Learning Disabilities Checklist
The LD Checklist is based on the work of Dr. Larry B. Silver:  Guide to  Learning Disabilities...(2010), and  The Misunderstood Child (1992, 2006).
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Your Email: *
Name: *
Are you completing this checklist for yourself? *
Provide your relationship to the subject, and important details: *
Age of subject: *
Current school status, city or town, state or province, country: *
INPUT DISABILTIES
(1) Visual Perception (Optometrist, Neurologist, Ed Psychologist, Orton-Gillingham Specialist, Occupational Therapist)
(2) Auditory Perception (Audiologist, Speech-Language Pathologist, M.D.-Ears, Nose, Throat Specialist)
(3) Sensory Integration [Sequencing, Abstraction, & Organization] (Occupational Therapist, Ed Psychologist, Neurologist, Orton-Gillingham Specialist, Special Educator, Language Therapist)
1.  Visual Perception and Processing Difficulties:[Dyslexia, Dyscalculia, Dysgraphia, Sensory Integration]
2.  Auditory Perception and Processing Difficulties: [Auditory Processing Disorder, Dyslexia]
3.  Sensory Integration Difficulties:
INTEGRATION DISABILITIES
(4) Sequencing Difficulties: (Ed Psychologist, Neurologist, Orton-Gillingham Specialist, Special Educator)
(5) Abstraction Difficulties: (Ed Psychologist, Neurologist, Orton-Gillingham Specialist, Language Therapist, Special Educator)
(6) Organization Difficulties: (Occupational Therapist)
4.  Sequencing Difficulties: [Dyslexia, Dysgraphia, Dyscalculia]
5.  Abstraction Difficulties: [Dyslexia, Dyscalculia]
6.  Organization Difficulties: [Dyslexia, Dysgraphia, Dyscalculia, ADD]
MEMORY DISABILITIES
(7) Short-Term Memory Difficulties: (Neurologist, Ed Psychologist, LD Specialist)
(8) Working Memory Difficulties:  (Neurologist, Ed Psychologist,  LD Specialist)
(9) Long-Term Memory Difficulties:  (M.D., Neurologist, Ed Psychologist, LD Specialist)
LTMD can be temporary or permanent, and can be caused by injury, disease, body chemistry, etc.
7.  Short-Term Memory Difficulties:
8.  Working-Memory Difficulties:
9.  Long-Term Memory Difficulties:
OUTPUT DISABILITIES
(10)  Language Difficulties (Audiologist, Speech-Language Pathologist)
(11)  Motor Difficulties (Neurologist, Occupational Therapist, Physical Therapist, Educational Therapist)

10.  Language Difficulties:
11.  Motor Difficulties:
Add important information about subject's health history, diagnoses, interventions, etc.
Notes:
Upon submission, you will receive an email of your LD checklist, which can be used to seek help from a properly qualified specialist.

Great resources: https://www.dyscalculia.org/learning-disabilities


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