Attention Deficit Disorder Test | Alternative Treatments for ADHD & ADD

Looking for Alternative Treatments for ADHD, ADD, Autism and other Learning Disabilities?

TAKE OUR VISION QUIZ

If you observe any of these symptoms in your child at school, or home, it could indicate a vision related learning problem that requires treatment. These problems cannot be resolved without professional help.

Vision Therapy is the treatment of choice to reduce or eliminate those problems, increase overall performance, and improve learning and concentration skills that are most times linked to ADD or ADHD and other learning disabilities.

Please note: we ask that you fill in all the answers with the best answer possible and please include your name, a phone number to reach you at and/or a valid email address.

These surveys are then sent to our confidential and secure email.

A staff member from our office will be reaching out to you to go over your survey and answer any other personal questions you may have, to determine if an appointment should be made.

Our office will not reveal any of your personal information to anyone, or sell your information. Again, we ask that you fill in all areas with the correct information.

Our Vision Quiz

Your Name (Required)

Your Age

Patient Name

Patient Age

Email Address (Required)

Phone (Required)

Comments

Do you have headaches? Do you have headaches? Often Sometimes Never

Fatigue with reading or comprehension drops with time? Fatigue with reading or comprehension drops with time? Often Sometimes Never

Confuse similar words or letters? Confuse similar words or letters? Often Sometimes Never

Short attention span? Short attention span? Often Sometimes Never

Difficulty keeping place while reading; use finger as marker? Difficulty keeping place while reading; use finger as marker? Often Sometimes Never

Slow reading or word-by-word reading? Slow reading or word-by-word reading? Often Sometimes Never

Skip or reread lines; omit words? Skip or reread lines; omit words? Often Sometimes Never

Avoid reading or close work? Avoid reading or close work? Often Sometimes Never

Reverses words or letters? Reverses words or letters? Often Sometimes Never

Difficulty remembering what has been read? Difficulty remembering what has been read? Often Sometimes Never

Tilts head to one side or closes/covers one eye? Tilts head to one side or closes/covers one eye? Often Sometimes Never

Hold head too close to reading material? Hold head too close to reading material? Often Sometimes Never

Difficulty copying from chalkboard or book? Difficulty copying from chalkboard or book? Often Sometimes Never

Poor eye-hand coordination, including poor writing? Poor eye-hand coordination, including poor writing? Often Sometimes Never

Crossed eyes, turning in or out? Crossed eyes, turning in or out? Often Sometimes Never

Nervousness, irritability, or restlessness after sustaining visual concentration? Nervousness, irritability, or restlessness after sustaining visual concentration? Often Sometimes Never

Does your vision get blurry at any time? Does your vision get blurry at any time? Often Sometimes Never

Do you ever see objects doubled? Do you ever see objects doubled? Often Sometimes Never

Do letters and lines “run together” or words “jump”? Do letters and lines “run together” or words “jump”? Often Sometimes Never

Do your eyes feel strained or tired after working on a computer? Do your eyes feel strained or tired after working on a computer? Often Sometimes Never

9 + 15 =

Looking for Alternative Treatments for ADHD, ADD, Autism and other Learning Disabilities?

TAKE OUR VISION QUIZ

Our Vision Quiz

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