DYSLEXIA SYMPTOMS CHECKLIST/QUESTIONNAIRE

DYSLEXIA SYMPTOMS CHECKLIST/QUESTIONNAIRE
(School-age children must evidence three or more of the following criteria
in addition to having difficulty with spelling tasks to warrant further
testing for dyslexia.)
□ Does anyone in your family have a diagnosis of dyslexia or have symptoms associated with
dyslexia?
□ Does your child have directionality issues (i.e. difficulty discriminating left vs. right, confusion
or delays when telling time on a clock with hands, north/south/east/west confusion,
difficulty with before/after concepts, confusion in math particularly with carrying numbers
in addition tasks, etc.)?
□ Does your child have or has your child ever had difficulty with retrieval of “random” facts from
long-term memory (i.e. months of the year or days of the week in sequence, alphabet,
multiplication facts, a sequence of mathematical steps, address, phone number, etc.)?
□ Was your child a late talker (i.e. not speaking at all by his/her first birthday or a limited
vocabulary at age two or three years)?
□ Was your child late establishing a dominant hand?
□ Are any of your child’s words phonologically out of sequence (i.e. flutterby for butterfly,
constonant for consonant, aminal for animal, etc)?
□ Did your child ever stutter or have dysfluent speech?
□ Does your child have errors in speech productions, or has your child had a history of a speech
disorder (i.e. substitutes one sound for another, leaves out sounds in words, etc. Example:
Says /l/ sounds for /r/ sounds such as flustrated for frustrated)?
□ Does your child have difficulty processing information presented auditorily (i.e. requires more
time to process information heard, difficulty following multi-step directions, difficulty
discriminating sounds in similar word pairs, difficulty segmenting words or blending
sounds, etc.)?
□ Does your child have difficulty with reading fluently and/or have difficulty with reading
comprehension?
□ Does your child have difficulty rhyming words (by the age of four years)?
□ Does your child have difficulty finding the correct word when speaking (i.e. “thingies” and
“whatyamacallits”)?
□ Does your child have slow, non-automatic handwriting that is difficult to read?
□ Does or did your child have difficulty learning to tie his/her shoes?
□ Does your child have an unusual pencil grip and/or letter formation?
□ Does your child have difficulty with spelling and written expression?
□ Does your child have difficulty with “inventive” spelling?
□ Does your child reverse letters (i.e. /b/ for /d/, /d/ for /b/, /p/ for /b/, /q/ for /p/, etc.) when
writing? (NOTE: These reversals are NOT due to the child seeing the letters backwards.
The child is typically guessing the letter formation due to difficulty with directionality---left
vs. right, visual imagery---a mental picture of the letter, and recall of the sequence involved
with writing the letter.)
□ Does your child dread going to school, complain of stomach aches or headaches, and/or have
nightmares about school?
Information compiled from seminar materials presented by Susan Barton,
www.BrightSolutions.us.