Bristol Dyslexia Centre

This is the questionnaire for the 7 - 13 age range.
Please ensure all questions are answered correctly.
Only tick the appropriate box and don't leave any blank, at the end of the questionnaire press the "Hand it in" button for our hairy expert to have a look at and make his recommendations.

Try these questions:

	Yes	No	Some
1. Is copying from the board slow and do you make mistakes ?
2. Is it difficult to remember multiplication tables ?
3. Do you still make lots of spelling mistakes ?
4. Is there any frustration, temper tantrums, problems with behavior or quiet withdrawal, particularly associated with school or school work?
5. Is there a reluctance to go to school ?
6. Is there any difficulty getting ideas down in writing ?
7. Is reading still difficult and slower than other children ?
8. Does not enjoy reading, especially aloud, and small words are misread or missed out ?
9. Is it difficult to take in information that is read out and heard, or are instructions recalled incomplete or in the wrong order ?
10. Writing has little or no punctuation ?

Thank you for taking the time to fill out the questionnaire, now 'Hand it in' to our expert by pressing the button and finding out what he thinks.

Bristol Dyslexia Centre, 10 Upper Belgrave Road, Clifton, Bristol, BS8 2XH.
Tel: 0117 9739405 Fax: 0117 9239703

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