Arrowsmith Program Suitability Form

The following checklist is a tool to determine whether you/your child’s learning difficulties are typical of those addressed by the Arrowsmith Programme. This checklist can help you determine Arrowsmith’s suitability for you/your child.

Note:

Some of the descriptors below might also sound familiar to the experiences of individuals with autism, developmental delay, brain injury or illness, or emotional or behavioural disorders. Please note these features may be beyond the scope of the Arrowsmith Programme and cannot be addressed by the Arrowsmith Programme.

Question Title

* 1. Motor Symbol Sequencing

Messy handwriting, and/or neat but effortful handwriting

Miscopying letters or numbers, making “careless” errors

Difficulty completing written timed tasks

Losing place when reading; misreading a known word; skipping letters, words or punctuation

Question Title

* 2. Symbol Relations

Below grade level reading comprehension; difficulties with symbolism, metaphors

Difficulty with logic puzzles e.g. Sally is taller than Joe but smaller than Mary

Understanding conceptual material found in mathematics and science

Difficulty considering another point of view, seeming “inflexible”

Question Title

* 3. Memory for Information or Instruction

Difficulty remembering information, instructions, details from conversations

Difficulty remembering details heard or read

Appears “forgetful” or irresponsible

Question Title

* 4. Predictive Speech

Communication can be non-sequential or incomplete

Difficulty learning and following procedures

Trouble putting thoughts into own words

Question Title

* 5. Broca's Speech Pronunciation

Difficulty learning to read through phonics-based programmes

Mispronounces words, or avoids new or unusual words

Difficulty learning foreign languages

Question Title

* 6. Symbolic Thinking

Trouble keeping attention to the important details of a task

Tendency to be distracted by irrelevant information or fall off-task

Problems being self-directed; self-organized; taking initiative; completing tasks

Question Title

* 7. Symbol Recognition

Difficulty learning to read and spell, trouble recognizing words seen before

Slowed reading speed because each word appears ‘new’

Question Title

* 8. Lexical Memory

Trouble learning the names of things like days of the week or colours

Difficulty building vocabulary

Question Title

* 9. Artifactual Thinking

Difficulty interpreting facial expressions, body language, voice tone

Impulsive tendencies – jumping in without considering the consequences

Passive tendencies– difficulty in self-advocating or asking for help

Appearing to lack “common sense”

Question Title

* 10. Contact Details

Name

ZIP/Postal Code

Email Address

Phone Number

Arrowsmith Program Suitability Form

Question Title

* 1. Motor Symbol Sequencing

Question Title

* 2. Symbol Relations

Question Title

* 3. Memory for Information or Instruction

Question Title

* 4. Predictive Speech

Question Title

* 5. Broca's Speech Pronunciation

Question Title

* 6. Symbolic Thinking

Question Title

* 7. Symbol Recognition

Question Title

* 8. Lexical Memory

Question Title

* 9. Artifactual Thinking

Question Title

* 10. Contact Details

Question Title

* 11. Current education level or year Level?