Am I Dyslexic Form 3

Please check all that apply
Memory and Cognition
23. Excellent long-term memory for:
Experiences
Locations
Faces
24. If not experienced, has poor memory for:
Sequences
Facts
Information
Behaviour, Health, Development and Personality
25.
Extremely disorderly
Compulsively orderly
26. Can be:
Class clown
Trouble-maker
Too quiet
27. Had unusually:
Early developmental stages: Talking Crawling Walking Tying shoes
Late developmental stages:   Talking Crawling Walking Tying shoes
28. Prone to ear infections
29. Sensitive to: Foods Additives Chemical products
30. Can be an extra deep sleeper
Can be an extra light sleeper
Bed wetting beyond appropriate age
31. Tolerance for pain unusually.
High
Low
32.
Strong sense of justice
Emotionally sensitive
Strives for perfection
Age range *:
Christian Name *
Surname *
Email Address *
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