LISA Academy Public Charter Schools
Student Services
SpEd
Referral
Parent Rights
Family's Guide to Special Education
ACT Aspire / DLM
Transition
Articles
Online Resource Guide
504
Referral
Parent Rights
Dyslexia
Myths about Dyslexia
Signs of Dyslexia and Strengths
>
Parent Checklist
Teacher Checklist
Successful Dyslexics
OG in 3D Program
Resources
Transitional Housing
Mental Health
STRIVE
>
Referral
BHSA
>
The Seven Challenges Program
Referral
Parent Referral for Dyslexia Screening
*This referral is for a Level One screening for the characteristics of dyslexia. This screening does not diagnose Dyslexia.
Choose LISA Academy Campus
*
North Elementary (Grades K to 5)
North Middle School / High School (Grades 6 to 12)
Springdale (Grades K to 8)
West Elementary (Grades K to 5)
West Middle School (Grade 6)
West Middle School (Grades 7 to 8)
West High School (Grades 6 to 12)
*
Indicates required field
Your Name
*
First
Last
Relationship to Student
*
Email
*
Name of Student
*
First
Last
Phone Number
*
Grade
*
Place a check beside each behavior observed at home or in the classroom.
*
Difficulty learning and remembering the names of he letters in the alphabet.
Difficulty sequencing the alphabet orally or in writing.
Difficulty associating letters with sounds, such as the letter t with the /t/ sound.
Difficulty recognizing and generating rhyming patterns.
Diffculty pulling words apart into individual sounds. (ex. mat /m/ /a/ /t/).
Difficulty with blending sounds to form words.
Very slow in acquiring reading skills.
Makes guesses on unfamiliar words in reading.
Problems keeping place on page when reading.
Deficient word attack skills.
Failure to understand what he / she reads.
Difficulty using the correct short vowels in spelling words.
Has trouble spelling words correctly in a sentence.
Makes spelling errors that involve changing the order of letters within a word.
Difficulty with finding the right word to say and / or seems to hesitate when trying to answer a question.
Spelling, reading, writing skills are below what you would expect in view of perceived intellectual ability.
Any family history of reading difficulties.
Reasons for Referral
*
Student's Strengths
*
Submit