1. Did you have any special testing for your school problems? (This refers to psychoeducational assessment; not to regular class tests and exams.)
    Yes graphic of check box  No graphic of X 
  2. What did you understand about your assessment? (please attach reports if available)   N/A

  3. Were you ever told that you had a learning disability or an attention-deficit disorder? (Other terms such as perceptual handicap or dyslexia may have been used.)   NO

  4. Have you ever been prescribed medication for an attention-deficit disorder (e.g. Ritalin)?
    Yes graphic of check box  No graphic of check box 
* Special Note

The learner may have been previously diagnosed as having a learning disability. It may have been termed dyslexia, a perceptual handicap, minimal brain dysfunction, language disabilities or attention-deficit disorder but is likely an indication of some kind of learning disability.


  1. Were you ever considered to have a behavioural problem in school?
     
    Yes graphic of check box  No graphic of check box

  2. How would your parents or teachers have described you as a child (e.g. nicknames, frequent comments,...)?

    Elementary - sort of shy but always smiling
    Secondary - more outgoing and involved

  3. Have you ever been identified as an exceptional student:
    (please attach documents if available)
    i) by an Identification, Placement and Review Committee (IPRC)?
    Yes graphic of check box  No graphic of check box
    ii) supported by an Individual Education Plan (IEP)?
    Yes graphic of check box  No graphic of check box
    iii) did you have any transition planning?
    Yes graphic of check box  No graphic of check box

  4. Have you received any training in assistive technology or learning strategies?  NO

  5. What learning strategies or assistive technology is most helpful to you? (e.g. mind mapping, flashcards, colour coding, tape recorder, voice synthesis computer...)?

    Memory techniques, study skills for multiple choice tests and note taking

  6. Do you have access to computer technology at home? Yes graphic of X  No graphic of check box