The following questionnaire is designed to identify behaviors and abilities indicative of Aspergers (high functioning autism) during the child’s primary school years. This is the age at which the unusual pattern of behavior and abilities is most conspicuous.
Answer the following with ‘yes’ or ‘no’:
1. Does the youngster appear unaware of social conventions or codes of conduct and make inappropriate actions and comments (e.g., making a personal comment to someone but the youngster seems unaware of how the comment could offend)?
2. Does the youngster become unduly upset by changes in routine or expectation (e.g., is distressed by going to school by a different route)?
3. Does the youngster develop elaborate routines or rituals that must be completed (e.g., lining up toys before going to bed)?
4. Does the youngster have a lack of sensitivity to low levels of pain?
5. Does the youngster have a tendency to flap or rock when excited or distressed?
6. Does the youngster have an exceptional long-term memory for events and facts (e.g., remembering the neighbor's car registration of several years ago, or clearly recalling scenes that happened many years ago)?
7. Does the youngster have an odd gait when running?
8. Does the youngster have an unusual tone of voice (e.g., seems to have a "foreign" accent or monotone that lacks emphasis on key words)?
9. Does the youngster have poor motor coordination (e.g., is not skilled at catching a ball)?
10. Does the youngster have problems repairing a conversation (e.g., when he is confused, he does not ask for clarification but simply switches to a familiar topic, or takes a very long time to think of a reply)?
11. Does the youngster have unusual facial grimaces or tics?
12. Does the youngster have unusual fear or distress due to light touch on skin or scalp?
13. Does the youngster have unusual fear or distress due to noisy crowded places (e.g., supermarkets)?
14. Does the youngster have unusual fear or distress due to ordinary sounds (e.g., electrical appliances)?
15. Does the youngster have unusual fear or distress due to seeing certain objects?
16. Does the youngster have unusual fear or distress due to unexpected noises?
17. Does the youngster have unusual fear or distress due to wearing particular items of clothing?
18. Does the youngster lack an understanding of how to play with other kids (e.g., unaware of the unwritten rules of social play)?
19. Does the youngster lack the intuitive understanding of another person's feelings (e.g., not realizing an apology would help the other person feel better)?
20. Does the youngster lack precision in his or her expression of emotion (e.g., not understanding the levels of emotional expression appropriate for different people)?
21. Does the youngster lack social imaginative play (e.g., other kids are not included in the youngster's imaginary games, or the youngster is confused by the pretend games of other kids)?
22. Does the youngster lack subtlety in his or her expression of emotion (e.g., the youngster shows distress or affection out of proportion to the situation)?
23. Does the youngster need an excessive amount of reassurance, especially if things are changed or go wrong?
24. Does the youngster read books primarily for information, not seeming to be interested in fictional works (e.g., being an avid reader of encyclopedias and science books, but not keen on adventure stories)?
25. Does the youngster seem to expect other people to know his thoughts, experiences and opinions?
26. Does the youngster take a literal interpretation of comments (e.g., is confused by phrases such as "pull your socks up," "looks can kill" or "hop on the scales")?
27. Have you had a ‘gut feeling’ that your youngster’s behavior was “different” compared to other kids?
28. Is the youngster fascinated by a particular topic and avidly collects information or statistics on that interest (e.g., becomes a walking encyclopedia of knowledge on vehicles, maps or league tables)?
29. Is the youngster indifferent to peer pressure (e.g., does not follow the latest craze in toys or clothes)?
30. Is the youngster not interested in participating in competitive sports, games and activities?
31. Is the youngster's speech over-precise or pedantic (e.g., talks in a formal way or like a walking dictionary)?
32. Was the youngster late in acquiring speech?
33. When free to play with other kids at school, does the youngster avoid social contact with them (e.g., finds a secluded place or goes to the library)?
34. When in a conversation, does the youngster tend to use less eye contact than you would expect?
35. When taking to the youngster, does he or she appear uninterested in your side of the conversation (e.g., not asking about or commenting on your thoughts or opinions on the topic)?
If the answer is yes to the majority of the questions above, it does not automatically suggest your youngster has Aspergers; however, it is a possibility – and a referral for a diagnostic assessment is warranted.