SpLD Screening Questionnaire

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Personal details

This can be found on your Goldsmiths ID card starting with 33.
E.g. have you been asked to by a tutor, has a friend encouraged you, do you think you might have a dyslexia / dyspraxia or ADHD?

Personal background

* Have you been ever been diagnosed with a Specific Learning Difficulty (e.g. dyspraxia)?
* Have you been ever been diagnosed with ADD or ADHD?
* Do you have any mental health problems?
* Do you have any vision or hearing problems?
* Do you have any health conditions or have you been in an accident?
* Are you currently taking any medication?
* As a child, were you late in learning to talk?
* Have you had any speech therapy?
* As a child, did you have a lot of minor injuries?
* Has anyone in your family been diagnosed with dyslexia, dyspraxia, ADHD or Autism?
Enter the year of your last eye test
* Have you ever used coloured overlays/tinted glasses?


* Is English your first language?

School education

At school, did you experience difficulties with any of the following:

* Learning to read?
* Learning to spell?
* Structuring your ideas in writing?
* Handwriting?
* Reading aloud?
* Mental arithmetic?
* Concentration?
* Did you miss long periods of school?
* Did you get any extra support at school? For example have extra sessions with a TA or have private tuition?
* Did you regularly run out of time in written examinations?
* Did you receive any special exams arrangements (additional time, scribe, reader, etc.)?

Motor co-ordination and spatial awareness

* Do you confuse left and right?
* Do you find map reading difficult?
* Do you often get lost in unfamiliar places?
* Do you find it hard to remember directions if they are given verbally?
* Do you drive?
* Can you ride a bike?
* At school did you enjoy team sports e.g. football or netball?
* Do you often bump into things or people?
* Do you often spill food and drink?
* Do you find practical tasks (such as DIY) difficult?


* Do you read for pleasure?
* Are you a slow reader compared to other students?
* Do you dislike reading long books?
* Do you dislike reading aloud?
* Do you often forget what you have just read?
* Do you re-read paragraphs to understand and absorb the meaning?
Think about this in the context of academic texts rather than a novel / newspaper.
* Do you find it hard to pick out relevant information (e.g. do you find it hard to know what to highlight or note down)?
* Do you sometimes misread words? e.g. January / journey or hysterical / historical?
* When you have a choice, do you tend to avoid activities that involve a lot of concentrated reading?
* Are you able to spot mistakes when proofreading your own work?
* Do you tend to move your lips and speak words quietly to yourself when you are reading?
* When you are reading, do you often lose your place on the page?
* Do the words sometimes blur or move?
* Do you find it difficult to pronounce unfamiliar words?


* Do you make spelling mistakes (if no access to spellcheck)?
* Do you sometimes confuse homophones (e.g. their/there/they’re)?
* Is your handwriting difficult to read?
* Do you have problems with sentence structure?
* Do you have problems with grammar or punctuation?
* Do you have problems structuring essays?
* Do you have problems writing meaningful notes in lectures?

Memory and concentration

* Do you think you have a poor short term memory?
* Do you often forget names?
* Do you have to write things down so as not to forget them?
* Do you often lose things or forget where you have put them? E.g. keys / phone etc.
* Do you find it difficult to remember facts for examinations?
* Do you run out of time in written timed examinations?
* Are you easily distracted?
* Do you lose track of conversations?
* Do you interrupt people?
* Do you ‘zone out’ or day dream in lectures?
* Do you fidget / find it hard to keep still?

Time management and organisation

* Do you procrastinate and put off starting a piece of work?
* Do you find it hard to meet coursework deadlines?
* Do you find it hard to keep your work organised?
* Are you generally disorganised and untidy?
* Are you often late for appointments?

Numbers and maths

* Do you find it difficult to do sums in your head?
* Did you find it hard to learn your multiplication tables?
* Do you often confuse or mix up certain numbers?
* Do you find formulas confusing or difficult to learn?

Data protection and confidentiality

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