Check Item 22
Refer to 1.
1[] 1 or more "Yes" in 1 a--c (2)
8[] All other (Check Item 23)
Ask 2a--h for each "Yes" in 1a--c.
2a. How old was -- when the (condition) was first noticed?
2[] Learning Disability
000[] Since birth
Age ____
1[] Months
2[] Years