Assessment Questionnaire

1. How often does your child avoid reading aloud or hesitate when asked to read?

Never Sometimes Often Almost always

2. Does your child confuse similar-looking letters or words more often than you would expect?

Never Sometimes Often Almost always

3. How easy is it for your child to stay focused through homework or written tasks?

Never Sometimes Often Almost always

4. When instructions have more than one step, how often does your child forget what comes next?

Never Sometimes Often Almost always

5. Add any notes that may help us understand your child better

Reading and classroom learning