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Q.1
Is your child of average or above-average intelligence, but often seems unable to read at her grade level?
*
Yes
No
Q.2
Does it seem like your child is better at expressing himself verbally than he is at writing?
*
Yes
No
Q.3
Does your child avoid reading altogether, or does she get easily frustrated when completing reading-related assignments?
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Yes
No
Q.4
Does your child have difficulty sustaining attention? Does she space out or get labeled a "daydreamer?”
*
Yes
No
Q.5
Does your child complain of headaches, stomachaches, or dizziness when reading?
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Yes
No
Q.6
Does your child ever say that words “wiggle” or “shimmer” on the page while he’s reading?
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Yes
No
Q.7
After reading a passage, is your child unable to give a summary or discuss key points with you?
*
Yes
No
Q.8
When reading out loud, does your child sometimes repeat words, mix up letters, or change word order without noticing?
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Yes
No
Q.9
Does your child spell inconsistently, often misspelling words she already knows?
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Yes
No
Q.10
Does your child struggle to sound out unknown words?
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Yes
No
Q.11
Does your child confuse his left from his right?
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Yes
No
Q.12
Does your child struggle to copy letters, numbers, or symbols?
*
Yes
No
Q.13
Is your child’s handwriting inconsistent? Is it less legible some days than others?
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Yes
No
Q.14
Does your child have difficulty budgeting her time or following a schedule?
*
Yes
No
Q.15
Does your child struggle with word problems — even though he’s otherwise good at math?
*
Yes
No
Q.16
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