Neuro-Visual Integration Scale™
Your Sensory-Visual Integration Score
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Who is this assessment for?
*
My child
Myself / an adult
Back
Next
🧠 CHILD VERSION (School, Play, Social, Sports)
Visual Function & Processing
Does your child lose their place when reading?
*
Never
Rarely
Often
Always
Do they complain that words move, blur, or double?
*
Never
Rarely
Often
Always
Do they avoid reading or schoolwork that requires visual focus?
*
Never
Rarely
Often
Always
Do they get headaches during homework or screen time?
*
Never
Rarely
Often
Always
Is it hard for them to copy from the board or shift focus?
*
Never
Rarely
Often
Always
Visual Function & Processing Total
*
Sensory Integration
Does your child get overwhelmed in busy environments (classroom, stores, parties)?
*
Never
Rarely
Often
Always
Are they sensitive to noise, light, or movement?
*
Never
Rarely
Often
Always
Do they avoid being touched or seem uncomfortable with touch?
*
Never
Rarely
Often
Always
Do they seek movement (crashing, spinning, constant motion)?
*
Never
Rarely
Often
Always
Do they have difficulty filtering out distractions in class?
*
Never
Rarely
Often
Always
Sensory Integration Total
*
Vestibular / Balance
Does your child get carsick easily?
*
Never
Rarely
Often
Always
Do they avoid playground equipment (swings, climbing)?
*
Never
Rarely
Often
Always
Do they seem off balance or unsteady?
*
Never
Rarely
Often
Always
Do they struggle with sports or coordinated movement?
*
Never
Rarely
Often
Always
Vestibular / Balance Total
*
Motor Coordination & Body Awareness
Does your child appear clumsy or bump into things?
*
Never
Rarely
Often
Always
Do they have difficulty with handwriting?
*
Never
Rarely
Often
Always
Do they tire easily during physical play?
*
Never
Rarely
Often
Always
Do they struggle with maintaining good posture when sitting at a desk?
*
Never
Rarely
Often
Always
Do sports or physical activities seem harder than expected?
*
Never
Rarely
Often
Always
Motor Coordination & Body Awareness Total
*
Cognitive Load & Attention
Does your child have trouble paying attention in school?
*
Never
Rarely
Often
Always
Do they get mentally tired quickly during learning tasks?
*
Never
Rarely
Often
Always
Do they struggle to follow multi-step directions?
*
Never
Rarely
Often
Always
Do they appear forgetful or easily distracted?
*
Never
Rarely
Often
Always
Do they have difficulty completing schoolwork independently?
*
Never
Rarely
Often
Always
Cognitive Load & Attention Total
*
Regulation & Stress Response
Does your child become easily frustrated or overwhelmed?
*
Never
Rarely
Often
Always
Do they have big reactions to small challenges?
*
Never
Rarely
Often
Always
Do they have difficulty calming down once upset?
*
Never
Rarely
Often
Always
Do they seem fatigued after school or social activities?
*
Never
Rarely
Often
Always
Do they have low energy or reduced stamina?
*
Never
Rarely
Often
Always
Regulation & Stress Response Total
*
Integration Efficiency
Does your child seem to work harder than peers to keep up?
*
Never
Rarely
Often
Always
Do their abilities vary from day to day?
*
Never
Rarely
Often
Always
Do symptoms worsen with fatigue or stress?
*
Never
Rarely
Often
Always
Do they have toileting challenges (accidents, urgency, awareness)?
*
Never
Rarely
Often
Always
Do daily routines feel more difficult than they should?
*
Never
Rarely
Often
Always
Integration Efficiency Total
*
CHILD VERSION Total
*
🧠 ADULT VERSION (Work, Driving, Social, Daily Life)
Visual Function & Processing
Do you lose your place when reading?
*
Never
Rarely
Often
Always
Do words blur, move, or double?
*
Never
Rarely
Often
Always
Do you experience headaches with screen use or reading?
*
Never
Rarely
Often
Always
Is it difficult to shift focus between near and far tasks?
*
Never
Rarely
Often
Always
Do your eyes feel strained or fatigued?
*
Never
Rarely
Often
Always
Visual Function & Processing Total
*
Sensory Integration
Do you feel overwhelmed in busy or noisy environments?
*
Never
Rarely
Often
Always
Are you sensitive to light, sound, or visual motion?
*
Never
Rarely
Often
Always
Do you avoid being touched or feel uncomfortable with touch?
*
Never
Rarely
Often
Always
Do you seek movement, pressure, or constant stimulation?
*
Never
Rarely
Often
Always
Do you have difficulty filtering distractions in work or social settings?
*
Never
Rarely
Often
Always
Sensory Integration Total
*
Vestibular / Balance
Do you experience dizziness or motion sensitivity?
*
Never
Rarely
Often
Always
Do you get carsick or uncomfortable as a passenger?
*
Never
Rarely
Often
Always
Do you feel unsteady while walking or turning?
*
Never
Rarely
Often
Always
Do you avoid activities involving movement or balance?
*
Never
Rarely
Often
Always
Vestibular / Balance Total
*
Motor Coordination & Body Awareness
Do you feel clumsy or bump into objects?
*
Never
Rarely
Often
Always
Do physical tasks require more effort than expected?
*
Never
Rarely
Often
Always
Do you have poor posture or difficulty sitting comfortably?
*
Never
Rarely
Often
Always
Do you fatigue easily during physical activity?
*
Never
Rarely
Often
Always
Do you notice changes in coordination since an injury?
*
Never
Rarely
Often
Always
Motor Coordination & Body Awareness Total
*
Cognitive Load & Attention
Do you have difficulty focusing at work or during tasks?
*
Never
Rarely
Often
Always
Do you experience brain fog or slowed thinking?
*
Never
Rarely
Often
Always
Do you become mentally fatigued quickly?
*
Never
Rarely
Often
Always
Do you struggle with multitasking or organization?
*
Never
Rarely
Often
Always
Do you have trouble following complex instructions or conversations?
*
Never
Rarely
Often
Always
Cognitive Load & Attention Total
*
Regulation & Stress Response
Do you feel easily overwhelmed or overstimulated?
*
Never
Rarely
Often
Always
Do you have difficulty recovering after stressful situations?
*
Never
Rarely
Often
Always
Do you feel shutdown or fatigued after social or work demands?
*
Never
Rarely
Often
Always
Do you have low energy or reduced endurance?
*
Never
Rarely
Often
Always
Do symptoms increase with stress?
*
Never
Rarely
Often
Always
Regulation & Stress Response Total
*
Integration Efficiency
Do everyday tasks feel harder than they used to?
*
Never
Rarely
Often
Always
Do you feel like you’re working harder just to function?
*
Never
Rarely
Often
Always
Do your symptoms fluctuate from day to day?
*
Never
Rarely
Often
Always
Do symptoms worsen with fatigue?
*
Never
Rarely
Often
Always
Do you struggle to recognize or respond to body signals, like needing to use the bathroom,or sensing where your body is in space?
*
Never
Rarely
Often
Always
Integration Efficiency Total
*
ADULT VERSION Total
*
Submit
Should be Empty: