1. hae now abet talk using short phrases o sentences? no, skp to question 6 yes 2, Do you have to and fro “convesation* with heh that involves {aking tums or Buldng on What YOU NEVE $24 nn 3, Does sefne ever use oda phrases o say he same thing over and ‘ver in almost exact the sare way (ether phrases that she/ne hears other people use or ones that she/he makes up? eee] 4, Doos sefne ever use socially inappropriate questions or statements? For example, does sheme ever requany ask personal questions or make personal comments at awkward tines? sa 5. Does she/he ever get herhis pronouns mixed up (9, saying your sheme tor 1? yes 6. Does she/he ever use words that shee seems to have invented ‘ormade up herfhimsef put things in dg, ndrect ways or use mmelaprical ways of saying things (e.g, saying otra for S2—M) Pane YO 7. Does she/ne ever say the same thing over and over in exactly the same way o insist that you say the same hing ‘over and aver again? yes 8. oes she/he ever have things that she/he seems to have to do in avery particular way or order or tual that shat insists ‘hat you go trough? 8. Does hers facial expression usual seem appropriate to the particular situation as far as you canto? yes 410. Doss sere aver use your hand ikea too or as if it wee pat ot hethis oun body 9, pointing wth your finger or puting your hand on a doorkna to get you to open the 01) 11. Dogs she/ho ever have any interest thet preoceupyhertim and ign cr po, ttn, np or timetables? es 412, Does she/he aver seem fo be more Interested in parts ota toy tran object 0. spinning the wheels ot car, rater than In using the object a twas intended? 13, Does she/he aver have any special interests that are unusual in their intensity but otherwise appropriate for herfis age and oer group (2. ans or dinosaurs)? ves 1 Boe toe sem oe unsaid nt sit, fea, sound, taste, oF sme of tings or poopie? 15, Does seine ever have any mannerisms or add ways of moving hetnis hand or ingers, such as lapping or moving herhis fingers in ont of herbs eyes? ves, 16, Does she/he ever have any complicated movements of hes whole body such as spining or repeatedly bouncing UD ANG COHN? sn s yes 17, Does she/he ever injure herfhimselt detberately, ‘uch as by bing nets arm er banging herhis head? yes 10 0 0 1m TTS Social Communication Questionnaire (SCQ) AutoScore™ Form lswelRtes LO. FAS, Aron eM. ‘Set kane, PD. Ctra Lad PA, shin Pes P0. Wps. aT maaan ORE Directions ‘Thank you for taking the time to complete this questionnaire. Please answer each ‘question by circling yes or no. A few ques- tions ask about several related types of behavior; please circle yesif anyof these behaviors were present during the past ‘8 months, Although you may be uncertain about whether some behaviors were pres- ‘ent or not, please answer yes or no to every ‘question on the basis of what you think. Ackitional copies ofthis form (W-3814) may be purchased from WPS, Please contact us at 800.648.8857 or www.wpspublish.com,+16, Does shee ever have any objects (other than a sot toy Cor comfort blanket) that she/he has to cary arcund?.. center YOR 18. Does she/he have any particular frends ora best fiend? yes 2. Does sme ee tak wth a tf been {eather than to oot somethin... Zot yes 21. Does shefhe ever spontaneously coy you (or other peop) or what you ae doing (euch as vacuuming, gardening, or mending things)? yes 22, Doss shee ever spontaneously pont at things aroun her him Just to show you things (oot because she/he wants thEM)? un. 23. Does she/he ever use gestures, oter than pointing or pulling your hand, et you know whet shee wants? yes ‘4, Does sheen eis hea inate yes? wes 25, Does sete shake hers head to indicate no? yes 28. Does she/he usualy ook at you deci in the face when doing things with you or talking wit you? en J 27, Does heise back if somenne smiles thei... ss YO 28 Doo tee shou you ngs anes erin twengage your attention? 29, boos sheme ever oor to shar things other than food with you? yes 90. ons sheers to war you on intr enoyment OF SOME? ns S31. Does sheme ever try to comfort you you are sed or hut? yes 82, shene wants something or wants help, does shee ook a you ‘and use gestures with sounds or words to gel your attention. 83. Does shofe show anormal ange of facial expressions? yes ‘34, Does sheme ever spontaneous join in and try to copy the actions in social games, such as The Mulberry Bush ‘0F London Bridges Falling Down? ati een 18 £35, Doos she play any pretend or make-tlieve games? : ves 36, Does sheme seem interested in other children ot approximately ‘the same age whom shefhe doesnot Kn? 837. Does shee respond postively when another cil approaches nel... yes 38, Ifyou come into a room and stat taking to neh without calling hethis name, does shee usval lok up anc pay attention to you? 39, Does sheme ever pla imaginative games wit another child im such a way that you can tll that each child understands wal the others protnding?. : ves 40, Does ste play cooperatively in games that need some ‘orm of joining in win a group of ther children, such as hide-and-seek ar bali ames? a yes 0 no no m0 no no