"I often have trouble reading household bills"
Strongly agree Agree Undecided Strongly Disagree

"I can do more than one thing at a time"
Never Almost never Rarely Occasionally Frequently Almost always Always

"I feel like I have control over things"
Never Almost never Rarely Occasionally Frequently Almost always Always

"I have trouble spelling common words"
Never Almost never Rarely Occasionally Frequently Almost always Always

The 25 items on the rating scales are organized into seven clusters: self-acknowledgment (e.g, "I wish I could change a lot about myself, I feel good about myself"), organization skills, spelling skills, sense of direction, social skills, reading skills and efficiency.

Part 2 - Self-Administered Inventory

This inventory elicits information about health, home and education histories. The questions are presented in a questionnaire format so that the person can complete them independently. These items are answered with "Yes" and "No." Based on the person's responses, additional questions may be asked in an interview format (Part 3).

The inventory items are organized into six clusters for scoring: math operations, learning problems, educational experience, fraction skills, mental health and learning influences. There are a total of 19 questions included on the inventory.

Sample questions
Have you ever had difficulties with attention or concentration?
Yes No
Did you attend more than two elementary schools (K-6)?
Yes No
Did you fail any classes in school?
Yes No
Do you have problems adding numbers?
Yes No


Part 3 - Interview

The interview is used as a follow-up instrument to the Self-Administered Inventory. Learners are asked additional questions to help clarify and seek further details to the questions they completed independently. To help save time, the interviewer only asks these follow-up questions for inventory items for which the participant gave "yes" answers. There are a total of 13 potential interview follow-up questions. The questions seek to gain additional information and or clarification on family history, personal health and educational experiences.