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Asperger's Screening Tool

SOCIAL CHALLENGES SCREENING QUESTIONNAIRE

This screening questionnaire may yield a recommendation to seek a formal

evaluation for autism spectrum disorder based on the responses provided. Please
note: this does not replace a comprehensive diagnostic assessment.

Version 3.1

DOES YOUR CHILD...

Have dif culty with ne or gross motor coordination (handwriting, throwing or catching balls,
riding a bike, etc.)?
etc.)
Yes No

Have unusual speech at times (too slow or loud, formal or "little professor-like", monotone, robotic
etc.)?
etc.)
Yes No

Have dif culty playing with others (Disrupts play, controls the activity, etc.)?
etc.)
Yes No

Have trouble making or keeping friends?

Yes No

Seem socially awkward at times (rude, inappropriate comments, unaware of social cues)?
cues)
Yes No

Have interests that seem overly intense and are expressed in conversation, play, and
thoughts?
Yes No
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Yes No

Find jokes or sarcasm dif cult to understand?

Yes No

Have few or unusual facial expressions?

Yes No

Often act without thinking (interrupts often, takes things from others without asking, etc.)?
etc.)
Yes No

Have dif culty following instructions or the ow of simple conversations?

Yes No

Become overly distressed when routines are changed at home or school?

Yes No

Have trouble following rules of personal space and boundaries (excessive touching, stands too
close, etc.)?
etc.)
Yes No

Have poor eye contact?

Yes No

Have exceptional skills (advanced language development, early letter or number recognition,
memorization of facts, etc.)?
etc.)
Yes No

The results of the DAVE Screening Questionnaire indicate the need for a formal
assessment for Autism Spectrum Disorder. Please print this page and contact
SARRC for next steps.

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