Irlen ADHD Self Test

Name
This field is for validation purposes and should be left unchanged.
Disclaimer*
I agree to participate.
This is not a diagnosis of ADHD, it is simply to determine if Irlen Spectral Filters may be beneficial.
Click 'I agree to participate' above before attempting the Self Test.
PERSONAL DETAILS
Name*
First Last
Email*
Phone
Does your child?
1. Avoid reading or writing tasks?
- Yes
- No
2. Find reading a chore?
- Yes
- No
3. Become fidgety, restless or easily distracted when reading?
- Yes
- No
4. Have difficulty with concentration and/or behaviour in the classroom?
- Yes
- No
5. Daydream in class?
- Yes
- No
6. Seem unmotivated in the classroom and/or when completing homework?
- Yes
- No
7. Seem disinterested in learning?
- Yes
- No
8. Become easily frustrated when completing school work or homework?
- Yes
- No
9. Suffer with headaches or eyestrain when reading?
- Yes
- No
10. Complain that reading and/or school is too hard?
- Yes
- No
11. Seem tired or lack energy after school?
- Yes
- No
12. Appear annoyed or irritated after school?
- Yes
- No

(make sure you print before you submit)

PERSONAL DETAILS