Dyslexia Checklist for Teachers Question Title * 1. Name of Student Question Title * 2. School Question Title * 3. Name of Teacher Completing Checklist Question Title * 4. Email Address of Teacher Completing this Checklist Question Title * 5. Student's Current Grade Question Title * 6. Does the student seem to have the intellectual ability or academic potential to develop reading, writing, and spelling skills? yes no Question Title * 7. Are the student’s reading, spelling, or writing skills below what you would expect in view of perceived intellectual ability or academic potential? yes no Question Title * 8. Does the student have difficulty identifying basic sight words? yes no Question Title * 9. Does the student have difficulty sounding out words using phonics skills? yes no Question Title * 10. Does the student comprehend text read aloud by others? yes no Question Title * 11. Is the student’s oral reading slow and laborious? yes no Question Title * 12. Does the student have difficulty writing the letters of the alphabet in sequence without a model? yes no Question Title * 13. Does the student have difficulty naming the vowels. yes no Question Title * 14. Does the student have difficulty using the correct short vowels in spelling words? yes no Question Title * 15. Does the student have difficulty with spelling? yes no Question Title * 16. Does the student frequently make spelling errors that involve changing the order of the letters within the word (i.e. left/felt or spelt/slept)? yes no Question Title * 17. Is handwriting often illegible or messy? yes no Question Title * 18. Is pencil grip awkward, tight, or fist-like? yes no Question Title * 19. Does the student have problems with organization or memory? yes no Question Title * 20. Does the student have problems with spatial orientation (i.e., before/after, left/right)? yes no Question Title * 21. Does the student have difficulty “finding the right word” or seem to hesitate when trying to answer direct questions? yes no Done
