Instructions:
Use this checklist to provide input for the initial referral, eligibility determination, and IEP development. This profile will also be helpful when communicating with your pediatrician or other service providers.
Remember: Your observations are important in helping the school determine if learning problems do exist and what special services your child may need. Use this checklist to provide input for the initial referral, eligibility determination, and IEP development. This profile will also be helpful when communicating with your pediatrician or other service providers.
Sensory/perceptual
Does your child have trouble because of…
____ making letter, number, word reversals?
____ confusing similar letter sounds?
____ other: _______________________________________________
____ other: _______________________________________________
Memory
Does your child have trouble…
____ following a series of oral directions?
____ retaining spelling words, math facts, history dates?
____ other: _______________________________________________
____ other: _______________________________________________
Organization
Does your child have trouble…
____ keeping school desk, notebook, and other belongings in order?
____ understanding concepts in social studies and science?
____ other: _______________________________________________
____ other: _______________________________________________
Spatial - temporal organization
Does your child have trouble…
____ arranging and spacing work on paper?
____ learning left from right?
____ other: _______________________________________________
____ other: _______________________________________________
Problem solving
Does your child have trouble…
____ predicting what will happen after hearing part of a story?
____ figuring out different ways to accomplish a task?
____ other: _______________________________________________
____ other: _______________________________________________
Motor
Does your child have trouble…
____ in sports, seeming to be awkward??
____ coloring, using scissors?
____ other: _______________________________________________
____ other: _______________________________________________
Language
Reading
Does your child have trouble…
____ sounding out words?
____ remembering sight vocabulary (what, where, etc.)?
____ recalling what has been read?
____ other: _______________________________________________
____ other: _______________________________________________
Writing
Does your child have trouble…
____ copying?
____ writing in manuscript or cursive?
____ other: _______________________________________________
____ other: _______________________________________________
Spelling
Does your child have trouble…
____ memorizing spelling words?
____ using these words later in sentences and paragraphs?
____ other: _______________________________________________
____ other: _______________________________________________
Listening
Does your child have trouble…
____ following directions?
____ interpreting what you say?
____ other: _______________________________________________
____ other: _______________________________________________
Math
Does your child have trouble…
____ remembering math facts?
____ using math signs (+,-„>, etc.)?
____ following a sequence of steps (as in long division)?
____ other: _______________________________________________
____ other: _______________________________________________
Behavior/social skills
Does your child have trouble…
____ focusing attention on one thing?
____ interpreting body language, facial expressions?
____ other: _______________________________________________
____ other: _______________________________________________
Understanding Learning Disabilities: A Parent Guide and Handbook is available from the Learning Disabilites Council, Inc., P.O. Box 8451, Richmond, VA 23226. Ph. (804) 748-5012.
Source
Understanding Learning Disabilities: A Parent Guide and Workbook