Sandy,

Here is the self-test I took. Some of the sections I did not relate
to, but others were like you were reading my mind. I apologize for
the length of this post, but I thought you might could tell me what
you think, based on my test.

Thanks,
David Grogan

Irlen Institute
5380 VILLAGE ROAD LONG BEACH, CA 90808 (562) 496-2550 FAX (562)
429-8699

SELF-TEST FOR IRLEN SYNDROME

Please fill out this form. Parents, complete the form in cooperation
with your child.

Name _______________________________________ Age _________
Grade _______
Address _____________________________________ Phone
________________________
Completed by _________________________________ Date
_______________________

CHARACTERISTICS
Please Circle Answer
Are you light sensitive?
Bothered by sunlight
Yes
Bothered by glare
Yes
Bothered by bright or fluorescent lights
Yes
Tired or drowsy under bright or fluorescent lights
Yes No ?
Become anxious under bright or fluorescent lights
No ?
Get a headache from bright or fluorescent lights
No ?
Feel antsy or fidgety under bright or fluorescent lights
No ?
Harder to listen under bright or fluorescent lights
No ?
Performance deteriorates under bright or fluorescent lights
Yes ?
Feel like there is not enough light when reading
No ?
Feel like there is too much light when reading
No ?
Read in dim light
No ?
Use fingers or other marker to block out part of the page
No ?
Shade the page with your hand or body
No ?

Types of reading difficulties:
Skip words or lines
Yes ?
Repeat or reread lines
Yes ?
Read for less than one hour
No ?
Lose place
Yes ?
Read in a "stop and go" rhythm
No ?
Omit small words
No ?
Poor reading comprehension
No ?
Reading becomes harder as you continue
No ?
Avoid reading
No ?
Avoid reading for pleasure
No ?
Rereads for comprehension
Yes ?
Reversals of letters and/or numbers
No ?

While reading or using a computer, do you:
Rub eyes
Yes ?
Move closer to or further away
No ?
Squint
No ?
Open eyes wide
No ?
Incorporate breaks
No ?
Change position to reduce glare
Yes ?
Close or cover one eye
Yes ?
Move head
Yes ?
Read word by word
No ?
Unable to speed read
No ?

Do you feel strain, fatigue, tired, or have headaches when:
Reading
No ?
Listening
Yes ?
Doing paper and pencil tasks
Yes ?
Working on the computer
Yes ?
Watching TV, movies, or live stage productions
Yes ?
Copying material
Yes ?
Doing math assignments
Yes ?
Playing video games
Yes ?
Writing long assignments
Yes ?
Doing visually-intensive activities like needlepoint, sewing,
cross stitching, crossword puzzles, woodworking,
soldering, etc. Yes ?
Working under bright or fluorescent lights
No ?
Looking at stripes, patterns, bright colors, and high contrast
Yes ?

Handwriting:
Write up or down hill
No ?
Unequal or no spacing between letters or words
Yes ?
Unequal letter size
Yes ?
Unable to write on the line
No ?
Leave out words, letters, or punctuation marks
Yes ?

Attention/Concentration:
Problems concentrating with reading or writing
No ?
Easily distracted when reading or writing
Yes ?
Easily distracted when listening
Yes ?
Easily distracted when taking tests
No ?
Daydreams in class or at lectures
Yes ?
Problems staying on task
Yes ?
Problems starting tasks
Yes ?
Difficulty with scantron answer sheets
No ?


Copying:
Lose place (book, chalkboard, whiteboard, overhead)
Yes ?
Leave out words (book, chalkboard, whiteboard, overhead)
Yes ?
Slow (book, chalkboard, whiteboard, overhead)
No ?
Incomplete (book, chalkboard, whiteboard, overhead)
No ?
Careless errors (book, chalkboard, whiteboard, overhead)
No ?
Blink or squint (book, chalkboard, whiteboard, overhead?
No ?
Difficulty refocusing
Yes ?
Difficulty copying things onto or off computer or typewriter
Yes ?

Composition/Essay Writing:
Disorganized
No ?
Problems with punctuation
No ?
Problems proofreading
No ?
Leave out letters or words
Yes ?
Write without rereading
No ?

Mathematics:
Misalign digits in number columns
No ?
Difficulty seeing numbers in the correct column
No ?
Sloppy or careless errors
No ?
Use finger, graph paper, or other marker when working
with columns of numbers
No ?
Difficulty seeing signs, symbols, numbers, decimal points
No ?
Reversals of numbers
No ?

Music:
Problems sight reading the notes
No ?
Prefer to memorize rather than read music
No ?
Prefer to play by ear
No ?
Use finger to track notes
Yes ?
Lose your place
No ?
Trouble reading the notes or notes and words together
No ?
Difficulty interpreting the music notations
No ?
Little progress in spite of regular practice
No ?

Depth Perception:
Difficulty getting on and off escalators
No ?
Clumsy
No ?
Bump into table edges or door jams
Yes ?
Difficulty walking up and/or down stairs
No ?
Difficulty judging distances
No ?
Drop or knock things over
No ?
As a child, accident prone or have bruises on your shins
No ?
When walking next to someone, do you drift into the person
Yes ?
When walking, do you feel dizzy or light headed
Yes ?
Difficulty getting on or off moving objects
No ?


Driving:
Difficulty parallel parking
Yes ?
Do you feel like you will hit the car in front when parking
Yes ?
When parking, do you hit the curb or leave too much space
Yes ?
Difficulty judging when to turn in front of oncoming traffic
No ?
Uncertain about making lane changes Yes
?
Extra cautious when making lane changes
Yes ?
Are the passengers tense when you make lane changes
No ?
Do passengers tell you that you tailgate
No ?
Are you overly cautious, leaving extra room between you and
the car ahead
Yes ?

Sports Performance:
Problems tracking a flying ball like golf, baseball, or tennis
Yes ?
Trouble following the ball when watching sports on TV
such as tennis, football or basketball
No ?
When watching sports on TV, can you follow the ball but not
see anything else
No ?
Trouble catching or hitting a ball
No ?
Difficulty playing pool
No ?
Difficulty hitting the ball when playing baseball or tennis
No ?
Trouble learning how to ride a bike
No ?
Trouble jumping rope? Jump in at the wrong time or jump
into the rope
Yes ?
Trouble playing games such as volley ball or four square
No ?
On playground equipment such as rings or bars, was it hard
to go from one to the other
No ?

Fatigue While In A Car:
As a passenger, do you become drowsy
No ?
When driving, do you become drowsy
No ?
Bothered by glare on the chrome on cars
Yes ?
Bothered by glare off the rear window of the car in front of you
Yes ?
Bothered by headlights and street lights at night
Yes ?
Avoid driving at night
No ?
Have night blindness
No ?
Bothered by red tail lights on cars
Yes ?
Bothered by red stop lights
Yes ?
Stressful to drive in the rain (glare)
Yes ?


If you answered yes to three or more of these questions in any one of
the above sections, then you might be experiencing the effects of a
perception problem called Irlen Syndrome/ Scotopic Sensitivity.