Self Assessment Page

Self Assessment Tool

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Self Assessment Tool

First name

Last name

Do you accidentally skip lines or sentences?

Do you lose your place?

Do you misread words?

Do you skip words or punctuation marks?

Do you read the same line over again?

Do you read words from lines above or below?

Do you avoid reading or reading aloud?

Is your reading slow or choppy?

Are you bothered by white or shiny pages?

Does reading make you restless, active, fidgety or distracted?

Does reading make you feel frustrated, angry or exhausted?

Does reading get harder the longer you do it?

Do you have to use a finger or marker?

Do you find it hard to concentrate?

Difficulty understanding and/or recalling what you’ve read?

Does it take effort to stay on the words you are reading?

Do you have any other symptons that wasn't listed?

Scoring system - 1 point – often / ½ point – sometimes / 0 points – never or don’t know

Total Score

Results for Reading Difficulties:

Slight

1 2 3

Moderate

4 5 6 7

Severe

8 9 10 11 12 13 14 15 16 17 18+