Change background
0421 310 768
clinic@irlenipswich.com.au
EMAIL ME
MAKE A BOOKING
Home
Who we are
Blog
Assessments
Irlen Assessment
Self Tests
Child Self Test
Teen Self Test
Adult Self Test
Headaches Migraines, Eye Strain, Fatigue Self Test
Light Sensitivity Self Test
ADHD Self Test
Autism Self Test
Training Courses
Research
FAQs
Contact Us
Menu
Home
Who we are
Blog
Assessments
Irlen Assessment
Self Tests
Child Self Test
Teen Self Test
Adult Self Test
Headaches Migraines, Eye Strain, Fatigue Self Test
Light Sensitivity Self Test
ADHD Self Test
Autism Self Test
Training Courses
Research
FAQs
Contact Us
Menu
Home
Who we are
Blog
Assessments
Irlen Assessment
Self Tests
Child Self Test
Teen Self Test
Adult Self Test
Headaches Migraines, Eye Strain, Fatigue Self Test
Light Sensitivity Self Test
ADHD Self Test
Autism Self Test
Training Courses
Research
FAQs
Contact Us
Irlen Syndrome Teen Self Test
PERSONAL DETAILS
Name
*
First
Last
Email
*
Phone
GENERAL INDICATORS
While reading do you?
1. Skip words or lines, lose your place, re-read lines?
Yes
No
2. Use your finger or a ruler as a marker?
Yes
No
3. Not notice the full stops and commas?
Yes
No
4. Read slowly, hesitantly or word by word?
Yes
No
5. Become fidgety, restless or easily distracted?
Yes
No
6. Have difficulty with comprehension?
Yes
No
Do you:
7. Avoid reading whenever possible?
Yes
No
8. Avoid writing tasks?
Yes
No
9. Find spelling difficult?
Yes
No
10. Daydream in class?
Yes
No
11. Are you hyperactive or easily distracted in class?
Yes
No
12. Lose your place when copying from the board or a book?
Yes
No
13. Make errors while copying from the board or a book?
Yes
No
VISUAL RESOLUTION / EYE STRAIN / FATIGUE
While reading do:
14. Do words ever look blurry or fuzzy?
Yes
No
15. Do words double, move or look funny?
Yes
No
16. Your eyes strain?
Yes
No
17. You blink, squint or open eyes wider to help see the words better?
Yes
No
18. You find your eyes hurt, burn, itch, water, feel dry, feel sleepy?
Yes
No
19. You confuse letters, words or numbers?
Yes
No
20. You rub your eyes?
Yes
No
21. You move closer to or further away from the page?
Yes
No
22. You suffer with headaches at the end of the school day?
Yes
No
23. You feel exhausted or lack energy after school?
Yes
No
PHOTOPHOBIA (Light Sensitivity)
Do you:
24. Prefer to read in dull light or in a darker part of the room?
Yes
No
25. Find computer screens and/or white boards bright or glary?
Yes
No
26. Squint when outside, complain about the light, like to wear sunglasses or a hat?
Yes
No
DEPTH PERCEPTION
27. Are you clumsy?
Yes
No
28. Do you trip on stairs, knock into furniture, spill drinks?
Yes
No
29. Do you have difficulty catching a tennis ball on the full?
Yes
No
30. Do you veer into people when walking?
Yes
No
Email
This field is for validation purposes and should be left unchanged.
(make sure you print before you submit)