* indicates a required field. First Name * Last Name * Email Address * Conditions Please indicate if any of the following applies to you. Strabismus (Crossed eyes, wall eyes, wandering eyes) Yes No Amblyopia (Lazy Eye) None Left Eye Right Eye Unsure Which Eye Cataracts None Right Eye - At Birth Right Eye - In Childhood Right Eye - In Adolescence or Adulthood Left Eye - At Birth Left Eye - In Childhood Left Eye - In Adolescence or Adulthood Severe myopia which went uncorrected for years Yes No ADHD Yes No Color Blindness / Color Deficiency Yes No Aphasia (Speech production or speech perception deficit) Yes No Depression Yes No Dyslexia (Reading deficit) Yes No Autism Yes No Asperger Syndrome Yes No Synaesthesia Yes No Speech Comprehension Problems (For example, central auditory processing deficit) Yes No Severe Navigational Problems Yes No Left-Right Confusion Yes No Learning Disabilities Yes No Motor Coordination Impairments Yes No Handedness Left Right Ambidextrous Perception and Cognition in Daily Life I can remember a seven digit telephone number long enough to write it down. Never Not Usually Sometimes Frequently Always I can recognize a close family member or good friend in a photograph. Never Not Usually Sometimes Frequently Always I can recognize my own baggage at the airport. Never Not Usually Sometimes Frequently Always I have trouble finding items in cluttered scenes. Never Not Usually Sometimes Frequently Always I have trouble recognizing voices. Never Not Usually Sometimes Frequently Always I treat strangers as if I know them to avoid offending people I might already know. Never Not Usually Sometimes Frequently Always I find it easy to play games with children that involve pretending. Never Not Usually Sometimes Frequently Always I find it hard to keep track of characters in TV shows or movies. Never Not Usually Sometimes Frequently Always When trying to find an acquaintance, I have trouble if they are in a room full of people. Never Not Usually Sometimes Frequently Always I find it hard to recognize someone I just met. Never Not Usually Sometimes Frequently Always I notice whether faces are attractive or unattractive. Never Not Usually Sometimes Frequently Always I have trouble recognizing houses I have visited. Never Not Usually Sometimes Frequently Always I have trouble recognizing people when they are in uniform. Never Not Usually Sometimes Frequently Always I can recognize well known actors/actresses when watching a movie. Never Not Usually Sometimes Frequently Always I have found out that two acquaintances I knew were actually the same person. Never Not Usually Sometimes Frequently Always I find it easy to "read between the lines" when someone is talking to me. Never Not Usually Sometimes Frequently Always I notice similarities in the faces of people from the same family. Never Not Usually Sometimes Frequently Always I can remember my own telephone number. Never Not Usually Sometimes Frequently Always I find streets I have often traveled unfamiliar. Never Not Usually Sometimes Frequently Always I can visualize the faces of family members and close friends. Never Not Usually Sometimes Frequently Always I have trouble perceiving emotions from faces. Never Not Usually Sometimes Frequently Always I can recognize famous celebrities in photos or on TV. Never Not Usually Sometimes Frequently Always I like to collect information about categories of things (e.g. types of cars, birds, trains, plants, etc.). Never Not Usually Sometimes Frequently Always I have trouble determining how old someone is from their face. Never Not Usually Sometimes Frequently Always I can recognize particular cats and dogs. Never Not Usually Sometimes Frequently Always I have thought that one person was actually two different people. Never Not Usually Sometimes Frequently Always I avoid social situations where I may not recognize people. Never Not Usually Sometimes Frequently Always I lose my way when traveling. Never Not Usually Sometimes Frequently Always I try to remember non-facial information about people's appearance. Never Not Usually Sometimes Frequently Always I'm more likely to identify a car from its license plate number than its overall appearance. Never Not Usually Sometimes Frequently Always When I meet someone I pretend to recognize them until their identity is revealed. Never Not Usually Sometimes Frequently Always I can "see" imaginary faces in objects--car fronts, rock formations, clouds. Never Not Usually Sometimes Frequently Always I have great difficulty recognizing people from their voices on the telephone. Never Not Usually Sometimes Frequently Always I can recognize casual acquaintances out of context. Never Not Usually Sometimes Frequently Always I can recognize family members and close friends out of context. Never Not Usually Sometimes Frequently Always I have trouble recognizing common fruits and vegetables. Never Not Usually Sometimes Frequently Always Please leave this field blank Submit