Dyslexia Early Screening
Checklist (Age 5–6)

Important Notice

This checklist is designed to identify children aged 5–6 years who may be at risk of dyslexia. It is an early screening tool only and does not diagnose dyslexia. Children with persistent difficulties should be referred to a qualified Educational Psychologist, Clinical Psychologist, Speech-Language Therapist, or Dyslexia Specialist for a comprehensive assessment.

Step 1: Demographics & Info

Child Details

Screener Details

Step 2: Rating Scale

How to Score

Please use the following scale to evaluate the child's skills for Sections A through G. Select the score that best reflects their current abilities.

0

No concern

Skill demonstrated consistently and independently; no concern observed.

1

Mild concern

Occasional difficulty but usually completes the skill independently.

2

Moderate concern

Noticeable difficulty and occasionally requires prompts or support.

3

Significant concern

Frequent difficulty requiring regular support.

4

Severe concern

Consistent difficulty despite appropriate teaching and intervention.

Section A: Speech & Language Development

Rate each question from 0 (No concern) to 4 (Severe concern)

Section A: Speech & Language Development

Speech & Language Development Scoring Interpretation

Section B: Phonological Awareness

Rate each question from 0 (No concern) to 4 (Severe concern)

Section B: Phonological Awareness

Phonological Awareness Scoring Interpretation

Section C: Letter Knowledge

Rate each question from 0 (No concern) to 4 (Severe concern)

Section C: Letter Knowledge

Letter Knowledge Scoring Interpretation

Section D: Early Reading Skills

Rate each question from 0 (No concern) to 4 (Severe concern)

Section D: Early Reading Skills

Early Reading Skills Scoring Interpretation

Section E: Writing & Spelling

Rate each question from 0 (No concern) to 4 (Severe concern)

Section E: Writing & Spelling

Writing & Spelling Scoring Interpretation

Section F: Memory & Rapid Retrieval

Rate each question from 0 (No concern) to 4 (Severe concern)

Section F: Memory & Rapid Retrieval

Memory & Rapid Retrieval Scoring Interpretation

Section G: Learning Behaviour

Rate each question from 0 (No concern) to 4 (Severe concern)

Section G: Learning Behaviour

Learning Behaviour Scoring Interpretation

Section H: Family & Developmental History

Family & Developmental History

Purpose

To identify biological, developmental, and educational factors that may increase the likelihood of dyslexia or indicate the need for further assessment.

Interpretation of Section H

This section is not numerically scored. Instead, use it to inform professional judgement regarding risk factors.

Low Concern

  • Few or no risk factors identified.

Moderate Concern

  • One or more developmental or educational risk factors present.

High Concern

Multiple risk factors are present, particularly:

  • Family history of dyslexia.
  • Persistent literacy difficulties despite appropriate instruction.
  • History of speech or language delay.
  • Ongoing concerns raised by teachers or therapists.

Professional Notes

Family history of dyslexia is one of the strongest known risk factors. However, the absence of a family history does not rule out dyslexia.

When interpreting this section:
  • Consider whether the child has had consistent opportunities to learn.
  • Rule out uncorrected hearing or vision problems.
  • Consider whether difficulties are better explained by limited language exposure, frequent school absence, or other developmental conditions.
Section H: Family & Developmental History

Please select Yes, No, or Unsure for the following historical and developmental factors.

Section I: Child's Strengths

Please tick all that apply to the child. Identifying strengths is crucial for building confidence and tailoring supportive interventions.

Dyslexia Early Screening Report

Confidential Screening Results

Child Information

Name: -

DOB: -

Age: -

Gender: -

Education: -

Screening Details

Date: -

Parent/Guardian: -

Contact: -

Completed By: -

Role: -

Disclaimer: This is a screening tool designed to identify children at risk of dyslexia. It is not a diagnostic tool. High scores indicate a need for further comprehensive assessment by a qualified professional.

Assessment Domains (Sections A–G)

Section Child's Score Level of Concern
Total Child's Score: 0 Maximum Total Score: 224

Interpretation

Total Score Range

-

Risk Level

-

Recommendation

-

Note: A high score indicates a greater likelihood of dyslexia risk, but does not confirm a diagnosis. Results should always be interpreted alongside the child's educational history, language exposure, developmental profile, and professional observations. Persistent difficulties despite effective instruction warrant further assessment. This checklist is intended as an early identification tool for use in Malaysian educational and clinical settings.

Risk Factors (Section H)

Child's Strengths (Section I)

Detailed Responses Report

Child:

Professional Consultation & Assessment

If you have concerns about your child’s learning, reading, writing, spelling, or language development after completing this screening checklist, we encourage you to seek a professional consultation.

At AE Autism & Special Needs Therapy Centre, our multidisciplinary team is committed to providing comprehensive, evidence-based support for children with learning and developmental needs. We work collaboratively with parents, guardians, and educators to better understand each child’s unique strengths and challenges.

Our services include:

  • Professional Consultation
  • Developmental & Learning Assessment
  • Dyslexia Screening & Support
  • Individualized Intervention Planning
  • Parent Guidance & Coaching
  • School Support & Professional Recommendations

Our multidisciplinary team will carefully review your child’s developmental and educational profile, discuss your concerns, and recommend the most appropriate assessment, intervention, and support to help your child reach their full potential.

Contact Us

AE AUTISM SERVICES KUANTAN (1417091-D)

ADDRESS: B-28, JALAN AIR PUTIH, TAMAN PENINSULAR, 25300 KUANTAN, PAHANG, MALAYSIA

TEL: +6012-3252368

AE AUTISM & SPECIAL NEEDS THERAPY CENTRE (CA0364656-A)

ADDRESS: B-1560, JALAN BESERAH, KAMPUNG AIR PUTIH, 25300 KUANTAN, PAHANG, MALAYSIA

TEL: +6013-9233438