difficulty applying fractions to real-world objects? Is she unable to determine that a dollar equals four quarters, for instance, or that one-half of the year is equal to six months?
*
Yes – frequently
Sometimes
No – never
Q.17
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