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1. Does the student have difficulty sounding out words phonetically, particularly new words. "Giraffe" as "J/Er/A/F" ?* YesNoI don't know

2. Does the student either reverse letters when writing, well after most children of similar age have stopped doing so, or leave out letters in a word ("swimng")?* YesNoI don't know

3. Does the student incorrectly copy notes from the board, by missing information, misspelling, or reversing information?* YesNoI don't know

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8. Does the student struggle with multiple choice tests, due to misunderstanding or misreading details in the question, rather than lack of knowledge about the answer? * YesNoI don't know

9. When reading, does the student have trouble keeping place, missing individual words or whole lines? * YesNoI don't know

10. Does the student make reading mistakes in letters, numbers, or grammar, such as confusing "a " and "o " (pat, pot); "7" and"1"; or not pausing for punctuation such as periods and commas? * YesNoI don't know

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