Learning Disability Screener

1

How should we address you?* This field is required.Your results will be sent using this name

First Name

Last Name

2

Where should we send your child’s results?Enter your email address

example@example.com

3

1.) My child has a hard time completing schoolwork independently.

Never

Sometimes

Frequently

Always

4

2.) After reading a passage/text my child struggles with reading comprehension.

Never

Sometimes

Frequently

Always

5

3.) My child requires frequent repetition for info to stick.

Never

Sometimes

Frequently

Always

6

4.) My child has in the past or currently has a hard time telling time, tying shoes, rhyming or pronouncing certain words like spaghetti (pasghetti).

Never

Sometimes

Frequently

Always

7

5.) My child has a hard time following multi-series instructions or requires multiple reminders to complete a simple task (hang up your towel).

Never

Sometimes

Frequently

Always

8

6.) My child has a hard time focusing, drifts off or has a hard time sitting still (not including device or tech).

Never

Sometimes

Frequently

Always

9

7.) My child reverses letters, skips words and letters and/or has a hard time blending sounds.

Never

Sometimes

Frequently

Always

10

8.) My child is confused with or can’t retain common sight words such as ‘the’, ‘and’ or ‘if’.

Never

Sometimes

Frequently

Always

11

9.) My child is a picky eater and/or craves sugars/carbs.

Never

Sometimes

Frequently

Always

12

10.) My child has had frequent ear infections.

Never

Sometimes

Frequently

Always

13

11.) My child has been on antibiotics.

Never

Sometimes

Frequently

Always

14

12.) My child has eczema, psoriasis, other skin issues or allergies.

Never

Sometimes

Frequently

Always

15

13.) My child had or has digestive issues (constipation, diarrhea, tummy pain).

Never

Sometimes

Frequently

Always

16

14.) My child has coordination issues, poor posture or gait.

Never

Sometimes

Frequently

Always

17

15.) My child did not crawl or crawled atypically or did not crawl long.

Never

Sometimes

Frequently

Always

18

16.) My child's handwriting is hard to read, complains of hand cramping or avoids writing things down.

Never

Sometimes

Frequently

Always

19

17.) My child is gifted in one area like art, mechanics, sports but struggles greatly in another like reading.

Never

Sometimes

Frequently

Always

20

18.) My child had or has speech or hearing issues.

Never

Sometimes

Frequently

Always

21

19.) My child has confusion with left and right.

Never

Sometimes

Frequently

Always

22

20.) My child says 'huh' or 'what’ a lot or I need to repeat what I said.

Never

Sometimes

Frequently

Always

23

21.) Spends an excessive amount of time to complete a task compared to peers of the same age.

Never

Sometimes

Frequently

Always

24

Calculation

25

Minimal Signs Message

26

Subtle Pattern Emerging Message

27

Likely Learning Challenges Message

28

Strong Indicators of Underlying Issues Message

29

Result Description