Irlen Autism Self Test

Disclaimer*
I agree to participate.
This is not a diagnosis of Autism, it is simply to determine if Irlen Filters will be beneficial.
Click 'I agree to participate' above before attempting the Self Test.
PERSONAL DETAILS
Name*
First Last
Email*
Phone
Does your child?
1. Find bright lights painful or bothersome?
- Yes
- No
2. Find some patterns painful or bothersome to look at?
- Yes
- No
3. Seem sensitive to fluorescent lights or have to wear sunglasses outside?
- Yes
- No
4. Become mesmerised by lights, colours or patterns?
- Yes
- No
5. Avoid reading?
- Yes
- No
6. Prefer to read newspapers and magazines rather than books?
- Yes
- No
7. Read better when words are on their own rather than in a book?
- Yes
- No
8. Have learning difficulties or dyslexia?
- Yes
- No
9. Have a history of migraines and/or headaches?
- Yes
- No
10. Seem sensitive to certain sounds?
- Yes
- No
11. Rub or push on his/her eyes?
- Yes
- No
12. Have difficulty copying from the board or a book?
- Yes
- No
13. Have problems colouring in or staying inside the lines?
- Yes
- No
14. Seem clumsy?
- Yes
- No
15. Bump into objects, door jams, table edges?
- Yes
- No
16. Have problems getting on/off escalators or walking down stairs?
- Yes
- No
17. Have problems falling asleep or staying asleep?
- Yes
- No
Phone
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PERSONAL DETAILS