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KATY : 281-492-6262 WEST OAKS : 281-589-2955

 

1. My child has difficulty concentrating and paying attention.
1.never 2.sometimes 3.often
2. My child requires a lot of time to complete homework.
1.never 2.sometimes 3.often
3. My child complains of blurred vision, or double vision when reading.
1.never 2.sometimes 3.often
4. My child complains of eyestrain or headaches when reading.
1.never 2.sometimes 3.often
5. My child loses his/her place when reading or skips words or lines.
1.never 2.sometimes 3.often
6. My child has difficulty copying from the board.
1.never 2.sometimes 3.often
7. My child has difficulty with handwriting.
1.never 2.sometimes 3.often
8. My child reverses letters, numbers or confuses similar words.
1.never 2.sometimes 3.often
9. My child becomes tired or sleepy after short periods of time or his/her reading comprehension deteriorates with time.
1.never 2.sometimes 3.often
10. My child has struggled in school.
1.never 2.sometimes 3.often

Add up the total score for the ten questions and compare it to the following guideline

Score What The Score Means
10-12 Your child probably does not have a vision problem interfering with school performance.
13-18 Your child may have a vision problem interfering with school performance.
19-30 Your child almost certainly has a vision problem interfering with school performance.

If a child has a score greater than 12 it is strongly suggested that an evaluation be done testing those aspects of vision that might be contributing to learning difficulties. If a problem is detected, a Vision Therapy program may be recommended to eliminate the vision disorders.

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