Hardy Assessment by info@benjamincripps.net | Nov 19, 2020 Directions Mark each statement that applies to your child (even if only sometimes). Not self-motivated - difficulty working independently Yes No Loses place when reading Yes No Bumps into people and things frequently - loses balance Yes No Difficulty remembering 2 or 3 instructions Yes No Picky about clothes, foods, noise Yes No Difficulty putting story parts in order - what happened first, second, third Yes No Assignments/chores take a long time to complete Yes No Guesses words when reading Yes No Gives up easily - doesn’t give things his/her ‘best effort’ Yes No Frequently says “What?” and often asks to have things repeated Yes No Repeats information over and over to remember it Yes No Slumps, sits on leg, or lays on table when working Yes No Difficulty remembering words that have been previously mastered Yes No Has difficulty hearing in a noisy classroom Yes No Has difficulty throwing and/or catching a ball or learning to ride a bike Yes No Misunderstands instructions - does something different than was asked (not out of defiance) Yes No Difficulty staying focused to complete a learning task Yes No Difficulty describing ‘What happened’ Yes No You often remind him/her to “Look at me when I’m talking.” Yes No Difficulty organizing ideas when telling (or writing) a story - goes ‘on and on’ but has difficulty getting ‘to the point of the story’ Yes No Difficulty estimating the amount of time needed for completing assignments - rushes to finish Yes No Difficulty turning off the television, computer, or other electronics with screens Yes No Loses train of thought if interrupted Yes No Difficulty remembering the spelling of a word to write it down if heard aloud or while copying from the white board - needs spelling repeated or looks up at the board several times to write it down Yes No Difficulty remembering to do all the parts of multi-step assignments Yes No Says (or believes) things like “I’m dumb”, I’ll never ‘get’ it, …. Yes No Difficulty paying attention to ‘boring’ things BUT having good attention for things that are interesting Yes No Does poorly on a test after studying hard and feeling well prepared Yes No Has difficulty staying seated for homework, dinner time, etc. Yes No Easily overwhelmed and frustrated by homework, schoolwork, or learning something new Yes No Can remember lines from movies, songs, etc. and likes to repeat them Yes No Difficulty remembering facts when having to use or combine new information - like getting confused solving math problems where s/he must remember a math fact as well as the order of the steps to solving the problem Yes No Blurts out answers Yes No Skips words, substitutes words, adds words when reading Yes No Difficulty organizing things like desk, backpack, toys Yes No Difficulty getting started on homework, chores, etc. Yes No Misses comprehension questions Yes No Difficulty finding belongings - loses things Yes No Has difficulty forming letters and spacing them when writing Yes No Behind grade level Yes No Child First & Last Name Relationship to the child Parent Guardian Family Other Child Grade Level Agree to our Terms of Use * Agree to our Privacy Policy * Parent/Guardian First & Last Name Email Phone Number Time's up
