12 QUESTIONS FOR PARENTS
This questionnaire is NOT a diagnostic tool. However
it can be useful to gather this information on possible early signs
before seeking a diagnosis.
Read each question and then write down a few sentences that describe
your child's behavior in that area. (Don't just answer "yes"
or "no"). Be honest and objective. Try not to give your
child the benefit of doubt – if you have not actually seen your
child perform the action then do not report it as present.
Be brief but try to come up with some descriptive
examples in each area. The pronoun “he” is used generically and
can refer to male or female. Print this questionnaire out, complete
it, and bring the results to your child's physician to aid in diagnosis.
How does your child communicate with you nonverbally?
That is, how does he get your attention, does
he look you in the eye, does he respond to your nonverbal communication?
How does he respond to tickling, hugging, holding?
How does your child react to other children?
Does he play with them? Does he have friends?
How does your child show you that he is interested in something?
Does he show you things he likes? Does he bring
things to you to show you or to share with you? Does he point to
things in the environment that interest him?
How does your child react to the social approaches of others?
If someone is happy, does he act happy too? If
someone is sad, does he respond appropriately? If someone hits him,
how does he respond?
How well does your child communicate verbally?
Is your child delayed in his speech?
How well does your child converse with others?
Can your child begin a conversation appropriately?
Can your child continue a conversation about a particular subject
fairly well? How does your child end a conversation?
How does your child talk?
Does he repeat words or phrases that seem unrelated
to what is going on? Does he use words or phrases that only you
would fully understand?
How well does your child pretend?
Can he play make-believe games where he pretends
to be an animal or pretends to be doing some action? Can he imitate
Does your child have very strong interests in certain things that
seem out of the ordinary?
How easy is it for you to redirect his attention
from this interest in certain toys, things, or topics of conversation?
Does your child have to do things a certain way?
Does he have a routine that must be followed?
If you do things to interrupt his routine, how does he react?
Does your child engage in odd movements with his body or parts
of his body?
Does he rock, bang his head, flick his fingers,
wave his arms or hands in the air, or make other repetitive movements?
Is your child fascinated with or strongly attracted to parts of
Does your child focus on a detail instead of the
whole object ie. a fascination with the wheels of a toy, instead
of the car or truck?
written by Gary J. Heffner, creator of The Autism Home Page at MSN Groups.
For more information, see the following fact sheets:
to autism and Asperger's syndrome
Assessment of Asperger's
syndrome and autism
My child's been diagnosed with autism - what do I do now?
Click here for the full
range of Asperger's and autism fact sheets and personal stories
Visit http://groups.msn.com/TheAutismHomePage/environmental.msnw which is the autism home page of Gary Heffner, the author of this
article. This personal story remains under his copyright and is
used with his permission. You are encouraged to visit his site as
it is one of the few autism websites offering free comprehensive