WARNING:
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This list only aims at guiding parents in their attempt to understand their child's difficulties. A professional assessment is necessary for diagnosis. |
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These are just some examples of difficulties a person may experience. Circle the appropriate items when more than one is presented on one line
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problems during pregnancy (bleeding, medication, drug or alcohol inake& ) |
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problems at birth (difficult delivery, born earlier or late, weight less than 5 pounds..) |
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learning difficulties (see longer checklist). Ex: difficulty telling time, reading and/or writing, copying difficulties " attention difficulties (see longer checklist). Ex: daydreams, takes 2 hours to do math homework that can take 10 minutes when the child decides to do it |
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history of learning difficulties in the immediate family Health History |
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suffers from allergies |
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adverse reaction to his vaccinations |
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sucks him thumb passed 5 years old |
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frequent ear, nose, throat or chest infection |
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high fever before 3 years old Auditory Functions |
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is startled when someone unexpectedly makes a sound |
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talks too loudly |
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shouts or screens for no apparent reason |
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hates hair cuts, hair washing or hair being brushed Visual Functions |
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keeps eyes close to the book or paper while reading or writing |
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looses his/her place. Skips from one line to the other |
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oversensitive to light |
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poor eye contact Tactile Functions |
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bed-wetting past 5 years old |
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high or low tolerance to pain (circle which one) |
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very ticklish |
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heavy walker |
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removes tags on clothes |
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