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Q.1
Does your child hold pencils, pens, crayons, or markers awkwardly?
*
Yes – frequently
Sometimes
No – never
Q.2
Is your child’s handwriting illegible? Is it ever so bad that even she can’t read it?
*
Yes – frequently
Sometimes
No – never
Q.3
Does your child omit letters or word endings when writing quickly?
*
Yes – frequently
Sometimes
No – never
Q.4
Does your child complain that writing or drawing hurts or makes his hand tired?
*
Yes – frequently
Sometimes
No – never
Q.5
Does your child seem to have difficulty picking up small objects?
*
Yes – frequently
Sometimes
No – never
Q.6
Does your child make excuses to try to get out of at-home writing assignments?
*
Yes – frequently
Sometimes
No – never
Q.7
Does your child have trouble using scissors, buttoning clothes, or zipping zippers?
*
Yes – frequently
Sometimes
No – never
Q.8
Does your child move in a way that doesn’t appear fluid? Do her opposite arms and hands ever seem to move out-of-sync with one another?
*
Yes – frequently
Sometimes
No – never
Q.9
Does your child make spelling errors in common words when writing?
*
Yes – frequently
Sometimes
No – never
Q.10
Does your child seem to avoid coloring or drawing?
*
Yes – frequently
Sometimes
No – never
Q.11
Can your child talk confidently about what he knows, but resists writing it down?
*
Yes – frequently
Sometimes
No – never
Q.12
Is your child restless when writing — jumping out of her seat or asking to be excused?
*
Yes – frequently
Sometimes
No – never
Q.13
Does your child use a random assortment of letter sizes, line spaces, spaces between words, or print and cursive?
*
Yes – frequently
Sometimes
No – never
Q.14
Does your child have difficulty following the rules of grammar when writing — but not when speaking?
*
Yes – frequently
Sometimes
No – never
Q.15
Does your child leave out critical facts or details when writing?
*
Yes – frequently
Sometimes
No – never
Q.16
Over the last month or more, have you worked with your child for at least 10 minutes a day using a handwriting workbook, and seen zero or very little improvement?
*
Yes – we have tried but seen no improvement
No – we have tried and seen some improvement
Not applicable – we have not tried handwriting workbooks
Q.17
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