Checklist Survey for Children Ages 5-7
Learning Difficulties Survey for Children Ages 5-7
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Answer “Yes” or “No” to each question about your child’s learning challenges.
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If you answered YES to 3 or more of these checklist questions,
your child may benefit from an educational assessment.
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Question 1 of 7
1. Question
Is your child having difficulty recognizing letters or numbers?
Correct
Answered YES
Incorrect
Answered NO
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Question 2 of 7
2. Question
Is your child having difficulty following a two-step direction?
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Answered YES
Incorrect
Answered NO
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Question 3 of 7
3. Question
Is your child having difficulty holding his pencil with his thumb and index finger?
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Answered YES
Incorrect
Answered NO
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Question 4 of 7
4. Question
Is your child having difficulty copying simple geometric figures with accuracy?
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Answered YES
Incorrect
Answered NO
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Question 5 of 7
5. Question
Is your child having difficulty answering before and after questions?
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Answered YES
Incorrect
Answered NO
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Question 6 of 7
6. Question
Is your child having difficulty understanding left and right?
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Incorrect
Answered NO
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Question 7 of 7
7. Question
Is your child having difficulty pronouncing some sounds or words?
Correct
Answered YES
Incorrect
Answered NO