Complete the Neurome® Interview about your child

The interview takes approximately 15 minutes and costs £45

for a basic analysis by our expert with a report

Neurome® Interview

Please answer all of the questions about your child carefully and accurately. The outcome of the report depends entirely on the data entered.

Pupil's First Name

Pupil's Last Name

Pupil's Email (optional)

Parent/Guardian's Email

Why are you completing the Neurome Interview?

To learn more about my child's mind

My child's school require it

School Name

Pupil's Date of Birth

I agree to answer the Neurome® Interview honestly & accurately.

Pupil's gender

Female

Male

Non-Binary

Is the pupil your...

Only child

Oldest child

Middle child

Youngest child

Is the pupil a twin?

Yes

Your relationship to the pupil

Mother

Father

Legal guardian / other

Is the pupil left or right handed?

Left handed

Right handed

Ambidextrous

Is the pupil left or right footed?

Left footed

Right footed

Ambidextrous

Is the pupil double-jointed?

Yes

Not sure

Does the pupil suffer from car / motion sickness?

Yes

Never / very rarely

Is the pupil ticklish?

Yes

Does the pupil suffer from any allergies?

Yes

Is the pupil thriving in school?

Yes, they are doing very well, in the top sets

They are doing pretty well, in the middle sets

They are struggling, in the lower sets

Has the pupil ever had a tutor to help them?

Yes

Is the pupil traditionally academic?

Yes

Is the pupil more of a creative?

Yes

Mixture of both

Is the pupil sporty?

Yes

Is the pupil a good actor?

Yes

Can the pupil sing well?

Yes, they excel

They are okay

No, not particularly

I'm not sure

Is the pupil planning to go to university?

Yes

Maybe / not sure yet

Did you or the other pupil's other parent go to university?

Yes

Did the pupil learn to read with ease?

Yes

Does the pupil enjoy reading?

Yes, they always have their head in a book!

They read when they have to

No, they avoid books

Does the pupil spell well?

Yes

Is the pupil's writing neat and tidy?

Yes - neat and tidy

No - big and messy

It's okay

Does the pupil find it tiring to write for lengths of time?

Yes

Does there seem to be a disparity between the pupil's verbal (spoken) ability and their written work?

Yes

I'm not sure

Is there a disparity between their cognitive ability and their motor speed?

Yes

I'm not sure

Does the pupil have any extra help at school?

Yes

I'm not sure

Has the pupil been assessed?

By the SEND

By an Educational Psychologist

By both

No, they have not

Does the pupil have any speech concerns?

Yes, they have a stutter

Yes, they have trouble with pronunciation

No, but they have in the past

Has the pupil got good vision?

Yes

They wear glasses

They have a perceptual processing difficulty

Does the pupil have trouble copying from the board?

Yes

I'm not sure

Does the pupil hear well?

Yes

They find it hard to hear in the classroom

They have auditory perceptual difficulties

I'm not sure

Is the pupil very talkative?

Yes, very

No, not particularly

They are quite quiet

Does the pupil happily do their homework?

Yes, most of the time

No, they avoid it

They have tantrums when they have to do it

I'm not sure - they do their homework elsewhere

Does the pupil do well in class but less well in their written work / homework?

Yes

Is the pupil fidgety/talkative/disruptive in class?

Yes

Does the pupil always know what homework they are meant to be doing?

Yes

Usually

Can the pupil easily access the homework they need to do on an online school portal?

Yes

I'm not sure

Does the pupil understand the instructions for their homework tasks?

Yes, most of the time

Quite often they do not

They rarely understand

If no, for what reasons?

Yes

Average

No, not particularly

Does the pupil perform well in assessments / exams?

Yes very well - on average above 70%

Yes pretty well - on average 60-70%

Yes quite well - on average 50-60%

No, in general they struggle

Does the pupil seem to learn easily for assessments / exams?

Yes

I'm not sure

Would you say the pupil is motivated to do well in school?

Yes

Would you say the pupil is organised?

Yes they are organised

No, they struggle to get organised

Does the pupil seem to remember well?

Yes

I'm not sure

Is/was the pupil able to learn their times tables easily?

Yes

No, it was a struggle

Is the pupil good at remembering & recalling names and dates in history?

Yes

No, not particularly

Is the pupil able to remember terminology for English, such as what a pronoun is, or do they have to look it up each time?

Yes

I'm not sure

Do you think the pupil understands what is being explained to them in class?

Yes

Sometimes

I'm not sure

Does the pupil have good concentration?

Yes, excellent

Reasonable

No, they struggle to concentrate

Does the pupil concentrate well on things they enjoy outside of school?

Yes

Does the pupil seem to 'super focus' i.e. get obsessively into certain things, for example making Lego, building models, computer games, teaching themself a new skill etc.

No, they concentrate well but are not obsessive

Yes, when they get into something they are obsessed

Is the pupil good at being on time?

Yes

Most of the time

No, they are often late

Is the pupil good at packing when going away?

Yes

Not applicable yet

What sort of thinker would you say the pupil is?

A daydreamer, often in their own world

Their thoughts are focussed and organised

They have lots of thoughts/ideas and struggle to stay focussed

Does/did the pupil ever experience night terrors (very vivid nightmares where they could interact with you but were still asleep)?

Yes

Does/did the pupil ever sleep walk?

Yes

Has the pupil every had an imaginary friend?

Yes

I'm not sure

Does the pupil sometimes say things that seem much more grown up for their years?

Yes, it's spooky!

No, not particularly

Does the pupil generally prefer the company of adults to children?

Yes

Does the pupil seem to connect information particularly well, or even make connections that you have not?

Yes

Does the pupil have unusual mannerisms or habits?

Yes

Does the pupil get socially anxious?

Yes

Not sure

Does the pupil make good eye contact?

Yes

Not initially, but after they get over their shyness they are fine

Is the pupil very different at home to how they are at school?

Yes

Is the pupil popular in school?

Yes

Does the pupil have...

Lots of friends

A few good friends

Hardly any friends

Is the pupil confident in their studies?

Yes, pretty confident

No, not very confident

Is the pupil confident in their social life?

Yes, pretty confident

No, not very confident

Does/has the pupil suffered from anxiety?

Yes

I'm not sure

Has the pupil ever experienced a major life event such as parental separation, divorce, death of a parent?

Yes

Does / has the pupil shown behavioural issues in class?

Yes

Not that I know of

Does / has the pupil shown behavioural issues at home?

Yes

Not that I know of

Does/has the pupil have/had any eating disorders?

Yes

Not that I know of

Has the pupil ever self-harmed?

Yes

Not that I know of

Has the pupil ever been bullied?

Yes

Not that I know of

Would you say the pupil is quirky?

Yes

No, not particularly

Does the pupil feel like the 'odd one out' at school?

Yes, but in a good way

Yes, and it's miserable for them

I'm not sure

Is the pupil emotionally intelligent? (they pick up on other people's feelings and empathise)

Yes

Reasonably

No, not particularly

Would you say the pupil is emotionally sensitive?

Very sensitive (gets upset easily)

About average

Not very sensitive (takes a lot to upset them)

Does the pupil prefer their own space?

Yes

A mixture

Please confirm the pupil's Date of Birth (DD/MM/YYYY format)

Thank you for your submission.