SELF TEST FOR IRLEN SYNDROME
   PAGE   1 OF 7.          © AAIC 2005

If subject is under 18 years, parents should complete
in cooperation with their child.

PRESIDENT: Dr Greg Robinson
Irlen Diagnostic Clinic, Newcastle
Suite 2, 136 Nelson Street
WALLSEND NSW 2287
Ph: (02) 4955 6904

SECRETARY: Mrs B. Freney
PO Box 733
Buderim QLD 4556
Ph: (07) 5445 2458



Are you light sensitive?

1. Bothered by sunlight? Yes No
2. Bothered by glare? Yes No
3. Do you frequently wear sunglasses? Yes No
4. Bothered by bright or fluorescent lights? Yes No
5. Tired or drowsy under bright or fluorescent lights? Yes No
6. Become anxious under bright or fluorescent lights? Yes No
7. Get a headache from bright or fluorescent lights? Yes No
8. Feel antsy or fidgety under bright or fluorescent lights? Yes No
9. Harder to listen under bright or fluorescent lights? Yes No
10. Performance deteriorates under bright or fluorescent lights? Yes No
11. Feel like there is not enough light when reading? Yes No
12. Feel like there is too much light when reading? Yes No
13. Read in dim light? Yes No
14. Use fingers or other marker to block out part of the page? Yes No
15. Shade the page with your hand or body? Yes No


Types of reading difficulties:

16. Skip words or lines? Yes No
17. Repeat or reread lines? Yes No
18. Read for less than one hour? Yes No
19. Lose place? Yes No
20. Read in a "stop and go" rhythm? Yes No
21. Omit small words? Yes No
22. Poor reading comprehension? Yes No
23. Reading becomes harder as you continue? Yes No
24. Avoid reading? Yes No
25. Avoid reading for pleasure? Yes No
26. Rereads for comprehension? Yes No
27. Reversals of letters and/or numbers? Yes No